WorldWideScience

Sample records for current clinical imaging

  1. Fundamentals of functional imaging I: current clinical techniques.

    Science.gov (United States)

    Luna, A; Martín Noguerol, T; Mata, L Alcalá

    2018-05-01

    Imaging techniques can establish a structural, physiological, and molecular phenotype for cancer, which helps enable accurate diagnosis and personalized treatment. In recent years, various imaging techniques that make it possible to study the functional characteristics of tumors quantitatively and reproducibly have been introduced and have become established in routine clinical practice. Perfusion studies enable us to estimate the microcirculation as well as tumor angiogenesis and permeability using ultrafast dynamic acquisitions with ultrasound, computed tomography, or magnetic resonance (MR) imaging. Diffusion-weighted sequences now form part of state-of-the-art MR imaging protocols to evaluate oncologic lesions in any anatomic location. Diffusion-weighted imaging provides information about the occupation of the extracellular and extravascular space and indirectly estimates the cellularity and apoptosis of tumors, having demonstrated its relation with biologic aggressiveness in various tumor lines and its usefulness in the evaluation of the early response to systemic and local targeted therapies. Another tool is hydrogen proton MR spectroscopy, which is used mainly in the study of the metabolic characteristics of brain tumors. However, the complexity of the technique and its lack of reproducibility have limited its clinical use in other anatomic areas, although much experience with the use of this technique in the assessment of prostate and breast cancers as well as liver lesions has also accumulated. This review analyzes the imaging techniques that make it possible to evaluate the physiological and molecular characteristics of cancer that have already been introduced into clinical practice, such as techniques that evaluate angiogenesis through dynamic acquisitions after the administration of contrast material, diffusion-weighted imaging, or hydrogen proton MR spectroscopy, as well as their principal applications in oncology. Copyright © 2018 SERAM. Publicado

  2. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play.

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-05-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders.

  3. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play

    Science.gov (United States)

    Savitz, J B; Rauch, S L; Drevets, W C

    2013-01-01

    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders. PMID:23546169

  4. Imaging of Mucosal Inflammation: Current Technological Developments, Clinical Implications, and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Maximilian J. Waldner

    2017-10-01

    Full Text Available In recent years, various technological developments markedly improved imaging of mucosal inflammation in patients with inflammatory bowel diseases. Although technological developments such as high-definition-, chromo-, and autofluorescence-endoscopy led to a more precise and detailed assessment of mucosal inflammation during wide-field endoscopy, probe-based and stationary confocal laser microscopy enabled in vivo real-time microscopic imaging of mucosal surfaces within the gastrointestinal tract. Through the use of fluorochromes with specificity against a defined molecular target combined with endoscopic techniques that allow ultrastructural resolution, molecular imaging enables in vivo visualization of single molecules or receptors during endoscopy. Molecular imaging has therefore greatly expanded the clinical utility and applications of modern innovative endoscopy, which include the diagnosis, surveillance, and treatment of disease as well as the prediction of the therapeutic response of individual patients. Furthermore, non-invasive imaging techniques such as computed tomography, magnetic resonance imaging, scintigraphy, and ultrasound provide helpful information as supplement to invasive endoscopic procedures. In this review, we provide an overview on the current status of advanced imaging technologies for the clinical non-invasive and endoscopic evaluation of mucosal inflammation. Furthermore, the value of novel methods such as multiphoton microscopy, optoacoustics, and optical coherence tomography and their possible future implementation into clinical diagnosis and evaluation of mucosal inflammation will be discussed.

  5. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

    Energy Technology Data Exchange (ETDEWEB)

    England, Christopher G. [University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); Rui, Lixin [University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, WI (United States); Cai, Weibo [University of Wisconsin School of Medicine and Public Health, Department of Medical Physics, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center, Madison, WI (United States); University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States)

    2017-03-15

    Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future. (orig.)

  6. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies

    International Nuclear Information System (INIS)

    England, Christopher G.; Rui, Lixin; Cai, Weibo

    2017-01-01

    Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future. (orig.)

  7. The Role of Clinical Cardiac Magnetic Resonance Imaging in China: Current Status and the Future

    Directory of Open Access Journals (Sweden)

    Shi Chen, MD

    2016-12-01

    Full Text Available Cardiac magnetic resonance (CMR imaging plays an important role in the diagnosis and management of cardiovascular diseases. The state-of-the-art CMR imaging has many advantages in cardiac imaging, including excellent spatial and temporal resolution, unrestricted imaging field, no exposure to ionizing radiation, excellent tissue contrast, and unique myocardial tissue characterization. Clinical CMR imaging is used during the cardiovascular diagnostic workup in the United States and some European countries. Use of CMR imaging is emerging in hospitals in China and has a promising future. This review briefly describes the real-world clinical application of CMR imaging in China and discuss obstacles for its future development.

  8. Current Concepts and Future Perspectives on Intraoperative Fluorescence Imaging in Cancer : Clinical Need

    NARCIS (Netherlands)

    van Dam, Gooitzen M.; Ntziachristos, Vasilis

    Progress with technology and regulatory approvals has recently allowed the successful clinical translation of fluorescence molecular imaging to intra-operative applications. Initial studies have demonstrated a promising outlook for imaging cancer micro-foci, margins and lymph-nodes. However, not all

  9. Amide proton transfer imaging in clinics: Basic concepts and current and future use in brain tumors and stoke

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Eun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Jahng, Geon Ho [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Jeong, Ha Kyu [Philips Korea, Seoul (Korea, Republic of)

    2016-12-15

    Amide proton transfer (APT) imaging is gaining attention as a relatively new in vivo molecular imaging technique that has higher sensitivity and spatial resolution than magnetic resonance spectroscopy imaging. APT imaging is a subset of the chemical exchange saturation transfer mechanism, which can offer unique image contrast by selectively saturating protons in target molecules that get exchanged with protons in bulk water. In this review, we describe the basic concepts of APT imaging, particularly with regard to the benefit in clinics from the current literature. Clinical applications of APT imaging are described from two perspectives: in the diagnosis and monitoring of the treatment response in brain glioma by reflecting endogenous mobile proteins and peptides, and in the potential for stroke imaging with respect to tissue acidity.

  10. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems

    Science.gov (United States)

    Vaquero, Juan José; Kinahan, Paul

    2017-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges. PMID:26643024

  11. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems.

    Science.gov (United States)

    Vaquero, Juan José; Kinahan, Paul

    2015-01-01

    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges.

  12. Nuclear medicine imaging in clinical practice: Current applications and future trends

    International Nuclear Information System (INIS)

    Galli, G.; Maini, C.L.

    1985-01-01

    The following conclusions can be drawn: 1) Even though developments in data digitalization enable also other imaging techniques to extract functional information, it is likely that nuclear medicine will keep and possibly increase its key role for functional studies requiring quantitative data analyses. This statement is true at present and it will probably remain true for a long time to come. 2) Nuclear medicine is and will remain an important clinical tool also for morphological or morphodynamic studies in selected situations. Of course the integration of nuclear medicine studies with other diagnostic procedures is highly desirable. The highest clinical yield of multi-test diagnostic protocols will be anyway obtained by the wisest physician as sophysticated technology is no substitution for intelligent clinical judgment. 3) The development of new radiopharmaceuticals with well characterized biokinetic features allowing precise tissue characterization opens new frontiers to be exploited by nuclear medicine centers equipped with conventional technology (digital gammacameras, SPECT). 4) Positron emission tomography is the most important new development of nuclear medicine imaging. Not only PET has already shown its enormous possibilities for physiological and pathophysiological studies, but the clinical relevance of selected applications has been proved. More experience is however needed to assess systematically the whole impact of PET studies in clinical practice and to perform dependable cost/benefit studies. 5) Among all other imaging techniques NMR is the closest to nuclear medicine because of a strict ''compatibility of aptitudes, training and methodology'' (4). Accordingly future improvements of both methods will be better achieved if they could be integrated and the results compared with the same institutions

  13. Current concepts in maxillofacial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Boeddinghaus, Rudolf [Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008 (Australia)], E-mail: rboeddinghaus@perthradclinic.com.au; Whyte, Andy [Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008 (Australia)], E-mail: awhyte@perthradclinic.com.au

    2008-06-15

    A review of state-of-the-art maxillofacial imaging is presented. Current imaging techniques include intra-oral radiographs, dental panoramic tomography, multidetector helical computed tomography, cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI). The commonest conditions encountered in clinical radiological practice are reviewed, including maxillofacial deformities, complicated dental impactions, maxillofacial trauma, jaw lesions (cysts, neoplasms, fibro-osseous lesions (FOLs) and infections), and temporomandibular joint pathology. Pre-operative assessment for dental implant placement is also briefly reviewed.

  14. Cranial MRI: Current clinical applications

    International Nuclear Information System (INIS)

    Bradley, W.G. Jr.; Kortman, K.E.

    1987-01-01

    Human MR images were first published by the Nottingham group in 1980. Since that time, there have been steady improvements in image quality and significant reductions in imaging time. After initial studies by the Hammersmith group in London, investigators at UCSF published studies comparing CT with MR, clearly demonstrating the higher sensitivity of MR to pathologic intracranial processes. Since that time, several investigators have demonstrated the efficacy of MR in the evaluation of a wide range of intracranial pathologic processes, including neoplasms, demyelinating disease, trauma, and congenital abnormalities. In the authors' studies comparing MR with CT in 400 consecutive cases of suspected CNS pathology, MR detected abnormalities which were not seen on CT in 30 percent of these cases. MR has become established as the imaging modality of choice in the evaluation of a broad range of CNS abnormalities and is rapidly being implemented not only at university medical centers but also in community hospitals and free-standing clinics. This chapter deals with fundamental principles of MR image interpretation and provides insight into current clinical indications for MR in intracranial disorders

  15. Clinical imaging of the pancreas

    International Nuclear Information System (INIS)

    May, G.; Gardiner, R.

    1987-01-01

    Featuring more than 300 high-quality radiographs and scan images, clinical imaging of the pancreas systematically reviews all appropriate imaging modalities for diagnosing and evaluating a variety of commonly encountered pancreatic disorders. After presenting a succinct overview of pancreatic embryology, anatomy, and physiology, the authors establish the clinical indications-including postoperative patient evaluation-for radiologic examination of the pancreas. The diagnostic capabilities and limitations of currently available imaging techniques for the pancreas are thoroughly assessed, with carefully selected illustrations depicting the types of images and data obtained using these different techniques. The review of acute and chronic pancreatitis considers the clinical features and possible complications of their variant forms and offers guidance in selecting appropriate imaging studies

  16. Magnetic resonance imaging for assessing hamstring injuries: clinical benefits and pitfalls – a review of the current literature

    Directory of Open Access Journals (Sweden)

    Greenky M

    2017-07-01

    Full Text Available Max Greenky, Steven B Cohen Department of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA Abstract: Hamstring injuries are common injuries in all levels of athletics. Hamstring injuries can cause prolonged absence from sports and have a notorious rate of reinjury. Magnetic resonance imaging (MRI is being increasingly utilized following a hamstring injury. Physicians are being increasingly asked to utilize MRI to predict clinical outcomes, including time frame for return to play and risk of reinjury. In spite of numerous studies in this area, no clear consensus exists. The purpose of this paper is to summarize the literature and evidence regarding the role of MRI in treating hamstring injuries. Keywords: hamstring injury, MRI, return to play

  17. Molecular imaging: current status and emerging strategies

    International Nuclear Information System (INIS)

    Pysz, M.A.; Gambhir, S.S.; Willmann, J.K.

    2010-01-01

    In vivo molecular imaging has a great potential to impact medicine by detecting diseases in early stages (screening), identifying extent of disease, selecting disease- and patient-specific treatment (personalized medicine), applying a directed or targeted therapy, and measuring molecular-specific effects of treatment. Current clinical molecular imaging approaches primarily use positron-emission tomography (PET) or single photon-emission computed tomography (SPECT)-based techniques. In ongoing preclinical research, novel molecular targets of different diseases are identified and, sophisticated and multifunctional contrast agents for imaging these molecular targets are developed along with new technologies and instrumentation for multi-modality molecular imaging. Contrast-enhanced molecular ultrasound (US) with molecularly-targeted contrast microbubbles is explored as a clinically translatable molecular imaging strategy for screening, diagnosing, and monitoring diseases at the molecular level. Optical imaging with fluorescent molecular probes and US imaging with molecularly-targeted microbubbles are attractive strategies as they provide real-time imaging, are relatively inexpensive, produce images with high spatial resolution, and do not involve exposure to ionizing irradiation. Raman spectroscopy/microscopy has emerged as a molecular optical imaging strategy for ultrasensitive detection of multiple biomolecules/biochemicals with both in vivo and ex vivo versatility. Photoacoustic imaging is a hybrid of optical and US techniques involving optically-excitable molecularly-targeted contrast agents and quantitative detection of resulting oscillatory contrast agent movement with US. Current preclinical findings and advances in instrumentation, such as endoscopes and microcatheters, suggest that these molecular imaging methods have numerous potential clinical applications and will be translated into clinical use in the near future.

  18. Clinical blood pool MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leiner, Tim [Maastrich University Medical Center (Netherlands). Dept. of Radiology; Goyen, Martin [University Medical Center Hamburg-Eppendorf (Germany); Rohrer, Mathias [Bayer Schering Pharma AG, Berlin (Germany). European Business Unit Diagnostic Imaging; Schoenberg, Stefan O. (eds.) [University Hospital Mannheim Medical Faculty Mannheim - Heidelberg Univ. (Germany). Dept. of Clinical Radiology and Nuclear Medicine

    2008-07-01

    Clinical Blood Pool MR Imaging - This excellent treatise on Vasovist {sup registered} created by a team of exceptional faculty who are pioneers in MR Angiography covers the basic techniques, safety, efficacy, image processing and pharmaco-economic details to successfully implement a new level of MRA image quality with this new contrast agent. Martin Prince, Cornell University, New York The editors and authors have made groundbreaking contributions towards establishing MR angiography in various investigative settings, rendering it more precise and applying it for diverse indications. The work presented here is founded upon the extensive experience of the editors, as well as the broad range of experience from other scientific working groups. Maximilian Reiser, Ludwig Maximilian University, Munich Vasovist {sup registered} (Gadofosveset), worldwide the first blood pool agent, has only recently become available for clinical use, but has already gained wide acceptance as a tool to improve magnetic resonance angiography. This book presents the first in-depth introduction to the basic physicochemical aspects of the agent, the application of Vasovist {sup registered} in clinical MRA, as well as potential clinical applications beyond MRA and patient management-related aspects. The first part of the book explains basic and technical properties of the agent and the differences of Vasovist {sup registered} compared to currently available extracellular agents. The second part contains detailed chapters on safety and efficacy. In the third part the focus is on MR angiographic applications, and in the fourth part of the book potential clinical fields beyond MRA are explored. All clinical chapters feature ready-to-use clinical protocols and a series of take home messages that concisely summarize the current role of blood pool imaging for each specific indication. (orig.)

  19. A review of molecular imaging studies reaching the clinical stage

    International Nuclear Information System (INIS)

    Wong, Franklin C.; Kim, E. Edmund

    2009-01-01

    The practice of molecular imaging in the clinics is examined across various imaging modalities to assess the current status of clinical molecular imaging. The various physiologic and scientific bases of clinical molecular imaging are surveyed to assess the possibilities and opportunities for the deployment of the different imaging modalities in the near future. The requisites for successful candidate(s) of clinical molecular imaging are reviewed for future development.

  20. Current strategy for the imaging of neuroblastoma

    International Nuclear Information System (INIS)

    Brisse, H.; Neuenschwander, S.; Edeline, V.; Michon, J.; Zucker, J.M.; Couanet, D.

    2001-01-01

    Advances in the management of neuroblastoma lead radiologists and nuclear medicine specialists to optimize their procedures in order to propose a rational use of their techniques, adjusted to the various clinical presentations and to therapeutic management. The aim of this paper is to assess the imaging procedures for the diagnosis and follow-up of neuroblastoma in children according to current therapeutic European protocols. An imaging strategy at diagnosis is first proposed: optimal assessment of local extension of the primary tumour is made with MRI, or spiral-CT when MRI is not available, for all locations except for abdominal tumours for which CT remains the best imaging modality. Metastatic extension is assessed with mlBG scan and liver sonography. Indications for bone metastasis evaluation with either radiological or radionuclide techniques are detailed. Imaging follow-up during treatment for metastatic or unresectable tumours is described. A check-list of radiological main points to be evaluated before surgery is proposed for localized neuroblastoma. The imaging strategy for the diagnosis of 'occult' neuroblastoma is considered. Finally, we explain the management of neuroblastoma detected during the prenatal or neonatal period. (authors)

  1. Current state of clinical lithotripsy

    Science.gov (United States)

    Lingeman, James E.

    2003-10-01

    Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the treatment of urolithiasis. Because of the clinical success of the original lithotriptor, the Dornier HM3, numerous manufacturers introduced different approaches to lithotripsy based on empiricism rather than an understanding of the fundamental mechanisms of this new technology. Our understanding of shock wave physics and the physiologic effects of shock waves has progressed greatly over the last decade resulting in insights that hopefully will be reflected favorably in future lithotriptor designs and lithotripsy techniques.

  2. Clinical photoacoustic imaging of cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valluru, Keerthi S.; Willmann, Juergen K. [Dept. of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford (United States)

    2016-08-15

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  3. Current imaging of spondylolytic spondylolisthesis

    International Nuclear Information System (INIS)

    Wybier, M.; Champsaur, P.; Hamze, B.

    1995-01-01

    Unilateral spondylolytic spondylolisthesis may cause lateral tilt of the overlying spinous processes towards the normal isthmus on PA views. Bilateral spondylolytic spondylolisthesis is generally located at the L5-S1 level. The vertebral shift is usually moderate. Instability at the level of spondylolisthesis may be demonstrated by stress lateral views but is uneasy to quantify. In case of sciatica associated to spondylolisthesis, foramen stenosis is probably the most frequent cause but foramen compression of the spinal ganglion is difficult to assess on imaging. (authors). 15 refs., 8 figs

  4. PET imaging in pediatric neuroradiology: current and future applications

    International Nuclear Information System (INIS)

    Kim, Sunhee; Salamon, Noriko; Jackson, Hollie A.; Blueml, Stefan; Panigrahy, Ashok

    2010-01-01

    Molecular imaging with positron emitting tomography (PET) is widely accepted as an essential part of the diagnosis and evaluation of neoplastic and non-neoplastic disease processes. PET has expanded its role from the research domain into clinical application for oncology, cardiology and neuropsychiatry. More recently, PET is being used as a clinical molecular imaging tool in pediatric neuroimaging. PET is considered an accurate and noninvasive method to study brain activity and to understand pediatric neurological disease processes. In this review, specific examples of the clinical use of PET are given with respect to pediatric neuroimaging. The current use of co-registration of PET with MR imaging is exemplified in regard to pediatric epilepsy. The current use of PET/CT in the evaluation of head and neck lymphoma and pediatric brain tumors is also reviewed. Emerging technologies including PET/MRI and neuroreceptor imaging are discussed. (orig.)

  5. PET imaging in pediatric neuroradiology: current and future applications

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sunhee [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Salamon, Noriko [UCLA David Geffen School of Medicine at UCLA, Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA (United States); Jackson, Hollie A.; Blueml, Stefan [Keck School of Medicine of USC, Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Keck School of Medicine of USC, Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)

    2010-01-15

    Molecular imaging with positron emitting tomography (PET) is widely accepted as an essential part of the diagnosis and evaluation of neoplastic and non-neoplastic disease processes. PET has expanded its role from the research domain into clinical application for oncology, cardiology and neuropsychiatry. More recently, PET is being used as a clinical molecular imaging tool in pediatric neuroimaging. PET is considered an accurate and noninvasive method to study brain activity and to understand pediatric neurological disease processes. In this review, specific examples of the clinical use of PET are given with respect to pediatric neuroimaging. The current use of co-registration of PET with MR imaging is exemplified in regard to pediatric epilepsy. The current use of PET/CT in the evaluation of head and neck lymphoma and pediatric brain tumors is also reviewed. Emerging technologies including PET/MRI and neuroreceptor imaging are discussed. (orig.)

  6. Image processing in radiology. Current applications

    International Nuclear Information System (INIS)

    Neri, E.; Caramella, D.; Bartolozzi, C.

    2008-01-01

    Few fields have witnessed such impressive advances as image processing in radiology. The progress achieved has revolutionized diagnosis and greatly facilitated treatment selection and accurate planning of procedures. This book, written by leading experts from many countries, provides a comprehensive and up-to-date description of how to use 2D and 3D processing tools in clinical radiology. The first section covers a wide range of technical aspects in an informative way. This is followed by the main section, in which the principal clinical applications are described and discussed in depth. To complete the picture, a third section focuses on various special topics. The book will be invaluable to radiologists of any subspecialty who work with CT and MRI and would like to exploit the advantages of image processing techniques. It also addresses the needs of radiographers who cooperate with clinical radiologists and should improve their ability to generate the appropriate 2D and 3D processing. (orig.)

  7. Current state of molecular imaging research

    International Nuclear Information System (INIS)

    Grimm, J.; Wunder, A.

    2005-01-01

    The recent years have seen significant advances in both molecular biology, allowing the identification of genes and pathways related to disease, and imaging technologies that allow for improved spatial and temporal resolution, enhanced sensitivity, better depth penetration, improved image processing, and beneficial combinations of different imaging modalities. These advances have led to a paradigm shift in the scope of diagnostic imaging. The traditional role of radiological diagnostic imaging is to define gross anatomy and structure in order to detect pathological abnormalities. Available contrast agents are mostly non-specific and can be used to image physiological processes such as changes in blood volume, flow, and perfusion but not to demonstrate pathological alterations at molecular levels. However, alterations at the anatomical-morphological level are relatively late manifestations of underlying molecular changes. Using molecular probes or markers that bind specifically to molecular targets allows for the non-invasive visualization and quantitation of biological processes such as gene expression, apoptosis, or angiogenesis at the molecular level within intact living organisms. This rapidly evolving, multidisciplinary approach, referred to as molecular imaging, promises to enable early diagnosis, can provide improved classification of stage and severity of disease, an objective assessment of treatment efficacy, and a reliable prognosis. Furthermore, molecular imaging is an important tool for the evaluation of physiological and pathophysiological processes, and for the development of new therapies. This article comprises a review of current technologies of molecular imaging, describes the development of contrast agents and various imaging modalities, new applications in specific disease models, and potential future developments. (orig.)

  8. Current developments in clinical multiphoton tomography

    Science.gov (United States)

    König, Karsten; Weinigel, Martin; Breunig, Hans Georg; Gregory, Axel; Fischer, Peter; Kellner-Höfer, Marcel; Bückle, Rainer

    2010-02-01

    Two-photon microscopy has been introduced in 1990 [1]. 13 years later, CE-marked clinical multiphoton systems for 3D imaging of human skin with subcellular resolution have been launched by the JenLab company with the tomograph DermaInspectTM. In 2010, the second generation of clinical multiphoton tomographs was introduced. The novel mobile multiphoton tomograph MPTflexTM, equipped with a flexible articulated optical arm, provides an increased flexibility and accessibility especially for clinical and cosmetical examinations. The multiphoton excitation of fluorescent biomolecules like NAD(P)H, flavins, porphyrins, elastin, and melanin as well as the second harmonic generation of collagen is induced by picojoule femtosecond laser pulses from an tunable turn-key near infrared laser system. The ability for rapid highquality image acquisition, the user-friendly operation of the system, and the compact and flexible design qualifies this system to be used for melanoma detection, diagnostics of dermatological disorders, cosmetic research, and skin aging measurements as well as in situ drug monitoring and animal research. So far, more than 1,000 patients and volunteers have been investigated with the multiphoton tomographs in Europe, Asia, and Australia.

  9. Obtaining and Using Images in the Clinical Setting

    International Nuclear Information System (INIS)

    Cendales, Ricardo

    2009-01-01

    Currently small electronic devices capable of producing high quality images are available. The massive use of these devices has become common in the clinical setting as medical images represent a useful tool to document relevant clinical conditions for patient diagnosis, treatment and follow-up. Besides, clinical images are beneficial for legal, scientific and academic purposes. The extended practice without proper ethical guidelines might represent a significant risk for the protection of patient rights and clinical practice. This document discusses risks and duties when obtaining medical images, and presents some arguments on institutional and professional responsibilities around the definition of policies regarding the protection of privacy and dignity of the patient.

  10. Clinical efficiency, image quality and dosimetric considerations

    Energy Technology Data Exchange (ETDEWEB)

    Arreola, M. [Director of Clinical Radiological Physics, Shands Hospital at the University of Florida College of Medicine, Gainesville, FL (United States)

    2000-07-01

    Three decades have passed since the first clinical use of the famous EMI Computed Axial Tomography (Cat) scanner. At the time, the prospects for clinical success of this innovative idea were not very good. Time, however, has proven otherwise as what is now simply known as Computed tomography (CT) has been boosted in each one of these decades for different reasons. In the 1970s, technological progress augmented by the realization of the importance of tomographic imaging got everything started; in the 1980s, the boom in health care demand in the US solidified its position and in the 1990s the technological explosion in computers and the imperative need to lower costs in the health care industry have prompted the most dramatic changes in the wy CT is utilized in the year 2000. Thus, different motivations have led the way of progress in CT at various times, and in spite of amazing developments in other crucial imaging modalities, such as ultrasound, Doppler ultrasound, digital subtraction angiography and magnetic resonance imaging, CT maintains its rightful place as the premiere imaging modality in the modern radiology department. This work covers the basic principles of tomographic image reconstruction, and how axial CT scanners progressed historically in the first two decades. Developments in X-ray tubes, and detection systems are highlighted, as well as the impact of clinical efficiency, image quality and patient doses. The basic construction of translate-rotate (1st and 2nd generation), rotate-rotate (3rd generation) and detector ring (4th generation) scanners are described. The so-called 5th generation scanner, the electron beam scanner, is also described, with its clinical and technical advantages and its inherent financial and maintenance disadvantages, which brought the advent of spiral and multi-slice scanners. These most recent developments in CT technology have opened a new era in the clinical use of CT; and although image quality has reached an expected

  11. Clinical efficiency, image quality and dosimetric considerations

    International Nuclear Information System (INIS)

    Arreola, M.

    2000-01-01

    Three decades have passed since the first clinical use of the famous EMI Computed Axial Tomography (Cat) scanner. At the time, the prospects for clinical success of this innovative idea were not very good. Time, however, has proven otherwise as what is now simply known as Computed tomography (CT) has been boosted in each one of these decades for different reasons. In the 1970s, technological progress augmented by the realization of the importance of tomographic imaging got everything started; in the 1980s, the boom in health care demand in the US solidified its position and in the 1990s the technological explosion in computers and the imperative need to lower costs in the health care industry have prompted the most dramatic changes in the wy CT is utilized in the year 2000. Thus, different motivations have led the way of progress in CT at various times, and in spite of amazing developments in other crucial imaging modalities, such as ultrasound, Doppler ultrasound, digital subtraction angiography and magnetic resonance imaging, CT maintains its rightful place as the premiere imaging modality in the modern radiology department. This work covers the basic principles of tomographic image reconstruction, and how axial CT scanners progressed historically in the first two decades. Developments in X-ray tubes, and detection systems are highlighted, as well as the impact of clinical efficiency, image quality and patient doses. The basic construction of translate-rotate (1st and 2nd generation, rotate-rotate (3rd generation) and detector ring (4th generation) scanners are described. The so-called 5th generation scanner, the electron beam scanner, is also described, with its clinical and technical advantages and its inherent financial and maintenance disadvantages, which brought the advent of spiral and multi-slice scanners. These most recent developments in CT technology have opened a new era in the clinical use of CT; and although image quality has reached an expected

  12. Lateral resolution of eddy current imaging

    International Nuclear Information System (INIS)

    Hassan, W.; Blodgett, M.; Nagy, P.B.

    2002-01-01

    Analytical, finite element simulation, and experimental methods were used to investigate the lateral resolution of eddy current microscopy. It was found that the lateral resolution of eddy current imaging is ultimately limited by the probe-coil geometry and dimensions, but both the inspection frequency and the phase angle can be used to optimize the resolution, to some degree, at the expense of sensitivity. Electric anisotropy exhibited by noncubic crystallographic classes of materials such as titanium alloys can play a very similar role in electromagnetic materials characterization of polycrystalline metals to that of elastic anisotropy in ultrasonic materials characterization. Our results demonstrate that eddy current microscopy can be enhanced via a high-resolution, small diameter probe-coil which delivers a unique materials characterization tool well suited for the evaluation of Ti alloys

  13. Molecular ultrasound imaging: current status and future directions

    International Nuclear Information System (INIS)

    Deshpande, N.; Needles, A.; Willmann, J.K.

    2010-01-01

    Targeted contrast-enhanced ultrasound (molecular ultrasound) is an emerging imaging strategy that combines ultrasound technology with novel molecularly-targeted ultrasound contrast agents for assessing biological processes at the molecular level. Molecular ultrasound contrast agents are nano- or micro-sized particles that are targeted to specific molecular markers by adding high-affinity binding ligands onto the surface of the particles. Following intravenous administration, these targeted ultrasound contrast agents accumulate at tissue sites overexpressing specific molecular markers, thereby enhancing the ultrasound imaging signal. High spatial and temporal resolution, real-time imaging, non-invasiveness, relatively low costs, lack of ionising irradiation and wide availability of ultrasound systems are advantages compared to other molecular imaging modalities. In this article we review current concepts and future directions of molecular ultrasound imaging, including different classes of molecular ultrasound contrast agents, ongoing technical developments of pre-clinical and clinical ultrasound systems, the potential of molecular ultrasound for imaging different diseases at the molecular level, and the translation of molecular ultrasound into the clinic.

  14. Quantitative imaging for clinical dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Bardies, Manuel [INSERM U601, 9 Quai Moncousu, 44093 Nantes (France)]. E-mail: manu@nantes.inserm.fr; Flux, Glenn [Department of Physics, Royal Marsden NHS Trust, Sutton (United Kingdom); Lassmann, Michael [Department of Nuclear Medicine, Julis-Maximilians University, Wuerzburg (Germany); Monsieurs, Myriam [Department of Health Physics, University of Ghent, 9000 Ghent (Belgium); Savolainen, Sauli [Department of Physical Sciences, University of Helsinki and HUS, Helsinki Medical Imaging Center, Helsinki University Central Hospital (Finland); Strand, Sven-Erik [Medical Radiation Physics, Department of Clinical Sciences Lund, Lund University (Sweden)

    2006-12-20

    Patient-specific dosimetry in nuclear medicine is now a legal requirement in many countries throughout the EU for targeted radionuclide therapy (TRT) applications. In order to achieve that goal, an increased level of accuracy in dosimetry procedures is needed. Current research in nuclear medicine dosimetry should not only aim at developing new methods to assess the delivered radiation absorbed dose at the patient level, but also to ensure that the proposed methods can be put into practice in a sufficient number of institutions. A unified dosimetry methodology is required for making clinical outcome comparisons possible.

  15. Current educational issues in the clinical neurosciences.

    Science.gov (United States)

    Desbiens, R; Elleker, M G; Goldsand, G; Hugenholtz, H; Puddester, D; Toyota, B; Findlay, J M

    2001-11-01

    Canadian training in the clinical neurosciences, neurology and neurosurgery, faces significant challenges. New balances are being set by residents, their associations and the Royal College of Physicians and Surgeons of Canada between clinical service, education and personal time. The nature of hospital-provided medical service has changed significantly over the past decade, impacting importantly on resident training. Finally, future manpower needs are of concern, especially in the field of neurosurgery, where it appears that soon more specialists will be trained than can be absorbed into the Canadian health care system. A special symposium on current challenges in clinical neuroscience training was held at the Canadian Congress of Neurological Sciences in June 2000. Representatives from the Canadian Association of Interns and Residents, the Royal College of Physicians and Surgeons of Canada and English and French neurology and neurosurgery training programs made presentations, which are summarized in this report. Residency training has become less service-oriented, and this trend will continue. In order to manage the increasingly sophisticated hospital services of neurology and neurosurgery, resident-alternatives in the form of physician "moonlighters" or more permanent hospital-based clinicians or "hospitalists" will be necessary in order to operate major neuroclinical units. Health authorities and hospitals will need to recognize and assume this responsibility. As clinical experience diminishes during residency training, inevitably so will the concept of the fully competent "generalist" at the end of specialty training. Additional subspecialty training is being increasingly sought by graduates, particularly in neurosurgery. Training in neurology and neurosurgery, as in all medical specialties, has changed significantly in recent years and continues to change. Programs and hospitals need to adapt to these changes in order to ensure the production of fully

  16. In vivo small animal imaging: Current status and future prospects

    International Nuclear Information System (INIS)

    Kagadis, George C.; Loudos, George; Katsanos, Konstantinos; Langer, Steve G.; Nikiforidis, George C.

    2010-01-01

    The use of small animal models in basic and preclinical sciences constitutes an integral part of testing new pharmaceutical agents prior to commercial translation to clinical practice. Whole-body small animal imaging is a particularly elegant and cost-effective experimental platform for the timely validation and commercialization of novel agents from the bench to the bedside. Biomedical imaging is now listed along with genomics, proteomics, and metabolomics as an integral part of biological and medical sciences. Miniaturized versions of clinical diagnostic modalities, including but not limited to microcomputed tomography, micromagnetic resonance tomography, microsingle-photon-emission tomography, micropositron-emission tomography, optical imaging, digital angiography, and ultrasound, have all greatly improved our investigative abilities to longitudinally study various experimental models of human disease in mice and rodents. After an exhaustive literature search, the authors present a concise and critical review of in vivo small animal imaging, focusing on currently available modalities as well as emerging imaging technologies on one side and molecularly targeted contrast agents on the other. Aforementioned scientific topics are analyzed in the context of cancer angiogenesis and innovative antiangiogenic strategies under-the-way to the clinic. Proposed hybrid approaches for diagnosis and targeted site-specific therapy are highlighted to offer an intriguing glimpse of the future.

  17. Practical Considerations for Clinical PET/MR Imaging.

    Science.gov (United States)

    Galgano, Samuel; Viets, Zachary; Fowler, Kathryn; Gore, Lael; Thomas, John V; McNamara, Michelle; McConathy, Jonathan

    2018-01-01

    Clinical PET/MR imaging is currently performed at a number of centers around the world as part of routine standard of care. This article focuses on issues and considerations for a clinical PET/MR imaging program, focusing on routine standard-of-care studies. Although local factors influence how clinical PET/MR imaging is implemented, the approaches and considerations described here intend to apply to most clinical programs. PET/MR imaging provides many more options than PET/computed tomography with diagnostic advantages for certain clinical applications but with added complexity. A recurring theme is matching the PET/MR imaging protocol to the clinical application to balance diagnostic accuracy with efficiency. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. [Current clinical significance of anaerobic bacteremia].

    Science.gov (United States)

    Jirsa, Roman; Marešová, Veronika; Brož, Zdeněk

    2010-10-01

    to estimate tje current clinical significance of anaerobic bacteremia in a group of Czech hospitals. this retrospective analysis comprised 8 444 anaerobic blood cultures in patients admitted to four Czech hospitals between 2004 and 2007. in 16 patients, blood cultures yielded significant anaerobic bacteria. Thus, anaerobic bacteremia accounted for less than 2 % of clinically significant bacteremia. Four patients (18 %) died but none of the deaths could be clearly attributable to anaerobic bacteria in the bloodstream. The most common comorbidities predisposing to anaerobic bacteremia and the most frequent sources of infection were similar to those reported by other authors. The majority of anaerobic bacteremia cases were due to gram-negative bacteria, followed by Clostridium perfringens and, surprisingly, Eubacterium spp. (particularly Eubacterium lentum). anaerobic bacteremia remains rare. The comparison of our data with those by other authors suggests that (despite the reported high mortality) the actual clinical significance of anaerobic bacteremia is rather controversial and that the anaerobic bacteremia might not correspond to more serious pathogenic role of the anaerobic bacteria as the source of infection.

  19. Current clinical evidence on pioglitazone pharmacogenomics

    Directory of Open Access Journals (Sweden)

    Marina eKawaguchi-Suzuki

    2013-11-01

    Full Text Available Pioglitazone is the most widely used thiazolidinedione and acts as an insulin-sensitizer through activation of the Peroxisome Proliferator-Activated Receptor-γ (PPARγ. Pioglitazone is approved for use in the management of type 2 diabetes mellitus, but its use in other therapeutic areas is increasing due to pleiotropic effects. In this hypothesis article, the current clinical evidence on pioglitazone pharmacogenomics is summarized and related to variability in pioglitazone response. How genetic variation in the human genome affects the pharmacokinetics and pharmacodynamics of pioglitazone was examined. For pharmacodynamic effects, hypoglycemic and anti-atherosclerotic effects, risks of fracture or edema, and the increase in body mass index in response to pioglitazone based on genotype were examined. The genes CYP2C8 and PPARG are the most extensively studied to date and selected polymorphisms contribute to respective variability in pioglitazone pharmacokinetics and pharmacodynamics. We hypothesized that genetic variation in pioglitazone pathway genes contributes meaningfully to the clinically observed variability in drug response. To test the hypothesis that genetic variation in PPARG associates with variability in pioglitazone response, we conducted a meta-analysis to synthesize the currently available data on the PPARG p.Pro12Ala polymorphism. The results showed that PPARG 12Ala carriers had a more favorable change in fasting blood glucose from baseline as compared to patients with the wild-type Pro12Pro genotype (p=0.018. Unfortunately, findings for many other genes lack replication in independent cohorts to confirm association; further studies are needed. Also, the biological functionality of these polymorphisms is unknown. Based on current evidence, we propose that pharmacogenomics may provide an important tool to individualize pioglitazone therapy and better optimize therapy in patients with T2DM or other conditions for which pioglitazone

  20. Topical steroids in the current clinical practice

    Directory of Open Access Journals (Sweden)

    T. A. Belousova

    2014-01-01

    Full Text Available The article discusses issues related to current criteria for selection of glucocorticosteroids for external use as the basic therapy for a great number of allergic and inflammatory skin diseases. The authors emphasize that non-fluorinated GCSs having the best efficacy-to-safety ratio must be the drugs of first choice. The article provides data on a positive clinical experience of using a non-halogenated glucocorticosteroid for external use - hydrocortisone 17-butyrate (Laticort - for treatment of steroid-sensitive dermatoses in children and adults. The drug has a high anti-inflammatory action and minimum risk of the development of side effects, which is sufficient for using it in sensitive areas of skin (face, neck, folds, genitals both in children and in adults. The availability of three forms of the drug (solution, cream and ointment ensures the expedience and convenience of its application at any stage of the inflammatory process and for any localization.

  1. Current Molecular Imaging Positron Emitting Radiotracers in Oncology

    International Nuclear Information System (INIS)

    Zhu, Aizhi; Shim, Hyunsuk

    2011-01-01

    Molecular imaging is one of the fastest growing areas of medical imaging. Positron emission tomography has been widely used in the clinical management of patients with cancer. Nuclear imaging provides biological information at the cellular, subcellular, and molecular level in living subjects with noninvasive procedures. In particular, PET imaging takes advantage of traditional diagnostic imaging techniques and introduces positron emitting probes to determine the expression of indicative molecular targets at different stages of cancer. 18F fluorodeoxyglucose ( 18F FDG), the only FDA approved oncological PET tracer, has been widely utilized in cancer diagnosis, staging, restaging, and even monitoring response to therapy; however, 18F FDG is not a tumor specific PET tracer. Over the last decade, many promising tumor specific PET tracer. Over the last decade, many promising tumor specific PET tracers have been developed and evaluated in preclinical and clinical studies. This review provides an overview of the current non 18F FDG PET tracers in oncology that have been developed based on tumor characteristics such as increased metabolism, hyperproliferation, angiogenesis, hypoxia, apoptosis, and tumor specific antigens and surface receptors

  2. Parotid lymphomas - clinical and computed tomogrphic imaging ...

    African Journals Online (AJOL)

    Parotid lymphomas - clinical and computed tomogrphic imaging features. ... South African Journal of Surgery ... Lymphoma has a clinical presentation similar ... CT scanning is a useful adjunctive investigation to determine the site and extent of ...

  3. Current status of imaging of articular cartilage

    International Nuclear Information System (INIS)

    Hodler, J.; Resnick, D.

    1996-01-01

    Various imaging methods have been applied to assessment of articular cartilage. These include standard radiography, arthrography, CT, CT arthrography, ultrasonography, and MR imaging. Radiography remains the initial musculoskeletal imaging method. However, it is insensitive to early stages of cartilage abnormalities. MR imaging has great potential in the assessment of articular cartilage, although high-quality scans are required because imaging signs of cartilage abnormalities may be subtle. The potential and limitations of various sequences and techniques are discussed, including MR arthrography. The role of the other imaging methods in assessment of articular cartilage appears to be limited. (orig.). With 8 figs., 6 tabs

  4. Laser imaging for clinical applications

    Science.gov (United States)

    Van Houten, John P.; Cheong, Wai-Fung; Kermit, Eben L.; King, Richard A.; Spilman, Stanley D.; Benaron, David A.

    1995-03-01

    Medical optical imaging (MOI) uses light emitted into opaque tissues in order to determine the interior structure and chemical content. These optical techniques have been developed in an attempt to prospectively identify impending brain injuries before they become irreversible, thus allowing injury to be avoided or minimized. Optical imaging and spectroscopy center around the simple idea that light passes through the body in small amounts, and emerges bearing clues about tissues through which it passed. Images can be reconstructed from such data, and this is the basis of optical tomography. Over the past few years, techniques have been developed to allow construction of images from such optical data at the bedside. We have used a time-of-flight system reported earlier to monitor oxygenation and image hemorrhage in neonatal brain. This article summarizes the problems that we believe can be addressed by such techniques, and reports on some of our early results.

  5. Brain imaging with synthetic MR in children: clinical quality assessment

    Energy Technology Data Exchange (ETDEWEB)

    Betts, Aaron M.; Serai, Suraj [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Leach, James L.; Jones, Blaise V. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); University of Cincinnati College of Medicine, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Biostatistics and Epidemiology, Cincinnati, OH (United States)

    2016-10-15

    Synthetic magnetic resonance imaging is a quantitative imaging technique that measures inherent T1-relaxation, T2-relaxation, and proton density. These inherent tissue properties allow synthesis of various imaging sequences from a single acquisition. Clinical use of synthetic MR imaging has been described in adult populations. However, use of synthetic MR imaging has not been previously reported in children. The purpose of this study is to report our assessment of diagnostic image quality using synthetic MR imaging in children. Synthetic MR acquisition was obtained in a sample of children undergoing brain MR imaging. Image quality assessments were performed on conventional and synthetic T1-weighted, T2-weighted, and FLAIR images. Standardized linear measurements were performed on conventional and synthetic T2 images. Estimates of patient age based upon myelination patterns were also performed. Conventional and synthetic MR images were evaluated on 30 children. Using a 4-point assessment scale, conventional imaging performed better than synthetic imaging for T1-weighted, T2-weighted, and FLAIR images. When the assessment was simplified to a dichotomized scale, the conventional and synthetic T1-weighted and T2-weighted images performed similarly. However, the superiority of conventional FLAIR images persisted in the dichotomized assessment. There were no statistically significant differences between linear measurements made on T2-weighted images. Estimates of patient age based upon pattern of myelination were also similar between conventional and synthetic techniques. Synthetic MR imaging may be acceptable for clinical use in children. However, users should be aware of current limitations that could impact clinical utility in the software version used in this study. (orig.)

  6. Software Toolbox for Low-Frequency Conductivity and Current Density Imaging Using MRI.

    Science.gov (United States)

    Sajib, Saurav Z K; Katoch, Nitish; Kim, Hyung Joong; Kwon, Oh In; Woo, Eung Je

    2017-11-01

    Low-frequency conductivity and current density imaging using MRI includes magnetic resonance electrical impedance tomography (MREIT), diffusion tensor MREIT (DT-MREIT), conductivity tensor imaging (CTI), and magnetic resonance current density imaging (MRCDI). MRCDI and MREIT provide current density and isotropic conductivity images, respectively, using current-injection phase MRI techniques. DT-MREIT produces anisotropic conductivity tensor images by incorporating diffusion weighted MRI into MREIT. These current-injection techniques are finding clinical applications in diagnostic imaging and also in transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and electroporation where treatment currents can function as imaging currents. To avoid adverse effects of nerve and muscle stimulations due to injected currents, conductivity tensor imaging (CTI) utilizes B1 mapping and multi-b diffusion weighted MRI to produce low-frequency anisotropic conductivity tensor images without injecting current. This paper describes numerical implementations of several key mathematical functions for conductivity and current density image reconstructions in MRCDI, MREIT, DT-MREIT, and CTI. To facilitate experimental studies of clinical applications, we developed a software toolbox for these low-frequency conductivity and current density imaging methods. This MR-based conductivity imaging (MRCI) toolbox includes 11 toolbox functions which can be used in the MATLAB environment. The MRCI toolbox is available at http://iirc.khu.ac.kr/software.html . Its functions were tested by using several experimental datasets, which are provided together with the toolbox. Users of the toolbox can focus on experimental designs and interpretations of reconstructed images instead of developing their own image reconstruction softwares. We expect more toolbox functions to be added from future research outcomes. Low-frequency conductivity and current density imaging using MRI includes

  7. Hyperthermia: Clinical promise and current challenges

    International Nuclear Information System (INIS)

    Kapp, D.S.

    1987-01-01

    Local-regional hyperthermia (HT) when used in conjunction with radiation therapy (XRT), has been shown in numerous clinical trials to result in considerable improvement in response rates and local tumor control rates when compared with treatment by XRT alone. Although considerable progress has been made in understanding the biological basis for hyperthermia induced cytotoxicity and radiosensitization, additional research remains in establishing the optimal treatment schedules for the clinical utilization of HT-XRT. The number of HT treatments; the sequencing of HT and XRT; the frequency of administration of HT; and the ideal temperature-time parameters all remain to be better defined for the clinical setting. The role of tumor blood flow on the thermal distributions also warrants further investigation. In addition, considerable effort is needed to improve hyperthermia equipment in order to provide more uniform therapeutic temperature distributions (temperatures ≥42.5%C). Better heating equipment is particularly needed for the treatment of deep seeted tumors. Pertinent clinical literature will be presented summarizing the clinical promise of hyperthermia and the above mentioned clinical challenges

  8. Gynecologic imaging: Current and emerging applications

    Directory of Open Access Journals (Sweden)

    Iyer V

    2010-01-01

    Full Text Available Common diagnostic challenges in gynecology and the role of imaging in their evaluation are reviewed. Etiologies of abnormal uterine bleeding identified on pelvic sonography and sonohysterography are presented. An algorithmic approach for characterizing an incidentally detected adnexal mass and use of magnetic resonance imaging for definitive diagnosis are discussed. Finally, the role of F18-fluorodeoxyglucose positron emission tomography in the management of gynecological malignancies, and pitfalls associated with their use are examined.

  9. Clinical software for MR imaging system, 4

    International Nuclear Information System (INIS)

    Shimizu, Koji; Kasai, Akira; Okamura, Shoichi

    1992-01-01

    Magnetic resonance imaging continues to elicit new application software through the recent technological advances of MR equipment. This paper describes several applications of our newly developed clinical software. The fast SE sequence (RISE) has proved to reduce routine examination time and to improve image quality, and ultra-fast FE sequence (SMASH) was found to extend the diagnostic capabilities in the field of cardiac study. Diffusion/perfusion imaging achieved in our MR system showed significant promise for providing novel information regarding tissue characterization. Furthermore, Image quality and practicalities of MR angiography have been improved by advanced imaging sequences and sophisticated post-processing software. (author)

  10. Electromagnetic considerations for RF current density imaging [MRI technique].

    Science.gov (United States)

    Scott, G C; Joy, M G; Armstrong, R L; Henkelman, R M

    1995-01-01

    Radio frequency current density imaging (RF-CDI) is a recent MRI technique that can image a Larmor frequency current density component parallel to B(0). Because the feasibility of the technique was demonstrated only for homogeneous media, the authors' goal here is to clarify the electromagnetic assumptions and field theory to allow imaging RF currents in heterogeneous media. The complete RF field and current density imaging problem is posed. General solutions are given for measuring lab frame magnetic fields from the rotating frame magnetic field measurements. For the general case of elliptically polarized fields, in which current and magnetic field components are not in phase, one can obtain a modified single rotation approximation. Sufficient information exists to image the amplitude and phase of the RF current density parallel to B(0) if the partial derivative in the B(0) direction of the RF magnetic field (amplitude and phase) parallel to B(0) is much smaller than the corresponding current density component. The heterogeneous extension was verified by imaging conduction and displacement currents in a phantom containing saline and pure water compartments. Finally, the issues required to image eddy currents are presented. Eddy currents within a sample will distort both the transmitter coil reference system, and create measurable rotating frame magnetic fields. However, a three-dimensional electro-magnetic analysis will be required to determine how the reference system distortion affects computed eddy current images.

  11. Clinical PET/MR Imaging in Oncology

    DEFF Research Database (Denmark)

    Kjær, Andreas; Torigian, Drew A.

    2016-01-01

    . The question, therefore, arises regarding what the future clinical applications of PET/MR imaging will be. In this article, the authors discuss ways in which PET/MR imaging may be used in future applications that justify the added cost, predominantly focusing on oncologic applications. The authors suggest...

  12. Evaluation of leak current of clinical electrometers

    International Nuclear Information System (INIS)

    Lopez G, W.; Campos, X.

    2002-01-01

    The present work shows the evaluation of two electrometers model Victoreen used in radiotherapy. The performance of the electrometers was proven using a source of current, built inside the work frame arcal 34, and using like reference the norm iec 60371. The results of the tests of leakage, displacement of the zero and linealty of the electrometers are presented

  13. Current clinical research in orthodontics: a perspective.

    Science.gov (United States)

    Baumrind, Sheldon

    2006-10-01

    This essay explores briefly the approach of the Craniofacial Research Instrumentation Laboratory to the systematic and rigorous investigation of the usual outcome of orthodontic treatment in the practices of experienced clinicians. CRIL's goal is to produce a shareable electronic database of reliable, valid, and representative data on clinical practice as an aid in the production of an improved environment for truly evidence-based orthodontic treatment.

  14. Current and future perspectives in clinical management

    International Nuclear Information System (INIS)

    Willett, Christopher

    1996-01-01

    In the past several years, there has been significant progress and controversy in the clinical management of patients with rectal cancer as well as important advances in the understanding the biology of these tumors. The panel will highlight relevant biologic and clinical developments. One of major advances has been in the understanding of the molecular basis for the development of colon and rectal cancer with many of the events leading to cancer development having been determined. Although there is much to be learned, there is now a much improved understanding of colon and rectal carcinogenesis with the prospect of being able to define high risk patient populations and the possibility of early detection (before cancer formation) now a real possibility. In addition, the identification of favorable or unfavorable subsets of patients wit rectal cancer based on molecular markers is under active investigation. These exciting developments will be summarized. In the clinical arena, there are a number of controversial issues in the management of patients with rectal cancer. For patients with distal rectal cancer, the goals of therapy have evolved from cure to cure with sphincter preservation. The role of resection with coloanal anastomosis as an alternative to an abdominoperineal resection is also being defined. A wide array of treatment programs of radiation therapy and chemotherapy and sphincter sparing surgery are under active investigation. The relative merits of preoperative chemo-irradiation versus postoperative chemo-irradiation continues to be debated. The utility of total mesorectal excision is being evaluated and the need for adjuvant therapy is being questioned. These clinical issues will be highlighted

  15. Endoscopic Ultrasound Elastography: Current Clinical Use in Pancreas.

    Science.gov (United States)

    Mondal, Utpal; Henkes, Nichole; Patel, Sandeep; Rosenkranz, Laura

    2016-08-01

    Elastography is a newer technique for the assessment of tissue elasticity using ultrasound. Cancerous tissue is known to be stiffer (hence, less elastic) than corresponding healthy tissue, and as a result, could be identified in an elasticity-based imaging. Ultrasound elastography has been used in the breast, thyroid, and cervix to differentiate malignant from benign neoplasms and to guide or avoid unnecessary biopsies. In the liver, elastography has enabled a noninvasive and reliable estimate of fibrosis. Endoscopic ultrasound has become a robust diagnostic and therapeutic tool for the management of pancreatic diseases. The addition of elastography to endoscopic ultrasound enabled further characterization of pancreas lesions, and several European and Asian studies have reported encouraging results. The current clinical role of endoscopic ultrasound elastography in the management of pancreas disorders and related literature are reviewed.

  16. Small Bowel Transplantation: Current Clinical Status

    Directory of Open Access Journals (Sweden)

    David Sigalet

    1991-01-01

    Full Text Available With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel transplantation. Both experimental and clinical experience with transplantation are discussed, as are the areas which appear to offer the most promise for future developments. Finally guidelines for consideration of patient selection for this procedure are reviewed.

  17. Malignant fatty tumors: classification, clinical course, imaging appearance and treatment

    International Nuclear Information System (INIS)

    Peterson, J.J.; Kransdorf, M.J.; Bancroft, L.W.; O'Connor, M.I.

    2003-01-01

    Liposarcoma is a relatively common soft tissue malignancy with a wide spectrum of clinical presentations and imaging appearances. Several subtypes are described, ranging from lesions nearly entirely composed of mature adipose tissue, to tumors with very sparse adipose elements. The imaging appearance of these fatty masses is frequently sufficiently characteristic to allow a specific diagnosis, while in other cases, although a specific diagnosis is not achievable, a meaningful limited differential diagnosis can be established. The purpose of this paper is to review the spectrum of malignant fatty tumors, highlighting the current classification system, clinical presentation and behavior, treatment and spectrum of imaging appearances. The imaging review will emphasize CT scanning and MR imaging, and will stress differentiating radiologic features. (orig.)

  18. Benign fatty tumors: classification, clinical course, imaging appearance, and treatment

    International Nuclear Information System (INIS)

    Bancroft, Laura W.; Kransdorf, Mark J.; Peterson, Jeffrey J.; O'Connor, Mary I.

    2006-01-01

    Lipoma is the most common soft-tissue tumor, with a wide spectrum of clinical presentations and imaging appearances. Several subtypes are described, ranging from lesions entirely composed of mature adipose tissue to tumors intimately associated with nonadipose tissue, to those composed of brown fat. The imaging appearance of these fatty masses is frequently sufficiently characteristic to allow a specific diagnosis. However, in other cases, although a specific diagnosis is not achievable, a meaningful limited differential diagnosis can be established. The purpose of this manuscript is to review the spectrum of benign fatty tumors highlighting the current classification system, clinical presentation and behavior, spectrum of imaging appearances, and treatment. The imaging review emphasizes computed tomography (CT) scanning and magnetic resonance (MR) imaging, differentiating radiologic features. (orig.)

  19. Ketamine use in current clinical practice

    Science.gov (United States)

    Gao, Mei; Rejaei, Damoon; Liu, Hong

    2016-01-01

    After nearly half a century on the market, ketamine still occupies a unique corner in the medical armamentarium of anesthesiologists or clinicians treating pain. Over the last two decades, much research has been conducted highlighting the drug's mechanisms of action, specifically those of its enantiomers. Nowadays, ketamine is also being utilized for pediatric pain control in emergency department, with its anti-hyperalgesic and anti-inflammatory effects being revealed in acute and chronic pain management. Recently, new insights have been gained on ketamine's potential anti-depressive and antisuicidal effects. This article provides an overview of the drug's pharmacokinetics and pharmacodynamics while also discussing the potential benefits and risks of ketamine administration in various clinical settings. PMID:27018176

  20. Syncope: causes, clinical evaluation, and current therapy.

    Science.gov (United States)

    Benditt, D G; Remole, S; Milstein, S; Bailin, S

    1992-01-01

    Syncope is a common clinical problem comprising the sudden loss of both consciousness and postural tone, with a subsequent spontaneous and relatively prompt recovery. Often it is difficult to differentiate a true syncopal spell from other conditions, such as seizure disorders, or from some simple accidents. Even more difficult is the identification of the cause of syncopal episodes. Nonetheless, establishing a definitive diagnosis ia an important task given the high risk of recurrent symptoms. Careful use of noninvasive and invasive cardiovascular studies (including electrophysiologic testing and tilt-table testing) along with selected hematologic, biochemical, and neurologic studies provides, in the majority of cases, the most effective strategy for obtaining a specific diagnosis and for directing therapy.

  1. Bladder exstrophy: current management and postoperative imaging

    International Nuclear Information System (INIS)

    Pierre, Ketsia; Borer, Joseph; Phelps, Andrew; Chow, Jeanne S.

    2014-01-01

    Bladder exstrophy is a rare malformation characterized by an infra-umbilical abdominal wall defect, incomplete closure of the bladder with mucosa continuous with the abdominal wall, epispadias, and alterations in the pelvic bones and muscles. It is part of the exstrophy-epispadias complex, with cloacal exstrophy on the severe and epispadias on the mild ends of the spectrum. Bladder exstrophy is the most common of these entities and is more common in boys. The goal of this paper is to describe common methods of repair and to provide an imaging review of the postoperative appearances. (orig.)

  2. Bladder exstrophy: current management and postoperative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pierre, Ketsia [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Borer, Joseph [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Phelps, Andrew [University of California, San Francisco, Department of Pediatric Radiology, San Francisco, CA (United States); Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2014-07-15

    Bladder exstrophy is a rare malformation characterized by an infra-umbilical abdominal wall defect, incomplete closure of the bladder with mucosa continuous with the abdominal wall, epispadias, and alterations in the pelvic bones and muscles. It is part of the exstrophy-epispadias complex, with cloacal exstrophy on the severe and epispadias on the mild ends of the spectrum. Bladder exstrophy is the most common of these entities and is more common in boys. The goal of this paper is to describe common methods of repair and to provide an imaging review of the postoperative appearances. (orig.)

  3. Magnetic particle imaging: current developments and future directions

    Directory of Open Access Journals (Sweden)

    Panagiotopoulos N

    2015-04-01

    Full Text Available Nikolaos Panagiotopoulos,1 Robert L Duschka,1 Mandy Ahlborg,2 Gael Bringout,2 Christina Debbeler,2 Matthias Graeser,2 Christian Kaethner,2 Kerstin Lüdtke-Buzug,2 Hanne Medimagh,2 Jan Stelzner,2 Thorsten M Buzug,2 Jörg Barkhausen,1 Florian M Vogt,1 Julian Haegele1 1Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig Holstein, Campus Lübeck, 2Institute of Medical Engineering, University of Lübeck, Lübeck, Germany Abstract: Magnetic particle imaging (MPI is a novel imaging method that was first proposed by Gleich and Weizenecker in 2005. Applying static and dynamic magnetic fields, MPI exploits the unique characteristics of superparamagnetic iron oxide nanoparticles (SPIONs. The SPIONs’ response allows a three-dimensional visualization of their distribution in space with a superb contrast, a very high temporal and good spatial resolution. Essentially, it is the SPIONs’ superparamagnetic characteristics, the fact that they are magnetically saturable, and the harmonic composition of the SPIONs’ response that make MPI possible at all. As SPIONs are the essential element of MPI, the development of customized nanoparticles is pursued with the greatest effort by many groups. Their objective is the creation of a SPION or a conglomerate of particles that will feature a much higher MPI performance than nanoparticles currently available commercially. A particle’s MPI performance and suitability is characterized by parameters such as the strength of its MPI signal, its biocompatibility, or its pharmacokinetics. Some of the most important adjuster bolts to tune them are the particles’ iron core and hydrodynamic diameter, their anisotropy, the composition of the particles’ suspension, and their coating. As a three-dimensional, real-time imaging modality that is free of ionizing radiation, MPI appears ideally suited for applications such as vascular imaging and interventions as well as cellular and targeted imaging. A number

  4. Image Information Retrieval: An Overview of Current Research

    OpenAIRE

    Abby A. Goodrum

    2000-01-01

    This paper provides an overview of current research in image information retrieval and provides an outline of areas for future research. The approach is broad and interdisciplinary and focuses on three aspects of image research (IR): text-based retrieval, content-based retrieval, and user interactions with image information retrieval systems. The review concludes with a call for image retrieval evaluation studies similar to TREC.

  5. Subclinical hyperthyroidism: current concepts and scintigraphic imaging.

    Science.gov (United States)

    Intenzo, Charles; Jabbour, Serge; Miller, Jeffrey L; Ahmed, Intekhab; Furlong, Kevin; Kushen, Medina; Kim, Sung M; Capuzzi, David M

    2011-09-01

    Subclinical hyperthyroidism is defined as normal serum free thyroxine and a free triiodothyronine level, with a thyroid-stimulating hormone level suppressed below the normal range and is usually undetectable. Although patients with this diagnosis have no or few signs and symptoms of overt thyrotoxicosis, there is sufficient evidence that it is associated with a relatively higher risk of supraventricular arrhythmias as well as the acceleration or the development of osteoporosis. Consequently, the approach to the patient with subclinical hyperthyroidism is controversial, that is, therapeutic intervention versus watchful waiting. Regardless, it is imperative for the referring physician to identify the causative thyroid disorder. This is optimally accomplished by a functional study, namely scintigraphy. Recognition of the scan findings of the various causes of subclinical hyperthyroidism enables the imaging specialist to help in diagnosing the underlying condition causing thyroid-stimulating hormone suppression thereby facilitating the workup and management of this thyroid disorder.

  6. Thymic hyperplasia - clinical course and imaging diagnostic

    International Nuclear Information System (INIS)

    Drebov, R.; Panov, M.; Totev, M.; Deliverski, T.; Tcandev, I.; Velkovski, I.

    2006-01-01

    The real thymic hyperplasia is benign disease sometimes simulating malignant tumours. The aim of this study is to analyse the clinical symptoms of real thymic hyperplasia and the results from imaging diagnostic based on our clinical material. Clinical material include 27 children, aged from two months to 15 years, admitted in department of thoracic surgery, for a period of 20 years (1985 - 2004). We retrospectively analyze the clinical signs and results from X-ray investigation, CT (Siemens Somatom DRG and Philips Secura) and echocardiography (Acuson TX, 5 and 7 MHz). We discuss the diagnostic value of different methods as well as typical and atypical findings. (authors)

  7. Current cardiac imaging techniques for detection of left ventricular mass

    Directory of Open Access Journals (Sweden)

    Celebi Aksuyek S

    2010-06-01

    Full Text Available Abstract Estimation of left ventricular (LV mass has both prognostic and therapeutic value independent of traditional risk factors. Unfortunately, LV mass evaluation has been underestimated in clinical practice. Assessment of LV mass can be performed by a number of imaging modalities. Despite inherent limitations, conventional echocardiography has fundamentally been established as most widely used diagnostic tool. 3-dimensional echocardiography (3DE is now feasible, fast and accurate for LV mass evaluation. 3DE is also superior to conventional echocardiography in terms of LV mass assessment, especially in patients with abnormal LV geometry. Cardiovascular magnetic resonance (CMR and cardiovascular computed tomography (CCT are currently performed for LV mass assessment and also do not depend on cardiac geometry and display 3-dimensional data, as well. Therefore, CMR is being increasingly employed and is at the present standard of reference in the clinical setting. Although each method demonstrates advantages over another, there are also disadvantages to receive attention. Diagnostic accuracy of methods will also be increased with the introduction of more advanced systems. It is also likely that in the coming years new and more accurate diagnostic tests will become available. In particular, CMR and CCT have been intersecting hot topic between cardiology and radiology clinics. Thus, good communication and collaboration between two specialties is required for selection of an appropriate test.

  8. Magneto-optical imaging of transport current densities in superconductors

    International Nuclear Information System (INIS)

    Crabtree, G.W.; Welp, U.; Gunter, D.O.; Zhong, W.; Balachandran, U.; Haldar, P.; Sokolowski, R.S.; Vlasko-Vlasov, V.K.; Nikitenko, V.I.

    1995-01-01

    Direct imaging of the paths of transport currents in superconductors creates many new possibilities for exploring the basic features of vortex pinning mechanisms and for improving the performance of superconducting materials. A technique for imaging the path and magnitude of the transport current density flowing in superconductors is described. Results are given for a 37-filament BSCCO 2223 powder-in-tube wire, showing a highly inhomogeneous current path within the filaments

  9. Barrett's esophagus: clinical features, obesity, and imaging.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2011-09-01

    The following includes commentaries on clinical features and imaging of Barrett\\'s esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett\\'s epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography\\/computed tomography.

  10. Functional brain imaging - baric and clinical questions

    International Nuclear Information System (INIS)

    Mager, T.; Moeller, H.J.

    1997-01-01

    The advancing biological knowledge of disease processes plays a central part in the progress of modern psychiatry. An essential contribution comes from the functional and structural brain imaging techniques (CT, MRI, SPECT, PET). Their application is important for biological oriented research in psychiatry and there is also a growing relevance in clinical aspects. This development is taken into account by recent diagnostic classification systems in psychiatry. The capabilities and limitations of functional brain imaging in the context of research and clinic will be presented and discussed by examples and own investigations. (orig.) [de

  11. Role of imaging in testicular cancer: current and future practice.

    Science.gov (United States)

    Barrisford, Glen W; Kreydin, Evgeniy I; Preston, Mark A; Rodriguez, Dayron; Harisighani, Mukesh G; Feldman, Adam S

    2015-09-01

    The article provides a summary of the epidemiologic and clinical aspects of testicular malignancy. Current standard imaging and novel techniques are reviewed. Present data and clinical treatment trends have favored surveillance protocols over adjuvant radiation or chemotherapy for low-stage testicular malignancy. This has resulted in increasing numbers of imaging studies and the potential for increased long-term exposure risks. Understanding imaging associated risks as well as strategies to minimize these risks is of increasing importance. The development, validation and incorporation of alternative lower risk highly efficacious and cost-effective imaging techniques is essential.

  12. [Molecular imaging; current status and future prospects in USA].

    Science.gov (United States)

    Kobayashi, Hisataka

    2007-02-01

    The goal of this review is to introduce the definition, current status, and future prospects of the molecular imaging, which has recently been a hot topic in medicine and the biological science in USA. In vivo imaging methods to visualize the molecular events and functions in organs or animals/humans are overviewed and discussed especially in combinations of imaging modalities (machines) and contrast agents(chemicals) used in the molecular imaging. Next, the close relationship between the molecular imaging and the nanotechnology, an important part of nanomedicine, is stressed from the aspect of united multidisciplinary sciences such as physics, chemistry, biology, and medicine.

  13. Parotid lymphomas - clinical and computed tomogrphic imaging ...

    African Journals Online (AJOL)

    Objective. To review the clinical presentation and computed tomography (CT) imaging characteristics of all parotid lymphomas diagnosed at the study institution over a 7-year period. Design. Retrospective chart review of parotid lymphomas diagnosed between 1997 and 2004. Subjects. A total of 121 patients with parotid ...

  14. Computer-aided diagnosis and artificial intelligence in clinical imaging.

    Science.gov (United States)

    Shiraishi, Junji; Li, Qiang; Appelbaum, Daniel; Doi, Kunio

    2011-11-01

    Computer-aided diagnosis (CAD) is rapidly entering the radiology mainstream. It has already become a part of the routine clinical work for the detection of breast cancer with mammograms. The computer output is used as a "second opinion" in assisting radiologists' image interpretations. The computer algorithm generally consists of several steps that may include image processing, image feature analysis, and data classification via the use of tools such as artificial neural networks (ANN). In this article, we will explore these and other current processes that have come to be referred to as "artificial intelligence." One element of CAD, temporal subtraction, has been applied for enhancing interval changes and for suppressing unchanged structures (eg, normal structures) between 2 successive radiologic images. To reduce misregistration artifacts on the temporal subtraction images, a nonlinear image warping technique for matching the previous image to the current one has been developed. Development of the temporal subtraction method originated with chest radiographs, with the method subsequently being applied to chest computed tomography (CT) and nuclear medicine bone scans. The usefulness of the temporal subtraction method for bone scans was demonstrated by an observer study in which reading times and diagnostic accuracy improved significantly. An additional prospective clinical study verified that the temporal subtraction image could be used as a "second opinion" by radiologists with negligible detrimental effects. ANN was first used in 1990 for computerized differential diagnosis of interstitial lung diseases in CAD. Since then, ANN has been widely used in CAD schemes for the detection and diagnosis of various diseases in different imaging modalities, including the differential diagnosis of lung nodules and interstitial lung diseases in chest radiography, CT, and position emission tomography/CT. It is likely that CAD will be integrated into picture archiving and

  15. Chest trauma in children: current imaging guidelines and techniques.

    LENUS (Irish Health Repository)

    Moore, Michael A

    2011-09-01

    Given the heterogeneous nature of pediatric chest trauma, the optimal imaging approach is tailored to the specific patient. Chest radiography remains the most important imaging modality for initial triage. The decision to perform a chest computed tomography scan should be based on the nature of the trauma, the child\\'s clinical condition, and the initial radiographic findings, taking the age-related pretest probabilities of serious injury into account. The principles of as low as reasonably achievable and Image Gently should be followed. The epidemiology and pathophysiology, imaging techniques, characteristic findings, and evidence-based algorithms for pediatric chest trauma are discussed.

  16. Narrow-Band Imaging: Clinical Application in Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Sandra Barbeiro

    2018-03-01

    Full Text Available Narrow-band imaging is an advanced imaging system that applies optic digital methods to enhance endoscopic images and improves visualization of the mucosal surface architecture and microvascular pattern. Narrow-band imaging use has been suggested to be an important adjunctive tool to white-light endoscopy to improve the detection of lesions in the digestive tract. Importantly, it also allows the distinction between benign and malignant lesions, targeting biopsies, prediction of the risk of invasive cancer, delimitation of resection margins, and identification of residual neoplasia in a scar. Thus, in expert hands it is a useful tool that enables the physician to decide on the best treatment (endoscopic or surgical and management. Current evidence suggests that it should be used routinely for patients at increased risk for digestive neoplastic lesions and could become the standard of care in the near future, at least in referral centers. However, adequate training programs to promote the implementation of narrow-band imaging in daily clinical practice are needed. In this review, we summarize the current scientific evidence on the clinical usefulness of narrow-band imaging in the diagnosis and characterization of digestive tract lesions/cancers and describe the available classification systems.

  17. Current clinical approach to patients with disorders of consciousness

    Directory of Open Access Journals (Sweden)

    Robson Luis Oliveira de Amorim

    Full Text Available Summary In clinical practice, hospital admission of patients with altered level of consciousness, sleepy or in a non-responsive state is extremely common. This clinical condition requires an effective investigation and early treatment. Performing a focused and objective evaluation is critical, with quality history taking and physical examination capable to locate the lesion and define conducts. Imaging and laboratory exams have played an increasingly important role in supporting clinical research. In this review, the main types of changes in consciousness are discussed as well as the essential points that should be evaluated in the clinical management of these patients.

  18. Magnetic resonance cardiac perfusion imaging-a clinical perspective

    Energy Technology Data Exchange (ETDEWEB)

    Hunold, Peter; Schlosser, Thomas; Barkhausen, Joerg [University Hospital, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2006-08-15

    Coronary artery disease (CAD) with its clinical appearance of stable or unstable angina and acute myocardial infarction is the leading cause of death in developed countries. In view of increasing costs and the rising number of CAD patients, there has been a major interest in reliable non-invasive imaging techniques to identify CAD in an early (i.e. asymptomatic) stage. Since myocardial perfusion deficits appear very early in the ''ischemic cascade'', a major breakthrough would be the non-invasive quantification of myocardial perfusion before functional impairment might be detected. Therefore, there is growing interest in other, target-organ-specific parameters, such as relative and absolute myocardial perfusion imaging. Magnetic resonance (MR) imaging has been proven to offer attractive concepts in this respect. However, some important difficulties have not been resolved so far, which still causes uncertainty and prevents the broad application of MR perfusion imaging in a clinical setting. This review explores recent technical developments in MR hardware, software and contrast agents, as well as their impact on the current and future clinical status of MR imaging of first-pass myocardial perfusion imaging. (orig.)

  19. Magnetic resonance cardiac perfusion imaging-a clinical perspective

    International Nuclear Information System (INIS)

    Hunold, Peter; Schlosser, Thomas; Barkhausen, Joerg

    2006-01-01

    Coronary artery disease (CAD) with its clinical appearance of stable or unstable angina and acute myocardial infarction is the leading cause of death in developed countries. In view of increasing costs and the rising number of CAD patients, there has been a major interest in reliable non-invasive imaging techniques to identify CAD in an early (i.e. asymptomatic) stage. Since myocardial perfusion deficits appear very early in the ''ischemic cascade'', a major breakthrough would be the non-invasive quantification of myocardial perfusion before functional impairment might be detected. Therefore, there is growing interest in other, target-organ-specific parameters, such as relative and absolute myocardial perfusion imaging. Magnetic resonance (MR) imaging has been proven to offer attractive concepts in this respect. However, some important difficulties have not been resolved so far, which still causes uncertainty and prevents the broad application of MR perfusion imaging in a clinical setting. This review explores recent technical developments in MR hardware, software and contrast agents, as well as their impact on the current and future clinical status of MR imaging of first-pass myocardial perfusion imaging. (orig.)

  20. Mammography image assessment; validity and reliability of current scheme

    International Nuclear Information System (INIS)

    Hill, C.; Robinson, L.

    2015-01-01

    Mammographers currently score their own images according to criteria set out by Regional Quality Assurance. The criteria used are based on the ‘Perfect, Good, Moderate, Inadequate’ (PGMI) marking criteria established by the National Health Service Breast Screening Programme (NHSBSP) in their Quality Assurance Guidelines of 2006 1 . This document discusses the validity and reliability of the current mammography image assessment scheme. Commencing with a critical review of the literature this document sets out to highlight problems with the national approach to the use of marking schemes. The findings suggest that ‘PGMI’ scheme is flawed in terms of reliability and validity and is not universally applied across the UK. There also appear to be differences in schemes used by trainees and qualified mammographers. Initial recommendations are to be made in collaboration with colleagues within the National Health Service Breast Screening Programme (NHSBSP), Higher Education Centres, College of Radiographers and the Royal College of Radiologists in order to identify a mammography image appraisal scheme that is fit for purpose. - Highlights: • Currently no robust evidence based marking tools in use for the assessment of images in mammography. • Is current system valid, reliable and robust? • How can the current image assessment tool be improved? • Should students and qualified mammographers use the same tool? • What marking criteria are available for image assessment?

  1. Contrast Media for X-ray and Magnetic Resonance Imaging: Development, Current Status and Future Perspectives.

    Science.gov (United States)

    Frenzel, Thomas; Lawaczeck, Rüdiger; Taupitz, Matthias; Jost, Gregor; Lohrke, Jessica; Sieber, Martin A; Pietsch, Hubertus

    2015-09-01

    Over the last 120 years, the extensive advances in medical imaging allowed enhanced diagnosis and therapy of many diseases and thereby improved the quality of life of many patient generations. From the beginning, all technical solutions and imaging procedures were combined with dedicated pharmaceutical developments of contrast media, to further enhance the visualization of morphology and physiology. This symbiosis of imaging hardware and contrast media development was of high importance for the development of modern clinical radiology. Today, all available clinically approved contrast media fulfill the highest requirements for clinical safety and efficacy. All new concepts to increase the efficacy of contrast media have also to consider the high clinical safety standards and cost of goods of current marketed contrast media. Nevertheless, diagnostic imaging will contribute significantly to the progresses in medicine, and new contrast media developments are mandatory to address the medical needs of the future.

  2. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    Directory of Open Access Journals (Sweden)

    Scott Okuno

    2011-08-01

    Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  3. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    International Nuclear Information System (INIS)

    Joglekar, Siddharth B.; Rose, Peter S.; Sim, Franklin; Okuno, Scott; Petersen, Ivy

    2011-01-01

    Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation

  4. Clinical applications of cardiovascular magnetic resonance imaging

    International Nuclear Information System (INIS)

    Marcu, C.B.; Beek, A.M.; Van Rossum, A.C.

    2006-01-01

    Cardiovascular magnetic resonance imaging (MRI) has evolved from an effective research tool into a clinically proven, safe and comprehensive imaging modality. It provides anatomic and functional information in acquired and congenital heart disease and is the most precise technique for quantification of ventricular volumes, function and mass. Owing to its excellent interstudy reproducibility, cardiovascular MRI is the optimal method for assessment of changes in ventricular parameters after therapeutic intervention. Delayed contrast enhancement is an accurate and robust method used in the diagnosis of ischemic and nonischemic cardiomyopathies and less common diseases, such as cardiac sarcoidosis and myocarditis. First-pass magnetic contrast myocardial perfusion is becoming an alternative to radionuclide techniques for the detection of coronary atherosclerotic disease. In this review we outline the techniques used in cardiovascular MRI and discuss the most common clinical applications. (author)

  5. Intracranial Infections: Clinical and Imaging Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Foerster, B.R.; Thurnher, M.M.; Malani, P.N.; Petrou, M.; Carets-Zumelzu, F.; Sundgren, P.C. [Dept. of Radiology, and Divisions of Infectious Diseases and G eriatric Medicine, Dept. of Internal Medicine, Univ. of Michigan Medical Center, Ann Arbor, MI (United States)

    2007-10-15

    The radiologist plays a crucial role in identifying and narrowing the differential diagnosis of intracranial infections. A thorough understanding of the intracranial compartment anatomy and characteristic imaging findings of specific pathogens, as well incorporation of the clinical information, is essential to establish correct diagnosis. Specific types of infections have certain propensities for different anatomical regions within the brain. In addition, the imaging findings must be placed in the context of the clinical setting, particularly in immunocompromised and human immunodeficiency virus (HIV)-positive patients. This paper describes and depicts infections within the different compartments of the brain. Pathology-proven infectious cases are presented in both immunocompetent and immunocompromised patients, with a discussion of the characteristic findings of each pathogen. Magnetic resonance spectroscopy (MRS) characteristics for several infections are also discussed.

  6. Imaging of lumbar degenerative disk disease: history and current state

    International Nuclear Information System (INIS)

    Emch, Todd M.; Modic, Michael T.

    2011-01-01

    One of the most common indications for performing magnetic resonance (MR) imaging of the lumbar spine is the symptom complex thought to originate as a result of degenerative disk disease. MR imaging, which has emerged as perhaps the modality of choice for imaging degenerative disk disease, can readily demonstrate disk pathology, degenerative endplate changes, facet and ligamentous hypertrophic changes, and the sequelae of instability. Its role in terms of predicting natural history of low back pain, identifying causality, or offering prognostic information is unclear. As available modalities for imaging the spine have progressed from radiography, myelography, and computed tomography to MR imaging, there have also been advances in spine surgery for degenerative disk disease. These advances are described in a temporal context for historical purposes with a focus on MR imaging's history and current state. (orig.)

  7. Metanephric Adenoma: clinical, imaging, and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Torricelli, Fabio Cesar Miranda; Marchini, Giovanni Scala, E-mail: fabio_torri@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Urologica; Campos, Rodrigo Sousa Madeira [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Dept. de Urologia; Gil, Antonio Otero [Instituto Dante Pazanezzi, Sao Paulo, SP (Brazil)

    2011-07-01

    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  8. [Clinical use of interventional MR imaging].

    Science.gov (United States)

    Kahn, Thomas; Schulz, Thomas; Moche, Michael; Prothmann, Sascha; Schneider, Jens-Peter

    2003-01-01

    The integration of diagnostic and therapeutic procedures by MRI is based on the combination of excellent morphologic and functional imaging. The spectrum of MR-guided interventions includes biopsies, thermal ablation procedures, vascular applications, and intraoperative MRI. In all these applications, different scientific groups have obtained convincing results in basic developments as well as in clinical use. Interventional MRI (iMRI) is expected to attain an important role in interventional radiology, minimal invasive therapy, and monitoring of surgical procedures.

  9. Clinical magnetic resonance: imaging and spectroscopy

    International Nuclear Information System (INIS)

    Andrew, E.R.; Bydder, Graeme; Griffiths, John; Iles, Richard; Styles, Peter

    1990-01-01

    This book begins with a readable, comprehensive but non-mathematical introduction to the basic underlying principles of magnetic resonance. Further chapters include information on the theory and principles of MRI and MRS, the interpretation of MR images, the clinical applications and scope of MRI and MRS, practical aspects of spectroscopy and magnetic resonance, and also the practical problems associated with the siting, safety and operation of large MRI and MRS equipment. (author)

  10. Cardiac magnetic source imaging based on current multipole model

    International Nuclear Information System (INIS)

    Tang Fa-Kuan; Wang Qian; Hua Ning; Lu Hong; Tang Xue-Zheng; Ma Ping

    2011-01-01

    It is widely accepted that the heart current source can be reduced into a current multipole. By adopting three linear inverse methods, the cardiac magnetic imaging is achieved in this article based on the current multipole model expanded to the first order terms. This magnetic imaging is realized in a reconstruction plane in the centre of human heart, where the current dipole array is employed to represent realistic cardiac current distribution. The current multipole as testing source generates magnetic fields in the measuring plane, serving as inputs of cardiac magnetic inverse problem. In the heart-torso model constructed by boundary element method, the current multipole magnetic field distribution is compared with that in the homogeneous infinite space, and also with the single current dipole magnetic field distribution. Then the minimum-norm least-squares (MNLS) method, the optimal weighted pseudoinverse method (OWPIM), and the optimal constrained linear inverse method (OCLIM) are selected as the algorithms for inverse computation based on current multipole model innovatively, and the imaging effects of these three inverse methods are compared. Besides, two reconstructing parameters, residual and mean residual, are also discussed, and their trends under MNLS, OWPIM and OCLIM each as a function of SNR are obtained and compared. (general)

  11. Cancer imaging phenomics toolkit: quantitative imaging analytics for precision diagnostics and predictive modeling of clinical outcome.

    Science.gov (United States)

    Davatzikos, Christos; Rathore, Saima; Bakas, Spyridon; Pati, Sarthak; Bergman, Mark; Kalarot, Ratheesh; Sridharan, Patmaa; Gastounioti, Aimilia; Jahani, Nariman; Cohen, Eric; Akbari, Hamed; Tunc, Birkan; Doshi, Jimit; Parker, Drew; Hsieh, Michael; Sotiras, Aristeidis; Li, Hongming; Ou, Yangming; Doot, Robert K; Bilello, Michel; Fan, Yong; Shinohara, Russell T; Yushkevich, Paul; Verma, Ragini; Kontos, Despina

    2018-01-01

    The growth of multiparametric imaging protocols has paved the way for quantitative imaging phenotypes that predict treatment response and clinical outcome, reflect underlying cancer molecular characteristics and spatiotemporal heterogeneity, and can guide personalized treatment planning. This growth has underlined the need for efficient quantitative analytics to derive high-dimensional imaging signatures of diagnostic and predictive value in this emerging era of integrated precision diagnostics. This paper presents cancer imaging phenomics toolkit (CaPTk), a new and dynamically growing software platform for analysis of radiographic images of cancer, currently focusing on brain, breast, and lung cancer. CaPTk leverages the value of quantitative imaging analytics along with machine learning to derive phenotypic imaging signatures, based on two-level functionality. First, image analysis algorithms are used to extract comprehensive panels of diverse and complementary features, such as multiparametric intensity histogram distributions, texture, shape, kinetics, connectomics, and spatial patterns. At the second level, these quantitative imaging signatures are fed into multivariate machine learning models to produce diagnostic, prognostic, and predictive biomarkers. Results from clinical studies in three areas are shown: (i) computational neuro-oncology of brain gliomas for precision diagnostics, prediction of outcome, and treatment planning; (ii) prediction of treatment response for breast and lung cancer, and (iii) risk assessment for breast cancer.

  12. Clinical requirements for radionuclide imaging and recording

    International Nuclear Information System (INIS)

    McCready, R.; Flower, M.; Royal Marsden Hospital, Sutton

    1985-01-01

    The quality of current nuclear medicine images and display on hard copy makes diagnosis difficult and the interpretation of results by colleagues more difficult than it need be. The solution is to take full advantage of the power of currently available digital computers. It is understandable that the relatively small sales in the nuclear medicine field limits the effort and expense that can put into development. However, it is hoped that if the requirements are defined then advantage can be taken of recent developments in the mass market to incorporate these into nuclear medicine systems at less cost than was previously possible. (orig.) [de

  13. Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

    Science.gov (United States)

    Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

    2018-05-01

    Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

  14. Current Status of Operation and Management of Dental School Clinics.

    Science.gov (United States)

    Reinhardt, John W

    2017-08-01

    This article summarizes the current status of the operation and management of dental school clinics as schools strive to provide excellent patient-centered care in an environment that is educationally sound, efficient, and financially strong. Clinical education is a large component of dental education and an area in which many dental schools have an opportunity to enhance revenue. Clinical efficiencies and alternative models of clinical education are evolving in U.S. dental schools, and this article describes some of those evolutionary changes. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  15. Deep Learning in Nuclear Medicine and Molecular Imaging: Current Perspectives and Future Directions.

    Science.gov (United States)

    Choi, Hongyoon

    2018-04-01

    Recent advances in deep learning have impacted various scientific and industrial fields. Due to the rapid application of deep learning in biomedical data, molecular imaging has also started to adopt this technique. In this regard, it is expected that deep learning will potentially affect the roles of molecular imaging experts as well as clinical decision making. This review firstly offers a basic overview of deep learning particularly for image data analysis to give knowledge to nuclear medicine physicians and researchers. Because of the unique characteristics and distinctive aims of various types of molecular imaging, deep learning applications can be different from other fields. In this context, the review deals with current perspectives of deep learning in molecular imaging particularly in terms of development of biomarkers. Finally, future challenges of deep learning application for molecular imaging and future roles of experts in molecular imaging will be discussed.

  16. Imaging of cystic fibrosis lung disease and clinical interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Wielpuetz, M.O.; Eichinger, M.; Kauczor, H.U. [Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology with Nuclear Medicine; Biederer, J. [Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Translational Lung Research Center Heidelberg (TLRC) (Germany); Gross-Gerau Community Hospital (Germany). Radiologie Darmstadt; Wege, S. [Heidelberg University Hospital (Germany). Dept. of Pulmonology and Respiratory Medicine; Stahl, M.; Sommerburg, O. [Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Div. of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center; Mall, M.A. [Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Div. of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center; Heidelberg University Hospital (Germany). Dept. of Translational Pulmonology; Puderbach, M. [Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology with Nuclear Medicine; Hufeland Hospital, Bad Langensalza (Germany). Dept. of Diagnostic and Interventional Radiology

    2016-09-15

    Progressive lung disease in cystic fibrosis (CF) is the life-limiting factor of this autosomal recessive genetic disorder. Increasing implementation of CF newborn screening allows for a diagnosis even in pre-symptomatic stages. Improvements in therapy have led to a significant improvement in survival, the majority now being of adult age. Imaging provides detailed information on the regional distribution of CF lung disease, hence longitudinal imaging is recommended for disease monitoring in the clinical routine. Chest X-ray (CXR), computed tomography (CT) and magnetic resonance imaging (MRI) are now available as routine modalities, each with individual strengths and drawbacks, which need to be considered when choosing the optimal modality adapted to the clinical situation of the patient. CT stands out with the highest morphological detail and has often been a substitute for CXR for regular severity monitoring at specialized centers. Multidetector CT data can be post-processed with dedicated software for a detailed measurement of airway dimensions and bronchiectasis and potentially a more objective and precise grading of disease severity. However, changing to CT was inseparably accompanied by an increase in radiation exposure of CF patients, a young population with high sensitivity to ionizing radiation and lifetime accumulation of dose. MRI as a cross-sectional imaging modality free of ionizing radiation can depict morphological hallmarks of CF lung disease at lower spatial resolution but excels with comprehensive functional lung imaging, with time-resolved perfusion imaging currently being most valuable.

  17. Magnetic resonance imaging of the shoulder: Rationale and current applications

    International Nuclear Information System (INIS)

    Holt, R.G.; Helms, C.A.; Steinbach, L.; Neumann, C.; Munk, P.L.; Genant, H.K.

    1990-01-01

    Because it can demonstrate a wide range of tissue contrast with excellent resolution, magnetic resonance (MR) imaging has revolutionized imaging in many areas of the musculoskeletal system and has generated excitement among those interested in the painful shoulder. Shoulder impingement syndrome and glenohumeral instability constitute the two major categories of shoulder derangements. Correct diagnosis requires the use of appropriate pulse sequences and imaging planes, proper patient positioning, and a satisfactory surface coil. In addition the imager must have a thorough understanding of shoulder anatomy and pathology. We present a summary of the current status of MR imaging of the shoulder including technical, anatomic, and pathologic considerations and a review of the pertinent literature. (orig.)

  18. Clinical pharmacology in Russia-historical development and current state.

    Science.gov (United States)

    Zagorodnikova Goryachkina, Ksenia; Burbello, Aleksandra; Sychev, Dmitry; Frolov, Maxim; Kukes, Vladimir; Petrov, Vladimir

    2015-02-01

    Clinical pharmacology in Russia has long history and is currently active, but rather unrecognized internationally. It is governmentally approved as a teaching/scientific specialty since 1983 and as a medical specialty since 1997. Courses of clinical pharmacology are included in the undergraduate curricula in the 5th and/or 6th year of education at all medical schools in the Russian Federation. Postgraduate education includes initial specialization in internal medicine with further residency in clinical pharmacology. Governmental legislation recommends that every healthcare institution has either a department or a single position of clinical pharmacologist. Major routine duties include information about and monitoring of medication use, consultations in difficult clinical situations, pharmacogenetic counseling, therapeutic drug monitoring, pharmacovigilance, and participation in drug and therapeutics (formulary) committees. There are official experts in clinical pharmacology in Russia responsible for coordinating relevant legislative issues. The chief expert clinical pharmacologist represents the discipline directly at the Ministry of Health. Research in clinical pharmacology in Russia is extensive and variable, but only some of it is published internationally. Russia is a participant of international societies of clinical pharmacology and therapeutics and collaboration is actively ongoing. There are still certain problems related to the development of the discipline in Russia-some healthcare institutions do not see the need for clinical pharmacology. However, the number of clinical pharmacologists in Russia is increasing as well as their role in physicians' education, national healthcare, and research.

  19. Current status on performance of CT colonography and clinical indications

    International Nuclear Information System (INIS)

    Laghi, Andrea; Rengo, Marco; Graser, Anno; Iafrate, Franco

    2013-01-01

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  20. Current status on performance of CT colonography and clinical indications

    Energy Technology Data Exchange (ETDEWEB)

    Laghi, Andrea, E-mail: andrea.laghi@uniroma1.it [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Rengo, Marco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Polo Pontino, I.C.O.T. Hospital, Via Franco Faggiana 43, 04100 Latina (Italy); Graser, Anno [InstitutfürKlinische Radiologie, Klinikumder Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377 München (Germany); Iafrate, Franco [Department of Radiological Sciences, Oncology and Pathology Sapienza – Università di Roma, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome (Italy)

    2013-08-15

    CT colonography (CTC) is a robust and reliable imaging test of the colon. Accuracy for the detection of colorectal cancer (CRC) is as high as conventional colonoscopy (CC). Identification of polyp is size dependent, with large lesions (≥10 mm) accurately detected and small lesions (6–9 mm) identified with moderate to good sensitivity. Recent studies show good sensitivity for the identification of nonpolypoid (flat) lesions as well. Current CTC indications include the evaluation of patients who had undergone a previous incomplete CC or those who are unfit for CC (elderly and frail individuals, patients with underlying severe clinical conditions, or with contraindication to sedation). CTC can also be efficiently used in the assessment of diverticular disease (excluding patients with acute diverticulitis, where the exam should be postponed), before laparoscopic surgery for CRC (to have an accurate localization of the lesion), in the evaluation of colonic involvement in the case of deep pelvic endometriosis (replacing barium enema). CTC is also a safe procedure in patients with colostomy. For CRC screening, CTC should be considered an opportunistic screening test (not available for population, or mass screening) to be offered to asymptomatic average-risk individuals, of both genders, starting at age 50. The use in individuals with positive family history should be discussed with the patient first. Absolute contraindication is to propose CTC for surveillance of genetic syndromes and chronic inflammatory bowel diseases (in particular, ulcerative colitis). The use of CTC in the follow-up after surgery for CRC is achieving interesting evidences despite the fact that literature data are still relatively weak in terms of numerosity of the studied populations. In patients who underwent previous polypectomy CTC cannot be recommended as first test because debate is still open. It is desirable that in the future CTC would be the first-line and only diagnostic test for

  1. Clinical exome sequencing reports: current informatics practice and future opportunities.

    Science.gov (United States)

    Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon

    2017-11-01

    The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Clinical evaluation of phased array multicoil for spine MR imaging

    International Nuclear Information System (INIS)

    Miller, G.M.; Forbes, G.S.; Onofrio, B.M.; Rasmusson, J.J.

    1990-01-01

    Often, it is necessary to image the entire spinal canal or cord. Current surface coil technology necessitates a small field of view (FOV) and multiple coil placements, prolonging the examination. The Phased Array Multicoil (General Electric, Milwaukee, Wis) allows for high-resolution imaging of a larger segment of the spinal axis (48 cm), negating the need for multiple coil placements. The purpose of this paper is to determine whether, this technology can produce higher-quality images with equal or better expediency in a high-volume clinical practice. The studies were performed with a modified 1.5-T system (General Electric, Milwaukee, Wis). Multiple small surface coils are electronically linked so that each coil images only a small segment of the spinal column. The individual images are then fused to display one high-resolution 512-matrix image with up to a 48-cm FOV. A variety of four coil arrays were tested, including a 24-cm FOV dedicated cervical coil, 48-cm FOV shaped cervical/thoracic and straight thoracic/lumbar coils, and a six-coil array 75-cm entire spine coil. The images were then evaluated for overall quality, resolution, signal-to-noise ratio, and area of coverage

  3. Magnetic imaging of superconducting tapes to determine current flow

    Energy Technology Data Exchange (ETDEWEB)

    Brown, G. W. (Geoffrey W.); Hawley, M. E. (Marilyn E.); Foltyn, S. R. (Stephen R.); Mueller, F. M. (Fred M.)

    2001-01-01

    We have developed a magnetic imaging system that uses magnetoresistive read heads from computer hard disk drives to map the transport-current-induced magnetic field at the surface of superconducting tapes at liquid nitrogen temperature. Transport current pathways are determined from the 2-dimensional magnetic field maps using established inversion schemes. We examined the current flow in pulsed-laser-deposited YBa{sub 2}Cu{sub 3}O{sub 7-{delta}} a films patterned on single crystal SrTiO{sub 3} substrates and on a textured yttria-stabilized-zirconia layer deposited on an Inconel ribbon by ion beam assisted deposition. The transport current densities in all cases were consistent with the Critical State Model. For the Inconel-based sample, the transport current density maps have allowed us to observe defects and determine the region that limits the current carrying capacity of the structure.

  4. Lessons from the masters current concepts in astronomical image processing

    CERN Document Server

    2013-01-01

    There are currently thousands of amateur astronomers around the world engaged in astrophotography at increasingly sophisticated levels. Their ranks far outnumber professional astronomers doing the same and their contributions both technically and artistically are the dominant drivers of progress in the field today. This book is a unique collaboration of individuals, all world-renowned in their particular area, and covers in detail each of the major sub-disciplines of astrophotography. This approach offers the reader the greatest opportunity to learn the most current information and the latest techniques directly from the foremost innovators in the field today.   The book as a whole covers all types of astronomical image processing, including processing of eclipses and solar phenomena, extracting detail from deep-sky, planetary, and widefield images, and offers solutions to some of the most challenging and vexing problems in astronomical image processing. Recognized chapter authors include deep sky experts su...

  5. An experimental clinical evaluation of EIT imaging with ℓ1 data and image norms.

    Science.gov (United States)

    Mamatjan, Yasin; Borsic, Andrea; Gürsoy, Doga; Adler, Andy

    2013-09-01

    Electrical impedance tomography (EIT) produces an image of internal conductivity distributions in a body from current injection and electrical measurements at surface electrodes. Typically, image reconstruction is formulated using regularized schemes in which ℓ2-norms are used for both data misfit and image prior terms. Such a formulation is computationally convenient, but favours smooth conductivity solutions and is sensitive to outliers. Recent studies highlighted the potential of ℓ1-norm and provided the mathematical basis to improve image quality and robustness of the images to data outliers. In this paper, we (i) extended a primal-dual interior point method (PDIPM) algorithm to 2.5D EIT image reconstruction to solve ℓ1 and mixed ℓ1/ℓ2 formulations efficiently, (ii) evaluated the formulation on clinical and experimental data, and (iii) developed a practical strategy to select hyperparameters using the L-curve which requires minimum user-dependence. The PDIPM algorithm was evaluated using clinical and experimental scenarios on human lung and dog breathing with known electrode errors, which requires a rigorous regularization and causes the failure of reconstruction with an ℓ2-norm solution. The results showed that an ℓ1 solution is not only more robust to unavoidable measurement errors in a clinical setting, but it also provides high contrast resolution on organ boundaries.

  6. Imaging of current distributions in superconducting thin film structures

    International Nuclear Information System (INIS)

    Doenitz, D.

    2006-01-01

    Local analysis plays an important role in many fields of scientific research. However, imaging methods are not very common in the investigation of superconductors. For more than 20 years, Low Temperature Scanning Electron Microscopy (LTSEM) has been successfully used at the University of Tuebingen for studying of condensed matter phenomena, especially of superconductivity. In this thesis LTSEM was used for imaging current distributions in different superconducting thin film structures: - Imaging of current distributions in Josephson junctions with ferromagnetic interlayer, also known as SIFS junctions, showed inhomogeneous current transport over the junctions which directly led to an improvement in the fabrication process. An investigation of improved samples showed a very homogeneous current distribution without any trace of magnetic domains. Either such domains were not present or too small for imaging with the LTSEM. - An investigation of Nb/YBCO zigzag Josephson junctions yielded important information on signal formation in the LTSEM both for Josephson junctions in the short and in the long limit. Using a reference junction our signal formation model could be verified, thus confirming earlier results on short zigzag junctions. These results, which could be reproduced in this work, support the theory of d-wave symmetry in the superconducting order parameter of YBCO. Furthermore, investigations of the quasiparticle tunneling in the zigzag junctions showed the existence of Andreev bound states, which is another indication of the d-wave symmetry in YBCO. - The LTSEM study of Hot Electron Bolometers (HEB) allowed the first successful imaging of a stable 'Hot Spot', a self-heating region in HEB structures. Moreover, the electron beam was used to induce an - otherwise unstable - hot spot. Both investigations yielded information on the homogeneity of the samples. - An entirely new method of imaging the current distribution in superconducting interference devices

  7. Acute stroke magnetic resonance imaging: current status and future perspective

    International Nuclear Information System (INIS)

    Kloska, Stephan P.; Wintermark, Max; Engelhorn, Tobias; Fiebach, Jochen B.

    2010-01-01

    Cerebral stroke is one of the most frequent causes of permanent disability or death in the western world and a major burden in healthcare system. The major portion is caused by acute ischemia due to cerebral artery occlusion by a clot. The minority of strokes is related to intracerebral hemorrhage or other sources. To limit the permanent disability in ischemic stroke patients resulting from irreversible infarction of ischemic brain tissue, major efforts were made in the last decade. To extend the time window for thrombolysis, which is the only approved therapy, several imaging parameters in computed tomography and magnetic resonance imaging (MRI) have been investigated. However, the current guidelines neglect the fact that the portion of potentially salvageable ischemic tissue (penumbra) is not dependent on the time window but the individual collateral blood flow. Within the last years, the differentiation of infarct core and penumbra with MRI using diffusion-weighted images (DWI) and perfusion imaging (PI) with parameter maps was established. Current trials transform these technical advances to a redefined patient selection based on physiological parameters determined by MRI. This review article presents the current status of MRI for acute stroke imaging. A special focus is the ischemic stroke. In dependence on the pathophysiology of cerebral ischemia, the basic principle and diagnostic value of different MRI sequences are illustrated. MRI techniques for imaging of the main differential diagnoses of ischemic stroke are mentioned. Moreover, perspectives of MRI for imaging-based acute stroke treatment as well as monitoring of restorative stroke therapy from recent trials are discussed. (orig.)

  8. A HIPAA-compliant architecture for securing clinical images

    Science.gov (United States)

    Liu, Brent J.; Zhou, Zheng; Huang, H. K.

    2005-04-01

    The HIPAA (Health Insurance Portability and Accountability Act, Instituted April 2003) Security Standards mandate health institutions to protect health information against unauthorized use or disclosure. One approach to addressing this mandate is by utilizing user access control and generating audit trails of the various authorized as well as unauthorized user access of health data. Although most current clinical image systems (eg, PACS) have components that generate log files as a solution to address the HIPAA mandate, there is a lack of methodology to obtain and synthesize the pertinent data from the large volumes of log file data generated by these multiple components within a PACS. We have designed and developed a HIPAA Compliant Architecture specifically for tracking and auditing the image workflow of clinical imaging systems such as PACS. As an initial first step, a software toolkit was implemented based on the HIPAA Compliant architecture. The toolkit was implemented within a testbed PACS Simulator located in the Image Processing and Informatics (IPI) lab at the University of Southern California. Evaluation scenarios were developed where different user types performed legal and illegal access of PACS image data within each of the different components in the PACS Simulator. Results were based on whether the scenarios of unauthorized access were correctly identified and documented as well as normal operational activity.

  9. Imaging vascular function for early stage clinical trials using dynamic contrast-enhanced magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leach, M.O.; Orton, M. [Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Morgan, B. [Univ. of Leicester, College of Medicine, Biological Sciences and Psychology, Leicester (United Kingdom); Tofts, P.S. [Brighton and Sussex Medical School, Univ. of Sussex, Clinical Imaging Sciences Centre, Sussex (United Kingdom); Buckley, D.L. [University of Leeds, Division of Medical Physics, Leeds (United Kingdom); Huang, W. [Oregon Health and Science Univ., Advanced Imaging Research Centre, Portland, OR (United States); Horsfield, M.A. [Medical Physics Section, Leicester Royal Infirmary, Dept. of Cardiovascular Sciences, Leicester (United Kingdom); Chenevert, T.L. [Univ. of Michigan Health System, Ann Arbor, MI (United States); Collins, D.J. [Royal Marsden Hospital NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Jackson, A. [Univ. of Manchester, Wolfson Molecular Imaging Centre, Withington, Manchester, M20 3LJ (United Kingdom); Lomas, D. [Univ. of Cambridge, Dept. of Radiology, Cambridge (United Kingdom); Whitcher, B. [Unit 2 Greenways Business Park, Mango Solutions, Chippenham (United Kingdom); Clarke, L. [Cancer Imaging Program, Imaging Technology Development Branch, Rockville, MD (United States); Plummer, R. [Univ. of Newcastle Upon Tyne, The Medical School, Medical Oncology, Northern Inst. for Cancer Research, Newcastle Upon Tyne (United Kingdom); Judson, I. [Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Jones, R. [Beatson West of Scotland Cancer Centre, Glasgow (United Kingdom); Alonzi, R. [Mount Vernon Cancer Centre, Northwood (United Kingdom); Brunner, T. [Gray Inst. for Radiation, Oncology and Biology, Oxford (United Kingdom); Koh, D.M. [Royal Marsden NHS Foundation Trust, Diagnostic Radiology, Sutton, Surrey (United Kingdom)] [and others

    2012-07-15

    Many therapeutic approaches to cancer affect the tumour vasculature, either indirectly or as a direct target. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important means of investigating this action, both pre-clinically and in early stage clinical trials. For such trials, it is essential that the measurement process (i.e. image acquisition and analysis) can be performed effectively and with consistency among contributing centres. As the technique continues to develop in order to provide potential improvements in sensitivity and physiological relevance, there is considerable scope for between-centre variation in techniques. A workshop was convened by the Imaging Committee of the Experimental Cancer Medicine Centres (ECMC) to review the current status of DCE-MRI and to provide recommendations on how the technique can best be used for early stage trials. This review and the consequent recommendations are summarised here. (orig.)

  10. Revisiting renovascular imaging for renal sympathetic denervation: current techniques and applications

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei; Tan, Cher Heng [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore); Ho, Hee Hwa; Tan, Julian Ko Beng; Ong, Paul Jau Leong [Tan Tock Seng Hospital, Department of Cardiology, Singapore (Singapore)

    2014-08-28

    Renal sympathetic denervation (RDN) is an emerging technique in the treatment of resistant hypertension, most commonly performed using an endovascular approach. Clinical and anatomical criteria for RDN are well established and imaging plays an integral role in selecting patients with suitable anatomy, procedural planning and device selection. Nevertheless, the current body of literature surrounding imaging related to RDN remains limited. The purpose of this article is to illustrate the expectations and limitations of various imaging techniques, including Doppler ultrasound, CT angiography, MR angiography and newer techniques such as non-contrast MR angiography, in the context of RDN. (orig.)

  11. Revisiting renovascular imaging for renal sympathetic denervation: current techniques and applications

    International Nuclear Information System (INIS)

    Pua, Uei; Tan, Cher Heng; Ho, Hee Hwa; Tan, Julian Ko Beng; Ong, Paul Jau Leong

    2015-01-01

    Renal sympathetic denervation (RDN) is an emerging technique in the treatment of resistant hypertension, most commonly performed using an endovascular approach. Clinical and anatomical criteria for RDN are well established and imaging plays an integral role in selecting patients with suitable anatomy, procedural planning and device selection. Nevertheless, the current body of literature surrounding imaging related to RDN remains limited. The purpose of this article is to illustrate the expectations and limitations of various imaging techniques, including Doppler ultrasound, CT angiography, MR angiography and newer techniques such as non-contrast MR angiography, in the context of RDN. (orig.)

  12. Current status of radionuclide imaging in valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Boucher, C.A.; Okada, R.D.; Pohost, G.M.

    1980-12-18

    The current state-of-the-art in radionuclide imaging of valvular heart disease is based on different angiographic patterns in three left-sided valve abnormalities: pressure overload, volume overload, and inflow obstruction. In pressure overload, the left ventricle has normal dimensions or is minimally dilated the volume overload involves a left ventricular dilatation with a normal or reduced ejection fraction at rest the left ventricular function in inflow obstruction is normal, but in some cases may be depressed. Radionuclide angiography evaluates the effect of a valve abnormality on cardiac chamber and function thallium-201 imaging diagnoses regional myocardial blood flow and cell integrity and can evaluate the associated coronary artery disease.

  13. Current status of radionuclide imaging in valvular heart disease

    International Nuclear Information System (INIS)

    Boucher, C.A.; Okada, R.D.; Pohost, G.M.

    1980-01-01

    The current state-of-the-art in radionuclide imaging of valvular heart disease is based on different angiographic patterns in three left-sided valve abnormalities: pressure overload, volume overload, and inflow obstruction. In pressure overload, the left ventricle has normal dimensions or is minimally dilated the volume overload involves a left ventricular dilatation with a normal or reduced ejection fraction at rest the left ventricular function in inflow obstruction is normal, but in some cases may be depressed. Radionuclide angiography evaluates the effect of a valve abnormality on cardiac chamber and function thallium-201 imaging diagnoses regional myocardial blood flow and cell integrity and can evaluate the associated coronary artery disease

  14. Cardiac magnetic resonance imaging in clinical practice

    Directory of Open Access Journals (Sweden)

    Adriana Dias Barranhas

    2014-01-01

    Full Text Available Objective To evaluate and describe indications, mainly diagnoses and cardiac magnetic resonance imaging findings observed in clinical practice. Materials and Methods Retrospective and descriptive study of cardiac magnetic resonance performed at a private hospital and clinic in the city of Niterói, RJ, Brazil, in the period from May 2007 to April 2011. Results The sample included a total of 1000 studies performed in patients with a mean age of 53.7 ± 16.2 years and predominance for male gender (57.2%. The majority of indications were related to assessment of myocardial perfusion at rest and under pharmacological stress (507/1000; 51%, with positive results in 36.2% of them. Suspected myocarditis was the second most frequent indication (140/1000; 14%, with positive results in 63.4% of cases. These two indications were followed by study of arrhythmias (116/1000; 12%, myocardial viability (69/1000; 7% and evaluation of cardiomyopathies (47/1000; 5%. In a subanalysis, it was possible to identify that most patients were assessed on an outpatient basis (58.42%. Conclusion Cardiac magnetic resonance has been routinely performed in clinical practice, either on an outpatient or emergency/inpatient basis, and myocardial ischemia represented the main indication, followed by investigation of myocarditis, arrhythmogenic right ventricular dysplasia and myocardial viability.

  15. Role of diffusion weighted imaging in musculoskeletal infections: Current perspectives

    International Nuclear Information System (INIS)

    Kumar, Yogesh; Khaleel, Mohammad; Boothe, Ethan; Awdeh, Haitham; Wadhwa, Vibhor; Chhabra, Avneesh

    2017-01-01

    Accurate diagnosis and prompt therapy of musculoskeletal infections are important prognostic factors. In most cases, clinical history, examination and laboratory findings help one make the diagnosis, and routine magnetic resonance imaging (MRI) is useful to identify the extent of the disease process. However, in many situations, a routine MRI may not be specific enough especially if the patient cannot receive contrast intravenously, thereby delaying the appropriate treatment. Diffusion-weighted imaging (DWI) can help in many such situations by providing additional information, accurate characterization and defining the extent of the disease, so that prompt treatment can be initiated. In this article, we illustrate the imaging findings of the spectrum of musculoskeletal infections, emphasizing the role of DWI in this domain. (orig.)

  16. Role of diffusion weighted imaging in musculoskeletal infections: Current perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Yogesh [Yale New Haven Health System at Bridgeport Hospital, Department of Radiology, Bridgeport, CT (United States); Khaleel, Mohammad [UT Southwestern Medical Center, Department of Orthopaedic Surgery, Dallas, TX (United States); Boothe, Ethan; Awdeh, Haitham [UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Wadhwa, Vibhor [University of Arkansas for Medical Sciences, Department of Radiology, Little Rock, AR (United States); Chhabra, Avneesh [UT Southwestern Medical Center, Department of Orthopaedic Surgery, Dallas, TX (United States); UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States)

    2017-01-15

    Accurate diagnosis and prompt therapy of musculoskeletal infections are important prognostic factors. In most cases, clinical history, examination and laboratory findings help one make the diagnosis, and routine magnetic resonance imaging (MRI) is useful to identify the extent of the disease process. However, in many situations, a routine MRI may not be specific enough especially if the patient cannot receive contrast intravenously, thereby delaying the appropriate treatment. Diffusion-weighted imaging (DWI) can help in many such situations by providing additional information, accurate characterization and defining the extent of the disease, so that prompt treatment can be initiated. In this article, we illustrate the imaging findings of the spectrum of musculoskeletal infections, emphasizing the role of DWI in this domain. (orig.)

  17. Practical Approach for the Clinical Use of Dopamine Transporter Imaging

    International Nuclear Information System (INIS)

    Kim, Jae Seung

    2008-01-01

    Dopamine transporter imaging is useful in the diagnosis of Parkinson's disease and the most successful technique in the clinical use of neuroreceptor imaging. Recently, several radiopharmaceuticals including I-123 FP-CIT, Tc-99m TRODAT, and F-18 FP-CIT for dopamine transporter imaging have been approved for the routine clinical use in several European countries, Taiwan and Korea, respectively. This review summarized the practical issue for the routine clinical examination of dopamine transporter imaging

  18. Advanced Imaging in Femoroacetabular Impingement: Current State and Future Prospects

    OpenAIRE

    Bittersohl, Bernd; Hosalkar, Harish S.; Hesper, Tobias; Tiderius, Carl Johan; Zilkens, Christoph; Krauspe, R?diger

    2015-01-01

    Symptomatic femoroacetabular impingement (FAI) is now a known precursor of early osteoarthritis (OA) of the hip. In terms of clinical intervention, the decision between joint preservation and joint replacement hinges on the severity of articular cartilage degeneration. The exact threshold during the course of disease progression when the cartilage damage is irreparable remains elusive. The intention behind radiographic imaging is to accurately identify the morphology of osseous structural abn...

  19. Mineralized Collagen: Rationale, Current Status, and Clinical Applications

    Directory of Open Access Journals (Sweden)

    Zhi-Ye Qiu

    2015-07-01

    Full Text Available This paper presents a review of the rationale for the in vitro mineralization process, preparation methods, and clinical applications of mineralized collagen. The rationale for natural mineralized collagen and the related mineralization process has been investigated for decades. Based on the understanding of natural mineralized collagen and its formation process, many attempts have been made to prepare biomimetic materials that resemble natural mineralized collagen in both composition and structure. To date, a number of bone substitute materials have been developed based on the principles of mineralized collagen, and some of them have been commercialized and approved by regulatory agencies. The clinical outcomes of mineralized collagen are of significance to advance the evaluation and improvement of related medical device products. Some representative clinical cases have been reported, and there are more clinical applications and long-term follow-ups that currently being performed by many research groups.

  20. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  1. Current literature and imaging techniques of aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL)

    International Nuclear Information System (INIS)

    Duggan, P.J.; Burke, C.J.; Saha, S.; Moonim, M.; George, M.; Desai, A.; Houghton, R.

    2013-01-01

    Aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL) are a recognized complication of metal-on-metal bearing hip prostheses. There is an impending concern regarding the future investigation and management of patients who have received such implants. The current literature is discussed, and the current guidelines for management of these patients in the UK are reviewed. The various imaging techniques available, such as computed tomography, metal artefact reduction magnetic resonance imaging, and ultrasound are discussed and evaluated with respect to the assessment of patients with suspected ALVAL. The histopathological findings are discussed with images of the tissue changes provided. Images of the radiological findings are also provided for all general radiological methods. ALVAL and its radiological presentation is an important issue that unfortunately may become a significant clinical problem

  2. Challenges of implementing fibromyalgia treatment guidelines in current clinical practice.

    Science.gov (United States)

    Arnold, Lesley M; Clauw, Daniel J

    2017-09-01

    The current diagnostic and treatment pathway for patients with fibromyalgia (FM) is lengthy, complex, and characterized by multiple physician visits with an average 2-year wait until diagnosis. It is clear that effective identification and appropriate treatment of FM remain a challenge in current clinical practice. Ideally, FM management involves a multidisciplinary approach with the preferable patient pathway originating in primary care but supported by a range of health care providers, including referral to specialist care when necessary. After the publication of individual clinical studies, high-quality reviews, and meta-analyses, recently published FM treatment guidelines have transitioned from an expert consensus to an evidence-based approach. Evidence-based guidelines provide a framework for ensuring early diagnosis and timely adoption of appropriate treatment. However, for successful outcomes, FM treatments must adopt a more holistic approach, which addresses more than just pain. Impact on the associated symptoms of fatigue and cognitive problems, sleep and mood disturbances, and lowered functional status are also important in judging the success of FM therapy. Recently published guidelines recommend the adoption of a symptom-based approach to guide pharmacologic treatment. Emerging treatment options for FM may be best differentiated on the basis of their effect on comorbid symptoms that are often associated with pain (e.g. sleep disturbance, mood, fatigue). The current review discusses the most recently published Canadian guidelines and the implications of the recent European League Against Rheumatism (EULAR) recommendations, with a focus on the challenges of implementing these guidelines in current clinical practice.

  3. Functional imaging in oncology. Clinical applications. Vol. 2

    International Nuclear Information System (INIS)

    Luna, Antonio; Vilanova, Joan C.

    2014-01-01

    Easy-to-read manual on new functional imaging techniques in oncology. Explains current clinical applications and outlines future avenues. Includes numerous high-quality illustrations to highlight the major teaching points. In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, including diffusion MRI, perfusion CT and MRI, dual-energy CT, spectroscopy, dynamic contrast-enhanced ultrasonography, PET, and hybrid modalities. This second volume considers the applications and benefits of these techniques in a wide range of tumor types, including their role in diagnosis, prediction of treatment outcome, and early evaluation of treatment response. Each chapter addresses a specific malignancy and is written by one or more acclaimed experts. The lucid text is complemented by numerous high-quality illustrations that highlight key features and major teaching points.

  4. Functional imaging in oncology. Clinical applications. Vol. 2

    Energy Technology Data Exchange (ETDEWEB)

    Luna, Antonio [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Radiology; MRI Health Time Group, Jaen (Spain); Vilanova, Joan C. [Girona Univ. (Spain). Clinica Girona - Hospital Sta. Caterina; Hygino da Cruz, L. Celso Jr. (ed.) [CDPI and IRM, Rio de Janeiro (Brazil). Dept. of Radiology; Rossi, Santiago E. [Centro de Diagnostico, Buenos Aires (Argentina)

    2014-06-01

    Easy-to-read manual on new functional imaging techniques in oncology. Explains current clinical applications and outlines future avenues. Includes numerous high-quality illustrations to highlight the major teaching points. In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, including diffusion MRI, perfusion CT and MRI, dual-energy CT, spectroscopy, dynamic contrast-enhanced ultrasonography, PET, and hybrid modalities. This second volume considers the applications and benefits of these techniques in a wide range of tumor types, including their role in diagnosis, prediction of treatment outcome, and early evaluation of treatment response. Each chapter addresses a specific malignancy and is written by one or more acclaimed experts. The lucid text is complemented by numerous high-quality illustrations that highlight key features and major teaching points.

  5. Is current clinical practice modified about intraoperative breast irradiation?

    Science.gov (United States)

    Massa, Michela; Franchelli, Simonetta; Panizza, Renzo; Massa, Tiberio

    2016-04-01

    After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

  6. Imaging techniques in the management of chronic kidney disease: current developments and future perspectives.

    Science.gov (United States)

    Herget-Rosenthal, Stefan

    2011-05-01

    The measurement of both renal function and structure is critical in clinical nephrology to detect, stage, and monitor chronic kidney disease (CKD). Current imaging modalities especially ultrasound (US), computed tomography, and magnetic resonance imaging (MRI) provide adequate information on structural changes but little on functional impairment in CKD. Although not yet considered first-line procedures for evaluating patients with renal disease, new US and MR imaging techniques may permit the assessment of renal function in the near future. Combined with established imaging techniques, contrast-enhanced US, dynamic contrast-enhanced MRI, blood oxygen level dependency MRI, or diffusion-weighted imaging may provide rapid, accurate, simultaneous, and noninvasive imaging of the structure of kidneys, macrovascular and microvascular renal perfusion, oxygenation, and glomerular filtration rate. Recent developments in molecular imaging indicate that pathophysiological pathways of renal diseases such as apoptosis, coagulation, fibrosis, and ischemia will be visualized at the tissue level. These major advances in imaging and developments in hardware and software could enable comprehensive imaging of renal structure and function in four dimensions (three dimensions plus time), and imaging is expected to play an increasing role in the management of CKD. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Current and future trends in marine image annotation software

    Science.gov (United States)

    Gomes-Pereira, Jose Nuno; Auger, Vincent; Beisiegel, Kolja; Benjamin, Robert; Bergmann, Melanie; Bowden, David; Buhl-Mortensen, Pal; De Leo, Fabio C.; Dionísio, Gisela; Durden, Jennifer M.; Edwards, Luke; Friedman, Ariell; Greinert, Jens; Jacobsen-Stout, Nancy; Lerner, Steve; Leslie, Murray; Nattkemper, Tim W.; Sameoto, Jessica A.; Schoening, Timm; Schouten, Ronald; Seager, James; Singh, Hanumant; Soubigou, Olivier; Tojeira, Inês; van den Beld, Inge; Dias, Frederico; Tempera, Fernando; Santos, Ricardo S.

    2016-12-01

    Given the need to describe, analyze and index large quantities of marine imagery data for exploration and monitoring activities, a range of specialized image annotation tools have been developed worldwide. Image annotation - the process of transposing objects or events represented in a video or still image to the semantic level, may involve human interactions and computer-assisted solutions. Marine image annotation software (MIAS) have enabled over 500 publications to date. We review the functioning, application trends and developments, by comparing general and advanced features of 23 different tools utilized in underwater image analysis. MIAS requiring human input are basically a graphical user interface, with a video player or image browser that recognizes a specific time code or image code, allowing to log events in a time-stamped (and/or geo-referenced) manner. MIAS differ from similar software by the capability of integrating data associated to video collection, the most simple being the position coordinates of the video recording platform. MIAS have three main characteristics: annotating events in real time, posteriorly to annotation and interact with a database. These range from simple annotation interfaces, to full onboard data management systems, with a variety of toolboxes. Advanced packages allow to input and display data from multiple sensors or multiple annotators via intranet or internet. Posterior human-mediated annotation often include tools for data display and image analysis, e.g. length, area, image segmentation, point count; and in a few cases the possibility of browsing and editing previous dive logs or to analyze the annotations. The interaction with a database allows the automatic integration of annotations from different surveys, repeated annotation and collaborative annotation of shared datasets, browsing and querying of data. Progress in the field of automated annotation is mostly in post processing, for stable platforms or still images

  8. Clinical potential for imaging in patients with asthma and other lung disorders.

    Science.gov (United States)

    DeBoer, Emily M; Spielberg, David R; Brody, Alan S

    2017-01-01

    The ability of lung imaging to phenotype patients, determine prognosis, and predict response to treatment is expanding in clinical and translational research. The purpose of this perspective is to describe current imaging modalities that might be useful clinical tools in patients with asthma and other lung disorders and to explore some of the new developments in imaging modalities of the lung. These imaging modalities include chest radiography, computed tomography, lung magnetic resonance imaging, electrical impedance tomography, bronchoscopy, and others. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Rectocele repair using biomaterial augmentation: current documentation and clinical experience.

    Science.gov (United States)

    Altman, Daniel; Mellgren, Anders; Zetterström, Jan

    2005-11-01

    Although the etiology of rectocele remains debated, surgical innovations are currently promoted to improve anatomic outcome while avoiding dyspareunia and alleviating rectal emptying difficulties following rectocele surgery. Use of biomaterials in rectocele repair has become widespread in a short time, but the clinical documentation of their effectiveness and complications is limited. Medline and the Cochrane database were searched electronically from 1964 to May 2005 using the Pubmed and Ovid search engines. All English language publications including any of the search terms "rectocele," "implant," "mesh," "biomaterial," "prolapse," "synthetical," "pelvic floor," "biological," and "compatibility" were reviewed. This review outlines the basic principles for use of biomaterials in pelvic reconstructive surgery and provides a condensation of peer-reviewed articles describing clinical use of biomaterials in rectocele surgery. Historical and new concepts in rectocele surgery are discussed. Factors of importance for human in vivo biomaterial compatibility are presented together with current knowledge from clinical studies. Potential risks and problems associated with the use of biomaterials in rectocele and pelvic reconstructive surgery in general are described. Although use of biomaterials in rectocele and other pelvic organ prolapse surgery offers exciting possibilities, it raises treatment costs and may be associated with unknown and potentially severe complications at short and long term. Clinical benefits are currently unknown and need to be proven in clinical studies. Obstetricians & Gynecologists, Family Physicians After completion of this article, the reader should be able to explain that the objective of surgical treatment is to improve anatomic outcome and alleviate rectal emptying difficulties, describe the efficacy of biomaterials in rectocele repair, and summarize the potential risks and problems associated with use of biomaterials in rectocele and pelvic

  10. WE-D-BRB-03: Current State of Volumetric Image Guidance for Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hua, C. [St. Jude Children’s Research Hospital (United States)

    2016-06-15

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  11. WE-D-BRB-03: Current State of Volumetric Image Guidance for Proton Therapy

    International Nuclear Information System (INIS)

    Hua, C.

    2016-01-01

    The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

  12. Current clinical research of immunoglobulin G4-related orbital disease

    Directory of Open Access Journals (Sweden)

    Yang Wang

    2016-05-01

    Full Text Available Immunoglobulin G4-related disease(IgG4-related diseasehas received lots of attention in medical community as a recently recognized fibro-inflammatory condition. It is characterized by infiltration of IgG4-immunopositive plasmacytes and concentration of elevated serum IgG4. IgG4-related disease shows organ enlargement or nodular/hyperplastic lesions in various organs including the pancreas, hepatobiliary tract and orbit, which is called IgG4-related orbital disease. The diagnostic criteria for IgG4-related disease and IgG4-related orbital disease has recently been established, which is based on clinical, imaging and histopathologic features of the orbital lesions. Besides, attention should be drawn to the differentiation from other diseases. The treatment is empirical including corticosteroids, immunosuppressive drugs, radiotherapy, and rituximab. This article reviews clinical progression of IgG4-related orbital disease.

  13. Treatment of sepsis: current status of clinical immunotherapy.

    LENUS (Irish Health Repository)

    O'Callaghan, A

    2012-02-03

    While antibiotics address the root cause of sepsis--that of pathogen infection--they fail to provide an adequate cure for the condition. Currently, 30% to 50% of septic patients die, and this figure is likely to increase in line with the proliferation of multi-drug resistant bacteria. With an increased understanding of the immune response, it has been proposed that modulation of this defence mechanism offers the best hope of cure. Many entry-points in the immune system have been identified and targeted therapies have been developed,but why are these not in routine clinical practice? This review examines the latest evidence for the use of immuno-modulating drugs, obtained from human clinical trials. We discuss cytokine-based therapies, steroids and anti-coagulants. Finally, consideration is given as to why successful therapies in the laboratory, and in vivo models, do not automatically translate into clinical benefit

  14. Practical evaluation of clinical image quality (4). Determination of image quality in digital radiography system

    International Nuclear Information System (INIS)

    Katayama, Reiji

    2016-01-01

    Recently, for medical imaging, digital radiography systems are widely used in clinical practices. However, a study in the past reported that a patient radiation exposure level by digital radiography is in fact not lower than that by analog radiography system. High level of attention needs to be paid for over-exposure when using the conventional analog radiography with a screen and a film, as it results in high density of the film. However, for digital radiography systems, since the automatic adjusting function of image density is equipped with them, no attention for radiation dose need to be paid. Thus technologists tend to be careless and results in higher chance for over-exposure. Current digital radiography systems are high-performance in the image properties and capable of patient dose reduction. Especially, the image quality of the flat panel detector system is recognized, higher than that of the computed radiography system by imaging plates, in both objective and subjective evaluations. Therefore, we technologists are responsible for optimizing the balance between the image quality of the digital radiogram and the radiation dose required for each case. Moreover, it is also required for us as medical technologists to make effective use of such evaluation result of medical images for patients. (author)

  15. Radiotracers for SPECT imaging. Current scenario and future prospects

    International Nuclear Information System (INIS)

    Adak, S.; Vijaya Raj, K.K.; Mandal, S.

    2012-01-01

    Single photon emission computed tomography (SPECT) has been the cornerstone of nuclear medicine and today it is widely used to detect molecular changes in cardiovascular, neurological and oncological diseases. While SPECT has been available since the 1980s, advances in instrumentation hardware, software and the availability of new radiotracers that are creating a revival in SPECT imaging are reviewed in this paper. The biggest change in the last decade has been the fusion of CT with SPECT, which has improved attenuation correction and image quality. Advances in collimator design, replacement of sodium iodide crystals in the detectors with cadmium zinc telluride (CZT) detectors as well as advances in software and reconstruction algorithms have all helped to retain SPECT as a much needed and used technology. Today, a wide spectrum of radiotracers is available for use in cardiovascular, neurology and oncology applications. The development of several radiotracers for neurological disorders is briefly described in this review, including [ 123 I]FP-CIT (DaTSCAN trademark) available for Parkinson's disease. In cardiology, while technetium-99m labeled tetrofosmin and technetium-99m labeled sestamibi have been well known for myocardial perfusion imaging, we describe a recently completed multicenter clinical study on the use of [ 123 I]mIBG (AdreView trademark) for imaging in chronic heart failure patients. For oncology, while bone scanning has been prevalent, newer radiotracers that target cancer mechanisms are being developed. Technetium-99m labeled RGD peptides have been reported in the literature that can be used for imaging angiogenesis, while technetium-99m labeled duramycin has been used to image apoptosis. While PET/CT is considered to be the more advanced technology particularly for oncology applications, SPECT continues to be the modality of choice and the workhorse in many hospitals and nuclear medicine centers. The cost of SPECT instruments also makes them more

  16. Radiotracers for SPECT imaging. Current scenario and future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Adak, S.; Vijaya Raj, K.K.; Mandal, S. [GE Healthcare Medical Diagnostics, John F. Welch Technology Center, Bangalore (India).; Bhalla, R.; Pickett, R.; Luthra, S.K. [GE Healthcare Medical Diagnostics, The Grove Centre, Amersham (United Kingdom)

    2012-07-01

    Single photon emission computed tomography (SPECT) has been the cornerstone of nuclear medicine and today it is widely used to detect molecular changes in cardiovascular, neurological and oncological diseases. While SPECT has been available since the 1980s, advances in instrumentation hardware, software and the availability of new radiotracers that are creating a revival in SPECT imaging are reviewed in this paper. The biggest change in the last decade has been the fusion of CT with SPECT, which has improved attenuation correction and image quality. Advances in collimator design, replacement of sodium iodide crystals in the detectors with cadmium zinc telluride (CZT) detectors as well as advances in software and reconstruction algorithms have all helped to retain SPECT as a much needed and used technology. Today, a wide spectrum of radiotracers is available for use in cardiovascular, neurology and oncology applications. The development of several radiotracers for neurological disorders is briefly described in this review, including [{sup 123}I]FP-CIT (DaTSCAN trademark) available for Parkinson's disease. In cardiology, while technetium-99m labeled tetrofosmin and technetium-99m labeled sestamibi have been well known for myocardial perfusion imaging, we describe a recently completed multicenter clinical study on the use of [{sup 123}I]mIBG (AdreView trademark) for imaging in chronic heart failure patients. For oncology, while bone scanning has been prevalent, newer radiotracers that target cancer mechanisms are being developed. Technetium-99m labeled RGD peptides have been reported in the literature that can be used for imaging angiogenesis, while technetium-99m labeled duramycin has been used to image apoptosis. While PET/CT is considered to be the more advanced technology particularly for oncology applications, SPECT continues to be the modality of choice and the workhorse in many hospitals and nuclear medicine centers. The cost of SPECT instruments also

  17. CT myocardial perfusion imaging: current status and future perspectives.

    Science.gov (United States)

    Yang, Dong Hyun; Kim, Young-Hak

    2017-07-01

    Computed tomography myocardial perfusion (CTP) combined with coronary computed tomography angiography (CCTA) may constitute a "1-stop shop" for the noninvasive diagnosis of hemodynamically significant coronary stenosis during a single CT examination. CTP shows high diagnostic performance and provides incremental value over CCTA for the detection of hemodynamically significant coronary stenosis in patients with a high Agatston calcium score or coronary artery stents. Future studies should determine the optimal protocol and clinical value of CTP for guiding revascularization strategy and prognostication. In this article, we review the current status and future perspectives of CTP, focusing on technical considerations, clinical applications, and future research topics.

  18. Magnetic resonance imaging for clinical management of rectal cancer

    DEFF Research Database (Denmark)

    Beets-Tan, Regina G H; Lambregts, Doenja M J; Maas, Monique

    2018-01-01

    OBJECTIVES: To update the 2012 ESGAR consensus guidelines on the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. METHODS: Fourteen abdominal imaging experts from the European Society of Gastrointestinal and Abdomin...

  19. Current status of paediatric post-mortem imaging: an ESPR questionnaire-based survey

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Rijn, Rick R. van [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Sebire, Neil J. [Great Ormond Street Hospital for Children, Department of Pathology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom)

    2014-03-15

    The use of post-mortem imaging, including skeletal radiography, CT and MRI, is increasing, providing a minimally invasive alternative to conventional autopsy techniques. The development of clinical guidelines and national standards is being encouraged, particularly for cross-sectional techniques. To outline the current practice of post-mortem imaging amongst members of the European Society of Paediatric Radiology (ESPR). We e-mailed an online questionnaire of current post-mortem service provisions to members of the ESPR in January 2013. The survey included direct questions about what services were offered, the population imaged, current techniques used, imaging protocols, reporting experience and intended future involvement. Seventy-one percent (47/66) of centres from which surveys were returned reported performing some form of post-mortem imaging in children, of which 81 % perform radiographs, 51% CT and 38% MRI. Eighty-seven percent of the imaging is performed within the radiology or imaging departments, usually by radiographers (75%), and 89% is reported by radiologists, of which 64% is reported by paediatric radiologists. Overall, 72% of positive respondents have a standardised protocol for radiographs, but only 32% have such a protocol for CT and 27% for MRI. Sixty-one percent of respondents wrote that this is an important area that needs to be developed. Overall, the majority of centres provide some post-mortem imaging service, most of which is performed within an imaging department and reported by a paediatric radiologist. However, the populations imaged as well as the details of the services offered are highly variable among institutions and lack standardisation. We have identified people who would be interested in taking this work forwards. (orig.)

  20. The current status of imaging diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Liu Fang; Tang Guangcai

    2013-01-01

    In recent years, the incidence and the mortality rate of female breast cancer in our country is increasing, Early diagnosis of breast cancer is particularly important. Precious preoperative staging in the breast cancer is advantageous for the treatment planning. Evaluating the efficacy of chemotherapy is beneficial for adjusting the follow-up plan. Imaging examination has become an important role in breast cancer management. At present, commonly used equipment include mammography, ultrasound, CT, and MRI, etc. This article reviews the present study status of these tools in diagnosis of breast cancer. A reasonable and effective choice of those tools can facilitate clinic diagnosis and treatment. (authors)

  1. The role of hybrid SPECT-CT in oncology: current and emerging clinical applications

    International Nuclear Information System (INIS)

    Chowdhury, F.U.; Scarsbrook, A.F.

    2008-01-01

    Single photon emission computed tomography - computed tomography (SPECT-CT) is an emerging dual-modality imaging technique with many established and potential clinical applications in the field of oncology. To date, there has been a considerable emphasis on the benefits of integrated positron emission tomography - computed tomography (PET-CT) in oncology, but relatively little focus on the clinical utility of SPECT-CT. As with PET-CT, accurate co-registration of anatomical and functional data from a combined SPECT-CT camera often provides complementary diagnostic information. Both sensitivity (superior disease localization) and specificity (exclusion of false-positives due to physiological tracer uptake) are improved, and the functional significance of indeterminate lesions detected on cross-sectional imaging can be defined. This article will review the scope of hybrid SPECT-CT in oncology and illustrate both current and emerging clinical applications

  2. Assessment of lung ventilation by MR imaging: current status and future perspectives

    International Nuclear Information System (INIS)

    Kauczor, Hans-Ulrich; Hanke, Alexander; Beek, Edwin J.R. van

    2002-01-01

    The aim of this paper is to review the present status of novel MRI techniques as a new important instrument for functional ventilation imaging. The current status and future perspectives in research and clinical applications are summarized. Morphological lung imaging is based on chest radiography and computed tomography, whereas scintigraphy is used for ventilation imaging. During recent years, MRI has emerged as a new means for functional imaging of ventilation. Aerosolized contrast agents and oxygen are used in proton imaging, whereas non-proton imaging relies on fluorine compounds, such as sulfur hexafluoride and perfluorcarbons, or on hyperpolarized noble gases, such as helium-3 or xenon-129. All the gases are administered as inhaled ''contrast agents'' for imaging of the airways and airspaces. In general, straightforward images demonstrate the homogeneity of ventilation in a breath-hold and allow for determination of ventilated lung. The different properties of the different compounds enable the measurement of additional functional parameters. They comprise airspace size, regional oxygen partial pressure, and analysis of ventilation distribution, ventilation/perfusion ratios, and gas exchange, including oxygen uptake. Novel MRI techniques provide the potential for functional imaging of ventilation. The next steps include definition of the value and the potential of the different contrast mechanisms as well as determination of the significance of the functional information with regard to physiological research and patient management in chronic obstructive pulmonary disease and others. (orig.)

  3. Characterizing POLG ataxia: clinics, electrophysiology and imaging.

    Science.gov (United States)

    Synofzik, Matthis; Srulijes, Karin; Godau, Jana; Berg, Daniela; Schöls, Ludger

    2012-12-01

    Mutations in the mitochondrial DNA polymerase gamma (POLG) cause a highly pleomorphic disease spectrum, and reports about their frequencies in ataxia populations yield equivocal results. This leads to uncertainties about the role of POLG genetics in the workup of patients with unexplained ataxia. A comprehensive characterization of POLG-associated ataxia (POLG-A) will help guide genetic diagnostics and advance our understanding of the disease processes underlying POLG-A. Thirteen patients with POLG-A were assessed by standardized clinical investigation, nerve conduction studies, motor-evoked potentials, magnetic resonance imaging (MRI) and transcranial sonography (TCS). The findings were compared with 13 matched patients with Friedreich's ataxia (FA). In addition to the well-known POLG-associated features of chronic external ophthalmoplegia (100 %), areflexia to the lower extremity (100 %), impaired vibration sense (100 %), bilateral ptosis (69 %) and epilepsy (38 %), also hyperkinetic movement disorders were frequent in POLG-A patients, including chorea (31 %), dystonia (31 %) and myoclonus (23 %). Similar to FA, polyneuropathy was of sensory axonal type (100 %). In contrast to FA, none of the POLG-A patients showed impaired central motor conduction. TCS demonstrated less enlargement of the fourth ventricle and more diffuse cerebellar hyperechogenicity in POLG-A. Corresponding to TCS, MRI revealed no or only mild cerebellar atrophy in most POLG-A patients (85 %). POLG ataxia presents with the clinical characteristics of both afferent and cerebellar ataxia. Cerebellar alterations diffusely involve various parts of the cerebellum, yet cerebellar atrophy is generally mild. POLG-A presents with a high load of distinct non-ataxia features, namely, sensory neuropathy, external ophthalmoplegia, ptosis, epilepsy and/or hyperkinetic movement disorders. Involvement of the corticospinal tract, however, is rare.

  4. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    International Nuclear Information System (INIS)

    Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun

    2012-01-01

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  5. MR imaging assessment of clinical problems in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, Jose A.; Roca, Yolanda; Aguilera, Carlos [Department of CT and MR Imaging, Hospital Duran i Reynals, Universitaria de Bellvitge, Barcelona (Spain); Narvaez, Javier [Department of Medicine, Delfos Medical Center, Barcelona (Spain)

    2002-07-01

    Although MR imaging has been increasingly recognized as a useful tool in the diagnosis of early rheumatoid arthritis (RA) and in the assessment of disease activity, these applications have not yet been usually included in the routine management of this condition. Our goal is to review the current role of MRI in the everyday clinical management of patients with RA. The usefulness of MRI in the evaluation of articular and para-articular changes in specific locations, mainly the craniocervical region and the temporomandibular joint, are reviewed. Clinical problems derived from local extra-articular involvement, such as tenosynovitis, ''rice-bodies'' bursitis, and Baker's cyst rupture, are also described. Finally, we also review the value of MRI in evaluation of some complications of RA such as tendinous rupture, osteonecrosis, stress fracture, and septic arthritis/osteomyelitis. (orig.)

  6. MR imaging assessment of clinical problems in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Narvaez, Jose A.; Roca, Yolanda; Aguilera, Carlos; Narvaez, Javier

    2002-01-01

    Although MR imaging has been increasingly recognized as a useful tool in the diagnosis of early rheumatoid arthritis (RA) and in the assessment of disease activity, these applications have not yet been usually included in the routine management of this condition. Our goal is to review the current role of MRI in the everyday clinical management of patients with RA. The usefulness of MRI in the evaluation of articular and para-articular changes in specific locations, mainly the craniocervical region and the temporomandibular joint, are reviewed. Clinical problems derived from local extra-articular involvement, such as tenosynovitis, ''rice-bodies'' bursitis, and Baker's cyst rupture, are also described. Finally, we also review the value of MRI in evaluation of some complications of RA such as tendinous rupture, osteonecrosis, stress fracture, and septic arthritis/osteomyelitis. (orig.)

  7. Surface flaw evaluation by vectorized eddy current testing image

    International Nuclear Information System (INIS)

    Endo, Hisashi; Takagi, Toshiyuki

    2006-01-01

    A method of eddy current testing (ECT) data mapping for surface breaking evaluation is studied. The multicoil ECT probe utilized in this paper consists of Transmit-Receive (TR) type sensors as array elements to obtain the information on crack directions. Switching two directional scans, U- and T- modes, gives two-dimensional vector mapping as ECT images. The ECT signals of the TR type sensor also give the information on crack directions from their variation displayed on the complex number plane. Extracting a complex number component of the signals makes it possible to visualize directions of numerically simulated proximate EDM slits. (author)

  8. Clinical and imaging diagnosis for heredodegenerative diseases.

    Science.gov (United States)

    Boddaert, Nathalie; Brunelle, Francis; Desguerre, Isabelle

    2013-01-01

    Clinical features (progressive psychomotor retardation, seizures, movement disorders and motor signs in both central and peripheral systems, sensorineural defects, and psychiatric symptoms) and brain imaging are the keys to diagnosis. CT is indicated for the detection of calcifications and blood, and for angiography. MRI in all three axes requires T1, T2, FLAIR (from 1 year on), eventually T2* or contrast administration, and diffusion in any acute condition. MR spectroscopy allows the dectection of lactate and creatine deficiency, elevated choline in high membrane turnover, and low NAA in neuronal death. The normal sequence of myelination needs to be taken into account. Pre- and neonatal anomalies include cystic and basal ganglia lesions, gyral and myelin anomalies, callosal agenesis, and large subdural spaces. Anomalies disclosed after 3 months of age include basal ganglia appearing hyper- or hypointense on T2, hypointense on T2*, or calcified white matter anomalies mainly periventricular or subcortical, or with contrast enhancement, associated with macrocephaly and/or large or very small cysts, and hypomyelination; there may be "vascular" or pseudostroke disorders, cortical atrophy, hypoplasia, or abnormal signal of the brainstem and/or cerebellum. Spectroscopy should investigate basal ganglia, white matter, and the cerebellum. MRI may reveal typical alterations of the brain at the preclinical stage in siblings of affected children. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. OSTEOARTHRITIS: CURRENT CLINICAL CONCEPT AND SOME PROMISING THERAPEUTIC APPROACHES

    Directory of Open Access Journals (Sweden)

    A. E. Karateev

    2018-01-01

    Full Text Available In recent years, there has been a trend toward changing the clinical concept of osteoarthritis (OA. This disease has been considered as an age-related disease and the long-term result of a current pathological process for a very long time. However, many experts are now inclined to consider it necessary to identify the early, pre-X-ray stage of OA, when adequate treatment may not only halt the progression, but also achieve the regression of joint structural changes. This review deals with a number of pathogenetic and clinical aspects of the early stages of OA, which are important for timely diagnosis and pathogenetic therapy choice. It also considers some therapeutic approaches, both a "classic" and recently actively discussed methods for using platelet-rich plasma and autologous chondrocyte transplantation.

  10. Cancer imaging with CEA antibodies: historical and current perspectives.

    Science.gov (United States)

    Goldenberg, D M

    1992-01-01

    This article reviews the history and status of cancer imaging with radiolabeled antibodies against carcinoembryonic antigen (CEA). Although CEA and many other cancer-associated antigens are not distinct for neoplasia, the quantitative increase of these markers in malignant tissues provides a sufficient differential for selective antibody targeting. Animal studies with xenografted human tumors provided the first evidence of the prospects of this technology, followed by initial clinical success with purified goat whole IgG antibodies to CEA, labeled with 131I and with the use of dual-isotope subtraction methods. Subsequently, improved and earlier imaging could be accomplished with monoclonal antibody fragments, which then would permit the use of shorter-lived radionuclides, such as 111In, 123I, and 99mTc. The preferred use of a monoclonal anti-CEA IgG Fab' fragment, labeled with 99mTc by a recently developed, simple and rapid kit, has enabled the detection of small lesions, including those in the liver, within 4 h of injection. By means of SPECT imaging, a high sensitivity and specificity for RAID could be achieved.

  11. Current role of multidetector computed tomography in imaging of wrist injuries.

    Science.gov (United States)

    Syed, Mohd Arif; Raj, Vimal; Jeyapalan, Kanagaratnam

    2013-01-01

    Imaging of the wrist is challenging to both radiologists and orthopedic surgeons. This is primarily because of the complex anatomy/functionality of the wrist and also the fact that many frequent injuries are sustained to the hands. On going developments in multidetector computed tomography (MDCT) technology with its "state of the art" postprocessing capabilities have revolutionized this field. Apart from routine imaging of wrist trauma, it is now possible to assess intrinsic ligaments with MDCT arthrography, thereby avoiding invasive diagnostic arthroscopies. Postoperative wrist imaging can be a diagnostic challenge, and MDCT can be helpful in assessment of these cases because volume acquisition and excellent postprocessing abilities help to evaluate these wrists in any desired plane and thinner slices. This article pictorially reviews the current clinical role of MDCT imaging of wrist in our practice. It also describes arthrography technique and scanning parameters used at our center. Copyright © 2013 Mosby, Inc. All rights reserved.

  12. Islet cell transplant: Update on current clinical trials

    Science.gov (United States)

    Schuetz, Christian; Markmann, James F.

    2016-01-01

    In the last 15 years clinical islet transplantation has made the leap from experimental procedure to standard of care for a highly selective group of patients. Due to a risk-benefit calculation involving the required systemic immunosuppression the procedure is only considered in patients with type 1 diabetes, complicated by severe hypoglycemia or end stage renal disease. In this review we summarize current outcomes of the procedure and take a look at ongoing and future improvements and refinements of beta cell therapy. PMID:28451515

  13. Clinical application of functional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Alwatban, Adnan Z.W.

    2002-01-01

    The work described in this thesis was carried out at the Magnetic Resonance Centre of the University of Nottingham during the time from May 1998 to April 2001, and is the work of the author except where indicated by reference. The main source of signal changes in functional magnetic resonance imaging (fMRJ) is the fluctuation of paramagnetic deoxyhaemoglobin in the venous blood during different states of functional performance. For the work of this thesis, fMRI studies were carried out using a 3 T MR system with an echo planar imaging (EPI) pulse sequence. Hearing research utilising fMRI has been previously reported in normal subjects. Hearing fMRI is normally performed by stimulating the auditory cortex via an acoustic task presentation such as music, tone, etc. However, performing the same research on deaf subjects requires special equipment to be designed to allow direct stimulation of the auditory nerve. In this thesis, a new method of direct electrical stimulation of the auditory nerve is described that uses a transtympanic electrode implanted onto the surface of the cochlea. This approach would however, result in electromotive forces (EMFs) being induced by the time varying magnetic field, which would lead to current flow and heating, as well as deflection of the metallic electrode within the static magnetic field, and image distortion due to the magnetic susceptibility difference. A gold-plated tungsten electrode with a zero magnetic susceptibility was developed to avoid image distortion. Used with carbon leads and a carbon reference pad, it enabled safe, distortion-free fMRI studies of deaf subjects. The study revealed activation of the primary auditory cortex. This fMRI procedure can be used to demonstrate whether the auditory pathway is fully intact, and may provide a useful method for pre-operative assessment of candidates for cochlear implantation. Glucose is the energy source on which the function of the human brain is entirely dependent. Failure to

  14. Clinical application of functional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Alwatban, Adnan Z W

    2002-07-01

    The work described in this thesis was carried out at the Magnetic Resonance Centre of the University of Nottingham during the time from May 1998 to April 2001, and is the work of the author except where indicated by reference. The main source of signal changes in functional magnetic resonance imaging (fMRJ) is the fluctuation of paramagnetic deoxyhaemoglobin in the venous blood during different states of functional performance. For the work of this thesis, fMRI studies were carried out using a 3 T MR system with an echo planar imaging (EPI) pulse sequence. Hearing research utilising fMRI has been previously reported in normal subjects. Hearing fMRI is normally performed by stimulating the auditory cortex via an acoustic task presentation such as music, tone, etc. However, performing the same research on deaf subjects requires special equipment to be designed to allow direct stimulation of the auditory nerve. In this thesis, a new method of direct electrical stimulation of the auditory nerve is described that uses a transtympanic electrode implanted onto the surface of the cochlea. This approach would however, result in electromotive forces (EMFs) being induced by the time varying magnetic field, which would lead to current flow and heating, as well as deflection of the metallic electrode within the static magnetic field, and image distortion due to the magnetic susceptibility difference. A gold-plated tungsten electrode with a zero magnetic susceptibility was developed to avoid image distortion. Used with carbon leads and a carbon reference pad, it enabled safe, distortion-free fMRI studies of deaf subjects. The study revealed activation of the primary auditory cortex. This fMRI procedure can be used to demonstrate whether the auditory pathway is fully intact, and may provide a useful method for pre-operative assessment of candidates for cochlear implantation. Glucose is the energy source on which the function of the human brain is entirely dependent. Failure to

  15. Magnetic resonance imaging of vulnerable atherosclerotic plaques: current imaging strategies and molecular imaging probes

    NARCIS (Netherlands)

    Briley-Saebo, Karen C.; Mulder, Willem J. M.; Mani, Venkatesh; Hyafil, Fabien; Amirbekian, Vardan; Aguinaldo, Juan Gilberto S.; Fisher, Edward A.; Fayad, Zahi A.

    2007-01-01

    The vulnerability or destabilization of atherosclerotic plaques has been directly linked to plaque composition. Imaging modalities, such as magnetic resonance (MR) imaging, that allow for evaluation of plaque composition at a cellular and molecular level, could further improve the detection of

  16. Biomarkers in prostate cancer - Current clinical utility and future perspectives.

    Science.gov (United States)

    Kretschmer, Alexander; Tilki, Derya

    2017-12-01

    Current tendencies in the treatment course of prostate cancer patients increase the need for reliable biomarkers that help in decision-making in a challenging clinical setting. Within the last decade, several novel biomarkers have been introduced. In the following comprehensive review article, we focus on diagnostic (PHI ® , 4K score, SelectMDx ® , ConfirmMDx ® , PCA3, MiPS, ExoDX ® , mpMRI) and prognostic (OncotypeDX GPS ® , Prolaris ® , ProMark ® , DNA-ploidy, Decipher ® ) biomarkers that are in widespread clinical use and are supported by evidence. Hereby, we focus on multiple clinical situations in which innovative biomarkers may guide decision-making in prostate cancer therapy. In addition, we describe novel liquid biopsy approaches (circulating tumor cells, cell-free DNA) that have been described as predictive biomarkers in metastatic castration-resistant prostate cancer and might support an individual patient-centred oncological approach in the nearer future. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Addressing unwarranted clinical variation: A rapid review of current evidence.

    Science.gov (United States)

    Harrison, Reema; Manias, Elizabeth; Mears, Stephen; Heslop, David; Hinchcliff, Reece; Hay, Liz

    2018-05-15

    Unwarranted clinical variation (UCV) can be described as variation that can only be explained by differences in health system performance. There is a lack of clarity regarding how to define and identify UCV and, once identified, to determine whether it is sufficiently problematic to warrant action. As such, the implementation of systemic approaches to reducing UCV is challenging. A review of approaches to understand, identify, and address UCV was undertaken to determine how conceptual and theoretical frameworks currently attempt to define UCV, the approaches used to identify UCV, and the evidence of their effectiveness. Rapid evidence assessment (REA) methodology was used. A range of text words, synonyms, and subject headings were developed for the major concepts of unwarranted clinical variation, standards (and deviation from these standards), and health care environment. Two electronic databases (Medline and Pubmed) were searched from January 2006 to April 2017, in addition to hand searching of relevant journals, reference lists, and grey literature. Results were merged using reference-management software (Endnote) and duplicates removed. Inclusion criteria were independently applied to potentially relevant articles by 3 reviewers. Findings were presented in a narrative synthesis to highlight key concepts addressed in the published literature. A total of 48 relevant publications were included in the review; 21 articles were identified as eligible from the database search, 4 from hand searching published work and 23 from the grey literature. The search process highlighted the voluminous literature reporting clinical variation internationally; yet, there is a dearth of evidence regarding systematic approaches to identifying or addressing UCV. Wennberg's classification framework is commonly cited in relation to classifying variation, but no single approach is agreed upon to systematically explore and address UCV. The instances of UCV that warrant investigation and

  18. A data grid for imaging-based clinical trials

    Science.gov (United States)

    Zhou, Zheng; Chao, Sander S.; Lee, Jasper; Liu, Brent; Documet, Jorge; Huang, H. K.

    2007-03-01

    Clinical trials play a crucial role in testing new drugs or devices in modern medicine. Medical imaging has also become an important tool in clinical trials because images provide a unique and fast diagnosis with visual observation and quantitative assessment. A typical imaging-based clinical trial consists of: 1) A well-defined rigorous clinical trial protocol, 2) a radiology core that has a quality control mechanism, a biostatistics component, and a server for storing and distributing data and analysis results; and 3) many field sites that generate and send image studies to the radiology core. As the number of clinical trials increases, it becomes a challenge for a radiology core servicing multiple trials to have a server robust enough to administrate and quickly distribute information to participating radiologists/clinicians worldwide. The Data Grid can satisfy the aforementioned requirements of imaging based clinical trials. In this paper, we present a Data Grid architecture for imaging-based clinical trials. A Data Grid prototype has been implemented in the Image Processing and Informatics (IPI) Laboratory at the University of Southern California to test and evaluate performance in storing trial images and analysis results for a clinical trial. The implementation methodology and evaluation protocol of the Data Grid are presented.

  19. Perinatal clinical and imaging features of CLOVES syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Pineda, Israel [Virgen del Rocio Children' s Hospital, Department of Pediatric Surgery, Seville (Spain); Fajardo, Manuel [Virgen del Rocio Children' s Hospital, Department of Pediatric Radiology, Seville (Spain); Chaudry, Gulraiz; Alomari, Ahmad I. [Children' s Hospital Boston and Harvard Medical School, Division of Vascular and Interventional Radiology, Boston, MA (United States)

    2010-08-15

    We report a neonate with antenatal imaging features suggestive of CLOVES syndrome. Postnatal clinical and imaging findings confirmed the diagnosis, with the constellation of truncal overgrowth, cutaneous capillary malformation, lymphatic and musculoskeletal anomalies. The clinical, radiological and histopathological findings noted in this particular phenotype help differentiate it from other overgrowth syndromes with complex vascular anomalies. (orig.)

  20. Clinical findings versus imaging studies in the diagnosis of infantile ...

    African Journals Online (AJOL)

    Background: Infantile hypertrophic pyloric stenosis is the most common surgical cause of vomiting in early infancy and can be diagnosed clinically or by imaging studies. Objectives: The aim of this study was to assess the accuracy of clinical examination compared with ultrasound and upper gastrointestinal contrast imaging ...

  1. Clinical advances in cardiovascular magnetic resonace imaging and angiography

    NARCIS (Netherlands)

    Bosch, van den H.C.M.

    2018-01-01

    Cardiovascular magnetic resonance imaging is an important noninvasive imaging modality for the diagnosis, clinical work‐up and treatment planning in patients suspected for a wide range of cardiovascular pathology. CMR imaging is accurate and reliable, and provides invaluable information to evaluate

  2. Clinical usefulness of dopamine transporter imaging

    International Nuclear Information System (INIS)

    Kim, Jong Min; Kim, Yu Kyeong; Kim, Sang Eun; Jeon, Beom S.

    2007-01-01

    Imaging of the dopamine transporter (DAT) provides a marker for the integrity of presynaptic nigrostriatal dopaminergic system. DAT density is reduced in Parkinson disease, multiple system atrophy, and progressive supranuclear palsy. In patients with suspicious parkinsonism, normal DAT imaging suggests an alternative diagnosis such as essential tremor, vascular parkinsonism, or drug-induced parkinsonism. DAT imaging is a useful tool to aid clinician's differential diagnosis in parkinsonism

  3. Clinical applications of choroidal imaging technologies

    Directory of Open Access Journals (Sweden)

    Jay Chhablani

    2015-01-01

    Full Text Available Choroid supplies the major blood supply to the eye, especially the outer retinal structures. Its understanding has significantly improved with the advent of advanced imaging modalities such as enhanced depth imaging technique and the newer swept source optical coherence tomography. Recent literature reports the findings of choroidal changes, quantitative as well as qualitative, in various chorioretinal disorders. This review article describes applications of choroidal imaging in the management of common diseases such as age-related macular degeneration, high myopia, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. This article briefly discusses future directions in choroidal imaging including angiography.

  4. Spinal diffusion tensor imaging: a comprehensive review with emphasis on spinal cord anatomy and clinical applications.

    Science.gov (United States)

    Hendrix, Philipp; Griessenauer, Christoph J; Cohen-Adad, Julien; Rajasekaran, Shanmuganathan; Cauley, Keith A; Shoja, Mohammadali M; Pezeshk, Parham; Tubbs, R Shane

    2015-01-01

    Magnetic resonance imaging technology allows for in vivo visualization of fiber tracts of the central nervous system using diffusion-weighted imaging sequences and data processing referred to as "diffusion tensor imaging" and "diffusion tensor tractography." While protocols for high-fidelity diffusion tensor imaging of the brain are well established, the spinal cord has proven a more difficult target for diffusion tensor methods. Here, we review the current literature on spinal diffusion tensor imaging and tractography with special emphasis on neuroanatomical correlations and clinical applications. © 2014 Wiley Periodicals, Inc.

  5. Classified study and clinical value of the phase imaging features

    International Nuclear Information System (INIS)

    Dang Yaping; Ma Aiqun; Zheng Xiaopu; Yang Aimin; Xiao Jiang; Gao Xinyao

    2000-01-01

    445 patients with various heart diseases were examined by the gated cardiac blood pool imaging, and the phase was classified. The relationship between the seven types with left ventricular function index, clinical heart function, different heart diseases as well as electrocardiograph was studied. The results showed that the phase image classification could match with the clinical heart function. It can visually, directly and accurately indicate clinical heart function and can be used to identify diagnosis of heart disease

  6. Magnetic resonance imaging of the breast: current indications

    International Nuclear Information System (INIS)

    Lalonde, L.; David, J.; Trop, I.

    2005-01-01

    Breast magnetic resonance imaging (MRI) plays an increasing role in the management of selecting breast cancer patients. MRI is recognized as the most sensitive modality for the detection of invasive breast cancer. Several valuable clinical applications of MRI have emerged for breast cancer detection and diagnosis from clinical investigations. Breast MRI is helpful for women diagnosed with breast cancer who contemplate breast conserving surgery; it provides valuable information on the extent of the disease. MRI can also help assess for residual invasive cancer in patients who have undergone lumpectomy with positive margins at pathology. It is very reliable in differentiating scar tissue from recurrence at the lumpectomy site. MRI is also reliable in finding a breast cancer in women with axillary nodal metastases and unknown primary tumour. MRI can help to monitor the response to chemotherapy. Breast MRI could be a better screening tool than mammography in women with very high risks of developing breast cancer, such as breast cancer gene carriers and patients treated with chest radiation. Other potential uses of MRI include evaluation of the integrity of silicone breast implants and evaluation of the parenchyma in women with silicone gel implants or free injection of silicone gel. However, like any other technique, breast MRI has some drawbacks, including low-to-moderate specificity, high costs, and variability in technique and interpretation. Radiologists must have a clear understanding of valid indications and selection criteria to use this technique appropriately. (author)

  7. Sturge-Weber syndrome. The current neuro-imaging data

    International Nuclear Information System (INIS)

    Boukobza, M.; Cambra, M.R.; Merland, J.J.; Enjolras, O.

    2000-01-01

    Sturge-Weber syndrome (SWS) is a rare congenital sporadic disease with neuro-ocular and cutaneous vascular findings. Clinically, the full-blown condition consists of a facial port-wine stain (PWS) the V1 facial trigeminal skin area, alone or in combination with V2 and V3 PWS, seizures and ocular abnormalities (glaucoma and choroidal angioma). Radiologically, a leptomeningeal (pial) capillary and venous malformation, mostly located in the parieto-occipital area, cerebral atrophy and calcifications are demonstrated. An ipsilateral enlarged choroid plexus may be an early anatomic symptom. Development neuro-diagnostic technique for the screening of infants with an at-risk V1 PWS, as well as for the follow-up of patients with evidence SWS. Accelerated myelination in the involved hemisphere may be early diagnostic feature before 6 months of age. Later, hyperintensity of white matter on T2 is considered a symptom of gliosis. Clinically, progression of the diseases is associated with anatomic changes and correlates with the extent of the pial vascular anomaly, extent and severity of cerebral atrophy, and white matter abnormalities. A neonatal neuro-imaging work-up, using CT or MRI, may not demonstrate the pial anomaly and should be repeated after 6 to 12 months in an at-risk infant with V1 PWS. (authors)

  8. Sress cardiomyopathy: clinical features and imaging findings

    International Nuclear Information System (INIS)

    Zhao Shihua; Yan Chaowu; Jiang Shiliang; Lu Minjie; Li Shiguo; Liu Qiong; He Zuoxiang

    2007-01-01

    Objective: One typical case with stress cardiomyopathy was reported and the current knowledge of the syndrome was reviewed to improve relevant knowledge. Methods: A 71-year-old female patient presented dyspnea and chest pain due to emotional stress. ECG, echocardiography, selective coronary, artery angiography, left ventriculography, 99 Tc m -MIBI single photon emission computed tomography (SPECT), 18 F-FDG SPECT and MRI were performed. Results: Electrocardiogram at admission showed ST segment elevation and T wave inversion in leads V1-V4. Pathological Q wave occurred 1 week later, it disappeared 1 month later however and severe T wave inversion occurred. Normal or slightly elevated cardiac enzymes in the blood were found during the course. Left ventriculogram at admission showed left ventricular apical ballooning with LVEF of 30%. The ballooning volume was about 3/4 of left ventricular volume, without any corresponding coronary artery diseases found in coronary angiogram. The abnormal apical ballooning decreased significantly in the follow-up left ventficulogram performed one month later. The LVEF rose up to 63.6%. 99 Tc m -MIBI and 18 F-FDG SPECT showed mismatch of perfusion and metabolism in the corresponding region, indicating presence of viable myocardium. MRI showed left ventricular apical ballooning without perfusion defect and late enhancement, indicating viability of corresponding myocardium. Conclusions: Emotional stress can cause transient left ventricular apical ballooning called 'stress cardiomyopathy'. Either 99 Tc m -MIBI SPECT associated with 18 F-FDG SPECT or delayed enhancement MRI plays an important role in identification of myocardial viability, which can efficiently guide clinical treatment. (authors)

  9. Figures in clinical trial reports: current practice & scope for improvement.

    Science.gov (United States)

    Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

    2007-11-19

    Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  10. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  11. Neoplastic stem cells: current concepts and clinical perspectives.

    Science.gov (United States)

    Schulenburg, Axel; Brämswig, Kira; Herrmann, Harald; Karlic, Heidrun; Mirkina, Irina; Hubmann, Rainer; Laffer, Sylvia; Marian, Brigitte; Shehata, Medhat; Krepler, Clemens; Pehamberger, Hubert; Grunt, Thomas; Jäger, Ulrich; Zielinski, Christoph C; Valent, Peter

    2010-11-01

    Neoplastic stem cells have initially been characterized in myeloid leukemias where NOD/SCID mouse-repopulating progenitors supposedly reside within a CD34+/Lin- subset of the malignant clone. These progenitors are considered to be self-renewing cells responsible for the in vivo long-term growth of neoplastic cells in leukemic patients. Therefore, these cells represent an attractive target of therapy. In some lymphoid leukemias, NOD/SCID mouse-repopulating cells were also reported to reside within the CD34+/Lin- subfraction of the clone. More recently, several attempts have been made to transfer the cancer stem cell concept to solid tumors and other non-hematopoietic neoplasms. In several of these tumors, the cell surface antigens AC133 (CD133) and CD44 are considered to indicate the potential of a cell to initiate permanent tumor formation in vivo. However, several questions concerning the phenotype, self-renewal capacity, stroma-dependence, and other properties of cancer- or leukemia-initiating cells remain to be solved. The current article provides a summary of our current knowledge on neoplastic (cancer) stem cells, with special emphasis on clinical implications and therapeutic options as well as a discussion about conceptual and technical limitations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Cognition in epilepsy: current clinical issues of interest.

    Science.gov (United States)

    Witt, Juri-Alexander; Helmstaedter, Christoph

    2017-04-01

    This review provides an update and summary of recent neuropsychological findings in epilepsy focusing on three major clinical topics among the many developments in the field. We will critically outline the current state with regard to cognition in new-onset epilepsies, social cognition in epilepsy, and the long-term outcome of epilepsy surgery and the cognitive outcomes of superselective surgical procedures. Current studies indicate that neuropsychological impairments are prevalent already at the onset of epilepsy and even before, social cognition (i.e., emotion recognition and theory of mind) is impaired in different epilepsy populations, the long-term outcome of epilepsy surgery is mostly characterized by a stable or even improved cognitive status, and superselective epilepsy surgeries are associated with a promising neuropsychological outcome. The high prevalence of cognitive deficits around epilepsy onset challenges the assumption that epilepsy is the major cause of cognitive problems and calls for early neuropsychological diagnostics. Social cognition seems to be a relevant domain that is not yet routinely considered in epilepsy. The cognitive long-term outcome of epilepsy surgery is mostly positive. Stereotactic thermocoagulation and gamma knife surgery appear to be cognitively safe procedures.

  13. Current profile reconstruction using electron temperature imaging diagnostics

    International Nuclear Information System (INIS)

    Tritz, K.; Stutman, D.; Delgado-Aparicio, L.F.; Finkenthal, M.; Pacella, D.; Kaita, R.; Stratton, B.; Sabbagh, S.

    2004-01-01

    Flux surface shape information can be used to constrain the current profile for reconstruction of the plasma equilibrium. One method of inferring flux surface shape relies on plasma x-ray emission; however, deviations from the flux surfaces due to impurity and density asymmetries complicate the interpretation. Electron isotherm surfaces should correspond well to the plasma flux surfaces, and equilibrium constraint modeling using this isotherm information constrains the current profile. The KFIT code is used to assess the profile uncertainty and to optimize the number, location and SNR required for the Te detectors. As Te imaging detectors we consider tangentially viewing, vertically spaced, linear gas electron multiplier arrays operated in pulse height analysis (PHA) mode and multifoil soft x-ray arrays. Isoflux coordinate sets provided by T e measurements offer a strong constraint on the equilibrium reconstruction in both a stacked horizontal array configuration and a crossed horizontal and vertical beam system, with q 0 determined to within ±4%. The required SNR can be provided with either PHA or multicolor diagnostic techniques, though the multicolor system requires ∼x4 better statistics for comparable final errors

  14. Advantages and Limitations of Current Imaging Techniques for Characterizing Liposome Morphology

    Directory of Open Access Journals (Sweden)

    Annie-Louise Robson

    2018-02-01

    Full Text Available There are currently a number of imaging techniques available for evaluating the morphology of liposomes and other nanoparticles, with each having its own advantages and disadvantages that should be considered when interpreting data. Controlling and validating the morphology of nanoparticles is of key importance for the effective clinical translation of liposomal formulations. There are a number of physical characteristics of liposomes that determine their in vivo behavior, including size, surface characteristics, lamellarity, and homogeneity. Despite the great importance of the morphology of nanoparticles, it is generally not well-characterized and is difficult to control. Appropriate imaging techniques provide important details regarding the morphological characteristics of nanoparticles, and should be used in conjunction with other methods to assess physicochemical parameters. In this review, we will discuss the advantages and limitations of available imaging techniques used to evaluate liposomal formulations.

  15. Current status and future perspectives of in vivo small animal imaging using radiolabeled nanoparticles

    International Nuclear Information System (INIS)

    Loudos, George; Kagadis, George C.; Psimadas, Dimitris

    2011-01-01

    Small animal molecular imaging is a rapidly expanding efficient tool to study biological processes non-invasively. The use of radiolabeled tracers provides non-destructive, imaging information, allowing time related phenomena to be repeatedly studied in a single animal. In the last decade there has been an enormous progress in related technologies and a number of dedicated imaging systems overcome the limitations that the size of small animal possesses. On the other hand, nanoparticles (NPs) gain increased interest, due to their unique properties, which make them perfect candidates for biological applications. Over the past 5 years the two fields seem to cross more and more often; radiolabeled NPs have been assessed in numerous pre-clinical studies that range from oncology, till HIV treatment. In this article the current status in the tools, applications and trends of radiolabeled NPs reviewed.

  16. Currently available methodologies for the processing of intravascular ultrasound and optical coherence tomography images.

    Science.gov (United States)

    Athanasiou, Lambros; Sakellarios, Antonis I; Bourantas, Christos V; Tsirka, Georgia; Siogkas, Panagiotis; Exarchos, Themis P; Naka, Katerina K; Michalis, Lampros K; Fotiadis, Dimitrios I

    2014-07-01

    Optical coherence tomography and intravascular ultrasound are the most widely used methodologies in clinical practice as they provide high resolution cross-sectional images that allow comprehensive visualization of the lumen and plaque morphology. Several methods have been developed in recent years to process the output of these imaging modalities, which allow fast, reliable and reproducible detection of the luminal borders and characterization of plaque composition. These methods have proven useful in the study of the atherosclerotic process as they have facilitated analysis of a vast amount of data. This review presents currently available intravascular ultrasound and optical coherence tomography processing methodologies for segmenting and characterizing the plaque area, highlighting their advantages and disadvantages, and discusses the future trends in intravascular imaging.

  17. Evaluation and comparison of current fetal ultrasound image segmentation methods for biometric measurements: a grand challenge.

    Science.gov (United States)

    Rueda, Sylvia; Fathima, Sana; Knight, Caroline L; Yaqub, Mohammad; Papageorghiou, Aris T; Rahmatullah, Bahbibi; Foi, Alessandro; Maggioni, Matteo; Pepe, Antonietta; Tohka, Jussi; Stebbing, Richard V; McManigle, John E; Ciurte, Anca; Bresson, Xavier; Cuadra, Meritxell Bach; Sun, Changming; Ponomarev, Gennady V; Gelfand, Mikhail S; Kazanov, Marat D; Wang, Ching-Wei; Chen, Hsiang-Chou; Peng, Chun-Wei; Hung, Chu-Mei; Noble, J Alison

    2014-04-01

    This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.

  18. The current status of cone beam computed tomography imaging in orthodontics

    Science.gov (United States)

    Kapila, S; Conley, R S; Harrell, W E

    2011-01-01

    Cone beam CT (CBCT) has become an increasingly important source of three dimensional (3D) volumetric data in clinical orthodontics since its introduction into dentistry in 1998. The purpose of this manuscript is to highlight the current understanding of, and evidence for, the clinical use of CBCT in orthodontics, and to review the findings to answer clinically relevant questions. Currently available information from studies using CBCT can be organized into five broad categories: 1, the assessment of CBCT technology; 2, its use in craniofacial morphometric analyses; 3, incidental and missed findings; 4, analysis of treatment outcomes; and 5, efficacy of CBCT in diagnosis and treatment planning. The findings in these topical areas are summarized, followed by current indications and protocols for the use of CBCT in specific cases. Despite the increasing popularity of CBCT in orthodontics, and its advantages over routine radiography in specific cases, the effects of information derived from these images in altering diagnosis and treatment decisions has not been demonstrated in several types of cases. It has therefore been recommended that CBCT be used in select cases in which conventional radiography cannot supply satisfactory diagnostic information; these include cleft palate patients, assessment of unerupted tooth position, supernumerary teeth, identification of root resorption and for planning orthognathic surgery. The need to image other types of cases should be made on a case-by-case basis following an assessment of benefits vs risks of scanning in these situations. PMID:21159912

  19. Current status on image processing in medical fields in Japan

    International Nuclear Information System (INIS)

    Atsumi, Kazuhiko

    1979-01-01

    Information on medical images are classified in the two patterns. 1) off-line images on films-x-ray films, cell image, chromosome image etc. 2) on-line images detected through sensors, RI image, ultrasonic image, thermogram etc. These images are divided into three characteristic, two dimensional three dimensional and dynamic images. The research on medical image processing have been reported in several meeting in Japan and many fields on images have been studied on RI, thermogram, x-ray film, x-ray-TV image, cancer cell, blood cell, bacteria, chromosome, ultrasonics, and vascular image. Processing on TI image useful and easy because of their digital displays. Software on smoothing, restoration (iterative approximation), fourier transformation, differentiation and subtration. Image on stomach and chest x-ray films have been processed automatically utilizing computer system. Computed Tomography apparatuses have been already developed in Japan and automated screening instruments on cancer cells and recently on blood cells classification have been also developed. Acoustical holography imaging and moire topography have been also studied in Japan. (author)

  20. Multiparametric magnetic resonance imaging of the prostate: current concepts.

    NARCIS (Netherlands)

    Bittencourt, L.K.; Hausmann, D.; Sabaneeff, N.; Gasparetto, E.L.; Barentsz, J.O.

    2014-01-01

    Multiparametric MR (mpMR) imaging is rapidly evolving into the mainstay in prostate cancer (PCa) imaging. Generally, the examination consists of T2-weighted sequences, diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) evaluation, and less often proton MR spectroscopy imaging (MRSI).

  1. Diffusion weighted imaging demystified. The technique and potential clinical applications for soft tissue imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ahlawat, Shivani [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Fayad, Laura M. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Oncology, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Orthopaedic Surgery, Baltimore, MD (United States)

    2018-03-15

    Diffusion-weighted imaging (DWI) is a fast, non-contrast technique that is readily available and easy to integrate into an existing imaging protocol. DWI with apparent diffusion coefficient (ADC) mapping offers a quantitative metric for soft tissue evaluation and provides information regarding the cellularity of a region of interest. There are several available methods of performing DWI, and artifacts and pitfalls must be considered when interpreting DWI studies. This review article will review the various techniques of DWI acquisition and utility of qualitative as well as quantitative methods of image interpretation, with emphasis on optimal methods for ADC measurement. The current clinical applications for DWI are primarily related to oncologic evaluation: For the assessment of de novo soft tissue masses, ADC mapping can serve as a useful adjunct technique to routine anatomic sequences for lesion characterization as cyst or solid and, if solid, benign or malignant. For treated soft tissue masses, the role of DWI/ADC mapping in the assessment of treatment response as well as recurrent or residual neoplasm in the setting of operative management is discussed, especially when intravenous contrast medium cannot be given. Emerging DWI applications for non-neoplastic clinical indications are also reviewed. (orig.)

  2. Diffusion weighted imaging demystified. The technique and potential clinical applications for soft tissue imaging

    International Nuclear Information System (INIS)

    Ahlawat, Shivani; Fayad, Laura M.

    2018-01-01

    Diffusion-weighted imaging (DWI) is a fast, non-contrast technique that is readily available and easy to integrate into an existing imaging protocol. DWI with apparent diffusion coefficient (ADC) mapping offers a quantitative metric for soft tissue evaluation and provides information regarding the cellularity of a region of interest. There are several available methods of performing DWI, and artifacts and pitfalls must be considered when interpreting DWI studies. This review article will review the various techniques of DWI acquisition and utility of qualitative as well as quantitative methods of image interpretation, with emphasis on optimal methods for ADC measurement. The current clinical applications for DWI are primarily related to oncologic evaluation: For the assessment of de novo soft tissue masses, ADC mapping can serve as a useful adjunct technique to routine anatomic sequences for lesion characterization as cyst or solid and, if solid, benign or malignant. For treated soft tissue masses, the role of DWI/ADC mapping in the assessment of treatment response as well as recurrent or residual neoplasm in the setting of operative management is discussed, especially when intravenous contrast medium cannot be given. Emerging DWI applications for non-neoplastic clinical indications are also reviewed. (orig.)

  3. The Current State and Path Forward For Enterprise Image Viewing: HIMSS-SIIM Collaborative White Paper.

    Science.gov (United States)

    Roth, Christopher J; Lannum, Louis M; Dennison, Donald K; Towbin, Alexander J

    2016-10-01

    Clinical specialties have widely varied needs for diagnostic image interpretation, and clinical image and video image consumption. Enterprise viewers are being deployed as part of electronic health record implementations to present the broad spectrum of clinical imaging and multimedia content created in routine medical practice today. This white paper will describe the enterprise viewer use cases, drivers of recent growth, technical considerations, functionality differences between enterprise and specialty viewers, and likely future states. This white paper is aimed at CMIOs and CIOs interested in optimizing the image-enablement of their electronic health record or those who may be struggling with the many clinical image viewers their enterprises may employ today.

  4. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-01-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  5. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2012-09-15

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  6. Current Role for Biomarkers in Clinical Diagnosis of Alzheimer Disease and Frontotemporal Dementia.

    Science.gov (United States)

    Sheikh-Bahaei, Nasim; Sajjadi, Seyed Ahmad; Pierce, Aimee L

    2017-11-14

    Purpose of review Alzheimer's disease (AD) and frontotemporal dementia can often be diagnosed accurately with careful clinical history, cognitive testing, neurological examination, and structural brain MRI. However, there are certain circumstances wherein detection of specific biomarkers of neurodegeneration or underlying AD pathology will impact the clinical diagnosis or treatment plan. We will review the currently available biomarkers for AD and frontotemporal dementia (FTD) and discuss their clinical importance. Recent findings With the advent of 18 F-labeled tracers that bind amyloid plaques, amyloid PET is now clinically available for the detection of amyloid pathology and to aid in a biomarker-supported diagnosis of AD or mild cognitive impairment (MCI) due to AD. It is not yet possible to test for the specific FTD pathologies (tau or TDP-43); however, a diagnosis of FTD may be "imaging supported" based upon specific MRI or FDG-PET findings. Cerebrospinal fluid measures of amyloid-beta, total-tau, and phospho-tau are clinically available and allow detection of both of the cardinal pathologies of AD: amyloid and tau pathology. Summary It is appropriate to pursue biomarker testing in cases of MCI and dementia when there remains diagnostic uncertainty and the result will impact diagnosis or treatment. Practically speaking, due to the rising prevalence of amyloid positivity with advancing age, measurement of biomarkers in cases of MCI and dementia is most helpful in early-onset patients, patients with atypical clinical presentations, or when considering referral for AD clinical trials.

  7. Progress toward clinical implementation of the first flat-panel amorphous silicon imager

    International Nuclear Information System (INIS)

    Antonuk, Larry E.; El-Mohri, Youcef; Weidong, Huang; Sandler, Howard; Siewerdsen, Jeffrey H.; Yorkston, John

    1995-01-01

    Purpose: Approximately 7 years after the development of the general concept, megavoltage imagers based on thin-film, flat-panel electronics will likely enter routine clinical use within the next few years. In this paper, current capabilities and anticipated development of this imaging technology as pertains to clinical use will be presented. The results of the first use of this technology with an early prototype imager in a clinical setting are reported. The development of a more advanced clinical prototype imager designed for routine clinical use is described and the clinically-relevant capabilities, advantages, and limitations of this device are described. Materials and Methods: Flat-panel amorphous silicon imagers consist of an imaging array, an x-ray converter, external data acquisition electronics, along with appropriate software and a host workstation. The array consists of a two-dimensional grid of imaging pixels with each pixel consisting of a transistor coupled to a photodiode. An initial study of patient imaging has been performed with an early prototype imager which incorporates a 512x560 array with 450 μm pixels giving an imaging surface of 23x25 cm 2 . Portal images acquired with this prototype imager and with film under similar geometric and irradiation conditions were acquired and compared. In addition, a clinical prototype imager based upon a 26x26 cm 2 array with 508 μm pixels (512x512 pixels) is under development. This prototype incorporates advanced analog and digital external electronics which will improve imaging performance thereby increasing clinical utility of the device. The imagers are interfaced to the operation of a treatment machine so as to allow both radiographic and fluoroscopic operation. Results: The image quality is limited by the presence of pixel and line defects in the array and by the presence of correlated and uncorrelated noise sources in the acquisition system. Nevertheless, the contrast and spatial resolution offered by

  8. Computer-aided diagnosis in radiological imaging: current status and future challenges

    Science.gov (United States)

    Doi, Kunio

    2009-10-01

    Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different types of CAD schemes are being developed for detection and/or characterization of various lesions in medical imaging, including conventional projection radiography, CT, MRI, and ultrasound imaging. Commercial systems for detection of breast lesions on mammograms have been developed and have received FDA approval for clinical use. CAD may be defined as a diagnosis made by a physician who takes into account the computer output as a "second opinion". The purpose of CAD is to improve the quality and productivity of physicians in their interpretation of radiologic images. The quality of their work can be improved in terms of the accuracy and consistency of their radiologic diagnoses. In addition, the productivity of radiologists is expected to be improved by a reduction in the time required for their image readings. The computer output is derived from quantitative analysis of radiologic images by use of various methods and techniques in computer vision, artificial intelligence, and artificial neural networks (ANNs). The computer output may indicate a number of important parameters, for example, the locations of potential lesions such as lung cancer and breast cancer, the likelihood of malignancy of detected lesions, and the likelihood of various diseases based on differential diagnosis in a given image and clinical parameters. In this review article, the basic concept of CAD is first defined, and the current status of CAD research is then described. In addition, the potential of CAD in the future is discussed and predicted.

  9. Recent Developments in Instrumentation for Pre-Clinical Imaging Studies

    International Nuclear Information System (INIS)

    Meikle, S.R.

    2002-01-01

    Full text: Recent advances in imaging instrumentation have led to a variety of tomograph designs for dedicated pre clinical imaging of laboratory animals. These advances make it possible to image and quantify the kinetics of radiolabelled pharmaceuticals in a wide range of animal models from rodents to non-human primates. Applications include evaluation of promising new radiopharmaceuticals, study of the molecular origins of human disease and evaluation of new forms of therapy. These applications and advances in instrumentation are equally applicable to positron emitters and single photon emitters. This paper provides an overview of recent advances which have led to the current state-of-the-art in pre clinical imaging. The common inorganic scintillators that have been used for SPECT and PET, including some of the promising materials recently studied. The current crystal of choice for SPECT imaging is NaI(Tl) because of its high light output and density which make it well suited to imaging photons in the 100-200 keV range. However, NaI(Tl) has the disadvantage that it must be hermetically sealed to prevent absorption of moisture from the environment. Therefore, investigators have explored a number of alternative inorganic crystals, including CsI(Tl) and cerium-doped yttrium aluminium perovskite (YAP), as well as solid state detectors such as cadmium zinc telluride (CZT). Many of the crystals used in SPECT have also been tried for PET, including NaI(Tl) and YAP. However these crystals have lower stopping power than BGO and NaI(Tl) is also relatively slow. A very promising scintillator for PET is cerium-doped lutetium oxyorthosilicate (LSO) (1) which has similar stopping power to BGO and relatively high light output and fast decay. The first PET scanner to use LSO was the UCLA animal scanner, microPET, which also makes use of a number of other new technologies and unique design features. Recently, improvements in multi-anode and crossed wire position sensitive

  10. Clinical comparison between 100 mm photofluorography and digital (1024/sup 2/) fluoroscopic image acquisition

    International Nuclear Information System (INIS)

    Hynes, D.M.; Edmonds, E.W.; Rowlands, J.A.; Porter, A.J.; Toth, B.D.

    1986-01-01

    The authors describe current work in progress in which a clinical image can be recorded on both 100-mm film and a 1,024/sup 2/ image store with the same exposure. The 100-mm film is exposed in the usual manner. However, the same radiation exposure is utilized by the optics of the beam splitter to transfer the output image of the intensifier into a 1,024/sup 2/ image store and thence to hard copy by multiformat camera or laser printer. Comparative phantom and clinical images will be presented, along with observations on dose rates needed for diagnostic digital imaging. Use of this system may allow fluoroscopic dose rates to be reduced

  11. A review of the current state of digital plate reading of cultures in clinical microbiology.

    Science.gov (United States)

    Rhoads, Daniel D; Novak, Susan M; Pantanowitz, Liron

    2015-01-01

    Digital plate reading (DPR) is increasingly being adopted as a means to facilitate the analysis and improve the quality and efficiency within the clinical microbiology laboratory. This review discusses the role of DPR in the context of total laboratory automation and explores some of the platforms currently available or in development for digital image capturing of microbial growth on media. The review focuses on the advantages and challenges of DPR. Peer-reviewed studies describing the utility and quality of these novel DPR systems are largely lacking, and professional guidelines for DPR implementation and quality management are needed. Further development and more widespread adoption of DPR is anticipated.

  12. Magnetic resonance imaging in clinically-definite multiple sclerosis

    International Nuclear Information System (INIS)

    Noakes, J.B.; Herkes, G.K.; Frith, J.A.

    1990-01-01

    Forty-two patients with clinically-definite multiple sclerosis were examined by magnetic resonance imaging using a 1.5-T instrument. Magnetic resonance imaging detected an abnormality in 90% of patients. In four patients, no lesions were demonstrated. The number, size and site of the lesions by magnetic resonance imaging were compared with the patients' clinical status and other variables. The Kurtzke disability status scale score increased in patients with corpus callosum atrophy, brainstem and basal ganglia lesions, and correlated with the total number of lesions. No correlation was shown between the findings of magnetic resonance imaging and disease duration, age, sex or pattern-reversal visual-evoked potentials. The variety of magnetic resonance images that could be obtained in patients with clinically-definite multiple sclerosis is highlighted. 24 refs., 8 figs., 1 tab

  13. Imaging the male reproductive tract: current trends and future directions.

    NARCIS (Netherlands)

    Futterer, J.J.; Heijmink, S.W.T.P.J.; Spermon, J.R.

    2008-01-01

    The male reproductive system encompasses several organs: the testes, ejaculatory ducts, seminal vesicles, prostate, and penis. The function of this system is to accomplish reproduction. Diagnostic imaging modalities, such as ultrasound, CT, MR imaging, and positron emission tomography (PET), are

  14. Clinical proteomics: Current status, challenges, and future perspectives

    Directory of Open Access Journals (Sweden)

    Shyh-Horng Chiou

    2011-01-01

    Full Text Available This account will give an overview and evaluation of the current advances in mass spectrometry (MS-based proteomics platforms and technology. A general review of some background information concerning the application of these methods in the characterization of molecular sizes and related protein expression profiles associated with different types of cells under varied experimental conditions will be presented. It is intended to provide a concise and succinct overview to those clinical researchers first exposed to this foremost powerful methodology in modern life sciences of postgenomic era. Proteomic characterization using highly sophisticated and expensive instrumentation of MS has been used to characterize biological samples of complex protein mixtures with vastly different protein structure and composition. These systems are then used to highlight the versatility and potential of the MS-based proteomic strategies for facilitating protein expression analysis of various disease-related organisms or tissues of interest. Major MS-based strategies reviewed herein include (1 matrix-assisted laser desorption ionization-MS and electron-spray ionization proteomics; (2 one-dimensional or two-dimensional gel-based proteomics; (3 gel-free shotgun proteomics in conjunction with liquid chromatography/tandem MS; (4 Multiple reaction monitoring coupled tandem MS quantitative proteomics and; (5 Phosphoproteomics based on immobilized metal affinity chromatography and liquid chromatography-MS/MS.

  15. Magnetic Resonance Imaging in Malawi: Contributions to Clinical ...

    African Journals Online (AJOL)

    Magnetic Resonance Imaging in Malawi: Contributions to Clinical Care, Medical Education and Biomedical Research. MJ Potchen, S Kampondeni, GL Birbeck, CA Hammond, A Gonani, KS Phiri, KB Seydel, TE Taylor ...

  16. Spine imaging after lumbar disc replacement: pitfalls and current recommendations

    OpenAIRE

    Robinson, Yohan; Sand?n, Bengt

    2009-01-01

    Abstract Background Most lumbar artificial discs are still composed of stainless steel alloys, which prevents adequate postoperative diagnostic imaging of the operated region when using magnetic resonance imaging (MRI). Thus patients with postoperative radicular symptoms or claudication after stainless steel implants often require alternative diagnostic procedures. Methods Possible complications of lumbar total disc replacement (TDR) are reviewed from the available literature and imaging reco...

  17. Differentiation of true anophthalmia from clinical anophthalmia using neuroradiological imaging

    OpenAIRE

    Celebi, Ali Riza Cenk; Sasani, Hadi

    2014-01-01

    Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit. It is associated with many known syndromes. Clinical findings, as well as imaging modalities and genetic analysis, are important in making the diagnosis. Imaging modalities are crucial scanning methods. Cryptophthalmos, cyclopia, synophthalmia and congenital cystic eye should be considered in differential diagnoses. We report two clinical anophthalmic siblings, emphasizing the importance of ...

  18. Multimodal imaging of bone metastases: From preclinical to clinical applications

    Directory of Open Access Journals (Sweden)

    Stephan Ellmann

    2015-10-01

    Full Text Available Metastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

  19. Current referral practices and adolescent transition to Adult clinic ...

    African Journals Online (AJOL)

    2016-02-02

    Feb 2, 2016 ... of adolescent transition from child to adult care ... from paediatric to adult clinics. Adolescent ... The fate of older adolescent patients in paediatric clinics is either one of ..... fer depends on physical and psychological factors and.

  20. Study of the leakage current of clinical dosimeters for teletherapy

    International Nuclear Information System (INIS)

    Damatto, Willian B.; Santos, Gelson P.; Potiens, Maria da Penha A.; Caldas, Linda V.E.; Vivolo, Vitor

    2009-01-01

    This work demonstrates the importance of quality control of clinical dosemeters and therefore the equipment for radiotherapy treatment, exhibiting the necessary care related to answers and sensibilities and the possible defects of the clinical assembly

  1. Incidental ferumoxytol artifacts in clinical brain MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bowser, Bruce A.; Campeau, Norbert G.; Carr, Carrie M.; Diehn, Felix E.; McDonald, Jennifer S.; Miller, Gary M.; Kaufmann, Timothy J. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2016-11-15

    Ferumoxytol (Feraheme) is a parenteral therapy approved for treatment of iron deficiency anemia. The product insert for ferumoxytol states that it may affect the diagnostic ability of MRI for up to 3 months. However, the expected effects may not be commonly recognized among clinical neuroradiologists. Our purpose is to describe the artifacts we have seen at our institution during routine clinical practice. We reviewed the patients at our institution that had brain MRI performed within 90 days of receiving intravenous ferumoxytol. The imaging was reviewed for specific findings, including diffusion-weighted imaging vascular susceptibility artifact, gradient-echo echo-planar T2*-weighted vascular susceptibility artifact, SWI/SWAN vascular susceptibility artifact, hypointense vascular signal on T2-weighted images, pre-gadolinium contrast vascular enhancement on magnetization-prepared rapid acquisition gradient echo (MPRAGE) imaging, and effects on post-gadolinium contrast T1 imaging. Multiple artifacts were observed in patients having a brain MRI within 3 days of receiving intravenous ferumoxytol. These included susceptibility artifact on DWI, GRE, and SWAN/SWI imaging, pre-gadolinium contrast increased vascular signal on MPRAGE imaging, and decreased expected enhancement on post-gadolinium contrast T1-weighted imaging. Ferumoxytol can create imaging artifacts which complicate clinical interpretation when brain MRI is performed within 3 days of administration. Recognition of the constellation of artifacts produced by ferumoxytol is important in order to obviate additional unnecessary examinations and mitigate errors in interpretation. (orig.)

  2. Ultrasound Image Quality Assessment: A framework for evaluation of clinical image quality

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Pedersen, Mads Møller; Nikolov, Svetoslav Ivanov

    2010-01-01

    Improvement of ultrasound images should be guided by their diagnostic value. Evaluation of clinical image quality is generally performed subjectively, because objective criteria have not yet been fully developed and accepted for the evaluation of clinical image quality. Based on recommendation 50...... information, which is fast enough to get sufficient number of scans under realistic operating conditions, so that statistical evaluation is valid and reliable....

  3. Clinical and imaging findings in spinal cord arteriovenous malformations

    International Nuclear Information System (INIS)

    Kim, Sang Heum; Kim, Dong Ik; Yoon, Pyeong Ho; Jeon, Pyoung; Ihn, Yeon Kwon

    1997-01-01

    The purpose of this study is to evaluate the findings of magnetic resonance (MR) imaging and selective spinal angiography of spinal cord arteriovenous malformations (SCAVMs) and to investigate the correlation of these findings with the development of clinical symptoms. In 16 patients diagnosed as suffering from SCAVMs, MR imaging and selective spinal angiograms were retrospectively analyzed and correlated with clinical symptoms. Clinical data were reviewed, especially concerning the mode of onset of clinical symptoms, and MR images of SCAVMs were evaluated with regard to the following parameters: spinal cord swelling with T2 hyperintensity, cord atrophy, intramedullary hemorrhage, and contrast enhancement of the spinal cord. Selective spinal angiographic findings of SCAVMs were also evaluated in terms of the following , parameters: type of SCAVM, presence of aneurysms, and patterns of venous drainage. Imaging findings were also correlated with the development of clinical symptoms. Systematic evaluation of the findings of MR imaging and angiography provides detailed information on the type of AVM and status of the spinal cord parenchyma, and this can be correlated with clinical manifestations of SCAVM. In patients suffering from this condition, spinal cord dysfunction due to venous congestion appears to be the main cause of clinical symptoms. (author). 18 refs., 2 tabs., 3 figs

  4. Diagnosis, imaging and clinical management of aortic coarctation.

    Science.gov (United States)

    Dijkema, Elles J; Leiner, Tim; Grotenhuis, Heynric B

    2017-08-01

    Coarctation of the aorta (CoA ) is a well-known congenital heart disease (CHD) , which is often associated with several other cardiac and vascular anomalies, such as bicuspid aortic valve (BAV), ventricular septal defect, patent ductus arteriosus and aortic arch hypoplasia. Despite echocardiographic screening, prenatal diagnosis of C o A remains difficult. Most patients with CoA present in infancy with absent, delayed or reduced femoral pulses, a supine arm-leg blood pressure gradient (> 20 mm Hg), or a murmur due to rapid blood flow across the CoA or associated lesions (BAV). Transthoracic echocardiography is the primary imaging modality for suspected CoA. However, cardiac magnetic resonance imaging is the preferred advanced imaging modality for non-invasive diagnosis and follow-up of CoA. Adequate and timely diagnosis of CoA is crucial for good prognosis, as early treatment is associated with lower risks of long-term morbidity and mortality. Numerous surgical and transcatheter treatment strategies have been reported for CoA. Surgical resection is the treatment of choice in neonates, infants and young children. In older children (> 25 kg) and adults, transcatheter treatment is the treatment of choice. In the current era, patients with CoA continue to have a reduced life expectancy and an increased risk of cardiovascular sequelae later in life, despite adequate relief of the aortic stenosis. Intensive and adequate follow-up of the left ventricular function, valvular function, blood pressure and the anatomy of the heart and the aorta are , therefore, critical in the management of CoA. This review provides an overview of the current state-of-the-art clinical diagnosis, diagnostic imaging algori thms, treatment and follow-up of patients with CoA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Terahertz endoscopic imaging for colorectal cancer detection: Current status and future perspectives.

    Science.gov (United States)

    Doradla, Pallavi; Joseph, Cecil; Giles, Robert H

    2017-08-16

    Terahertz (THz) imaging is progressing as a robust platform for myriad applications in the field of security, health, and material science. The THz regime, which comprises wavelengths spanning from microns to millimeters, is non-ionizing and has very low photon energy: Making it inherently safe for biological imaging. Colorectal cancer is one of the most common causes of death in the world, while the conventional screening and standard of care yet relies exclusively on the physician's experience. Researchers have been working on the development of a flexible THz endoscope, as a potential tool to aid in colorectal cancer screening. This involves building a single-channel THz endoscope, and profiling the THz response from colorectal tissue, and demonstrating endogenous contrast levels between normal and diseased tissue when imaging in reflection modality. The current level of contrast provided by the prototype THz endoscopic system represents a significant step towards clinical endoscopic application of THz technology for in-vivo colorectal cancer screening. The aim of this paper is to provide a short review of the recent advances in THz endoscopic technology and cancer imaging. In particular, the potential of single-channel THz endoscopic imaging for colonic cancer screening will be highlighted.

  6. Acoustic Imaging of a Turbidity Current Flowing along a Channel

    Science.gov (United States)

    Hughes Clarke, J. E.; Hiroji, A.; Cahill, L.; Fedele, J. J.

    2017-12-01

    As part of a 3 month sequence of repetitive surveys and ADCP monitoring, more than 30 turbidity currents have been identified modifying a lobe channel in 130 to 190m of water on the Squamish prodelta. For a 6 day period, daily surveys at low tide tried to capture the change resulting from a single flow. On the 8thof June three flows occurred within a half hour. Along channel multibeam images of the seabed and water column were obtained from a moving vessel immediately before, during and after the passage of the third flow. In this manner the spatial extent of the in-channel and overbank flow could be constrained. By following the flow, the spatial pattern of scattering from the flow upper surface could be examined over a 2 km length of the channel. Along channel bands of high scattering appear related to enhanced release of gas along the channel flanks. Notably, no signature of the underlying across-channel bedform modulations were evident, suggesting that the upper surface of the flow does not feel the influence of the channel floor. Overbank spillage of the flow could be detected by perturbation of a plankton scattering layer just above the seabed. Additionally, evidence of enhanced overbank deposition due to flow stripping on the outer corner of a bend was identified from backscatter changes. The specific seabed alteration due to this flow could be identified and compared with the cumulative change over three months in the channel and adjacent channel-lobe transition zone. As the flow passed under the ADCP, it had a peak velocity of over 2 m/s, a thickness of 4-5m and duration of 35 minutes. Based on the timing of the flow head when in view of the surface vessel, it was decelerating as it exited the mouth of the channel.

  7. Clinical Features and Patterns of Imaging in Cerebral Venous Sinus ...

    African Journals Online (AJOL)

    Background: Cerebral venous sinus thrombosis (CVST) is an uncommon neurological deficit. It shows a wide range of clinical manifestations that may mimic many other neurological disorders and lead to misdiagnosis. Imaging plays a key role in the diagnosis. Objective: To evaluate the clinical characteristics and patterns ...

  8. Idiopathic granulomatous hypophysitis: clinical and imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Vasile, M. [Service de Radiologie, Hopital Saint-Antoine, 75 - Paris (France); Marsot-Dupuch, K. [Service de Radiologie, Hopital Saint-Antoine, 75 - Paris (France); Kujas, M. [Service d`Histologie Embryologie Cytogenetique, Hopital Pitie-Salpetriere, 75 - Paris (France); Brunereau, L. [Service de Radiologie, Hopital Saint-Antoine, 75 - Paris (France); Bouchard, P. [Service d`Histologie Embryologie Cytogenetique, Hopital Pitie-Salpetriere, 75 - Paris (France); Comoy, J. [Service de Neurochirurgie, Hopital Kremlin Bicetre, 94 (France); Tubiana, J.M. [Service de Radiologie, Hopital Saint-Antoine, 75 - Paris (France)

    1997-01-01

    Idiopathic pituitary granuloma is a rare disorder similar to lymphocytic adenohypophysitis. Few cases have been reported. We report a new histologically case proven with MRI. The patterns of clinical and radiological presentation and the management of this disorder are discussed. MRI findings suggestive of this condition include an intensely enhancing pituitary mass, associated with dural enhancement. Steroid therapy may be suggested avoiding unnecessary surgery. (orig.)

  9. [Microdose clinical trial--impact of PET molecular imaging].

    Science.gov (United States)

    Yano, Tsuneo; Watanabe, Yasuyoshi

    2010-10-01

    Microdose (MD) clinical trial and exploratory IND study including sub-therapeutic dose and therapeutic dose which are higher than microdoses are expected to bring about innovations in drug development. The outlines of guidances for microdose clinical trial and ICH-M3 (R2) issued by the MHLW in June, 2008, and February, 2010, are first explained, respectively, and some examples of their application to clinical developments of therapeutic drugs in the infection and cancer fields are introduced. Especially, thanks to the progress of molecular imaging research, a new field of drug development is explored by using imaging biomarkers for efficacy or safety evaluation which visualize biomarkers by PET imaging agents. Finally, the roadmap for drug development in infection and cancer fields utilizing PET molecular imaging is discussed.

  10. Imaging and Data Acquisition in Clinical Trials for Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    FitzGerald, Thomas J., E-mail: Thomas.Fitzgerald@umassmed.edu [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Bishop-Jodoin, Maryann [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Followill, David S. [Imaging and Radiation Oncology Core Houston, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Galvin, James [Imaging and Radiation Oncology Core Philadelphia, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Knopp, Michael V. [Imaging and Radiation Oncology Core Ohio, Wexner Medical Center, Ohio State University, Columbus, Ohio (United States); Michalski, Jeff M. [Imaging and Radiation Oncology Core St. Louis, Washington University School of Medicine, St. Louis, Missouri (United States); Rosen, Mark A. [Imaging and Radiation Oncology Core Philadelphia, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Bradley, Jeffrey D. [Washington University School of Medicine–Radiation Oncology, St. Louis, Missouri (United States); Shankar, Lalitha K. [National Cancer Institute, Clinical Radiation Oncology Branch, Rockville, Maryland (United States); Laurie, Fran [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Cicchetti, M. Giulia; Moni, Janaki [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Coleman, C. Norman; Deye, James A.; Capala, Jacek; Vikram, Bhadrasain [National Cancer Institute, Clinical Radiation Oncology Branch, Rockville, Maryland (United States)

    2016-02-01

    Cancer treatment evolves through oncology clinical trials. Cancer trials are multimodal and complex. Assuring high-quality data are available to answer not only study objectives but also questions not anticipated at study initiation is the role of quality assurance. The National Cancer Institute reorganized its cancer clinical trials program in 2014. The National Clinical Trials Network (NCTN) was formed and within it was established a Diagnostic Imaging and Radiation Therapy Quality Assurance Organization. This organization is Imaging and Radiation Oncology Core, the Imaging and Radiation Oncology Core Group, consisting of 6 quality assurance centers that provide imaging and radiation therapy quality assurance for the NCTN. Sophisticated imaging is used for cancer diagnosis, treatment, and management as well as for image-driven technologies to plan and execute radiation treatment. Integration of imaging and radiation oncology data acquisition, review, management, and archive strategies are essential for trial compliance and future research. Lessons learned from previous trials are and provide evidence to support diagnostic imaging and radiation therapy data acquisition in NCTN trials.

  11. Imaging and Data Acquisition in Clinical Trials for Radiation Therapy

    International Nuclear Information System (INIS)

    FitzGerald, Thomas J.; Bishop-Jodoin, Maryann; Followill, David S.; Galvin, James; Knopp, Michael V.; Michalski, Jeff M.; Rosen, Mark A.; Bradley, Jeffrey D.; Shankar, Lalitha K.; Laurie, Fran; Cicchetti, M. Giulia; Moni, Janaki; Coleman, C. Norman; Deye, James A.; Capala, Jacek; Vikram, Bhadrasain

    2016-01-01

    Cancer treatment evolves through oncology clinical trials. Cancer trials are multimodal and complex. Assuring high-quality data are available to answer not only study objectives but also questions not anticipated at study initiation is the role of quality assurance. The National Cancer Institute reorganized its cancer clinical trials program in 2014. The National Clinical Trials Network (NCTN) was formed and within it was established a Diagnostic Imaging and Radiation Therapy Quality Assurance Organization. This organization is Imaging and Radiation Oncology Core, the Imaging and Radiation Oncology Core Group, consisting of 6 quality assurance centers that provide imaging and radiation therapy quality assurance for the NCTN. Sophisticated imaging is used for cancer diagnosis, treatment, and management as well as for image-driven technologies to plan and execute radiation treatment. Integration of imaging and radiation oncology data acquisition, review, management, and archive strategies are essential for trial compliance and future research. Lessons learned from previous trials are and provide evidence to support diagnostic imaging and radiation therapy data acquisition in NCTN trials.

  12. Analysis and clinical usefullness of cardiac ECT images

    International Nuclear Information System (INIS)

    Hayashi, Makoto; Kagawa, Masaaki; Yamada, Yukinori

    1983-01-01

    We estimated basically and clinically myocardial ECT image and ECG gated cardiac blood-pool ECT image. ROC curve is used for the evaluation of the accuracy in diagnostic myocardial infarction. The accuracy in diagnostic of MI is superior in myocardial ECT image and ECT estimation is unnecessary skillfulness and experience. We can absene the whole defect of MI than planar image by using ECT. LVEDV between estimated volume and contrast volume is according to it and get one step for automatic analysis of cardiac volume. (author)

  13. Clinical PET/CT imaging. Promises and misconceptions

    International Nuclear Information System (INIS)

    Czernin, J.; Auerbach, M.A.

    2005-01-01

    PET/CT is now established as the most important imaging tool in oncology. PET/CT stages and restages cancer with a higher accuracy than PET or CT alone. The sometimes irrational approach to combine state of the art PET with the highest end CT devices should give way to a more reasonable equipment design tailored towards the specific clinical indications in well-defined patient populations. The continuing success of molecular PET/CT now depends more upon advances in molecular imaging with the introduction of targeted imaging probes for individualized therapy approaches in cancer patients and less upon technological advances of imaging equipment. (orig.)

  14. Quantitative Clinical Imaging Methods for Monitoring Intratumoral Evolution.

    Science.gov (United States)

    Kim, Joo Yeun; Gatenby, Robert A

    2017-01-01

    Solid tumors are multiscale, open, complex, dynamic systems: complex because they have many interacting components, dynamic because both the components and their interactions can change with time, and open because the tumor freely communicates with surrounding and even distant host tissue. Thus, it is not surprising that striking intratumoral variations are commonly observed in clinical imaging such as MRI and CT and that several recent studies found striking regional variations in the molecular properties of cancer cells from the same tumor. Interestingly, this spatial heterogeneity in molecular properties of tumor cells is typically ascribed to branching clonal evolution due to accumulating mutations while macroscopic variations observed in, for example, clinical MRI scans are usually viewed as functions of blood flow. The clinical significance of spatial heterogeneity has not been fully determined but there is a general consensus that the varying intratumoral landscape along with patient factors such as age, morbidity and lifestyle, contributes significantly to the often unpredictable response of individual patients within a disease cohort treated with the same standard-of-care therapy.Here we investigate the potential link between macroscopic tumor heterogeneity observed by clinical imaging and spatial variations in the observed molecular properties of cancer cells. We build on techniques developed in landscape ecology to link regional variations in the distribution of species with local environmental conditions that define their habitat. That is, we view each region of the tumor as a local ecosystem consisting of environmental conditions such as access to nutrients, oxygen, and means of waste clearance related to blood flow and the local population of tumor cells that both adapt to these conditions and, to some extent, change them through, for example, production of angiogenic factors. Furthermore, interactions among neighboring habitats can produce broader

  15. Weight status and body image perceptions in adolescents: current perspectives.

    Science.gov (United States)

    Voelker, Dana K; Reel, Justine J; Greenleaf, Christy

    2015-01-01

    Adolescence represents a pivotal stage in the development of positive or negative body image. Many influences exist during the teen years including transitions (eg, puberty) that affect one's body shape, weight status, and appearance. Weight status exists along a spectrum between being obese (ie, where one's body weight is in the 95th percentile for age and gender) to being underweight. Salient influences on body image include the media, which can target adolescents, and peers who help shape beliefs about the perceived body ideal. Internalization of and pressures to conform to these socially prescribed body ideals help to explain associations between weight status and body image. The concepts of fat talk and weight-related bullying during adolescence greatly contribute to an overemphasis on body weight and appearance as well as the development of negative body perceptions and dissatisfaction surrounding specific body parts. This article provides an overview of the significance of adolescent development in shaping body image, the relationship between body image and adolescent weight status, and the consequences of having a negative body image during adolescence (ie, disordered eating, eating disorders, and dysfunctional exercise). Practical implications for promoting a healthy weight status and positive body image among adolescents will be discussed.

  16. Optical Imaging of Ionizing Radiation from Clinical Sources.

    Science.gov (United States)

    Shaffer, Travis M; Drain, Charles Michael; Grimm, Jan

    2016-11-01

    Nuclear medicine uses ionizing radiation for both in vivo diagnosis and therapy. Ionizing radiation comes from a variety of sources, including x-rays, beam therapy, brachytherapy, and various injected radionuclides. Although PET and SPECT remain clinical mainstays, optical readouts of ionizing radiation offer numerous benefits and complement these standard techniques. Furthermore, for ionizing radiation sources that cannot be imaged using these standard techniques, optical imaging offers a unique imaging alternative. This article reviews optical imaging of both radionuclide- and beam-based ionizing radiation from high-energy photons and charged particles through mechanisms including radioluminescence, Cerenkov luminescence, and scintillation. Therapeutically, these visible photons have been combined with photodynamic therapeutic agents preclinically for increasing therapeutic response at depths difficult to reach with external light sources. Last, new microscopy methods that allow single-cell optical imaging of radionuclides are reviewed. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  17. FDG PET/CT in infection and inflammation—current and emerging clinical applications

    International Nuclear Information System (INIS)

    Vaidyanathan, S.; Patel, C.N.; Scarsbrook, A.F.; Chowdhury, F.U.

    2015-01-01

    Integrated positron emission tomography/computed tomography (PET/CT) with the glucose analogue, 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG), is an evolving hybrid imaging technique in the evaluation of an important and diverse group of pathological conditions, which are characterised by infection and aseptic inflammation. With a rapidly expanding body of evidence, it is being increasingly recognised that, in addition to its established role in oncological imaging, FDG PET/CT also has clinical utility in suspected infection and inflammation. The technique can identify the source of infection or inflammation in a timely fashion ahead of morphological changes on conventional anatomical imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), map the extent and severity of disease, identify sites for tissue sampling, and assess therapy response. FDG PET/CT exhibits distinct advantages over traditional radionuclide imaging techniques in terms of shorter duration of examination, higher spatial resolution, non-invasive nature of acquisition, ability to perform quantitative analyses, and the provision of a synergistic combination of functional and anatomical imaging. With the use of illustrative clinico-radiological cases, this article discusses the current and emerging evidence for the use of FDG PET/CT in a broad spectrum of disorders, such as fever of unknown origin, sarcoidosis, large vessel vasculitis, musculoskeletal infections, joint prosthesis or implant-related complications, human immunodeficiency virus (HIV)-related infections, and miscellaneous indications, such as IgG4-related systemic disease. It will also briefly summarise the role of more novel tracers such as FDG-labelled leukocytes and gallium-68 PET tracers in this arena

  18. Microvascular imaging: techniques and opportunities for clinical physiological measurements

    International Nuclear Information System (INIS)

    Allen, John; Howell, Kevin

    2014-01-01

    The microvasculature presents a particular challenge in physiological measurement because the vessel structure is spatially inhomogeneous and perfusion can exhibit high variability over time. This review describes, with a clinical focus, the wide variety of methods now available for imaging of the microvasculature and their key applications. Laser Doppler perfusion imaging and laser speckle contrast imaging are established, commercially-available techniques for determining microvascular perfusion, with proven clinical utility for applications such as burn-depth assessment. Nailfold capillaroscopy is also commercially available, with significant published literature that supports its use for detecting microangiopathy secondary to specific connective tissue diseases in patients with Raynaud's phenomenon. Infrared thermography measures skin temperature and not perfusion directly, and it has only gained acceptance for some surgical and peripheral microvascular applications. Other emerging technologies including imaging photoplethysmography, optical coherence tomography, photoacoustic tomography, hyperspectral imaging, and tissue viability imaging are also described to show their potential as techniques that could become established tools for clinical microvascular assessment. Growing interest in the microcirculation has helped drive the rapid development in perfusion imaging of the microvessels, bringing exciting opportunities in microvascular research. (topical review)

  19. An adaptive optics imaging system designed for clinical use

    Science.gov (United States)

    Zhang, Jie; Yang, Qiang; Saito, Kenichi; Nozato, Koji; Williams, David R.; Rossi, Ethan A.

    2015-01-01

    Here we demonstrate a new imaging system that addresses several major problems limiting the clinical utility of conventional adaptive optics scanning light ophthalmoscopy (AOSLO), including its small field of view (FOV), reliance on patient fixation for targeting imaging, and substantial post-processing time. We previously showed an efficient image based eye tracking method for real-time optical stabilization and image registration in AOSLO. However, in patients with poor fixation, eye motion causes the FOV to drift substantially, causing this approach to fail. We solve that problem here by tracking eye motion at multiple spatial scales simultaneously by optically and electronically integrating a wide FOV SLO (WFSLO) with an AOSLO. This multi-scale approach, implemented with fast tip/tilt mirrors, has a large stabilization range of ± 5.6°. Our method consists of three stages implemented in parallel: 1) coarse optical stabilization driven by a WFSLO image, 2) fine optical stabilization driven by an AOSLO image, and 3) sub-pixel digital registration of the AOSLO image. We evaluated system performance in normal eyes and diseased eyes with poor fixation. Residual image motion with incremental compensation after each stage was: 1) ~2–3 arc minutes, (arcmin) 2) ~0.5–0.8 arcmin and, 3) ~0.05–0.07 arcmin, for normal eyes. Performance in eyes with poor fixation was: 1) ~3–5 arcmin, 2) ~0.7–1.1 arcmin and 3) ~0.07–0.14 arcmin. We demonstrate that this system is capable of reducing image motion by a factor of ~400, on average. This new optical design provides additional benefits for clinical imaging, including a steering subsystem for AOSLO that can be guided by the WFSLO to target specific regions of interest such as retinal pathology and real-time averaging of registered images to eliminate image post-processing. PMID:26114033

  20. Current Role of Imaging in Diagnosing Aortic Graft Infections

    NARCIS (Netherlands)

    Bruggink, Janneke L. M.; Slart, Riemer H. J. A.; Pol, Jillis A.; Reijnen, Michel M. P. J.; Zeebregts, Clark J.

    2011-01-01

    Vascular prosthetic graft infection is a rare but serious complication after aortic graft replacement, with high morbidity and mortality rates. Therefore, adequate diagnostics are needed to detect and treat these infections as early as possible. Several imaging modalities provide different

  1. Thermal imaging for current D&S priorities

    Science.gov (United States)

    Craig, Robert; Parsons, John F.

    2012-11-01

    Supplying thermal imagers for today's operational needs requires flexibility, responsiveness and ever reducing costs. This paper will use the latest thermal imager development in the Catherine range from Thales UK to address the technical interactions with such issues as modularity, re-use, regions of deployment and supply chain management. All this is in the context of the increasingly public operations and the pressures on validating performance especially when weapon aiming is involved.

  2. Current features of primary tuberculosis on medical imaging based on a series of fourteen cases

    International Nuclear Information System (INIS)

    Ouzidane, L.; Adamsbaum, C.; Cohen, P.A.; Kalifa, G.; Gendrel, D.

    1995-01-01

    Active pulmonary tuberculosis, a source of contamination, is currently undergoing a recrudescence in developed countries, particularly in clinical contexts of immuno-depression. The authors report a retrospective series of 14 cases of primary tuberculosis in a paediatric population (7 girls and 7 boys) with a mean age of 3.5 years (range: 4 months - 16 years) observed over a 3-year period. After reviewing the current radiological features of patent primary tuberculosis, the authors emphasize the contribution of chest CT scan in latent forms with a normal chest x-ray and a difficult bacteriological diagnosis. Imaging remains an essential tool in early diagnosis, therapeutic management and active surveillance of this form. The authors propose a decisional flow-chart in the case of suspected primary tuberculosis in children. (authors). 20 refs., 8 figs

  3. Three-dimensional imaging and scanning: Current and future applications for pathology

    Directory of Open Access Journals (Sweden)

    Navid Farahani

    2017-01-01

    Full Text Available Imaging is vital for the assessment of physiologic and phenotypic details. In the past, biomedical imaging was heavily reliant on analog, low-throughput methods, which would produce two-dimensional images. However, newer, digital, and high-throughput three-dimensional (3D imaging methods, which rely on computer vision and computer graphics, are transforming the way biomedical professionals practice. 3D imaging has been useful in diagnostic, prognostic, and therapeutic decision-making for the medical and biomedical professions. Herein, we summarize current imaging methods that enable optimal 3D histopathologic reconstruction: Scanning, 3D scanning, and whole slide imaging. Briefly mentioned are emerging platforms, which combine robotics, sectioning, and imaging in their pursuit to digitize and automate the entire microscopy workflow. Finally, both current and emerging 3D imaging methods are discussed in relation to current and future applications within the context of pathology.

  4. Magnetic Resonance Imaging in Aneurysmal Subarachnoid Hemorrhage: Current Evidence and Future Directions.

    Science.gov (United States)

    Nelson, Sarah E; Sair, Haris I; Stevens, Robert D

    2018-04-09

    Aneurysmal subarachnoid hemorrhage (aSAH) is associated with an unacceptably high mortality and chronic disability in survivors, underscoring a need to validate new approaches for treatment and prognosis. The use of advanced imaging, magnetic resonance imaging (MRI) in particular, could help address this gap given its versatile capacity to quantitatively evaluate and map changes in brain anatomy, physiology and functional activation. Yet there is uncertainty about the real value of brain MRI in the clinical setting of aSAH. In this review, we discuss current and emerging MRI research in aSAH. PubMed was searched from inception to June 2017, and additional studies were then chosen on the basis of relevance to the topics covered in this review. Available studies suggest that brain MRI is a feasible, safe, and valuable testing modality. MRI detects brain abnormalities associated with neurologic examination, outcomes, and aneurysm treatment and thus has the potential to increase knowledge of aSAH pathophysiology as well as to guide management and outcome prediction. Newer pulse sequences have the potential to reveal structural and physiological changes that could also improve management of aSAH. Research is needed to confirm the value of MRI-based biomarkers in clinical practice and as endpoints in clinical trials, with the goal of improving outcome for patients with aSAH.

  5. Clinical advantages of three dimensional cine cardiac images

    International Nuclear Information System (INIS)

    Kinosada, Yasutomi; Okuda, Yasuyuki; Nakagawa, Tsuyoshi; Itou, Takafumi; Hattori, Takao.

    1996-01-01

    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. Clinical evaluation of FMPSPGR sequence of the brain MR imaging

    International Nuclear Information System (INIS)

    Takahashi, Mitsuyuki; Hasegawa, Makoto; Mori, Naohiko; Yamanoguchi, Minoru; Matsubara, Tadashi

    1998-01-01

    In order to apply the FMPSPGR (fast multi planar spoiled GRASS) method to diagnose brain diseases, authors obtained the optimal condition for imaging by the phantom experiments and examined the clinical usefulness. Six kinds of the phantom, which were 4 of diluted Gd solution with different concentrations, olive oil and physiological saline solution were used. From the phantom experiments, TR/TE/FR=300/3.3/90 degrees was the optimal condition. The evaluation of the clinical images was performed on the same section by the ST method and the FMPSPGR method. Fifteen patients (9 men and 6 women, aged from 17 to 80 years) suspected of brain diseases were examined, including 8 of cerebral infarction, 1 of pontine infarction, 1 of brain contusion, 1 of intracerebral bleeding and 4 of brain tumors. Four cases of brain tumor were evaluated on the contrast imaging and the others were on the plain imaging. In the plain imaging, the FMPSPGR method was better than the SE method on the low signal region in the T1 weighted imaging. Furthermore, in the contrast imaging, it could give more clear images of the lesion in anterior cranial pit by suppressing artifacts of blood flow. The present results indicate that the FMPSPGR method is useful to diagnose brain diseases. (K.H.)

  7. Challenges in clinical studies with multiple imaging probes

    International Nuclear Information System (INIS)

    Krohn, Kenneth A.; O'Sullivan, Finbarr; Crowley, John; Eary, Janet F.; Linden, Hannah M.; Link, Jeanne M.; Mankoff, David A.; Muzi, Mark; Rajendran, Joseph G.; Spence, Alexander M.; Swanson, Kristin R.

    2007-01-01

    This article addresses two related issues: (a) When a new imaging agent is proposed, how does the imager integrate it with other biomarkers, either sampled or imaged? (b) When we have multiple imaging agents, is the information additive or duplicative and how is this objectively determined? Molecular biology is leading to new treatment options with reduced normal tissue toxicity, and imaging should have a role in objectively evaluating new treatments. There are two roles for molecular characterization of disease. Molecular imaging measurements before therapy help predict the aggressiveness of disease and identify therapeutic targets and, therefore, help choose the optimal therapy for an individual. Measurements of specific biochemical processes made during or after therapy should be sensitive measures of tumor response. The rules of evidence are not fully developed for the prognostic role of imaging biomarkers, but the potential of molecular imaging provides compelling motivation to push forward with convincing validation studies. New imaging procedures need to be characterized for their effectiveness under realistic clinical conditions to improve the management of patients and achieve a better outcome. The purpose of this article is to promote a critical discussion within the molecular imaging community because our future value to the overall biomedical community will be in supporting better treatment outcomes rather than in detection

  8. Weight status and body image perceptions in adolescents: current perspectives

    Directory of Open Access Journals (Sweden)

    Voelker DK

    2015-08-01

    Full Text Available Dana K Voelker,1 Justine J Reel,2 Christy Greenleaf3 1West Virginia University, College of Physical Activity and Sport Sciences, Morgantown, WV, 2University of North Carolina Wilmington, College of Health and Human Services, Wilmington, NC, 3University of Wisconsin–Milwaukee, College of Health Sciences, Milwaukee, WI, USA Abstract: Adolescence represents a pivotal stage in the development of positive or negative body image. Many influences exist during the teen years including transitions (eg, puberty that affect one’s body shape, weight status, and appearance. Weight status exists along a spectrum between being obese (ie, where one’s body weight is in the 95th percentile for age and gender to being underweight. Salient influences on body image include the media, which can target adolescents, and peers who help shape beliefs about the perceived body ideal. Internalization of and pressures to conform to these socially prescribed body ideals help to explain associations between weight status and body image. The concepts of fat talk and weight-related bullying during adolescence greatly contribute to an overemphasis on body weight and appearance as well as the development of negative body perceptions and dissatisfaction surrounding specific body parts. This article provides an overview of the significance of adolescent development in shaping body image, the relationship between body image and adolescent weight status, and the consequences of having a negative body image during adolescence (ie, disordered eating, eating disorders, and dysfunctional exercise. Practical implications for promoting a healthy weight status and positive body image among adolescents will be discussed. Keywords: adolescence, eating disorders, obesity, bullying, puberty, physical activity

  9. NCI Workshop Report: Clinical and Computational Requirements for Correlating Imaging Phenotypes with Genomics Signatures

    Directory of Open Access Journals (Sweden)

    Rivka Colen

    2014-10-01

    Full Text Available The National Cancer Institute (NCI Cancer Imaging Program organized two related workshops on June 26–27, 2013, entitled “Correlating Imaging Phenotypes with Genomics Signatures Research” and “Scalable Computational Resources as Required for Imaging-Genomics Decision Support Systems.” The first workshop focused on clinical and scientific requirements, exploring our knowledge of phenotypic characteristics of cancer biological properties to determine whether the field is sufficiently advanced to correlate with imaging phenotypes that underpin genomics and clinical outcomes, and exploring new scientific methods to extract phenotypic features from medical images and relate them to genomics analyses. The second workshop focused on computational methods that explore informatics and computational requirements to extract phenotypic features from medical images and relate them to genomics analyses and improve the accessibility and speed of dissemination of existing NIH resources. These workshops linked clinical and scientific requirements of currently known phenotypic and genotypic cancer biology characteristics with imaging phenotypes that underpin genomics and clinical outcomes. The group generated a set of recommendations to NCI leadership and the research community that encourage and support development of the emerging radiogenomics research field to address short-and longer-term goals in cancer research.

  10. Magnetic resonance imaging- physical principles and clinical application

    International Nuclear Information System (INIS)

    Tavri, Omprakash J.

    1996-01-01

    The advances in equipment and knowledge related to radiology are occurring at an astonishingly rapid rate. On November 8, 1895, William Conrad Roentgen discovered x-rays. In 1972, Godfrey Hounsfield and George Ambrose introduced computec tomography at a meeting of the British Institute of Radiology. In the same year, Paul Lauterbur published the idea of spatially resolving nuclear magnetic resonance samples, naming it zeugmatography. In 1977, Waldo Hinshaw and co-workers published a magnetic resonance image of a human hand and wrist, and by 1981 several centres were obtaining clinical magnetic resonance (MR) images. In a very short time, magnetic resonance imaging (MRI) has gained acceptance as a clinically useful imaging tool. (author)

  11. Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis

    DEFF Research Database (Denmark)

    Rocca, Maria A; Amato, Maria P; De Stefano, Nicola

    2015-01-01

    In patients with multiple sclerosis (MS), grey matter damage is widespread and might underlie many of the clinical symptoms, especially cognitive impairment. This relation between grey matter damage and cognitive impairment has been lent support by findings from clinical and MRI studies. However...... that causes clinical symptoms to trigger. Findings on cortical reorganisation support the contribution of brain plasticity and cognitive reserve in limiting cognitive deficits. The development of clinical and imaging biomarkers that can monitor disease development and treatment response is crucial to allow...

  12. Multilocular cystic renal cell carcinoma: imaging and clinical correlation

    International Nuclear Information System (INIS)

    Xu Yong; Zhang Sheng

    2013-01-01

    Multilocular cystic renal cell carcinoma (MCRCC) is a subtype of clear cell renal cell carcinoma and has mild clinical symptoms and a favorable prognosis. Accordingly, nephron-sparing surgery is recommended as a therapeutic strategy. If histologic subtype of MCRCC can be predicted preoperatively with an acceptable level of accuracy, it may be important in predicting prognosis and make clinical management. Most MCRCCs show characteristic cross-sectional imaging findings and permit accurate diagnosis before the treatment. Cross -sectional imaging of MCRCC reveals a well -defined multilocular cystic mass with irregularly enhanced thickened septa and without enhanced intracystic solid nodule. It is often classified as Bosniak classification Ⅲ , which is significantly different from that of other renal cystic masses. The clinical, pathologic, and radiologic features of MCRCC were discussed and illustrated in this article. The role of the imaging preoperative evaluation for MCRCC, and management implications were emphasized. (authors)

  13. Clinical advance in radionuclide imaging of pulmonary cancer

    International Nuclear Information System (INIS)

    Deng Zhiyong; Yang Lichun

    2008-01-01

    Radionuclide imaging of pulmonary cancer develops very rapidly in recent years. Its important value on the diagnosis, staging, monitoring recur and metastasis after treatment, and judging the curative effect and prognosis has been demonstrated. Clinicians pay more attention to it than before. This present article introduces the imaging principle, clinical use, good and bad points, progress situation of 67 Ga, 201 Tl, 99 Tc m , 18 F and their labelled compounds, which are more commonly used in clinical. And introduces the clinical progress of radionuclide imaging of pulmonary neoplasm concerning 99 Tc m -sestamibi ( 99 Tc m -MIBI), 99 Tc m -HL91 and 18 F-fluorodeoxyglucose ( 18 F-FDG) with emphasis. (authors)

  14. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    International Nuclear Information System (INIS)

    1990-01-01

    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not? by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens

  15. ANTIFUNGAL SUSCEPTIBILITY TESTING: CURRENT ROLE FROM THE CLINICAL LABORATORY PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Brunella Posteraro

    2014-04-01

    Full Text Available Despite availability of many antifungal agents, antifungal clinical resistance occurs, perhaps as a result of an infecting organism found to be resistant in vitro to one or more antifungals tested. Thus, antifungal susceptibility testing (AFST results, if timely generated by the clinical microbiology and communicated to clinicians, can aid them in the therapeutic decision making, especially for difficult-to-treat invasive candidiasis and aspergillosis. Although recently refined AFST methods are commercially available to allow a close antifungal resistance surveillance in many clinical setting, novel assays, relying on short-time antifungal drug exposure of fungal isolates, are upcoming tools for AFST. Based on emerging technologies such as flow cytometry, MALDI-TOF mass spectrometry, and isothermal microcalorimetry, these assays could provide a reliable means for quicker and sensitive assessment of AFST.

  16. Markerless motion estimation for motion-compensated clinical brain imaging

    Science.gov (United States)

    Kyme, Andre Z.; Se, Stephen; Meikle, Steven R.; Fulton, Roger R.

    2018-05-01

    Motion-compensated brain imaging can dramatically reduce the artifacts and quantitative degradation associated with voluntary and involuntary subject head motion during positron emission tomography (PET), single photon emission computed tomography (SPECT) and computed tomography (CT). However, motion-compensated imaging protocols are not in widespread clinical use for these modalities. A key reason for this seems to be the lack of a practical motion tracking technology that allows for smooth and reliable integration of motion-compensated imaging protocols in the clinical setting. We seek to address this problem by investigating the feasibility of a highly versatile optical motion tracking method for PET, SPECT and CT geometries. The method requires no attached markers, relying exclusively on the detection and matching of distinctive facial features. We studied the accuracy of this method in 16 volunteers in a mock imaging scenario by comparing the estimated motion with an accurate marker-based method used in applications such as image guided surgery. A range of techniques to optimize performance of the method were also studied. Our results show that the markerless motion tracking method is highly accurate (brain imaging and holds good promise for a practical implementation in clinical PET, SPECT and CT systems.

  17. Ulnar-sided wrist pain. II. Clinical imaging and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Atsuya; Souza, Felipe [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Vezeridis, Peter S.; Blazar, Philip [Brigham and Women' s Hospital, Department of Orthopaedic Surgery, Boston, MA (United States); Yoshioka, Hiroshi [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); University of California-Irvine, Department of Radiological Sciences, Irvine, CA (United States); UC Irvine Medical Center, Department of Radiological Sciences, Orange, CA (United States)

    2010-09-15

    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. (orig.)

  18. Clinical value of renal images obtained incidentally to bone scintigraphy

    International Nuclear Information System (INIS)

    Ohishi, Y.; Machida, T.; Miki, M.; Kido, A.; Tanaka, A.

    1982-01-01

    Various studies were made on 400 renal (including 325 clinical cases) observed during whole-body bone scintigraphy using 99mTc-MDP. Asymmetrical renal images in bone scintigrams were obtained from 40% of the urologic patients and 7.5% of the nonurologic patients. Out of the asymmetrical images of the urologic patients, 50% provided nonvisualized kidneys and 35% showed unilateral renal high accumulation. It can be said from the above that renal images incidentally obtained during whole-body bone scintigraphy should not be overlooked

  19. Clinical knowledge management: an overview of current understanding.

    Science.gov (United States)

    Bali, Rajeev K; Dwivedi, Ashish

    2005-01-01

    This chapter outlines contributions to a workshop for ICMCC 2005. We details some of the central issues surrounding the incorporation of the Knowledge Management (KM) paradigm for the healthcare and clinical sectors. The complex nature of KM is discussed, together with some essential theories and some contemporary applications of the tools and techniques are presented.

  20. The current status of oral contraceptive clinical development in Japan.

    Science.gov (United States)

    Kuwabara, Y

    1989-01-01

    Since the oral contraceptive guideline was issued in April 1987, Japanese pharmaceutical firms have been asking physicians to perform clinical studies of the low-dose OCs. At present, eight products from six companies are under clinical development. Ethinyl estradiol (30-35 micrograms per tablet) as an estrogen component is common to all the test drugs. The progestin component in each OC is norethindrone, levonorgestrel, or desogestrel. Phase I clinical studies on small numbers of healthy volunteers showed that they could tolerate the test drugs without any serious complaints. The effects on endocrine systems, including the inhibition of ovulation, were also examined. Pharmacokinetic parameters of active ingredients were comparable to those of Western women, and no substantial difference seemed to exist between Japanese and Western women. As an example, the results of phase I studies of OJK-777 (Ortho-Novum 7/7/7) are mentioned. Phase III clinical studies, which are "open studies," are now under progress with more than 3,000 women. The major objectives are to examine (1) how well the drugs are tolerated, and the dropout rates; (2) the effects on cycle control, especially bleeding patterns; (3) effects on the cardiovascular system, including coagulation and lipid metabolism; (4) effects on hormone secretions. Although some women have been taking the test drugs for more than 12 cycles, overall statistics are not yet available, because the guideline requires long-term administration (for more than 24 cycles). However, some characteristic features observed thus far are discussed.

  1. Abnormal Uterine Bleeding: Current Classification and Clinical Management.

    Science.gov (United States)

    Bacon, Janice L

    2017-06-01

    Abnormal uterine bleeding is now classified and categorized according to the International Federation of Gynecology and Obstetrics classification system: PALM-COEIN. This applies to nongravid women during their reproductive years and allows more clear designation of causes, thus aiding clinical care and future research. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Current clinical trials testing combinations of immunotherapy and radiation.

    Science.gov (United States)

    Crittenden, Marka; Kohrt, Holbrook; Levy, Ronald; Jones, Jennifer; Camphausen, Kevin; Dicker, Adam; Demaria, Sandra; Formenti, Silvia

    2015-01-01

    Preclinical evidence of successful combinations of ionizing radiation with immunotherapy has inspired testing the translation of these results to the clinic. Interestingly, the preclinical work has consistently predicted the responses encountered in clinical trials. The first example came from a proof-of-principle trial started in 2001 that tested the concept that growth factors acting on antigen-presenting cells improve presentation of tumor antigens released by radiation and induce an abscopal effect. Granulocyte-macrophage colony-stimulating factor was administered during radiotherapy to a metastatic site in patients with metastatic solid tumors to translate evidence obtained in a murine model of syngeneic mammary carcinoma treated with cytokine FLT-3L and radiation. Subsequent clinical availability of vaccines and immune checkpoint inhibitors has triggered a wave of enthusiasm for testing them in combination with radiotherapy. Examples of ongoing clinical trials are described in this report. Importantly, most of these trials include careful immune monitoring of the patients enrolled and will generate important data about the proimmunogenic effects of radiation in combination with a variety of immune modulators, in different disease settings. Results of these studies are building a platform of evidence for radiotherapy as an adjuvant to immunotherapy and encourage the growth of this novel field of radiation oncology. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Perspectives on Current Training Guidelines for Cardiac Imaging and Recommendations for the Future.

    Science.gov (United States)

    Arrighi, James A; Kilic, Sena; Haines, Philip G

    2018-04-23

    To summarize current training guidelines for cardiac imaging and provide recommendations for future guidelines. The current structure of training in cardiac imaging is largely dictated by modality-specific guidelines. While there has been debate on how to define the advanced cardiac imager for over a decade, a uniform consensus has not emerged. We report the perspectives of three key stakeholders in this debate: a senior faculty member-former fellowship program director, a cardiology fellow, and an academic junior faculty imaging expert. The observations of these stakeholders suggest that there is no consensus on the definition of advanced cardiac imaging, leading to ambiguity in training guidelines. This may have negative impact on recruitment of fellows into cardiac imaging careers. Based on the current status of training in cardiac imaging, the authors suggest that the relevant professional groups reconvene to form a consensus in defining advanced cardiac imaging, in order to guide future revisions of training guidelines.

  4. Spine imaging after lumbar disc replacement: pitfalls and current recommendations

    Directory of Open Access Journals (Sweden)

    Sandén Bengt

    2009-07-01

    Full Text Available Abstract Background Most lumbar artificial discs are still composed of stainless steel alloys, which prevents adequate postoperative diagnostic imaging of the operated region when using magnetic resonance imaging (MRI. Thus patients with postoperative radicular symptoms or claudication after stainless steel implants often require alternative diagnostic procedures. Methods Possible complications of lumbar total disc replacement (TDR are reviewed from the available literature and imaging recommendations given with regard to implant type. Two illustrative cases are presented in figures. Results Access-related complications, infections, implant wear, loosening or fracture, polyethylene inlay dislodgement, facet joint hypertrophy, central stenosis, and ankylosis of the operated segment can be visualised both in titanium and stainless steel implants, but require different imaging modalities due to magnetic artifacts in MRI. Conclusion Alternative radiographic procedures should be considered when evaluating patients following TDR. Postoperative complications following lumbar TDR including spinal stenosis causing radiculopathy and implant loosening can be visualised by myelography and radionucleotide techniques as an adjunct to plain film radiographs. Even in the presence of massive stainless steel TDR implants lumbar radicular stenosis and implant loosening can be visualised if myelography and radionuclide techniques are applied.

  5. Current approach to masked hypertension: From diagnosis to clinical management.

    LENUS (Irish Health Repository)

    Dolan, Eamon

    2013-11-28

    The term masked hypertension phenomenon was first described by the late Professor Thomas Pickering and is commonly defined as having a normal clinic blood pressure (BP) but an elevated "out of office" reading. In the main these elevated readings have been provided through ambulatory blood pressure monitoring (ABPM) but sometimes home BP monitoring is used. It is now largely accepted that ABPM gives a better classification of risk than clinic BP. Thus the elevated ABPM levels should relate to higher cardiovascular risk and it follows that these people might be regarded as being genuinely hypertensive and at higher cardiovascular risk. The problem for clinical practice is how to identify and manage these subjects. The phenomenon should be suspected in subjects who have had an elevated clinic BP at some time, in young subjects with normal or normal-high clinic BP who have early left ventricular hypertrophy, in subjects with a family history of hypertension in both parents, patients with multiple risks for cardiovascular disease and perhaps diabetic patients. It appears to be more prevalent in subjects of male gender, with younger age, higher heart rate, obesity or high cholesterol levels and in smokers. Those with masked hypertension are at higher risk of events such as stroke and have a higher prevalence of target organ damage, for example, nephropathy. In conclusion most of the debate around this topic relates to its reliable identification. Given the higher ambulatory readings there is an increases cardiovascular risk making this diagnosis important. This article is protected by copyright. All rights reserved.

  6. Highly accelerated cardiovascular MR imaging using many channel technology: concepts and clinical applications

    International Nuclear Information System (INIS)

    Niendorf, Thoralf; Sodickson, Daniel K.

    2008-01-01

    Cardiovascular magnetic resonance imaging (CVMRI) is of proven clinical value in the non-invasive imaging of cardiovascular diseases. CVMRI requires rapid image acquisition, but acquisition speed is fundamentally limited in conventional MRI. Parallel imaging provides a means for increasing acquisition speed and efficiency. However, signal-to-noise (SNR) limitations and the limited number of receiver channels available on most MR systems have in the past imposed practical constraints, which dictated the use of moderate accelerations in CVMRI. High levels of acceleration, which were unattainable previously, have become possible with many-receiver MR systems and many-element, cardiac-optimized RF-coil arrays. The resulting imaging speed improvements can be exploited in a number of ways, ranging from enhancement of spatial and temporal resolution to efficient whole heart coverage to streamlining of CVMRI work flow. In this review, examples of these strategies are provided, following an outline of the fundamentals of the highly accelerated imaging approaches employed in CVMRI. Topics discussed include basic principles of parallel imaging; key requirements for MR systems and RF-coil design; practical considerations of SNR management, supported by multi-dimensional accelerations, 3D noise averaging and high field imaging; highly accelerated clinical state-of-the art cardiovascular imaging applications spanning the range from SNR-rich to SNR-limited; and current trends and future directions. (orig.)

  7. Acceleration of cardiovascular MRI using parallel imaging: basic principles, practical considerations, clinical applications and future directions

    International Nuclear Information System (INIS)

    Niendorf, T.; Sodickson, D.

    2006-01-01

    Cardiovascular Magnetic Resonance (CVMR) imaging has proven to be of clinical value for non-invasive diagnostic imaging of cardiovascular diseases. CVMR requires rapid imaging; however, the speed of conventional MRI is fundamentally limited due to its sequential approach to image acquisition, in which data points are collected one after the other in the presence of sequentially-applied magnetic field gradients and radiofrequency coils to acquire multiple data points simultaneously, and thereby to increase imaging speed and efficiency beyond the limits of purely gradient-based approaches. The resulting improvements in imaging speed can be used in various ways, including shortening long examinations, improving spatial resolution and anatomic coverage, improving temporal resolution, enhancing image quality, overcoming physiological constraints, detecting and correcting for physiologic motion, and streamlining work flow. Examples of these strategies will be provided in this review, after some of the fundamentals of parallel imaging methods now in use for cardiovascular MRI are outlined. The emphasis will rest upon basic principles and clinical state-of-the art cardiovascular MRI applications. In addition, practical aspects such as signal-to-noise ratio considerations, tailored parallel imaging protocols and potential artifacts will be discussed, and current trends and future directions will be explored. (orig.)

  8. Clinical Supervision of Substance Abuse Counselors: Current and Preferred Practices.

    Science.gov (United States)

    Culbreth, John R.

    1999-01-01

    Reports on a national survey of substance abuse counselors (N=134) to learn their current and preferred supervision practices. Results suggests that substance abuse counselor are receiving supervision similar to other counselors. No preference was indicated for the sex of the supervisor, nor for the 12-step recovery experience. Counselors did…

  9. Joubert syndrome: Clinical manifestations and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kim, Seung Cheol; Kim, In One; Yoon, Yong Kyu; Yeon, Kyung Mo; Kim, Woo Sun; Song, Jong Gi; Hwang, Yong Seung

    1994-01-01

    Joubert syndrome presents neonatal respiratory abnormalities and other clinical manifestations. Pathologically the patients show hypoplasia or agenesis of cerebellar vermis and other intracranial anomalies. Our purpose is to evaluate the clinical manifestations and MR findings of Joubert syndrome. Among the patient presenting with clinical stigmata of Joubert syndrome and agenesis of vermis on MR imaging, eight patients who did not satisfied the criteria of Dandy-Walker malformation, tectocerebellar dysraphia and rhombencephalosynapsis were selected. MR findings and clinical manifestation were analyzed. On MR imaging, agenesis of the cerebellar vermis (all cases), hypoplasia of the cerebellar peduncle (6 cases), fourth ventricular contour deformity (6 cases), tentorial elevation (4 caes), deformity of the lateral ventricles (4 cases), dysgenesis of the straight sinus (3 cases) were demonstrated. Other findings were abnormalities of corpus callosum (3 cases), falx anomalies (3 case), occipital encephalomeningocele (2 cases) and fluid collection in posterior cranial fossa (2 cases). Clinical manifestations were developmental delay (5 cases), abnormal eyeball movement (3 cases), hypotonia (2 cases), neonatal respiratory abnormality (2 cases), etc. Joubert syndrome showed various clinical manifestations and intracranial anomalies. MR imaging is an useful modality in detection of the cerebellar vermian agenesis and other anomalies of the patients

  10. Clinical images evaluation of mammograms: a national survey

    International Nuclear Information System (INIS)

    Moon, Woo Kyung; Kim, Tae Jung; Cha, Joo Hee

    2003-01-01

    The goal of this study was to survey the overall quality of mammographic images in Korea. A total of 598 mammographic images collected from 257 hospitals nationwide were reviewed in terms of eight images quality categories, namely positioning, compression, contrast, exposure, sharpness, noise, artifacts, and examination identification, and rated on a five-point scale: (1=severe deficiency, 2=major deficiency, 3=minor deficiency, 4=good, 5=best). Failure was defined as the occurrence of more than four major deficiencies or one severe deficiency (score of 1 or 2). The results were compared among hospitals of varying kinds, and common problems in clinical images quality were identified. Two hundred and seventeen mammographic images (36.3%) failed the evaluation. Poor images were found in descending order of frequency, at The Society for Medical Examination (33/69, 47.8%), non-radiologyclinics (42/88, 47.7%), general hospitals (92/216, 42.6%), radiology clinics (39/102, 38.2%), and university hospitals (11/123, 8.9%) (p<0.01, Chi-square test). Among the 598 images, serious problems which occurred were related to positioning in 23.7% of instances (n=142) (p<0.01, Chi-square test), examination identification in 5.7% (n=34), exposure in 5.4% (n=32), contrast in 4.2% (n=25), sharpness in 2.7% (n=16), compression in 2.5% (n=15), artifacts in 2.5% (n=15), and noise in 0.3% (n=2). This study showed that in Korea, 36.3% of the mammograms examined in this sampling had important image-related defects that might have led to serious errors in patient management. The failure rate was significantly higher in non-radiology clinics and at The Society for Medical Examination than at university hospitals

  11. CSF-1R Inhibitor Development: Current Clinical Status.

    Science.gov (United States)

    Peyraud, Florent; Cousin, Sophie; Italiano, Antoine

    2017-09-05

    Colony-stimulating factor 1 receptor (CSF-1R) and its ligands, CSF-1 and interleukin 34 (IL-34), regulate the function and survival of tumor-associated macrophages, which are involved in tumorigenesis and in the suppression of antitumor immunity. Moreover, the CSF-1R/CSF-1 axis has been implicated in the pathogenesis of pigmented villonodular synovitis (PVNS), a benign tumor of the synovium. As advanced or metastatic malignant solid tumors and relapsed/refractory PVNS remain unresolved therapeutic problems, new approaches are needed to improve the outcome of patients with these conditions. In solid tumors, targeting CSF-1R via either small molecules or antibodies has shown interesting results in vitro but limited antitumor activity in vivo. Concerning PVNS, clinical trials assessing CSF-1R inhibitors have revealed promising initial outcomes. Blocking CSF-1/CSF-1R signaling represents a promising immunotherapy approach and several new potential combination therapies for future clinical testing.

  12. Clinical observation of cerebrovascular diseases current in Chernobyl accident liquidators

    International Nuclear Information System (INIS)

    Golovchenko, Yu.Yi.; Usatenko, O.G.; Romanenko, N.Yi.

    1999-01-01

    The results of the clinical follow up study (1993-1997) of cerebrovascular diseases development in the Chernobyl accident liquidators are presented. The syndrome of autonomous nervous system dysfunction following to an exposure to the Chernobyl accident consequences factors promotes to fast development of atherosclerosis and arterial hypertension. On the base of an analysis of the data obtained it was established that the primary diencephalic structures damage resulted in severe changes of different metabolic system, particularly in the cerebrovascular disorders development

  13. Current challenges for clinical trials of cardiovascular medical devices.

    Science.gov (United States)

    Zannad, Faiez; Stough, Wendy Gattis; Piña, Ileana L; Mehran, Roxana; Abraham, William T; Anker, Stefan D; De Ferrari, Gaetano M; Farb, Andrew; Geller, Nancy L; Kieval, Robert S; Linde, Cecilia; Redberg, Rita F; Stein, Kenneth; Vincent, Alphons; Woehrle, Holger; Pocock, Stuart J

    2014-07-15

    Several features of cardiovascular devices raise considerations for clinical trial conduct. Prospective, randomized, controlled trials remain the highest quality evidence for safety and effectiveness assessments, but, for instance, blinding may be challenging. In order to avoid bias and not confound data interpretation, the use of objective endpoints and blinding patients, study staff, core labs, and clinical endpoint committees to treatment assignment are helpful approaches. Anticipation of potential bias should be considered and planned for prospectively in a cardiovascular device trial. Prospective, single-arm studies (often referred to as registry studies) can provide additional data in some cases. They are subject to selection bias even when carefully designed; thus, they are generally not acceptable as the sole basis for pre-market approval of high risk cardiovascular devices. However, they complement the evidence base and fill the gaps unanswered by randomized trials. Registry studies present device safety and effectiveness in day-to-day clinical practice settings and detect rare adverse events in the post-market period. No single research design will be appropriate for every cardiovascular device or target patient population. The type of trial, appropriate control group, and optimal length of follow-up will depend on the specific device, its potential clinical benefits, the target patient population and the existence (or lack) of effective therapies, and its anticipated risks. Continued efforts on the part of investigators, the device industry, and government regulators are needed to reach the optimal approach for evaluating the safety and performance of innovative devices for the treatment of cardiovascular disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Current status, opportunities and problems in clinical combined chemoradiotherapy

    International Nuclear Information System (INIS)

    Phillips, T.L.

    1979-01-01

    The clinical experience with combined radiation and chemotherapy has been positive in a number of situations. The enhanced local tumor control and patient cure due to the sterilization of distant metastases have been observed. More widespread clinical applications have been limited by the enhanced effects in normal tissues, necessitating radiation dose reduction which in some situations may be counterproductive. The limitations have been caused by the lack of a wide range of active anti-tumor compounds, particularly for most common solid tumors. The very active combinations of cyclophosphamide and adriamycin or cyclophosphamide and cis-Pt, as well as of the 3 agents, caused the response of a number of the solid tumors previously found to be drug resistant. The introduction of these compounds and a number of others active in slowly proliferating solid tumors will allow new look for improved survival in the tumors not yet amenable to combined radiation and chemotherapy. The experiments designed to elucidate the nature of the interaction of radiation and chemotherapy and in particular the nature of normal tissue response should allow for the safer employment of 2 modalities and should help in the design of prospective clinical trials on a more rational basis. (Yamashita, S.)

  15. Current status of verification practices in clinical biochemistry in Spain.

    Science.gov (United States)

    Gómez-Rioja, Rubén; Alvarez, Virtudes; Ventura, Montserrat; Alsina, M Jesús; Barba, Núria; Cortés, Mariano; Llopis, María Antonia; Martínez, Cecilia; Ibarz, Mercè

    2013-09-01

    Verification uses logical algorithms to detect potential errors before laboratory results are released to the clinician. Even though verification is one of the main processes in all laboratories, there is a lack of standardization mainly in the algorithms used and the criteria and verification limits applied. A survey in clinical laboratories in Spain was conducted in order to assess the verification process, particularly the use of autoverification. Questionnaires were sent to the laboratories involved in the External Quality Assurance Program organized by the Spanish Society of Clinical Biochemistry and Molecular Pathology. Seven common biochemical parameters were included (glucose, cholesterol, triglycerides, creatinine, potassium, calcium, and alanine aminotransferase). Completed questionnaires were received from 85 laboratories. Nearly all the laboratories reported using the following seven verification criteria: internal quality control, instrument warnings, sample deterioration, reference limits, clinical data, concordance between parameters, and verification of results. The use of all verification criteria varied according to the type of verification (automatic, technical, or medical). Verification limits for these parameters are similar to biological reference ranges. Delta Check was used in 24% of laboratories. Most laboratories (64%) reported using autoverification systems. Autoverification use was related to laboratory size, ownership, and type of laboratory information system, but amount of use (percentage of test autoverified) was not related to laboratory size. A total of 36% of Spanish laboratories do not use autoverification, despite the general implementation of laboratory information systems, most of them, with autoverification ability. Criteria and rules for seven routine biochemical tests were obtained.

  16. Pleiotropic effects of niacin: Current possibilities for its clinical use

    Directory of Open Access Journals (Sweden)

    Zeman Miroslav

    2016-12-01

    Full Text Available Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic, which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin’s role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.

  17. Radioiodinated BMIPP for myocardial imaging - current status and future perspectives

    International Nuclear Information System (INIS)

    Knapp, F.F. Jr.; Kropp, J.; Franken, P.R.

    1998-01-01

    Since the 1970's both basic research applications and clinical use of radioiodinated free fatty acids has continued to be of interest in nuclear cardiology. Clinical use of iodine-123-labeled fatty acids offers a unique opportunity for direct or indirect evaluation of alterations in myocardial metabolism by single photon computed tomography (SPECT). The relationship between the negative 'mismatches' often observed between regional fatty acid uptake and perfusion tracer distribution (i.e. BMIPP defect larger than flow tracer defect) has been an important observation which can often provide information on myocardial viability. Although the widespread use of the iodine-123-labeled 15-(p-iodophenyl)-3-(R, S)-methylpentadecanoic acid (BMIPP) analogue in Japan continues to provide extensive clinical data defining indications for the use of this agent, it remains to be seen, however, if iodine-123-labeled fatty acids such as BMIPP will enter routine clinical use in other countries, since their commercial availability as approved radiopharmaceuticals will be required. In this paper further studies describing the resolution and evaluation of the metabolism and myocardial uptake and release kinetics of the 3R- and 3S-BMIPP isomers are described. Although it is beyond the scope of this brief paper to review and discuss the voluminous data which have been published concerning both clincial applications and research studies with BMIPP over the last several years, the issues associated with the broader clinical use of BMIPP and other iodine-123-labeled fatty acid agents are discussed. (orig.) [de

  18. Clinical review: Current state and future perspectives in the diagnosis of diabetes insipidus: a clinical review.

    Science.gov (United States)

    Fenske, Wiebke; Allolio, Bruno

    2012-10-01

    The differential diagnosis of diabetes insipidus (DI) is often challenging but essential, because treatment may vary substantially. This article analyzes the database and performance of currently used differential diagnostic tests for DI and discusses future perspectives for diagnostic improvement. A review of electronic and print data comprising original and review articles retrieved from the PubMed or Cochrane Library database up to January 2012 was conducted. The search term "polyuria polydipsia syndrome" was cross-referenced with underlying forms of disease and associated clinical, diagnostic, and therapeutic MeSH terms. In addition, references from review articles and textbook chapters were screened for papers containing original data. Search results were narrowed to articles containing primary data with a description of criteria for the differential diagnosis of DI. Fifteen articles on differential diagnosis of DI were identified, mainly consisting of small series of patients, and mostly covering only part of the differential diagnostic spectrum of DI. Test protocols differed, and prospective validation of diagnostic criteria was consistently missing. Inconsistent data were reported on the diagnostic superiority of direct plasma arginine vasopressin determination over the indirect water deprivation test. Both test methods revealed limitations, especially in the differentiation of disorders with a milder phenotype. The available data demonstrate limitations of current biochemical tests for the differential diagnosis of DI, potentially leading to incorrect diagnosis and treatment. The newly available assay for copeptin, the C terminus of the vasopressin precursor, holds promise for a higher diagnostic specificity and simplification of the differential diagnostic protocol in DI.

  19. Pheochromocytoma and Paraganglioma: Current Functional and Future Molecular Imaging

    International Nuclear Information System (INIS)

    Blanchet, Elise M.; Martucci, Victoria; Pacak, Karel

    2012-01-01

    Paragangliomas are neural crest-derived tumors, arising either from chromaffin sympathetic tissue (in adrenal, abdominal, intra-pelvic, or thoracic paraganglia) or from parasympathetic tissue (in head and neck paraganglia). They have a specific cellular metabolism, with the ability to synthesize, store, and secrete catecholamines (although most head and neck paragangliomas do not secrete any catecholamines). This disease is rare and also very heterogeneous, with various presentations (e.g., in regards to localization, multifocality, potential to metastasize, biochemical phenotype, and genetic background). With growing knowledge, notably about the pathophysiology and genetic background, guidelines are evolving rapidly. In this context, functional imaging is a challenge for the management of paragangliomas. Nuclear imaging has been used for exploring paragangliomas for the last three decades, with MIBG historically as the first-line exam. Tracers used in paragangliomas can be grouped in three different categories. Agents that specifically target catecholamine synthesis, storage, and secretion pathways include: 123 and 131I-metaiodobenzylguanidine (123/131I-MIBG), 18F-fluorodopamine (18F-FDA), and 18F-fluorodihydroxyphenylalanine (18F-FDOPA). Agents that bind somatostatin receptors include 111In-pentetreotide and 68Ga-labeled somatostatin analog peptides (68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE). The non-specific agent most commonly used in paragangliomas is 18F-fluorodeoxyglucose (18F-FDG). This review will first describe conventional scintigraphic exams that are used for imaging paragangliomas. In the second part we will emphasize the interest in new PET approaches (specific and non-specific), considering the growing knowledge about genetic background and pathophysiology, with the aim of understanding how tumors behave, and optimally adjusting imaging technique for each tumor type.

  20. Amyloid plaque imaging in vivo: current achievement and future prospects

    International Nuclear Information System (INIS)

    Nordberg, Agneta

    2008-01-01

    Alzheimer's disease (AD) is a very complex neurodegenerative disorder, the exact cause of which is still not known. The major histopathological features, amyloid plaques and neurofibrillary tangles, already described by Alois Alzheimer, have been the focus in research for decades. Despite a probable whole cascade of events in the brain leading to impairment of cognition, amyloid is still the target for diagnosis and treatment. The rapid development of molecular imaging techniques now allows imaging of amyloid plaques in vivo in Alzheimer patients by PET amyloid ligands such as Pittsburgh compound B (PIB). Studies so far have revealed high 11 C-PIB retention in brain at prodromal stages of AD and a possibility to discriminate AD from other dementia disorders by 11 C-PIB. Ongoing studies are focussing to understand the relationship between brain and CSF amyloid processes and cognitive processes. In vivo imaging of amyloid will be important for early diagnosis and evaluation of new anti-amyloid therapies in AD. (orig.)

  1. MR imaging and clinical findings of spontaneous spinal epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sam Soo [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Moon Hee; Kim, Hyun Beom [College of Medicine, Seoul National University, Seoul (Korea, Republic of)] [and others

    2000-01-01

    To describe the MR imaging and clinical findings of spontaneous spinal epidural hematoma. The MR and clinical findings in six patients (M:F=3D4:2;adult:child=3D3:3) with spontaneous spinal epidural hematoma were reviewed. Five patients without any predisposing factor which might cause the condition and one with acute myelogenous leukemia were included. Emergency surgery was performed in two patients, and the other four were managed conservatively. The epidural lesion involved between three and seven vertebrae (mean:4.5), and relative to the spinal cord was located in the posterior-lateral (n=3D4), anterior (n=3D1), or right lateral (n=3D1) area. The hematoma was isointense (n=3D1) or hyperintense (n=3D5) with spinal cord on T1-weighted images, and hypointense (n=3D2) or hyperintense (n=3D4) on T2-weighted images. It was completely absorbed in four of five patients who underwent follow-up MR imaging, but not changed in one. The clinical outcome of these patients was complete recovery (n=3D4), spastic cerebral palsy (n=3D1), or unknown (n=3D1). Because of the lesion's characteristic signal intensity; MR imaging is very useful in the diagnosis and evaluation of spontaneous spinal epidural hematoma. (author)

  2. Clinical diagnosis and brain imaging in nuclear medicine

    International Nuclear Information System (INIS)

    Fujie, Hiroshi

    1989-01-01

    Fifty-five patients of cerebral occlusive diseases were studied using IMP and single photon emission tomograph (HEADTOME-II). Early imaging was begun after intravenous injection of IMP and delayed imaging was performed 3 hours more later. We classified the change of IMP distribution into 4 types, type 1: no uptake of the lesion in both early and delayed images, type 2: low IMP uptake of the lesion in early images but recognized redistribution of IMP is delayed images, type 3: high IMP uptake of the lesion in both early and delayed images, type 4: high IMP uptake of the lesion in early images but it decreased more rapidly in delayed images. In cases of type 3 and 4 recanalization of the occlusive arteries was found by cerebral angiography. The difference of IMP distribution has relation to the time of recanalization and the amount of collateral circulation at the lesion. Clinical prognosis shows a tendency to be better in cases of type 2 and 4 than type 1 and 3. IMP brain scans with SPECT seems useful for estimating the prognosis of patients. (author)

  3. Clinical utility of imaging for evaluation of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Murakami T

    2014-07-01

    Full Text Available Takamichi Murakami,1 Masakatsu Tsurusaki,1 Tomoko Hyodo,1 Yasuharu Imai2 1Department of Radiology, Kinki University Faculty of Medicine, 2Department of Hepatology and Gastroenterology, Ikeda Municipal Hospital, Osaka, Japan Abstract: The hemodynamics of a hepatocellular nodule is the most important imaging parameter used to characterize various hepatocellular nodules in liver cirrhosis, because sequential changes occur in the feeding vessels and hemodynamic status during hepatocarcinogenesis. Therefore, the imaging criteria for hepatocellular carcinoma (HCC are also usually based on vascular findings, eg, early arterial uptake followed by washout in the portal venous and equilibrium phases. Contrast-enhanced ultrasonography, dynamic multidetector-row computed tomography (MDCT, and dynamic magnetic resonance (MR imaging with gadopentetate dimeglumine (Gd-DTPA are useful for detecting hypervascular HCC on the basis of vascular criteria but are not as useful for hypovascular HCC. Contrast-enhanced MR imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA, a hepatocyte-specific MR contrast agent, is superior to dynamic MDCT and dynamic MR imaging with Gd-DTPA in detecting both hypervascular and hypovascular HCC. Moreover, Gd-EOB-DTPA-enhanced MR imaging can display each histologically differentiated HCC as hypointense relative to the liver parenchyma. 18F-fluorodeoxyglucose positron emission tomography imaging might not be suitable for the screening and detection of HCC, given its lower diagnostic performance. However, this technique plays an important role in determining whether HCC has spread beyond the liver. Keywords: hepatocellular carcinoma, evaluation, imaging, clinical utility

  4. Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.

    Science.gov (United States)

    Schuerer, Douglas J E; Kolovos, Nikoleta S; Boyd, Kayla V; Coopersmith, Craig M

    2008-07-01

    Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes. Its usage is more controversial in adults, but select medical centers have reported favorable findings in patients with ARDS and other causes of severe pulmonary failure. ECMO is also rarely used as a rescue therapy in a small subset of adult patients with cardiac failure. This article will review the current uses and techniques of ECMO in the critical care setting as well as the evidence supporting its usage. In addition, current practice management related to coding and reimbursement for this intensive therapy will be discussed.

  5. Functional brain imaging in the clinical assessment of consciousness.

    Directory of Open Access Journals (Sweden)

    Michael S Rafii

    2010-11-01

    Full Text Available Recent findings suggest that functional brain imaging might be used to identify consciousness in patients diagnosed with persistent vegetative state and minimally conscious state. Michael Rafii and James Brewer discuss the potential for fMRI's wider implementation in clinical practice, and associated caveats.

  6. TH-A-207B-01: Basics and Current Implementations of Ultrasound Imaging of Shear Wave Speed and Elasticity

    International Nuclear Information System (INIS)

    Chen, S.

    2016-01-01

    Biomarker Alliance and the need for such an organization Review the QIBA process for creating a quantitative biomarker Summarize steps needed to verify adherence of site, operators, and imaging systems to a QIBA profile Underlying Premise and Assumptions Objective, quantifiable results are needed to enhance the value of diagnostic imaging in clinical practice Reasons for quantification Evidence based medicine requires objective, not subjective observer data Computerized decision support tools (eg CAD) generally require quantitative input. Quantitative, reproducible measures are more easily used to develop personalized molecular medical diagnostic and treatment systems What is quantitative imaging? Definition from Imaging Metrology Workshop The Quantitative Imaging Biomarker Alliance Formation 2008 Mission Structure Example Imaging Biomarkers Being Explored Biomarker Selection Groundwork Draft Protocol for imaging and data evaluation QIBA Profile Drafting Equipment and Site Validation Technical Clinical Site and Equipment QA and Compliance Checking Ultrasound Elasticity Estimation Biomarker US Elasticity Estimation Background Current Status and Problems Biomarker Selection-process and outcome US SWS for Liver Fibrosis Biomarker Work Groundwork Literature search and analysis results Phase I phantom testing-Elastic phantoms Phase II phantom testing-Viscoelastic phantoms Digital Simulated Data Protocol and Profile Drafting Protocol: based on UPICT and existing literature and standards bodies protocols Profile-Current claims, Manufacturer specific appendices What comes after the profile Profile Validation Technical validation Clinical validation QA and Compliance Possible approaches Site Operator testing Site protocol re-evaluation Imaging system Manufacturer testing and attestation User acceptance testing and periodic QA Phantom Tests Digital Phantom Based Testing Standard QA Testing Remediation Schemes Profile Evolution Towards additional applications Towards higher accuracy

  7. TH-A-207B-01: Basics and Current Implementations of Ultrasound Imaging of Shear Wave Speed and Elasticity

    Energy Technology Data Exchange (ETDEWEB)

    Chen, S. [Mayo Clinic (United States)

    2016-06-15

    Biomarker Alliance and the need for such an organization Review the QIBA process for creating a quantitative biomarker Summarize steps needed to verify adherence of site, operators, and imaging systems to a QIBA profile Underlying Premise and Assumptions Objective, quantifiable results are needed to enhance the value of diagnostic imaging in clinical practice Reasons for quantification Evidence based medicine requires objective, not subjective observer data Computerized decision support tools (eg CAD) generally require quantitative input. Quantitative, reproducible measures are more easily used to develop personalized molecular medical diagnostic and treatment systems What is quantitative imaging? Definition from Imaging Metrology Workshop The Quantitative Imaging Biomarker Alliance Formation 2008 Mission Structure Example Imaging Biomarkers Being Explored Biomarker Selection Groundwork Draft Protocol for imaging and data evaluation QIBA Profile Drafting Equipment and Site Validation Technical Clinical Site and Equipment QA and Compliance Checking Ultrasound Elasticity Estimation Biomarker US Elasticity Estimation Background Current Status and Problems Biomarker Selection-process and outcome US SWS for Liver Fibrosis Biomarker Work Groundwork Literature search and analysis results Phase I phantom testing-Elastic phantoms Phase II phantom testing-Viscoelastic phantoms Digital Simulated Data Protocol and Profile Drafting Protocol: based on UPICT and existing literature and standards bodies protocols Profile-Current claims, Manufacturer specific appendices What comes after the profile Profile Validation Technical validation Clinical validation QA and Compliance Possible approaches Site Operator testing Site protocol re-evaluation Imaging system Manufacturer testing and attestation User acceptance testing and periodic QA Phantom Tests Digital Phantom Based Testing Standard QA Testing Remediation Schemes Profile Evolution Towards additional applications Towards higher accuracy

  8. Adaptive digital image processing in real time: First clinical experiences

    International Nuclear Information System (INIS)

    Andre, M.P.; Baily, N.A.; Hier, R.G.; Edwards, D.K.; Tainer, L.B.; Sartoris, D.J.

    1986-01-01

    The promise of computer image processing has generally not been realized in radiology, partly because the methods advanced to date have been expensive, time-consuming, or inconvenient for clinical use. The authors describe a low-cost system which performs complex image processing operations on-line at video rates. The method uses a combination of unsharp mask subtraction (for low-frequency suppression) and statistical differencing (which adjusts the gain at each point of the image on the basis of its variation from a local mean). The operator interactively adjusts aperture size, contrast gain, background subtraction, and spatial noise reduction. The system is being evaluated for on-line fluoroscopic enhancement, for which phantom measurements and clinical results, including lithotripsy, are presented. When used with a video camera, postprocessing of radiographs was advantageous in a variety of studies, including neonatal chest studies. Real-time speed allows use of the system in the reading room as a ''variable view box.''

  9. Normal feline brain: clinical anatomy using magnetic resonance imaging.

    Science.gov (United States)

    Mogicato, G; Conchou, F; Layssol-Lamour, C; Raharison, F; Sautet, J

    2012-04-01

    The purpose of this study was to provide a clinical anatomy atlas of the feline brain using magnetic resonance imaging (MRI). Brains of twelve normal cats were imaged using a 1.5 T magnetic resonance unit and an inversion/recovery sequence (T1). Fourteen relevant MRI sections were chosen in transverse, dorsal, median and sagittal planes. Anatomic structures were identified and labelled using anatomical texts and Nomina Anatomica Veterinaria, sectioned specimen heads, and previously published articles. The MRI sections were stained according to the major embryological and anatomical subdivisions of the brain. The relevant anatomical structures seen on MRI will assist clinicians to better understand MR images and to relate this neuro-anatomy to clinical signs. © 2011 Blackwell Verlag GmbH.

  10. The introduction of clinical magnetic resonance imaging in Australia

    International Nuclear Information System (INIS)

    Sorby, W.; Baddeley, H.

    1986-01-01

    Magnetic resonance imaging is a new, but expensive, modality that is being introduced into clinical use in Australia. While it promises increased safety and accuracy in many situations, its precise role when compared with computed tomography and other modalities is not fully established. Therefore, a Government financed evaluation of costs and efficacy of magnetic resonance imaging units in five teaching hospitals is to be conducted over two years (1986-1988). Experience with the introduction of computed tomography to Australia and other nations has revealed difficulties in the evaluation by conventional methods of a diagnostic technology that is improving rapidly; it is to be hoped that a systematic evaluation of the clinical applications of magnetic resonance imaging will be more achievable and useful

  11. Imaging: Guiding the Clinical Translation of Cardiac Stem Cell Therapy

    Science.gov (United States)

    Nguyen, Patricia K.; Lan, Feng; Wang, Yongming; Wu, Joseph C.

    2011-01-01

    Stem cells have been touted as the holy grail of medical therapy with promises to regenerate cardiac tissue, but it appears the jury is still out on this novel therapy. Using advanced imaging technology, scientists have discovered that these cells do not survive nor engraft long-term. In addition, only marginal benefit has been observed in large animal studies and human trials. However, all is not lost. Further application of advanced imaging technology will help scientists unravel the mysteries of stem cell therapy and address the clinical hurdles facing its routine implementation. In this review, we will discuss how advanced imaging technology will help investigators better define the optimal delivery method, improve survival and engraftment, and evaluate efficacy and safety. Insights gained from this review may direct the development of future preclinical investigations and clinical trials. PMID:21960727

  12. [Current situation of clinical research on impacted premolars].

    Science.gov (United States)

    Liu, Ran-Ran; Tian, Jun

    2018-04-01

    Teeth impaction is a common developmental malformation in oral diseases. Impacted teeth are usually the canines, third molar, central incisors, premolars, and second molars. The prevalence of impaction of maxillary canines and mandibular wisdom teeth is higher than that of other teeth. Most recent studies have focused on the canines and third molars, but research on impacted premolars is limited. In clinical practice, the majority of orthodontic patients require premolar extraction. Thus, impacted premolars play important roles in orthodontic design and prognosis. This article provides an overview of recent research on impacted premolars and summarizes epidemiological features, localizations, and treatments, with the aim of guiding practitioners on orthodontic design and therapy.

  13. Magnetic resonance imaging and magnetic resonance spectroscopy in current medicine

    International Nuclear Information System (INIS)

    Ganssen, A.; Hartl, W.; Kaiser, W.; Margosian, P.; Weikl, A.

    1987-01-01

    The first MR scanning methods have been developed to a maturity allowing application for clinical MRI. Essentially reduced measuring periods are possible now in connection with three-dimensional and multi-layer methods, and this certainly will have a positive effect towards enhanced use of MRI. Still shorter measuring periods is the future goal with regard to so important examinations as chest studies. MR angiography without contrast agent is applicable now for clinical examination of larger vessels. For small vessels, size-adjusted surface coils are required. A number of specially tailored surface coils is available now for achieving high spatial resolution in the regions of interest. This trend will continue. In-vivo MR spectroscopy now offers methods of selection of the volume of interest that encourage clinical trial application. Due to the rapidly growing experience obtained by in-vivo animal experiments, correlations can now be revealed between MRS data and pathologic conditions. Despite the still unresolved sensitivity problems, clinical applicability can be expected in a not too far future. (orig./SHA) [de

  14. Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

    Science.gov (United States)

    Sanders, Vicki L; Flanagan, Jennifer

    2015-01-01

    The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

  15. Magnetic resonance imaging of the chest: current and new applications, with an emphasis on pulmonology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcel Koenigkam; Mauad, Fernando Marum, E-mail: marcelk46@yahoo.com.b [Universidade de Sao Paulo (HC/FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas; Elias Junior, Jorge; Muglia, Valdair Francisco [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Secao de Radiologia

    2011-03-15

    The objective of the present review study was to present the principal applications of magnetic resonance imaging (MRI) of the chest, including the description of new techniques. Over the past decade, this method has evolved considerably because of the development of new equipment, including the simultaneous interconnection of phased-array multiple radiofrequency receiver coils and remote control of the table movement, in addition to faster techniques of image acquisition, such as parallel imaging and partial Fourier acquisitions, as well as the introduction of new contrast agents. All of these advances have allowed MRI to gain ground in the study of various pathologies of the chest, including lung diseases. Currently, MRI is considered the modality of choice for the evaluation of lesions in the mediastinum and in the chest wall, as well as of superior sulcus tumors. However, it can also facilitate the diagnosis of lung, pleural, and cardiac diseases, as well as of those related to the pulmonary vasculature. Pulmonary MRI angiography can be used in order to evaluate various pulmonary vascular diseases, and it has played an ever greater role in the study of thromboembolism. Because cardiac MRI allows morphological and functional assessment in the same test, it has also become part of the clinical routine in the evaluation of various cardiac diseases. Finally, the role of MRI has been extended to the identification and characterization of pulmonary nodules, the evaluation of airway diseases, and the characterization of pleural effusion. (author)

  16. Development of a CT simulator and its current clinical status

    International Nuclear Information System (INIS)

    Nagata, Yasushi; Hiraoka, Masahiro; Nishidai, Takehiro

    2000-01-01

    A computed tomography (CT) simulator is defined as a radiotherapy treatment planning (RTP) system which consists of an X-ray CT scanner, a treatment planning computer, and a marking projector. The developmental process from the introduction of an X-ray CT to a CT simulator is described in this article. After the development of the first CT simulator, several new developments in CT scanners, marking projector, and data transfer networks were introduced. CT simulator systems have recently become more widely available and are produced by more than 8 commercial companies. The advantages of a CT simulator are a shortening of overall RTP time, increased accuracy of RTP, and the possibility of 3-D conformal therapy. Clinical experience with CT simulators has accumulated over the past 10 years. Site-specific trials have been undertaken, and the clinical usefulness of CT simulators for breast cancer, maxillary cancer, nasopharyngeal cancer, orbital tumor, lung cancer and other tumors has been demonstrated. The use of CT simulators has resulted in a decrease in the complications of radiotherapy. It also appears to be an essential tool for dose escalation studies, which may permit increased local control of certain tumors. In Japan, CT simulators were in use at more than 134 (20%) of 682 radiotherapy institutions as of the end of 1998. In the USA, CT simulators were present in more than 12% of 1,542 radiotherapy centers in 1994. The CT simulator is now an essential RTP system for advanced radiotherapy. (author)

  17. Perceptions of dry eye disease management in current clinical practice.

    Science.gov (United States)

    Williamson, Jennifer F; Huynh, Kyle; Weaver, Mark A; Davis, Richard M

    2014-03-01

    To assess the perceptions of eye care providers regarding the clinical management of dry eye. Invitations to complete a 17-question online survey were mailed to 400 members of the North Carolina Ophthalmology and Optometry Associations including community optometrists, comprehensive ophthalmologists, and cornea specialists. The survey was completed by 100 eye care providers (25% response rate). Providers reported burning (46.5%) as the most frequent symptom described by patients, followed by foreign body sensation (30.3%) and tearing (17.2%). Most respondents (80.8%) listed artificial tears as the recommended first-line treatment, even though providers reported high failure rates for both artificial tears and cyclosporine A (Restasis). Rheumatoid arthritis, Sjögren syndrome, affective disorders such as anxiety and depression, history of photorefractive surgery, smoking, and thyroid disease were acknowledged as common comorbid conditions. The survey provided an informative snapshot into the preferences of eye care providers concerning the diagnosis and management of dry eye disease. Overall, burning was the most common symptom reported by patients. Providers relied more on patient history in guiding their clinical decisions than objective signs. The survey underscores the incongruence when comparing subjective symptoms with objective signs, thereby highlighting the urgent need for the development of reliable metrics to better quantify dry eye symptoms and also the development of a more sensitive and specific test that can be used as the gold standard to diagnose dry eye.

  18. [Clinical neuropsychology in perspective: future challenges based on current developments].

    Science.gov (United States)

    Verdejo-García, Antonio; Tirapu-Ustárroz, Javier

    2012-02-01

    New lines of translational, interdisciplinary research are emerging among different fields of the neurosciences, which often point at clinical neuropsychology as the hinge discipline capable of linking the basic findings with their clinical implications and thereby endow them with some meaning for phenomenological experience. To establish the great lines of progress made in the fields of neuroscience and neuropsychology in recent years, so as to be able to foresee the strategic lines and priorities of neuroscience in the near future. To achieve this aim, the first step will be to identify the changes of paradigm that have taken place in the areas of neuroscience and psychology in the last two decades. The next step will be to propose new topics and fields of application that these changes in paradigm offer and demand from neuroscience. The false dichotomies of genes versus environment, mind versus brain, and reason versus emotion are considered, as are the new applications of neuropsychology to the understanding of psychopathological disorders, from the neurodegenerative to neurodevelopment, from 'dirty' drugs to cognitive and affective enhancers.

  19. [Current status and clinical application prospect of Akabane's test].

    Science.gov (United States)

    Wang, Wenjie; Du, Yanjun

    2016-06-12

    The Akabane's test is one of the meridian diagnostic methods. Compared with the current meridian diagnostic methods, it has the advantages of convenience and efficiency, but it also has several disadvantages such as the accuracy is difficult to control, the outcome interpretation is limited, etc. In this paper, the influence factors of Akabane's test were analyzed one by one, especially proposed personal opinion on outcome interpretation, which could ascertain the location and nature of disease, leading to disease syndrome. With accurate syndrome, the treatment plan could be established. The application prospect of Akabane's test was initially explored, and it was proposed that wearable automation equipment could be one of the development directions.

  20. Prospective clinical evaluation of an electronic portal imaging device

    International Nuclear Information System (INIS)

    Michalski, Jeff M.; Graham, Mary V.; Bosch, Walter R.; Wong, John; Gerber, Russell L.; Cheng, Abel; Tinger, Alfred; Valicenti, Richard K.

    1996-01-01

    Purpose: To determine whether the clinical implementation of an electronic portal imaging device can improve the precision of daily external beam radiotherapy. Methods and Materials: In 1991, an electronic portal imaging device was installed on a dual energy linear accelerator in our clinic. After training the radiotherapy technologists in the acquisition and evaluation of portal images, we performed a randomized study to determine whether online observation, interruption, and intervention would result in more precise daily setup. The patients were randomized to one of two groups: those whose treatments were actively monitored by the radiotherapy technologists and those that were imaged but not monitored. The treating technologists were instructed to correct the following treatment errors: (a) field placement error (FPE) > 1 cm; (b) incorrect block; (c) incorrect collimator setting; (d) absent customized block. Time of treatment delivery was recorded by our patient tracking and billing computers and compared to a matched set of patients not participating in the study. After the patients radiation therapy course was completed, an offline analysis of the patient setup error was planned. Results: Thirty-two patients were treated to 34 anatomical sites in this study. In 893 treatment sessions, 1,873 fields were treated (1,089 fields monitored and 794 fields unmonitored). Ninety percent of the treated fields had at least one image stored for offline analysis. Eighty-seven percent of these images were analyzed offline. Of the 1,011 fields imaged in the monitored arm, only 14 (1.4%) had an intervention recorded by the technologist. Despite infrequent online intervention, offline analysis demonstrated that the incidence of FPE > 10 mm in the monitored and unmonitored groups was 56 out of 881 (6.1%) and 95 out of 595 (11.2%), respectively; p 10 mm was confined to the pelvic fields. The time to treat patients in this study was 10.78 min (monitored) and 10.10 min (unmonitored

  1. Technological advances in perioperative monitoring: Current concepts and clinical perspectives.

    Science.gov (United States)

    Chilkoti, Geetanjali; Wadhwa, Rachna; Saxena, Ashok Kumar

    2015-01-01

    Minimal mandatory monitoring in the perioperative period recommended by Association of Anesthetists of Great Britain and Ireland and American Society of Anesthesiologists are universally acknowledged and has become an integral part of the anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, transesophageal echocardiography, advanced neurological monitoring, improved alarm system and technological advancement in objective pain assessment. Various factors that need to be considered with the use of improved monitoring techniques are their validation data, patient outcome, safety profile, cost-effectiveness, awareness of the possible adverse events, knowledge of technical principle and ability of the convenient routine handling. In this review, we will discuss the new monitoring techniques in anesthesia, their advantages, deficiencies, limitations, their comparison to the conventional methods and their effect on patient outcome, if any.

  2. Imaging of thoracic tuberculosis in children: current and future directions

    International Nuclear Information System (INIS)

    Sodhi, Kushaljit Singh; Bhalla, Ashu S.; Mahomed, Nasreen; Laya, Bernard F.

    2017-01-01

    Tuberculosis continues to be an important cause of morbidity and mortality worldwide. It is the leading cause of infection-related deaths worldwide. Children are amongst the high-risk groups for developing tuberculosis and often pose a challenge to the clinicians in making a definitive diagnosis. The newly released global tuberculosis report from World Health Organization reveals a 50% increase in fatality from tuberculosis in children. Significantly, diagnostic and treatment algorithms of tuberculosis for children differ from those of adults. Bacteriologic confirmation of the disease is often difficult in children; hence radiologists have an important role to play in early diagnosis of this disease. Despite advancing technology, the key diagnostic imaging modalities for primary care and emergency services, especially in rural and low-resource areas, are chest radiography and ultrasonography. In this article, we discuss various diagnostic imaging modalities used in diagnosis and treatment of tuberculosis and their indications. We highlight the use of US as point-of-care service along with mediastinal US and rapid MRI protocols, especially in mediastinal lymphadenopathy and thoracic complications. MRI is the ideal modality in high-resource areas when adequate infrastructure is available. Because the prevalence of tuberculosis is highest in lower-resource countries, we also discuss global initiatives in low-resource settings. (orig.)

  3. Imaging of thoracic tuberculosis in children: current and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Sodhi, Kushaljit Singh [Post Graduate Institute of Medical Education and Research (PGIMER), Department of Radiodiagnosis and Imaging, Chandigarh (India); Bhalla, Ashu S. [All India Institute of Medical Sciences (AIIMS), Department of Radiodiagnosis, New Delhi (India); Mahomed, Nasreen [University of Witwatersrand, Department of Radiology, Rahima Moosa Mother and Child Hospital, Johannesburg (South Africa); Laya, Bernard F. [St. Luke' s Medical Center-Global City, Institute of Radiology, Taguig City (Philippines)

    2017-09-15

    Tuberculosis continues to be an important cause of morbidity and mortality worldwide. It is the leading cause of infection-related deaths worldwide. Children are amongst the high-risk groups for developing tuberculosis and often pose a challenge to the clinicians in making a definitive diagnosis. The newly released global tuberculosis report from World Health Organization reveals a 50% increase in fatality from tuberculosis in children. Significantly, diagnostic and treatment algorithms of tuberculosis for children differ from those of adults. Bacteriologic confirmation of the disease is often difficult in children; hence radiologists have an important role to play in early diagnosis of this disease. Despite advancing technology, the key diagnostic imaging modalities for primary care and emergency services, especially in rural and low-resource areas, are chest radiography and ultrasonography. In this article, we discuss various diagnostic imaging modalities used in diagnosis and treatment of tuberculosis and their indications. We highlight the use of US as point-of-care service along with mediastinal US and rapid MRI protocols, especially in mediastinal lymphadenopathy and thoracic complications. MRI is the ideal modality in high-resource areas when adequate infrastructure is available. Because the prevalence of tuberculosis is highest in lower-resource countries, we also discuss global initiatives in low-resource settings. (orig.)

  4. Imaging of thoracic tuberculosis in children: current and future directions.

    Science.gov (United States)

    Sodhi, Kushaljit Singh; Bhalla, Ashu S; Mahomed, Nasreen; Laya, Bernard F

    2017-09-01

    Tuberculosis continues to be an important cause of morbidity and mortality worldwide. It is the leading cause of infection-related deaths worldwide. Children are amongst the high-risk groups for developing tuberculosis and often pose a challenge to the clinicians in making a definitive diagnosis. The newly released global tuberculosis report from World Health Organization reveals a 50% increase in fatality from tuberculosis in children. Significantly, diagnostic and treatment algorithms of tuberculosis for children differ from those of adults. Bacteriologic confirmation of the disease is often difficult in children; hence radiologists have an important role to play in early diagnosis of this disease. Despite advancing technology, the key diagnostic imaging modalities for primary care and emergency services, especially in rural and low-resource areas, are chest radiography and ultrasonography. In this article, we discuss various diagnostic imaging modalities used in diagnosis and treatment of tuberculosis and their indications. We highlight the use of US as point-of-care service along with mediastinal US and rapid MRI protocols, especially in mediastinal lymphadenopathy and thoracic complications. MRI is the ideal modality in high-resource areas when adequate infrastructure is available. Because the prevalence of tuberculosis is highest in lower-resource countries, we also discuss global initiatives in low-resource settings.

  5. Clinical use of gadobutrol for contrast-enhanced magnetic resonance imaging of neurological diseases

    Directory of Open Access Journals (Sweden)

    Cheng KT

    2012-02-01

    Full Text Available Kenneth T Cheng1, Hannah Y Cheng2, Kam Leung31Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; 2Freelance Technical Writer, New Orleans, LA, USA; 3National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, USAAbstract: Contrast-enhanced magnetic resonance imaging (CE-MRI is an important clinical tool for diagnosing neurological diseases. The appropriate use of a suitable MRI contrast agent or contrast pharmaceutical is essential for CE-MRI to produce desirable diagnostic images. Currently, there are seven contrast agents (CAs or pharmaceuticals approved for clinical imaging of the central nervous system (CNS in the US, Europe, or Japan. All of the clinically approved CAs are water-soluble gadolinium-based contrast agents (GBCAs which do not penetrate the CNS blood–brain barrier (BBB. These agents are used for imaging CNS areas without a BBB, or various pathologies, such as tumors and infection that break down the BBB and allow CAs to enter into the surrounding parenchyma. Clinically, GBCAs are most useful for detecting primary and secondary cerebral neoplastic lesions. Among these CNS GBCAs, gadobutrol (Gd-BT-DO3A, Gadovist™ is a neutral, nonionic, macrocyclic compound that showed promising results from clinical trials of CNS imaging. In comparison with other GBCAs, Gd-BT-DO3A has relatively high in vitro kinetic stability and r1 relaxivity. Gd-BT-DO3A has been recently approved by the US Food and Drug Administration (FDA in 2011 for CNS imaging. A review of available literature shows that Gd-BT-DO3A exhibits similar safety and clinical efficacy profiles to other GBCAs. Gd-BT-DO3A has the distinguishing feature that it is the only clinical agent commercially available in a formulation of 1.0 M concentration with a relatively higher in vitro T1 shortening per unit volume than other clinical GBCAs which are only

  6. Image noise reduction algorithm for digital subtraction angiography: clinical results.

    Science.gov (United States)

    Söderman, Michael; Holmin, Staffan; Andersson, Tommy; Palmgren, Charlotta; Babic, Draženko; Hoornaert, Bart

    2013-11-01

    To test the hypothesis that an image noise reduction algorithm designed for digital subtraction angiography (DSA) in interventional neuroradiology enables a reduction in the patient entrance dose by a factor of 4 while maintaining image quality. This clinical prospective study was approved by the local ethics committee, and all 20 adult patients provided informed consent. DSA was performed with the default reference DSA program, a quarter-dose DSA program with modified acquisition parameters (to reduce patient radiation dose exposure), and a real-time noise-reduction algorithm. Two consecutive biplane DSA data sets were acquired in each patient. The dose-area product (DAP) was calculated for each image and compared. A randomized, blinded, offline reading study was conducted to show noninferiority of the quarter-dose image sets. Overall, 40 samples per treatment group were necessary to acquire 80% power, which was calculated by using a one-sided α level of 2.5%. The mean DAP with the quarter-dose program was 25.3% ± 0.8 of that with the reference program. The median overall image quality scores with the reference program were 9, 13, and 12 for readers 1, 2, and 3, respectively. These scores increased slightly to 12, 15, and 12, respectively, with the quarter-dose program imaging chain. In DSA, a change in technique factors combined with a real-time noise-reduction algorithm will reduce the patient entrance dose by 75%, without a loss of image quality. RSNA, 2013

  7. Clinical stage T1c prostate cancer: evaluation with endorectal MR imaging and MR spectroscopic imaging.

    Science.gov (United States)

    Zhang, Jingbo; Hricak, Hedvig; Shukla-Dave, Amita; Akin, Oguz; Ishill, Nicole M; Carlino, Lauren J; Reuter, Victor E; Eastham, James A

    2009-11-01

    To assess the diagnostic accuracy of endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging for prediction of the pathologic stage of prostate cancer and the presence of clinically nonimportant disease in patients with clinical stage T1c prostate cancer. The institutional review board approved-and waived the informed patient consent requirement for-this HIPAA-compliant study involving 158 patients (median age, 58 years; age range, 40-76 years) who had clinical stage T1c prostate cancer, had not been treated preoperatively, and underwent combined 1.5-T endorectal MR imaging-MR spectroscopic imaging between January 2003 and March 2004 before undergoing radical prostatectomy. On the MR images and combined endorectal MR-MR spectroscopic images, two radiologists retrospectively and independently rated the likelihood of cancer in 12 prostate regions and the likelihoods of extracapsular extension (ECE), seminal vesicle invasion (SVI), and adjacent organ invasion by using a five-point scale, and they determined the probability of clinically nonimportant prostate cancer by using a four-point scale. Whole-mount step-section pathology maps were used for imaging-pathologic analysis correlation. Receiver operating characteristic curves were constructed and areas under the curves (AUCs) were estimated nonparametrically for assessment of reader accuracy. At surgical-pathologic analysis, one (0.6%) patient had no cancer; 124 (78%) patients, organ-confined (stage pT2) disease; 29 (18%) patients, ECE (stage pT3a); two (1%) patients, SVI (stage pT3b); and two (1%) patients, bladder neck invasion (stage pT4). Forty-six (29%) patients had a total tumor volume of less than 0.5 cm(3). With combined MR imaging-MR spectroscopic imaging, the two readers achieved 80% accuracy in disease staging and AUCs of 0.62 and 0.71 for the prediction of clinically nonimportant cancer. Clinical stage T1c prostate cancers are heterogeneous in pathologic stage and volume. MR imaging may

  8. Current status of superparamagnetic iron oxide contrast agents for liver magnetic resonance imaging.

    Science.gov (United States)

    Wang, Yi-Xiang J

    2015-12-21

    Five types of superparamagnetic iron oxide (SPIO), i.e. Ferumoxides (Feridex(®) IV, Berlex Laboratories), Ferucarbotran (Resovist(®), Bayer Healthcare), Ferumoxtran-10 (AMI-227 or Code-7227, Combidex(®), AMAG Pharma; Sinerem(®), Guerbet), NC100150 (Clariscan(®), Nycomed,) and (VSOP C184, Ferropharm) have been designed and clinically tested as magnetic resonance contrast agents. However, until now Resovist(®) is current available in only a few countries. The other four agents have been stopped for further development or withdrawn from the market. Another SPIO agent Ferumoxytol (Feraheme(®)) is approved for the treatment of iron deficiency in adult chronic kidney disease patients. Ferumoxytol is comprised of iron oxide particles surrounded by a carbohydrate coat, and it is being explored as a potential imaging approach for evaluating lymph nodes and certain liver tumors.

  9. Myocardial perfusion imaging in Denmark: activity from 1997 to 2001 and current practice

    DEFF Research Database (Denmark)

    Petersen, Claus Leth; Kjaer, Andreas

    2003-01-01

    , and the survey thus covers all MPI performed in Denmark during the period in question. The number of MPI studies (examined patients) was 2,531 in 1997 (0.47 MPI/1,000/year) and 4,961 (0.93 MPI/1,000/year) in 2001, which is a doubling in activity in 5 years. Nineteen (95%) of the Danish departments performed MPI...... in 2001, and 14 (74%) of these reported that activity had increased over the past 5 years. MPI activity was unevenly distributed between hospitals and regions. In 2001, the university hospitals in the central Copenhagen region (capital) accounted for the highest MPI activity (2.00/1,000/year), while......A questionnaire was sent to all departments of nuclear medicine in Denmark (n=20) asking for details of myocardial perfusion imaging (MPI), including the number of patients examined each year from 1997 to 2001 and the current clinical and technical practice. All (100%) departments replied...

  10. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues.

    Directory of Open Access Journals (Sweden)

    Ethan Budd Russo

    2016-09-01

    Full Text Available This overview covers a wide range of cannabis topics, initially examining issue in dispensaries and self-administration, plus regulatory requirement for production of cannabis-based medicines, particularly the Food and Drug Administration Botanical Guidance. The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety and public health issues remain.

  11. Current Therapeutic Cannabis Controversies and Clinical Trial Design Issues

    Science.gov (United States)

    Russo, Ethan B.

    2016-01-01

    This overview covers a wide range of cannabis topics, initially examining issues in dispensaries and self-administration, plus regulatory requirements for production of cannabis-based medicines, particularly the Food and Drug Administration “Botanical Guidance.” The remainder pertains to various cannabis controversies that certainly require closer examination if the scientific, consumer, and governmental stakeholders are ever to reach consensus on safety issues, specifically: whether botanical cannabis displays herbal synergy of its components, pharmacokinetics of cannabis and dose titration, whether cannabis medicines produce cyclo-oxygenase inhibition, cannabis-drug interactions, and cytochrome P450 issues, whether cannabis randomized clinical trials are properly blinded, combatting the placebo effect in those trials via new approaches, the drug abuse liability (DAL) of cannabis-based medicines and their regulatory scheduling, their effects on cognitive function and psychiatric sequelae, immunological effects, cannabis and driving safety, youth usage, issues related to cannabis smoking and vaporization, cannabis concentrates and vape-pens, and laboratory analysis for contamination with bacteria and heavy metals. Finally, the issue of pesticide usage on cannabis crops is addressed. New and disturbing data on pesticide residues in legal cannabis products in Washington State are presented with the observation of an 84.6% contamination rate including potentially neurotoxic and carcinogenic agents. With ongoing developments in legalization of cannabis in medical and recreational settings, numerous scientific, safety, and public health issues remain. PMID:27683558

  12. Current and past strategies for bacterial culture in clinical microbiology.

    Science.gov (United States)

    Lagier, Jean-Christophe; Edouard, Sophie; Pagnier, Isabelle; Mediannikov, Oleg; Drancourt, Michel; Raoult, Didier

    2015-01-01

    A pure bacterial culture remains essential for the study of its virulence, its antibiotic susceptibility, and its genome sequence in order to facilitate the understanding and treatment of caused diseases. The first culture conditions empirically varied incubation time, nutrients, atmosphere, and temperature; culture was then gradually abandoned in favor of molecular methods. The rebirth of culture in clinical microbiology was prompted by microbiologists specializing in intracellular bacteria. The shell vial procedure allowed the culture of new species of Rickettsia. The design of axenic media for growing fastidious bacteria such as Tropheryma whipplei and Coxiella burnetii and the ability of amoebal coculture to discover new bacteria constituted major advances. Strong efforts associating optimized culture media, detection methods, and a microaerophilic atmosphere allowed a dramatic decrease of the time of Mycobacterium tuberculosis culture. The use of a new versatile medium allowed an extension of the repertoire of archaea. Finally, to optimize the culture of anaerobes in routine bacteriology laboratories, the addition of antioxidants in culture media under an aerobic atmosphere allowed the growth of strictly anaerobic species. Nevertheless, among usual bacterial pathogens, the development of axenic media for the culture of Treponema pallidum or Mycobacterium leprae remains an important challenge that the patience and innovations of cultivators will enable them to overcome. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  13. Clinical Characteristics and Current Therapies for Inherited Retinal Degenerations

    Science.gov (United States)

    Sahel, José-Alain; Marazova, Katia; Audo, Isabelle

    2015-01-01

    Inherited retinal degenerations (IRDs) encompass a large group of clinically and genetically heterogeneous diseases that affect approximately 1 in 3000 people (>2 million people worldwide) (Bessant DA, Ali RR, Bhattacharya SS. 2001. Molecular genetics and prospects for therapy of the inherited retinal dystrophies. Curr Opin Genet Dev 11: 307–316.). IRDs may be inherited as Mendelian traits or through mitochondrial DNA, and may affect the entire retina (e.g., rod–cone dystrophy, also known as retinitis pigmentosa, cone dystrophy, cone–rod dystrophy, choroideremia, Usher syndrome, and Bardet-Bidel syndrome) or be restricted to the macula (e.g., Stargardt disease, Best disease, and Sorsby fundus dystrophy), ultimately leading to blindness. IRDs are a major cause of severe vision loss, with profound impact on patients and society. Although IRDs remain untreatable today, significant progress toward therapeutic strategies for IRDs has marked the past two decades. This progress has been based on better understanding of the pathophysiological pathways of these diseases and on technological advances. PMID:25324231

  14. Influence of total beam current on HRTEM image resolution in differentially pumped ETEM with nitrogen gas

    International Nuclear Information System (INIS)

    Bright, A.N.; Yoshida, K.; Tanaka, N.

    2013-01-01

    Environmental transmission electron microscopy (ETEM) enables the study of catalytic and other reaction processes as they occur with Angstrom-level resolution. The microscope used is a dedicated ETEM (Titan ETEM, FEI Company) with a differential pumping vacuum system and apertures, allowing aberration corrected high-resolution transmission electron microscopy (HRTEM) imaging to be performed with gas pressures up to 20 mbar in the sample area and with significant advantages over membrane-type E-cell holders. The effect on image resolution of varying the nitrogen gas pressure, electron beam current density and total beam current were measured using information limit (Young's fringes) on a standard cross grating sample and from silicon crystal lattice imaging. As expected, increasing gas pressure causes a decrease in HRTEM image resolution. However, the total electron beam current also causes big changes in the image resolution (lower beam current giving better resolution), whereas varying the beam current density has almost no effect on resolution, a result that has not been reported previously. This behavior is seen even with zero-loss filtered imaging, which we believe shows that the drop in resolution is caused by elastic scattering at gas ions created by the incident electron beam. Suitable conditions for acquiring high resolution images in a gas environment are discussed. Lattice images at nitrogen pressures up to 16 mbar are shown, with 0.12 nm information transfer at 4 mbar. -- Highlights: ► ETEM images with point resolution of 0.12 nm in 4 mbar of nitrogen gas. ► Clear Si lattice imaging with 16 mbar of nitrogen gas. ► ETEM image resolution in gas can be much improved by decreasing total beam current. ► Beam current density (beam convergence) has no effect on the image resolution.

  15. Multimodality molecular imaging - from target description to clinical studies

    International Nuclear Information System (INIS)

    Schober, O.; Rahbar, K.; Riemann, B.

    2009-01-01

    This highlight lecture was presented at the closing session of the Annual Congress of the European Association of Nuclear Medicine (EANM) in Munich on 15 October 2008. The Congress was a great success: there were more than 4,000 participants, and 1,597 abstracts were submitted. Of these, 1,387 were accepted for oral or poster presentation, with a rejection rate of 14%. In this article a choice was made from 100 of the 500 lectures which received the highest scores by the scientific review panel. This article outlines the major findings and trends at the EANM 2008, and is only a brief summary of the large number of outstanding abstracts presented. Among the great number of oral and poster presentations covering nearly all fields of nuclear medicine some headlines have to be defined highlighting the development of nuclear medicine in the 21st century. This review focuses on the increasing impact of molecular and multimodality imaging in the field of nuclear medicine. In addition, the question may be asked as to whether the whole spectrum of nuclear medicine is nothing other than molecular imaging and therapy. Furthermore, molecular imaging will and has to go ahead to multimodality imaging. In view of this background the review was structured according to the single steps of molecular imaging, i.e. from target description to clinical studies. The following topics are addressed: targets, radiochemistry and radiopharmacy, devices and computer science, animals and preclinical evaluations, and patients and clinical evaluations. (orig.)

  16. [Clinical, pathological and imaging features of primary pelvic Ewing's sarcoma].

    Science.gov (United States)

    Liu, J; Chen, Y; Ling, X L; Gong, Y; Ding, J P; Zhang, Z K; Wang, Y J

    2016-07-19

    To explore the clinical, pathological and imaging features of Ewing's sarcoma in pelvis and to improve knowledge and diagnosis of the disease. A retrospective analysis of the clinical, pathological and imaging data of pathologically confirmed 13 cases of Ewing's sarcoma in pelvis was carried out between May 2008 and March 2016 in the Affiliated Hospital of Hangzhou Normal University, the Third Hospital of Hebei Medical University and the Second Hospital of Hebei Medical University. The median age 13 cases of pelvic primary Ewing's sarcoma was 17 years old.The X-ray and CT imagings showed osteolytic and mixed bone destruction, CT showed mixed type in 10 cases, 8 cases of bone tumors as a flocculent, 10 cases of bone expansion failure, 10 cases of periosteal reaction, the layered 5 cases, radial in 5 cases.Thirteen cases showed soft tissue mass, soft tissue mass was equal or slightly lower density.Four cases showed heterogeneous contrast enhancement.The lesions showed low signal in T1WI and mixed high signal in T2WI of magnetic resonance imaging(MRI). The boundary of the lesions were obscure, and 5 cases had patchy necrosis area, and 9 cases had incomplete false capsule, surrounding soft tissue was violated.Four cases showed heterogeneous contrast enhancement after MRI enhancement scan. The age of onset of Ewing's sarcoma of the pelvis is more concentrated in about 15 years.The imaging feaures are mixed bone destruction and more bone is swelling and permeability damage, soft tissue mass is larger, bone tumor is cloudy or acicular, periosteal reaction in a layered and radial, most cases show that the false envelope is not complete.Combined with clinical and imaging examination, the diagnosis of the disease can be made.

  17. Utilizing data grid architecture for the backup and recovery of clinical image data.

    Science.gov (United States)

    Liu, Brent J; Zhou, M Z; Documet, J

    2005-01-01

    Grid Computing represents the latest and most exciting technology to evolve from the familiar realm of parallel, peer-to-peer and client-server models. However, there has been limited investigation into the impact of this emerging technology in medical imaging and informatics. In particular, PACS technology, an established clinical image repository system, while having matured significantly during the past ten years, still remains weak in the area of clinical image data backup. Current solutions are expensive or time consuming and the technology is far from foolproof. Many large-scale PACS archive systems still encounter downtime for hours or days, which has the critical effect of crippling daily clinical operations. In this paper, a review of current backup solutions will be presented along with a brief introduction to grid technology. Finally, research and development utilizing the grid architecture for the recovery of clinical image data, in particular, PACS image data, will be presented. The focus of this paper is centered on applying a grid computing architecture to a DICOM environment since DICOM has become the standard for clinical image data and PACS utilizes this standard. A federation of PACS can be created allowing a failed PACS archive to recover its image data from others in the federation in a seamless fashion. The design reflects the five-layer architecture of grid computing: Fabric, Resource, Connectivity, Collective, and Application Layers. The testbed Data Grid is composed of one research laboratory and two clinical sites. The Globus 3.0 Toolkit (Co-developed by the Argonne National Laboratory and Information Sciences Institute, USC) for developing the core and user level middleware is utilized to achieve grid connectivity. The successful implementation and evaluation of utilizing data grid architecture for clinical PACS data backup and recovery will provide an understanding of the methodology for using Data Grid in clinical image data backup for

  18. Current trends in the cardiovascular clinical trial arena (I

    Directory of Open Access Journals (Sweden)

    Pater Cornel

    2004-06-01

    Full Text Available Abstract The existence of effective therapies for most cardiovascular disease states, coupled with increased requirements that potential benefits of new drugs be evaluated on clinical rather than surrogate endpoints, makes it increasingly difficult to substantiate any incremental improvements in efficacy that these new drugs might offer. Compounding the problem is the highly controversial issue of comparing new agents with placebos rather than active pharmaceuticals in drug efficacy trials. Despite the recent consensus that placebos may be used ethically in well-defined, justifiable circumstances, the problem persists, in part because of increased scrutiny by ethics committees but also because of considerable lingering disagreement regarding the propriety and scientific value of placebo-controlled trials (and trials of antihypertensive drugs in particular. The disagreement also substantially affects the most viable alternative to placebo-controlled trials: actively controlled equivalence/noninferiority trials. To a great extent, this situation was prompted by numerous previous trials of this type that were marked by fundamental methodological flaws and consequent false claims, inconsistencies, and potential harm to patients. As the development and use of generic drugs continue to escalate, along with concurrent pressure to control medical costs by substituting less-expensive therapies for established ones, any claim that a new drug, intervention, or therapy is "equivalent" to another should not be accepted without close scrutiny. Adherence to proper methods in conducting studies of equivalence will help investigators to avoid false claims and inconsistencies. These matters will be addressed in the third article of this three-part series.

  19. HYPOPARATHYROIDISM: ETIOLOGY, CLINICAL MANIFESTATION, CURRENT DIAGNOSTICS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    N. G. Mokrysheva

    2016-01-01

    treatment with recombinant PTH is not widely used. Replacement therapy with recombinant human PTH is a  promising area, especially in severe clinical cases, refractory to conventional treatment.

  20. Autoimmune liver serology: current diagnostic and clinical challenges.

    Science.gov (United States)

    Bogdanos, Dimitrios-P; Invernizzi, Pietro; Mackay, Ian-R; Vergani, Diego

    2008-06-07

    Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseases (AiLD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC), and the sclerosing cholangitis variants in adults and children. AIH-1 is specified by anti-nuclear antibody (ANA) and smooth muscle antibody (SMA). AIH-2 is specified by antibody to liver kidney microsomal antigen type-1 (anti-LKM1) and anti-liver cytosol type 1 (anti-LC1). SMA, ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation. PBC is specified by antimitochondrial antibodies (AMA) reacting with enzymes of the 2-oxo-acid dehydrogenase complexes (chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly reacting with nuclear pore gp210 and nuclear body sp100. Sclerosing cholangitis presents as at least two variants, first the classical primary sclerosing cholangitis (PSC) mostly affecting adult men wherein the only (and non-specific) reactivity is an atypical perinuclear antineutrophil cytoplasmic antibody (p-ANCA), also termed perinuclear anti-neutrophil nuclear antibodies (p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis (ASC) with serological features resembling those of type 1 AIH. Liver diagnostic serology is a fast-expanding area of investigation as new purified and recombinant autoantigens, and automated technologies such as ELISAs and bead assays, become available to complement (or even compete with) traditional immunofluorescence procedures. We survey for the first time global trends in quality assurance impacting as it does on (1) manufacturers/purveyors of kits and reagents, (2) diagnostic service laboratories that fulfill clinicians' requirements, and (3) the end-user, the physician providing patient care, who must properly interpret test results in the overall clinical context.

  1. Lateral Augmentation Procedures in Anterior Cruciate Ligament Reconstruction: Anatomic, Biomechanical, Imaging, and Clinical Evidence.

    Science.gov (United States)

    Weber, Alexander E; Zuke, William; Mayer, Erik N; Forsythe, Brian; Getgood, Alan; Verma, Nikhil N; Bach, Bernard R; Bedi, Asheesh; Cole, Brian J

    2018-02-01

    There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date. Systematic review. A systematic search of the literature was conducted via the Medline, EMBASE, Scopus, SportDiscus, and CINAHL databases. The search was designed to encompass the literature on lateral extra-articular tenodesis (LET) procedures and the anterolateral ligament (ALL) reconstruction. Titles and abstracts were reviewed for relevance and sorted into the following categories: anatomy, biomechanics, imaging/diagnostics, surgical techniques, and clinical outcomes. The search identified 4016 articles. After review for relevance, 31, 53, 27, 35, 45, and 78 articles described the anatomy, biomechanics, imaging/diagnostics, surgical techniques, and clinical outcomes of either LET procedures or the ALL reconstruction, respectively. A multitude of investigations were available, revealing controversy in addition to consensus in several categories. The level of evidence obtained from this search was not adequate for systematic review or meta-analysis; thus, a current concepts review of the anatomy, biomechanics, imaging, surgical techniques, and clinical outcomes was performed. Histologically, the ALL appears to be a distinct structure that can be identified with advanced imaging techniques. Biomechanical evidence suggests that the anterolateral structures of the knee, including the ALL, contribute to minimizing anterolateral rotational instability

  2. Preliminary Experience with Small Animal SPECT Imaging on Clinical Gamma Cameras

    Directory of Open Access Journals (Sweden)

    P. Aguiar

    2014-01-01

    Full Text Available The traditional lack of techniques suitable for in vivo imaging has induced a great interest in molecular imaging for preclinical research. Nevertheless, its use spreads slowly due to the difficulties in justifying the high cost of the current dedicated preclinical scanners. An alternative for lowering the costs is to repurpose old clinical gamma cameras to be used for preclinical imaging. In this paper we assess the performance of a portable device, that is, working coupled to a single-head clinical gamma camera, and we present our preliminary experience in several small animal applications. Our findings, based on phantom experiments and animal studies, provided an image quality, in terms of contrast-noise trade-off, comparable to dedicated preclinical pinhole-based scanners. We feel that our portable device offers an opportunity for recycling the widespread availability of clinical gamma cameras in nuclear medicine departments to be used in small animal SPECT imaging and we hope that it can contribute to spreading the use of preclinical imaging within institutions on tight budgets.

  3. Indian Adolescent Living with HIV-AIDS: Current Clinical Scenario.

    Science.gov (United States)

    Joshi, Kavita S; Bhaware, Bhushan D; Pazare, Amar R

    2017-07-01

    Statistics suggest that, HIV has now largely become the disease of young patients. Hence, the adolescent HIV/AIDS needs to be handled and managed separately from adult HIV. Relatively fewer Indian data exist to characterize the associations in adolescents and young adults infected with HIV disease. The present study explores the current challenges in the management of HIV infected adolescents. The study was aimed at evaluating, relationship between CD4 count and duration of antiretroviral therapy (ART), effects of ART on body mass index and the adverse effects of antiretroviral drugs in adolescent HIV positive patients. This was a cross-sectional study involving 60 HIV positive adolescent patients attending tertiary care Institute KEM Hospital, Parel over duration of one year conducted at Mumbai. Patients on ART between age group 12 to 19 years. ART naïve patients were excluded from the study. 60 adolescent HIV positive patients attended our OPD including 37 males (61.67%) and 23 females (38.33%).The most common mode of transmission was vertical (80%). Education level was: school dropouts - 15%, primary education - 30%, Completed SSC - 31.7%, higher secondary - 23%. Among ADRs were 12 (63.15%) cases of anaemia due to Zidovudine, 4 (21.05%) hepatitis due to Nevirapine, 2 (10.52%) Tenofovir induced AKI and 1 (5.26%) Nevirapine rash. Wilcoxon matched pairs test showed a highly significant increase in the BMI (p ART under government programme has increased the duration of survival of the adolescent population with HIV. Treatment with HAART showed a favourable response with a statistical significant increase in CD4 count. Longer the duration of HAART, higher was the gain in CD4 count. Indian adolescent receiving long term ART, Lipodystrophy is not a troubling issue. Indian adolescent seems to be more tolerance of ART than the other parts of world.

  4. Magnetic resonance imaging inside cylindrical metal containers with an eddy current self-compensated method

    International Nuclear Information System (INIS)

    Han, Hui; Balcom, Bruce J

    2011-01-01

    Magnetic resonance imaging (MRI) measurements inside cylindrical metal structures have recently been proposed and form the basis for new high-pressure MRI studies. The critical problem for MRI inside cylindrical metal structures is significant eddy currents induced by the switched magnetic field gradients, which usually corrupt spatial and motion encoding without appropriate correction. In this work a so-called standard SPRITE (single point ramped imaging with T 1 enhancement) technique is applied for imaging inside cylindrical metal structures. We show that the standard SPRITE technique is fundamentally immune to large-scale eddy current effects and yields artifact-free high-quality images with no eddy current correction required. Standard SPRITE image acquisition avoids the complications involved in the measurement and compensation of eddy current effects for MRI with cylindrical metal structures. This work is a substantial advance toward the extension of MRI to new challenging systems, which are of practical importance

  5. PET radioligands for imaging of Tau pathology: Current status

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Yearn Seong [Dept. of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Kyung Han [Dept. of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul (Korea, Republic of)

    2015-12-15

    The incidence of Alzheimer’s disease (AD), a progressive neurodegenerative disorder, continues to soar with the rapid growth of the elderly population, thus creating an enormous social and economic burden. Although disease-modifying drugs to treat AD are not yet available, several candidate drugs are in clinical trials. Most of these drugs are expected to be effective at the early stages of the disease, and therefore the early and accurate diagnosis of AD will be a critical factor in efforts to improve the prognosis of patients with AD. This review focuses on lead radioligands developed to date and their preclinical data in order to facilitate the development of tau-specific positron emission tomography radioligands that are of great interest to the scientific community.

  6. Apoptosis imaging: current state of the art and future perspective

    International Nuclear Information System (INIS)

    Wang Feng; Wang Zizheng

    2007-01-01

    This review provides a critical and thorough overview of the radionpharmaceutical development and in vivo evaluation of all apoptosis-detecting radioligands that emerged so far, along with these possible applications in nuclear medicine. Radiolabelled annexin bears the promise of becoming a clinically applied radio-pharmaceutical with potential applications in cardiology and oncology. Visualization of cell death is important in pathologies such as myocardial infarction, atherosclerosis, and cancer. Furthermore, radiolabelled annexin may be developed as a tool for monitoring cell death-induceing or cell death-preventing therapies. Some future perspective are presented with the aim of promoting the development of potential new strategies in pursuit of the idealcell death-detecting radioligand. (authors)

  7. Clinical application of quantitative 99Tcm-pertechnetate thyroid imaging

    International Nuclear Information System (INIS)

    Gao Yongju; Xie Jian; Yan Xinhui; Wand Jiebin; Zhu Xuanmin; Liu Lin; Sun Haizhou

    2002-01-01

    Objective: To investigate the clinical value of quantitative 99 Tc m -pertechnetate thyroid imaging for the diagnosis and therapeutic evaluation in patients with thyroid disease. Methods: With the Siemens Orbit SPECT, 99 Tc m sodium pertechnetate thyroid imaging was performed on a control group and 108 patients with Graves' disease, 58 patients with Hashimoto's disease, 41 patients with subacute thyroiditis. Three functional parameters were calculated as follows: AR=5 min thyroid count/1 min thyroid count; UI=20 min thyroid count/thigh count; T d =imaging interval between carotid and thyroid. Results: 1) Three functional parameters were basically concordant with serological parameters in patients with Graves' disease. While uptake was high in patients who had contracted Graves' disease for ≤0.5 year, for those whose disease relapsed within 2 years the 99 Tc m thyroid uptake increased when the antithyroid medication was stopped. 2) Thyroid images of hyperthyroid patients with Hashimoto's disease showed increased perfusion and 99 Tc m uptake, a pattern similar to that found in Graves' disease. Differences in T d , AR , UI were not significant among euthyroid, subclinical hypothyroid patients with Hashimoto's disease, so uptake ratios could indicate the thyroid activity. 3) Delayed thyroid image and diffuse uptake decrease were found in hyperthyroid patients with SAT, however, focal damages were observed in euthyroid patients. Conclusion: Quantitative 99 Tc m -pertechnetate thyroid imaging is a significantly helpful technique in the diagnosis and treatment for common thyroid disorders

  8. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods

    Directory of Open Access Journals (Sweden)

    Ahmed R

    2014-03-01

    Full Text Available Rafay Ahmed,1 Matthew J Oborski,2 Misun Hwang,1 Frank S Lieberman,3 James M Mountz11Department of Radiology, 2Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; 3Department of Neurology and Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USAAbstract: Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12–15 months for glioblastomas and 2–5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies

  9. Ectopic pregnancy: current clinical trends, a fifteen year study.

    Science.gov (United States)

    Weekes, L R

    1981-09-01

    This paper reviews the clinical recognition, diagnosis, and management of ectopic pregnancy at the Queen of Angels Hospital for the past 15 years. The incidence of ectopic pregnancy to deliveries is 1:195. Pain is the cardinal symptom of ectopic pregnancy, and amenorrhea of some degree was present in all cases. Pelvic inflammatory disease is a factor in the development of tubal pregnancy in some women. A careful history and thorough physical examination are important in making a careful diagnosis. The only laboratory procedures which are of any value are the blood type and the Rh determination. While examination of endometrial tissue obtained by biopsy or curettage has proved useful in ectopic pregnancy diagnosis, it is not totally decisive. Culdocentesis has proved to be the diagnostic procedure of the greatest value in recognizing intraperitoneal hemorrhage and it increases the correct preoperative diagnosis from 65-70% to 95%. Laparoscopy is useful when the physician is in doubt about the nature of the problem and it has produced an increase in the number of ectopic pregnancies diagnosed. Ultrasound is another useful tool in confirming a diagnosis of ectopic pregnancy; its accuracy ranges from 70-92%. A newly developed pregnancy test is more sensitive than conventional pregnancy tests and would be positive for pregnancy. Women who have had a previous ectopic pregnancy have a higher subsequent incidence of persistent infertility, recurrent ectopic pregnancy, and pregnancy wastage; the risk of another ectopic pregnancy increases 30-50 fold. While extopic pregnancy does recur, it is true that about 1/3 of those women do have successful pregnancies. Where previous induced abortion has occurred, there is a 10-fold increased risk of ectopic pregnancy. Women who become pregnant accidentally with an IUD in place have a greater likelihood of experiencing an extrauterine pregnancy. Abdominal pregnancy is often encountered as an aborting ectopic pregnancy during the 1st

  10. Molecular imaging of prostate cancer: translating molecular biology approaches into the clinical realm.

    Science.gov (United States)

    Vargas, Hebert Alberto; Grimm, Jan; F Donati, Olivio; Sala, Evis; Hricak, Hedvig

    2015-05-01

    The epidemiology of prostate cancer has dramatically changed since the introduction of prostate-specific antigen (PSA) screening in the 1980's. Most prostate cancers today are detected at early stages of the disease and are considered 'indolent'; however, some patients' prostate cancers demonstrate a more aggressive behaviour which leads to rapid progression and death. Increasing understanding of the biology underlying the heterogeneity that characterises this disease has led to a continuously evolving role of imaging in the management of prostate cancer. Functional and metabolic imaging techniques are gaining importance as the impact on the therapeutic paradigm has shifted from structural tumour detection alone to distinguishing patients with indolent tumours that can be managed conservatively (e.g., by active surveillance) from patients with more aggressive tumours that may require definitive treatment with surgery or radiation. In this review, we discuss advanced imaging techniques that allow direct visualisation of molecular interactions relevant to prostate cancer and their potential for translation to the clinical setting in the near future. The potential use of imaging to follow molecular events during drug therapy as well as the use of imaging agents for therapeutic purposes will also be discussed. • Advanced imaging techniques allow direct visualisation of molecular interactions in prostate cancer. • MRI/PET, optical and Cerenkov imaging facilitate the translation of molecular biology. • Multiple compounds targeting PSMA expression are currently undergoing clinical translation. • Other targets (e.g., PSA, prostate-stem cell antigen, GRPR) are in development.

  11. Diagnostic imaging, a 'parallel' discipline. Can current technology provide a reliable digital diagnostic radiology department

    International Nuclear Information System (INIS)

    Moore, C.J.; Eddleston, B.

    1985-01-01

    Only recently has any detailed criticism been voiced about the practicalities of the introduction of generalised, digital, imaging complexes in diagnostic radiology. Although attendant technological problems are highlighted the authors argue that the fundamental causes of current difficulties are not in the generation but in the processing, filing and subsequent retrieval for display of digital image records. In the real world, looking at images is a parallel process of some complexity and so it is perhaps untimely to expect versatile handling of vast image data bases by existing computer hardware and software which, by their current nature, perform tasks serially. (author)

  12. [3D imaging benefits in clinical pratice of orthodontics].

    Science.gov (United States)

    Frèrejouand, Emmanuel

    2016-12-01

    3D imaging possibilities raised up in the last few years in the orthodontic field. In 2016, it can be used for diagnosis improvement and treatment planning by using digital set up combined to CBCT. It is relevant for orthodontic mechanic updating by creating visible or invisible customised appliances. It forms the basis of numerous scientific researches. The author explains the progress 3D imaging brings to diagnosis and clinics but also highlights the requirements it creates. The daily use of these processes in orthodontic clinical practices needs to be regulated regarding the benefit/risk ratio and the patient satisfaction. The command of the digital work flow created by these technics requires habits modifications from the orthodontist and his staff. © EDP Sciences, SFODF, 2016.

  13. Clinical and imaging characteristics of the vascular dementia. Preliminary studies

    International Nuclear Information System (INIS)

    Gomez Viera, Nelson; Rivero Arias, Edmundo; Perez Nellar, Jesus; Begueria Santos, Ramon; Arias Sifontes, William; Raiteris Flores, Juan

    1997-01-01

    A descriptive prospective study was carried out in 41 patients presenting with vascular dementia from Habana Vieja municipality, Havana City, in order to know some of the clinical and imaging characteristics of this disease. The main risk factors observed were the history of cerebrovascular disease and arterial hypertension. Depression, sleeping disorders and focal and pseudo bulbar neurologic signs were the most frequent clinical findings. Folstein neuropsychological test evidenced an important disorder of attention, calculation, the evocation memory and orientation. According to this test, 29 % of the patients had a severe dementia and nearly 50 % showed a severe handicap. The most frequent imaging findings observed in the computerized axial tomography of the cranium were cerebral atrophy, and single or multiple infarctions. Multiple cerebral infarctions, the lacunar status, subcortical encephalopathy of Binswanger, and single infarction located in cerebral areas related to cognition were considered as possible psychopathological mechanisms associated with the disease

  14. Cerebral sparganosis in children: epidemiological, clinical and MR imaging characteristics

    Directory of Open Access Journals (Sweden)

    Gong Caigui

    2012-09-01

    Full Text Available Abstract Background Cerebral sparganosis in children is an extremely rare disease of central nervous system, and caused by a tapeworm larva from the genus of Spirometra. In this study, we discussed and summarized epidemiological, clinical and MR imaging characteristics of eighteen children with cerebral sparganosis for a better diagnosis and treatment of the disease. Methods Eighteen children with cerebral sparganosis verified by pathology, serological tests and MR presentations were retrospectively investigated, and the epidemiologic and clinical characteristics of the disease were studied. Results Twenty-seven lesions were found in the eighteen children. Twelve lesions in twelve patients were solitary while the lesions in the rest six patients were multiple and asymmetrical. The positions of the lesions were: seven in frontal, eleven in parietal, four in temporal and two in occipital lobes, one in basal ganglia, one in cerebella hemisphere and one in pons. The lesions were presented as slight hypointensity on T1-weighted images but moderate hyperintensity on T2-weighted images with perilesional brain parenchyma edema. Enhanced MR scans by using Gadopentetic Acid Dimeglumine Salt were performed in the patients, and the images demonstrated abnormal enhancements with the patterns of a peripheral ring, or a tortuous beaded, or a serpiginous tubular shape. Follow-up MR scans were preformed for eight patients, and three out of the eight cases exposed migrations and changes in shapes of the lesion areas. Conclusions The MR presentations in our study in general were similar to those in previous studies. However serpiginous tubular and comma-shaped enhancements of lesions have not been previously reported. The enhanced MR imaging and follow-up MR scans with the positive results from serological tests are the most important methods for the clinical diagnosis of cerebral sparganosis in children.

  15. The clinical application of the digital imaging in urography

    International Nuclear Information System (INIS)

    Zhu Yuelong; Xie Sumin; Zhang Li; Li Huayu

    2003-01-01

    Objective: To evaluate the clinical application of the digital imaging in the urography. Methods: In total 112 patients underwent digital urography, including intravenous pyelography (IVP) in 38 cases and retrograde pyelography in 74 cases. Results: the entire urinary tract was better shown on digital imaging, which was accurate in locating the obstruction of urinary tract and helped the qualitative diagnosis. Digital urography was especially valuable in detecting urinary calculus. In 38 cases of IVP, the results were normal in 5 patients, renal stone in 12, ureteral stone in 13, ureteral stenosis in 6 and nephroblastom in 2. In the 74 cases of retrograde pyelography, benign ureteral stenosis was found in 31 patients, ureteral stone in 27, ureteral polyp in 2, urethral stone in 8 and benign urethral stenosis in 6. Conclusion: Digital imaging technique is of big value in the diagnosis of urinary tract lesions

  16. Clinics in diagnostic imaging (179). Severe rhabdomyolysis complicated by myonecrosis.

    Science.gov (United States)

    Kok, Shi Xian Shawn; Tan, Tien Jin

    2017-08-01

    A 32-year-old man presented to the emergency department with severe right lower limb pain and swelling of three days' duration. He had multiple prior admissions for recurrent seizures and suicide attempts. Markedly elevated serum creatine kinase levels and urine myoglobinuria were consistent with a diagnosis of rhabdomyolysis. Initial magnetic resonance imaging of the right lower limb revealed diffuse muscle oedema and features of myositis in the gluteal muscles and the adductor, anterior and posterior compartments of the thigh. Follow-up magnetic resonance imaging performed 11 days later showed interval development of areas of myonecrosis and haemorrhage. The causes, clinical presentation and imaging features of rhabdomyolysis are discussed. Copyright: © Singapore Medical Association.

  17. Clinical utility of MR imaging in chronic progressive radiation myelopathy

    International Nuclear Information System (INIS)

    Melki, P.S.; Halimi, P.; Wibault, P.; Doyon, D.

    1990-01-01

    This paper defines the diagnostic and prognostic value of MR imaging in chronic progressive radiation myelopathy 9CPRM). In this series, MR imaging showed excellent sensitivity (199%) for the demonstration of radiation-induced lesions of the spinal cord. Fifty percent of the cases showed spinal cord hypertrophy (pseudotumoral, 33%; cystic, 17%) occurring within 8 months of the clinical onset of myelopathy. The remaining 50% showed spinal cord atrophy, which occurred more than 8 months following the onset of myelopathy. These medullary lesions were located at least partially in the radiation field but extended beyond its boundaries in 73% of the cases. MR imaging helped to establish disease prognosis: spinal cord hypertrophy was usually associated with neurologic deterioration and fatal outcome within a mean of 11.5 months; in spinal atrophy, neurologic deficit was often static and survival rates were better

  18. NMR imaging of the head-neck region. Topography of function - clinical findings - imaging and spectroscopy

    International Nuclear Information System (INIS)

    Vogl, T.J.

    1991-01-01

    The book on nmr imaging in the head-neck region offers, on a total of 221 pages, 344 detailed representations with 141 figures and 44 tables. It provides information as to the relevant topography of function, presents clinical findings, explains imaging characteristics and also takes account of spectroscopic procedures. The multifarious methods of investigation are described and discussed in connection with the differential diagnoses. A score of suitable diagnostic measures is assigned to each region of examination. The method's value is assessed against that of other imaging techniques. (orig.) [de

  19. The glenoid track: a review of the clinical relevance, method of calculation and current evidence behind this method

    Energy Technology Data Exchange (ETDEWEB)

    Younan, Yara; Wong, Philip K.; Umpierrez, Monica; Gonzalez, Felix; Singer, Adam Daniel [Emory University Hospital, Department of Radiology and Imaging Sciences, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Karas, Spero [Emory University Hospital, Department of Orthopedic Surgery, Atlanta, GA (United States); Jose, Jean [University of Miami, Department of Radiology, Miami, FL (United States)

    2017-12-15

    In the setting of bipolar bone injury, orthopedic surgeons are currently making use of the glenoid track method to guide surgical management. Using preoperative CT or MR imaging, this method allows the identification of patients who are more likely to fail a primary capsuloligamentous Bankart repair. As the glenoid track method becomes increasingly used in preoperative planning, it is important for the radiologist to become familiar with its concept and method of calculation. This review article aims to concisely summarize the current literature and the clinical implications of the glenoid track method. (orig.)

  20. Imaging and clinical analysis of 12 cases with melioidosis

    International Nuclear Information System (INIS)

    Yu Anle; Chen Hai; Li Qun

    2007-01-01

    Objective: Imaging and clinical manifestations of melioidosis were analyzed in order to improve our understanding of the disease and to reduce the rate of misdiagnosis. Methods: From 2001 to 2006, 12 melioidosis cases were confirmed by blood, pus and sputum culture. All cases were examined with radiography, and nine of them with CT and 2 with US. The imaging and clinical data were assessed retrospectively. Results: Ten of 12 cases revealed lung abnormalities, the main organ involved by melioidosis in the body. The appearances were observed as follows: diffused sheets and sheets fused partly in bilateral fields of the lungs can be seen on chest radiograph; homogeneous dense shadow of the lobe or segment were observed on plain chest film and CT; blurred strips radiated from hilum were revealed on plain chest film; multitude nodules in 2 lungs showed on CT; cavity with air and liquid be seen on plain chest film and CT; patches and granules in superior and middle fields or (and) inferior fields be seen on plain chest film and CT; arc shadow of water attenuation in dorsal thorax showed on CT. Infections outside the lung can be observed in orbital, lumbar muscle, liver and spleen in 1 case, and thighbone osteomyelitis with multi abscesses in one case. Conclusion: Alhough medioidosis has no characteristic imaging appearances, the disease's location, extent, severity and quantity objectively can be demonstrated by imaging, final confirmation is necessary using the culture of blood, pus and sputum. (authors)

  1. Influence of total beam current on HRTEM image resolution in differentially pumped ETEM with nitrogen gas.

    Science.gov (United States)

    Bright, A N; Yoshida, K; Tanaka, N

    2013-01-01

    Environmental transmission electron microscopy (ETEM) enables the study of catalytic and other reaction processes as they occur with Angstrom-level resolution. The microscope used is a dedicated ETEM (Titan ETEM, FEI Company) with a differential pumping vacuum system and apertures, allowing aberration corrected high-resolution transmission electron microscopy (HRTEM) imaging to be performed with gas pressures up to 20 mbar in the sample area and with significant advantages over membrane-type E-cell holders. The effect on image resolution of varying the nitrogen gas pressure, electron beam current density and total beam current were measured using information limit (Young's fringes) on a standard cross grating sample and from silicon crystal lattice imaging. As expected, increasing gas pressure causes a decrease in HRTEM image resolution. However, the total electron beam current also causes big changes in the image resolution (lower beam current giving better resolution), whereas varying the beam current density has almost no effect on resolution, a result that has not been reported previously. This behavior is seen even with zero-loss filtered imaging, which we believe shows that the drop in resolution is caused by elastic scattering at gas ions created by the incident electron beam. Suitable conditions for acquiring high resolution images in a gas environment are discussed. Lattice images at nitrogen pressures up to 16 mbar are shown, with 0.12 nm information transfer at 4 mbar. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Current studies and future perspectives of synchrotron radiation imaging trials in human patients

    Energy Technology Data Exchange (ETDEWEB)

    Longo, Renata, E-mail: renata.longo@ts.infn.it [Department of Physics, University of Trieste, via Valerio 2 3410 Trieste (Italy); INFN- sezione di Trieste, via Valerio 2 3410 Trieste (Italy)

    2016-02-11

    The coherent and monochromatic x-ray beams available at the synchrotron radiation (SR) laboratories are ideal tools for the development and the initial application of new imaging techniques. In the present paper the history of the clinical studies in k-edge subtraction imaging with SR is summarized, including coronary angiography and bronchography. The results of the recent trial in phase-contrast mammography at Elettra (Trieste, Italy) are discussed, in order to assess the clinical impact of the new imaging modality and the potential interest in its translation to clinical practice. The direct measurement of linear attenuation coefficient obtained during the SR mammography trial is also discussed. The new program of phase-contrast breast CT under development at Elettra is presented. Recently, 3D breast imaging (tomosynthesis and cone beam breast CT) has been introduced in clinical practice with significant improvement in diagnostic accuracy. The aim of this research is to study the contribution of the phase-contrast to the image quality of breast CT. Increasing the image quality of the x-ray medical images at the level of the results obtained at the SR laboratories is highly desirable, hence the promising techniques for the translation of the phase-contrast imaging to the hospitals are briefly discussed.

  3. Current studies and future perspectives of synchrotron radiation imaging trials in human patients

    International Nuclear Information System (INIS)

    Longo, Renata

    2016-01-01

    The coherent and monochromatic x-ray beams available at the synchrotron radiation (SR) laboratories are ideal tools for the development and the initial application of new imaging techniques. In the present paper the history of the clinical studies in k-edge subtraction imaging with SR is summarized, including coronary angiography and bronchography. The results of the recent trial in phase-contrast mammography at Elettra (Trieste, Italy) are discussed, in order to assess the clinical impact of the new imaging modality and the potential interest in its translation to clinical practice. The direct measurement of linear attenuation coefficient obtained during the SR mammography trial is also discussed. The new program of phase-contrast breast CT under development at Elettra is presented. Recently, 3D breast imaging (tomosynthesis and cone beam breast CT) has been introduced in clinical practice with significant improvement in diagnostic accuracy. The aim of this research is to study the contribution of the phase-contrast to the image quality of breast CT. Increasing the image quality of the x-ray medical images at the level of the results obtained at the SR laboratories is highly desirable, hence the promising techniques for the translation of the phase-contrast imaging to the hospitals are briefly discussed.

  4. Current development of cardiac imaging with multidetector-row CT

    International Nuclear Information System (INIS)

    Becker, Christoph R.; Ohnesorge, Bernd M.; Schoepf, U. Joseph; Reiser, Maximilian F.

    2000-01-01

    Multidector-row CT (MDCT) with retrospective ECG gating allows scanning the entire heart with 1.25 mm slice thickness and 250 ms effective exposure time within 35 s investigation time. The resulting images allow for an accurate high-resolution assessment of morphological detail of both the coronary arteries and the cardiac chambers. Performing a contrast-enhanced MDCT angiography (MD-CTA) in addition to a non-enhanced scan for the detection and quantification of coronary calcifications may be indicated in patients with atypical chest pain and in young patients with high cardiovascular risk. This group of patients may show non-calcified plaques as the first sign of their coronary artery disease. As the proximal part of the coronary arteries is well displayed by MD-CTA it also helps to delineate the course in anomalous coronary vessels. Additional information is drawn from the preoperative use of MD-CTA do determine the distance of the left internal mammarian artery to the left anterior descending coronary artery prior to minimal invasive bypass grafting. Additional indications for MD-CTA are the non-invasive follow up after venous bypass grafting, PTCA, and coronary stent interventions. MD-CTA allows following the course of the coronary vessels to the level of third generation coronary segmental arteries. A definite diagnosis to rule out coronary artery disease can be reliably made in vessels with a diameter of 1.5 mm or greater. With MDCT a number of different atherosclerotic changes can be observed in diseased coronary arteries. Non-stenotic lesions may show tiny calcifications surrounded by large areas of irregularly distributed soft tissue. Calcifications in this type of atherosclerotic coronary artery wall changes appear as 'the tip of iceberg'. Heavy calcifications usually tend to be non-stenotic because of vessel remodelling resulting in a widening of the coronary vessel lumen. Therefore, heavy calcifications appear to act like an 'internal stent' for a

  5. Fifty Years of Technological Innovation: Potential and Limitations of Current Technologies in Abdominal Magnetic Resonance Imaging and Computed Tomography.

    Science.gov (United States)

    Attenberger, Ulrike I; Morelli, John; Budjan, Johannes; Henzler, Thomas; Sourbron, Steven; Bock, Michael; Riffel, Philipp; Hernando, Diego; Ong, Melissa M; Schoenberg, Stefan O

    2015-09-01

    Magnetic resonance imaging (MRI) has become an important modality for the diagnosis of intra-abdominal pathology. Hardware and pulse sequence developments have made it possible to derive not only morphologic but also functional information related to organ perfusion (dynamic contrast-enhanced MRI), oxygen saturation (blood oxygen level dependent), tissue cellularity (diffusion-weighted imaging), and tissue composition (spectroscopy). These techniques enable a more specific assessment of pathologic lesions and organ functionality. Magnetic resonance imaging has thus transitioned from a purely morphologic examination to a modality from which image-based disease biomarkers can be derived. This fits well with several emerging trends in radiology, such as the need to accurately assess response to costly treatment strategies and the need to improve lesion characterization to potentially avoid biopsy. Meanwhile, the cost-effectiveness, availability, and robustness of computed tomography (CT) ensure its place as the current workhorse for clinical imaging. Although the lower soft tissue contrast of CT relative to MRI is a long-standing limitation, other disadvantages such as ionizing radiation exposure have become a matter of public concern. Nevertheless, recent technical developments such as dual-energy CT or dynamic volume perfusion CT also provide more functional imaging beyond morphology.The aim of this article was to review and discuss the most important recent technical developments in abdominal MRI and state-of-the-art CT, with an eye toward the future, providing examples of their clinical utility for the evaluation of hepatic and renal pathologies.

  6. Tumour angiogenesis pathways: related clinical issues and implications for nuclear medicine imaging

    International Nuclear Information System (INIS)

    Wiele, Christophe van de; De Winter, Olivier; Dierckx, Rudi Andre; Oltenfreiter, Ruth; Slegers, Guido; Signore, Alberto

    2002-01-01

    Tumour angiogenesis is essential for growth, invasion and metastasis. Retrospective studies suggest that it is an independent prognostic factor that merits prospective validation. Furthermore, as tumour blood vessels show many differences from normal vessels and are not genetically unstable, they form a key area for therapy development. However, as anti-angiogenic therapy is primarily cytostatic and not cytotoxic, novel tailor-made specific end-points for treatment monitoring are required. In this regard, suitable molecular parameters for imaging tumour angiogenesis by means of nuclear medicine are being explored. Here we review current knowledge on the multiple pathways controlling tumour angiogenesis and try to assess which are the most clinically relevant for nuclear medicine imaging. Parameters that may influence the imaging potential of radiopharmaceuticals for angiogenesis imaging such as molecular weight and structure, their targeted location within the tumour and their usefulness in terms of specificity and constancy of the targeted molecular pathway are discussed. (orig.)

  7. [Evaluating the maturity of IT-supported clinical imaging and diagnosis using the Digital Imaging Adoption Model : Are your clinical imaging processes ready for the digital era?

    Science.gov (United States)

    Studzinski, J

    2017-06-01

    The Digital Imaging Adoption Model (DIAM) has been jointly developed by HIMSS Analytics and the European Society of Radiology (ESR). It helps evaluate the maturity of IT-supported processes in medical imaging, particularly in radiology. This eight-stage maturity model drives your organisational, strategic and tactical alignment towards imaging-IT planning. The key audience for the model comprises hospitals with imaging centers, as well as external imaging centers that collaborate with hospitals. The assessment focuses on different dimensions relevant to digital imaging, such as software infrastructure and usage, workflow security, clinical documentation and decision support, data exchange and analytical capabilities. With its standardised approach, it enables regional, national and international benchmarking. All DIAM participants receive a structured report that can be used as a basis for presenting, e.g. budget planning and investment decisions at management level.

  8. Adaptive Optical System for Retina Imaging Approaches Clinic Applications

    Science.gov (United States)

    Ling, N.; Zhang, Y.; Rao, X.; Wang, C.; Hu, Y.; Jiang, W.; Jiang, C.

    We presented "A small adaptive optical system on table for human retinal imaging" at the 3rd Workshop on Adaptive Optics for Industry and Medicine. In this system, a 19 element small deformable mirror was used as wavefront correction element. High resolution images of photo receptors and capillaries of human retina were obtained. In recent two years, at the base of this system a new adaptive optical system for human retina imaging has been developed. The wavefront correction element is a newly developed 37 element deformable mirror. Some modifications have been adopted for easy operation. Experiments for different imaging wavelengths and axial positions were conducted. Mosaic pictures of photoreceptors and capillaries were obtained. 100 normal and abnormal eyes of different ages have been inspected.The first report in the world concerning the most detailed capillary distribution images cover ±3° by ± 3° field around the fovea has been demonstrated. Some preliminary very early diagnosis experiment has been tried in laboratory. This system is being planned to move to the hospital for clinic experiments.

  9. The image schema and innate archetypes: theoretical and clinical implications.

    Science.gov (United States)

    Merchant, John

    2016-02-01

    Based in contemporary neuroscience, Jean Knox's 2004 JAP paper 'From archetypes to reflective function' honed her position on image schemas, thereby introducing a model for archetypes which sees them as 'reliably repeated early developmental achievements' and not as genetically inherited, innate psychic structures. The image schema model is used to illustrate how the analyst worked with a patient who began life as an unwanted pregnancy, was adopted at birth and as an adult experienced profound synchronicities, paranormal/telepathic phenomena and visions. The classical approach to such phenomena would see the intense affectivity arising out of a ruptured symbiotic mother-infant relationship constellating certain archetypes which set up the patient's visions. This view is contrasted with Knox's model which sees the archetype an sich as a developmentally produced image schema underpinning the emergence of later imagery. The patient's visions can then be understood to arise from his psychoid body memory related to his traumatic conception and birth. The contemporary neuroscience which supports this view is outlined and a subsequent image schema explanation is presented. Clinically, the case material suggests that a pre-birth perspective needs to be explored in all analytic work. Other implications of Knox's image schema model are summarized. © 2016, The Society of Analytical Psychology.

  10. Clinical and imaging manifestations of adult mitochondrial encephalomyopathy

    International Nuclear Information System (INIS)

    Xing Haifang; Dai Jianping; Gao Peiyi; Li Shaowu; Ren Haitao; Zhu Mingwang; Wang Qinghe

    2005-01-01

    Objective: To investigate clinical manifestations and neuroimaging in the adult patients with mitochondrial encephalomyopathy (ME). Methods: Systematic study was performed on the clinical features of six adult patients with ME with observations on electromyogram (EMG), electroencephalogram (EEG), the blood lactic acid level, muscle biopsies results and neuroimaging features of CT and MRI. Results: The main clinical features were characterized by seizures, intolerance to exercise, audio-visual dysfunction, mental retardation, and so forth. EMG showed neurogenic damages (4/5 cases); EEG showed extensive mild to severe abnormal activities (3/3 cases) and lactic acidosis was also observed (4 /4 cases). Neuroimaging findings included symmetric supratentorial multi foci lesions, located in frontal, temporal, parietal, and occipital lobes, thalami and basal ganglia with widening of ventricles and cerebral atrophy; the neuroimaging findings also included hyperintensity on T 2 -weighted images and hypointensity/ isointensity on T 1 -weighted images; No stenosis and occlusion of main artery was displayed by magnetic resonance angiography (MRA). Muscle biopsies showed red ragged fiber (RRF) (4/6 cases). Conclusions: Based on clinical features and neuroimaging, diagnosis of ME in early stage may be made in combination with muscle biopsy. (authors)

  11. The clinical use of contrast agents in magnetic resonance imaging

    International Nuclear Information System (INIS)

    Bydder, G.M.

    1987-01-01

    Interest in the use of external agents to increase tissue contrasts has come from many sources dating back to the earliest work in NMR, to animal studies and to the widespread use of contrast agents in conventional radiological practice. The first clinical magnetic resonance images were published in 1980 and in the following year a brief account of the use of the paramagnetic agents in human volunteers was established. It was apparent relatively early in the development of magnetic resonance imaging (MRI) that a high level of soft tissue contrast was available de novo and the need for externally administered agents might therefore be small. This observation was tempered by the fact that separation of tumour from oedema was frequently better with contrast enhanced CT X-ray than with unenhanced MRI and that of a contrast agent might therefore be needed for MRI. At the end of 1983 the first parenteral agent gadoliminum diethylene triamine pentaacetic acid (Gd-DTPA) was used in volunteers and clinical studies began in 1984. At the present time only molecular O/sub 2/, oral iron compounds and Gd-DTPA are in clinical use although there are a number of other agents which have been used in animals and some of these may become available for clinical use in the foreseeable future

  12. Building blocks for a clinical imaging informatics environment.

    Science.gov (United States)

    Kohli, Marc D; Warnock, Max; Daly, Mark; Toland, Christopher; Meenan, Chris; Nagy, Paul G

    2014-04-01

    Over the past 20 years, imaging informatics has been driven by the widespread adoption of radiology information and picture archiving and communication and speech recognition systems. These three clinical information systems are commonplace and are intuitive to most radiologists as they replicate familiar paper and film workflow. So what is next? There is a surge of innovation in imaging informatics around advanced workflow, search, electronic medical record aggregation, dashboarding, and analytics tools for quality measures (Nance et al., AJR Am J Roentgenol 200:1064-1070, 2013). The challenge lies in not having to rebuild the technological wheel for each of these new applications but instead attempt to share common components through open standards and modern development techniques. The next generation of applications will be built with moving parts that work together to satisfy advanced use cases without replicating databases and without requiring fragile, intense synchronization from clinical systems. The purpose of this paper is to identify building blocks that can position a practice to be able to quickly innovate when addressing clinical, educational, and research-related problems. This paper is the result of identifying common components in the construction of over two dozen clinical informatics projects developed at the University of Maryland Radiology Informatics Research Laboratory. The systems outlined are intended as a mere foundation rather than an exhaustive list of possible extensions.

  13. Multimodal backside imaging of a microcontroller using confocal laser scanning and optical-beam-induced current imaging

    Science.gov (United States)

    Finkeldey, Markus; Göring, Lena; Schellenberg, Falk; Brenner, Carsten; Gerhardt, Nils C.; Hofmann, Martin

    2017-02-01

    Microscopy imaging with a single technology is usually restricted to a single contrast mechanism. Multimodal imaging is a promising technique to improve the structural information that could be obtained about a device under test (DUT). Due to the different contrast mechanisms of laser scanning microscopy (LSM), confocal laser scanning microscopy (CLSM) and optical beam induced current microscopy (OBICM), a combination could improve the detection of structures in integrated circuits (ICs) and helps to reveal their layout. While OBIC imaging is sensitive to the changes between differently doped areas and to semiconductor-metal transitions, CLSM imaging is mostly sensitive to changes in absorption and reflection. In this work we present the implementation of OBIC imaging into a CLSM. We show first results using industry standard Atmel microcontrollers (MCUs) with a feature size of about 250nm as DUTs. Analyzing these types of microcontrollers helps to improve in the field of side-channel attacks to find hardware Trojans, possible spots for laser fault attacks and for reverse engineering. For the experimental results the DUT is placed on a custom circuit board that allows us to measure the current while imaging it in our in-house built stage scanning microscope using a near infrared (NIR) laser diode as light source. The DUT is thinned and polished, allowing backside imaging through the Si-substrate. We demonstrate the possibilities using this optical setup by evaluating OBIC, LSM and CLSM images above and below the threshold of the laser source.

  14. 'Ready-access' CT imaging for an orthopaedic trauma clinic.

    LENUS (Irish Health Repository)

    Cawley, D

    2011-03-01

    \\'Ready-Access\\' to CT imaging facilities in Orthopaedic Trauma Clinics is not a standard facility. This facility has been available at the regional trauma unit, in Merlin Park Hospital, Galway for the past four years. We reviewed the use of this facility over a 2-year period when 100 patients had CT scans as part of their trauma clinic assessment. The rate of CT scan per clinic was 0.6. The mean waiting time for a CT scan was 30 minutes. 20 (20%) new fractures were confirmed, 33 (33%) fractures were out-ruled, 25 (25%) fractures demonstrated additional information and 8 (8%) had additional fractures. 20 (20%) patients were discharged and 12 (12%) patients were admitted as a result of the CT scan. It adds little time and cost to CT scanning lists.

  15. Echocardiographic and Fluoroscopic Fusion Imaging for Procedural Guidance: An Overview and Early Clinical Experience.

    Science.gov (United States)

    Thaden, Jeremy J; Sanon, Saurabh; Geske, Jeffrey B; Eleid, Mackram F; Nijhof, Niels; Malouf, Joseph F; Rihal, Charanjit S; Bruce, Charles J

    2016-06-01

    There has been significant growth in the volume and complexity of percutaneous structural heart procedures in the past decade. Increasing procedural complexity and accompanying reliance on multimodality imaging have fueled the development of fusion imaging to facilitate procedural guidance. The first clinically available system capable of echocardiographic and fluoroscopic fusion for real-time guidance of structural heart procedures was approved by the US Food and Drug Administration in 2012. Echocardiographic-fluoroscopic fusion imaging combines the precise catheter and device visualization of fluoroscopy with the soft tissue anatomy and color flow Doppler information afforded by echocardiography in a single image. This allows the interventionalist to perform precise catheter manipulations under fluoroscopy guidance while visualizing critical tissue anatomy provided by echocardiography. However, there are few data available addressing this technology's strengths and limitations in routine clinical practice. The authors provide a critical review of currently available echocardiographic-fluoroscopic fusion imaging for guidance of structural heart interventions to highlight its strengths, limitations, and potential clinical applications and to guide further research into value of this emerging technology. Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  16. Quantitative imaging of the human upper airway: instrument design and clinical studies

    Science.gov (United States)

    Leigh, M. S.; Armstrong, J. J.; Paduch, A.; Sampson, D. D.; Walsh, J. H.; Hillman, D. R.; Eastwood, P. R.

    2006-08-01

    Imaging of the human upper airway is widely used in medicine, in both clinical practice and research. Common imaging modalities include video endoscopy, X-ray CT, and MRI. However, no current modality is both quantitative and safe to use for extended periods of time. Such a capability would be particularly valuable for sleep research, which is inherently reliant on long observation sessions. We have developed an instrument capable of quantitative imaging of the human upper airway, based on endoscopic optical coherence tomography. There are no dose limits for optical techniques, and the minimally invasive imaging probe is safe for use in overnight studies. We report on the design of the instrument and its use in preliminary clinical studies, and we present results from a range of initial experiments. The experiments show that the instrument is capable of imaging during sleep, and that it can record dynamic changes in airway size and shape. This information is useful for research into sleep disorders, and potentially for clinical diagnosis and therapies.

  17. MO-C-BRB-06: Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging

    International Nuclear Information System (INIS)

    Jackson, E.

    2015-01-01

    between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology

  18. MO-C-BRB-06: Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, E. [University of Wisconsin (United States)

    2015-06-15

    between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.

  19. Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe.

    Science.gov (United States)

    Mouthaan, Brian E; Rados, Matea; Barsi, Péter; Boon, Paul; Carmichael, David W; Carrette, Evelien; Craiu, Dana; Cross, J Helen; Diehl, Beate; Dimova, Petia; Fabo, Daniel; Francione, Stefano; Gaskin, Vladislav; Gil-Nagel, Antonio; Grigoreva, Elena; Guekht, Alla; Hirsch, Edouard; Hecimovic, Hrvoje; Helmstaedter, Christoph; Jung, Julien; Kalviainen, Reetta; Kelemen, Anna; Kimiskidis, Vasilios; Kobulashvili, Teia; Krsek, Pavel; Kuchukhidze, Giorgi; Larsson, Pål G; Leitinger, Markus; Lossius, Morten I; Luzin, Roman; Malmgren, Kristina; Mameniskiene, Ruta; Marusic, Petr; Metin, Baris; Özkara, Cigdem; Pecina, Hrvoje; Quesada, Carlos M; Rugg-Gunn, Fergus; Rydenhag, Bertil; Ryvlin, Philippe; Scholly, Julia; Seeck, Margitta; Staack, Anke M; Steinhoff, Bernhard J; Stepanov, Valentin; Tarta-Arsene, Oana; Trinka, Eugen; Uzan, Mustafa; Vogt, Viola L; Vos, Sjoerd B; Vulliémoz, Serge; Huiskamp, Geertjan; Leijten, Frans S S; Van Eijsden, Pieter; Braun, Kees P J

    2016-05-01

    In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  20. Current status of multi-detector row helical CT in imaging of adult ...

    African Journals Online (AJOL)

    Current status of multi-detector row helical CT in imaging of adult acquired pancreatic diseases and assessing surgical neoplastic resectability. ... The presence of inflammation, masses, and vascular invasion was evaluated and interpreted images were obtained during each phase. Results were compared with surgery, ...

  1. [Diagnostic imaging of high-grade astrocytoma: heterogeneity of clinical manifestation, image characteristics, and histopathological findings].

    Science.gov (United States)

    Okajima, Kaoru; Ohta, Yoshio

    2012-10-01

    Recent developments in diagnostic radiology, which have enabled accurate differential diagnoses of brain tumors, have been well described in the last three decades. MR and PET imaging can also provide information to predict histological grades and prognoses that might influence treatment strategies. However, high-grade astrocytomas consist of many different subtypes that are associated with different imaging and histological characteristics. Hemorrhage and necrosis results in a variety of imaging features, and infiltrative tumor growth entrapping normal neurons may cause different clinical manifestations. We reviewed patients with high-grade astrocytomas that showed various imaging characteristics, with special emphasis on initial symptoms and histological features. Clinicopathological characteristics of astrocytomas were also compared with other malignant tumors. Neurological deficits were not notable in patients with grade 3-4 astrocytomas when they showed infiltrative tumor growth, while brain metastases with compact cellular proliferation caused more neurological symptoms. Infiltrative tumors did not show any enhancing masses on MR imaging, but these tumors may show intratumor heterogeneity. Seizures were reported to be more frequent in low-grade glioma and in secondary glioblastoma. Tumor heterogeneity was also reported in molecular genetic profile, and investigators identified some subsets of astrocytomas. They investigated IHD1/2 mutation, EGFR amplification, TP53 mutation, Ki-67 index, etc. In summary, high-grade astrocytomas are not homogenous groups of tumors, and this is associated with the heterogeneity of clinical manifestation, image characteristics, and histopathological findings. Molecular studies may explain the tumor heterogeneity in the near future.

  2. Current status of PET imaging in Huntington's disease

    International Nuclear Information System (INIS)

    Pagano, Gennaro; Niccolini, Flavia; Politis, Marios

    2016-01-01

    To review the developments of recent decades and the current status of PET molecular imaging in Huntington's disease (HD). A systematic review of PET studies in HD was performed. The MEDLINE, Web of Science, Cochrane and Scopus databases were searched for articles in all languages published up to 19 August 2015 using the major medical subject heading ''Huntington Disease'' combined with text and key words ''Huntington Disease'', ''Neuroimaging'' and ''PET''. Only peer-reviewed, primary research studies in HD patients and premanifest HD carriers, and studies in which clinical features were described in association with PET neuroimaging results, were included in this review. Reviews, case reports and nonhuman studies were excluded. A total of 54 PET studies were identified and analysed in this review. Brain metabolism ([ 18 F]FDG and [ 15 O]H 2 O), presynaptic ([ 18 F]fluorodopa, [ 11 C]β-CIT and [ 11 C]DTBZ) and postsynaptic ([ 11 C]SCH22390, [ 11 C]FLB457 and [ 11 C]raclopride) dopaminergic function, phosphodiesterases ([ 18 F]JNJ42259152, [ 18 F]MNI-659 and [ 11 C]IMA107), and adenosine ([ 18 F]CPFPX), cannabinoid ([ 18 F]MK-9470), opioid ([ 11 C]diprenorphine) and GABA ([ 11 C]flumazenil) receptors were evaluated as potential biomarkers for monitoring disease progression and for assessing the development and efficacy of novel disease-modifying drugs in premanifest HD carriers and HD patients. PET studies evaluating brain restoration and neuroprotection were also identified and described in detail. Brain metabolism, postsynaptic dopaminergic function and phosphodiesterase 10A levels were proven to be powerful in assessing disease progression. However, no single technique may be currently considered an optimal biomarker and an integrative multimodal imaging approach combining different techniques should be developed for monitoring potential neuroprotective and preventive treatment

  3. Epithelioid sarcoma: clinical, MR imaging and pathologic findings

    International Nuclear Information System (INIS)

    Hanna, S.L.; Kaste, S.; Jenkins, J.J.; Hewan-Lowe, K.; Spence, J.V.; Gupta, M.; Monson, D.; Fletcher, B.D.

    2002-01-01

    Objective. To report and describe the MR imaging features of eight new cases of this rare soft tissue sarcoma and correlate them with the clinical and histologic findings.Design and patients. Retrospective analysis was carried out for the MR imaging characteristics and histologic findings of eight patients with pathologically proven epithelioid sarcoma and the literature was reviewed. Findings were correlated in each case with the patient's clinical presentation and eventual outcome.Results. The patients, whose primary tumors ranged from 2.5 cm to 19 cm in maximum dimension, were 1 to 90 years of age. Tumors involved the extremities (n=5), the scalp (n=2) and the paraspinal muscles (n=1). Five tumors presented as well-defined, frequently painful, deeply situated masses and three as subcutaneous nodules or cutaneous ulcers with no palpable mass. Four patients had associated regional lymphadenopathy and one had distant metastases at diagnosis. MR imaging showed tumor infiltration of adjacent tissues in seven patients. Signal characteristics reflected varying degrees of cellularity, and the presence of necrosis, hemorrhage, fibrosis, hyalinization and inflammation. Bone marrow involvement was demonstrated in one patient. Clinical outcomes were generally poor.Conclusions. Epithelioid sarcoma is an aggressive soft tissue sarcoma with a varied clinical presentation, growth pattern, MR signal characteristics and histologic picture. The tumor favors the distal extremities and is commonly infiltrative and accompanied by enlarged regional lymph nodes. This neoplasm may present as an intramuscular mass but should also be suspected in patients with ulcerating cutaneous nodules with or without regional lymphadenopathy. (orig.)

  4. Clinical trials in near infrared fluorescence imaging with IRDye 800CW

    Science.gov (United States)

    Draney, Daniel R.

    2015-03-01

    A monofunctional, heptamethine dye, IRDye® 800CW, is being manufactured under GMP conditions for use in human clinical trials. When attached to a suitable targeting agent and paired with an appropriate camera system, the dye allows Near Infrared (NIR) fluorescence imaging of tumor tissue during surgery. The talk will describe the properties of the dye and give an overview of current and planned clinical trials in Europe and the USA. The dye is available in both the NHS ester and carboxylate forms for conjugation to targeting molecules. A GMP toxicology study of the dye was described in a previous publication.

  5. CT Image Contrast of High-Z Elements: Phantom Imaging Studies and Clinical Implications.

    Science.gov (United States)

    FitzGerald, Paul F; Colborn, Robert E; Edic, Peter M; Lambert, Jack W; Torres, Andrew S; Bonitatibus, Peter J; Yeh, Benjamin M

    2016-03-01

    To quantify the computed tomographic (CT) image contrast produced by potentially useful contrast material elements in clinically relevant imaging conditions. Equal mass concentrations (grams of active element per milliliter of solution) of seven radiodense elements, including iodine, barium, gadolinium, tantalum, ytterbium, gold, and bismuth, were formulated as compounds in aqueous solutions. The compounds were chosen such that the active element dominated the x-ray attenuation of the solution. The solutions were imaged within a modified 32-cm CT dose index phantom at 80, 100, 120, and 140 kVp at CT. To simulate larger body sizes, 0.2-, 0.5-, and 1.0-mm-thick copper filters were applied. CT image contrast was measured and corrected for measured concentrations and presence of chlorine in some compounds. Each element tested provided higher image contrast than iodine at some tube potential levels. Over the range of tube potentials that are clinically practical for average-sized and larger adults-that is, 100 kVp and higher-barium, gadolinium, ytterbium, and tantalum provided consistently increased image contrast compared with iodine, respectively demonstrating 39%, 56%, 34%, and 24% increases at 100 kVp; 39%, 66%, 53%, and 46% increases at 120 kVp; and 40%, 72%, 65%, and 60% increases at 140 kVp, with no added x-ray filter. The consistently high image contrast produced with 100-140 kVp by tantalum compared with bismuth and iodine at equal mass concentration suggests that tantalum could potentially be favorable for use as a clinical CT contrast agent.

  6. Integration Of An MR Image Network Into A Clinical PACS

    Science.gov (United States)

    Ratib, Osman M.; Mankovich, Nicholas J.; Taira, Ricky K.; Cho, Paul S.; Huang, H. K.

    1988-06-01

    A direct link between a clinical pediatric PACS module and a FONAR MRI image network was implemented. The original MR network combines together the MR scanner, a remote viewing station and a central archiving station. The pediatric PACS directly connects to the archiving unit through an Ethernet TCP-IP network adhering to FONAR's protocol. The PACS communication software developed supports the transfer of patient studies and the patient information directly from the MR archive database to the pediatric PACS. In the first phase of our project we developed a package to transfer data between a VAX-111750 and the IBM PC I AT-based MR archive database through the Ethernet network. This system served as a model for PACS-to-modality network communication. Once testing was complete on this research network, the software and network hardware was moved to the clinical pediatric VAX for full PACS integration. In parallel to the direct transmission of digital images to the Pediatric PACS, a broadband communication system in video format was developed for real-time broadcasting of images originating from the MR console to 8 remote viewing stations distributed in the radiology department. These analog viewing stations allow the radiologists to directly monitor patient positioning and to select the scan levels during a patient examination from remote locations in the radiology department. This paper reports (1) the technical details of this implementation, (2) the merits of this network development scheme, and (3) the performance statistics of the network-to-PACS interface.

  7. TU-E-BRB-00: Deformable Image Registration: Is It Right for Your Clinic

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

  8. Magnetic resonance imaging of athletic pubalgia and the sports hernia: current understanding and practice.

    Science.gov (United States)

    Khan, Waseem; Zoga, Adam C; Meyers, William C

    2013-02-01

    Magnetic resonance imaging (MRI) has become the standard imaging modality for activity-related groin pain. Lesions, including rectus abdominis/adductor aponeurosis injury and osteitis pubis, can be accurately identified and delineated in patients with clinical conditions termed athletic pubalgia, core injury, and sports hernia. A dedicated noncontrast athletic pubalgia MRI protocol is easy to implement and should be available at musculoskeletal MR imaging centers. This article will review pubic anatomy, imaging considerations, specific lesions, and common MRI findings encountered in the setting of musculoskeletal groin pain. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Estimation of clinical efficacy for scintigraphic images of liver, 1

    International Nuclear Information System (INIS)

    Matsumoto, Toru; Iinuma, Takeshi; Tateno, Yukio; Machida, Kikuo.

    1982-01-01

    In this study, the clinical efficacy No. 1 (diagnostic accuracy) of liver images on various liver diseases is investigated. From 8 different medical institutions the liver images of 406 cases most of which were imaged with 99mTc-phytate and confirmed for its final diagnosis by the autopsy, surgery and other techniques excluding the liver scintigraphy were collected. In order to evaluate the results of image reading, an input sheet for computer was designed to describe the confirmed diagnosis of each case. The liver images were read by 11 physicians from the 8 institutions that presented the cases and the results of reading were recorded on the work sheet for computer input. The work sheet includes abnormality in shape, size and position of the liver, position and number of SOL, and diagnosis of liver diseases, etc. By comparing the record of confirmed diagnosis and the results of image reading for individual case, various programs of analysis are being undertaken. The accuracy in detecting the SOL by means of receiver operating characteristic (ROC) analysis is presented here. The results of analysis are as follows. (1) ROC curves are rather similar in all physicians and average ROC points are TPR = 71, 80, 91%, FPR = 5, 15, 27%, respectively. (2) The SOL of size larger than 3 cm are detected more easily than those of size less than 3 cm, although number of SOL less than 3 cm is only nine cases and so variation of TPR between physicians is large. It is found that the ROC curve for many SOL of small size is almost identical to that of SOL larger than 3 cm. As to the detection of SOL larger than 3 cm, Anger camera and scanner are found to have an identical capability. (author)

  10. Physiological and technical limitations of functional magnetic resonance imaging (fMRI) - consequences for clinical use

    International Nuclear Information System (INIS)

    Wuestenberg, T.; Jordan, K.; Giesel, F.L.; Villringer, A.

    2003-01-01

    Functional magnetic resonance imaging (fMRI) is the most common noninvasive technique in functional neuroanatomy. The capabilities and limitations of the method will be discussed based on a short review of the current knowledge about the neurovascular relationship. The focus of this article is on current methodical and technical problems regarding fMRI-based detection and localization of neuronal activity. Main error sources and their influence on the reliability and validity of fMRI-methods are presented. Appropriate solution strategies will be proposed and evaluated. Finally, the clinical relevance of MR-based diagnostic methods are discussed. (orig.) [de

  11. Imaging findings and referral outcomes of rapid assessment stroke clinics

    International Nuclear Information System (INIS)

    Widjaja, E.; Manuel, D.; Hodgson, T.J.; Connolly, D.J.A.; Coley, S.C.; Romanowski, C.A.J.; Gaines, P.; Cleveland, T.; Thomas, S.; Griffiths, P.D.; Doyle, C.; Venables, G.S.

    2005-01-01

    AIM: A rapid assessment stroke clinic (RASC) was established to provide a rapid diagnostic service to individuals with suspected transient cerebral or ocular ischaemia or recovered non-hospitalized strokes. In this report we review imaging findings and clinical outcomes of patients proceeding to the carotid surgery programme. METHODS: Between October 2000 and December 2002, 1339 people attended the RASC. The findings of head CT and carotid Doppler ultrasound of the 1320 patients who underwent brain and carotid imaging were reviewed, and the number subsequently proceeding to carotid angiography and intervention was reported. RESULTS: CT head scans were normal in 57% of cases; 38% demonstrated ischaemia or infarction; and 3% yielded incidental or other significant findings not related to ischaemia. On screening with carotid Doppler ultrasound, 7.5% showed greater than 50% stenosis on the symptomatic side. A total of 83 patients (6.2%) proceeded to cerebral angiography and 65 (4.8%) underwent carotid endarterectomy or endovascular repair. CONCLUSION: Rapid-access neurovascular clinics are efficient in selecting patients for carotid intervention, but this is at a cost and the number of potential strokes prevented is small. Alternative management pathways based on immediate medical treatment need to be evaluated

  12. Functional imaging of the pancreas. Image processing techniques and clinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Fumiko

    1984-02-01

    An image processing technique for functional imaging of the pancreas was developed and is here reported. In this paper, clinical efficacy of the technique for detecting pancreatic abnormality is evaluated in comparison with conventional pancreatic scintigraphy and CT. For quantitative evaluation, functional rate, i.e. the rate of normal functioning pancreatic area, was calculated from the functional image and subtraction image. Two hundred and ninety-five cases were studied using this technique. Conventional image had a sensitivity of 65% and a specificity of 78%, while the use of functional imaging improved sensitivity to 88% and specificity to 88%. The mean functional rate in patients with pancreatic disease was significantly lower (33.3 +- 24.5 in patients with chronic pancreatitis, 28.1 +- 26.9 in patients with acute pancreatitis, 43.4 +- 22.3 in patients with diabetes mellitus, 20.4 +- 23.4 in patients with pancreatic cancer) than the mean functional rate in cases without pancreatic disease (86.4 +- 14.2). It is suggested that functional image of the pancreas reflecting pancreatic exocrine function and functional rate is a useful indicator of pancreatic exocrine function.

  13. Characterization of clinical-imaging characteristics of the binswanger's disease

    International Nuclear Information System (INIS)

    Rodriguez Mutuberria, Livan; Serra Valdes, Yusimi

    2002-01-01

    A review was made to go deep into the understanding of vascular dementias that behave as the second cause of dementia in practice. Binswanger's disease is one of the most important among them. Its detection has progressively increased with the continual improvement of the radiological diagnostic tools that allow to identify the ischemic damage of the hemispherical cerebral white matter and the presence of lacunar infarctions. It is a disease of chronic course and inexorably progressive that is characterized by the association of subcortical cognitive dysfunction, evidence of cerebrovascular disease, Parkinsonian rigidity and vesicle dysfunction with a characteristic imaging picture. The clinical picture and the main imaging characteristics are explained in this paper and the pathogens of the disease is briefly described

  14. Patellofemoral pain, instability, and arthritis. Clinical presentation, imaging, and treatment

    International Nuclear Information System (INIS)

    Zaffagnini, Stefano; Dejour, David; Arendt, Elizabeth A.

    2010-01-01

    Despite numerous studies, a lack of consensus still exists over many aspects of patellofemoral pain, instability, and arthritis. This book adopts an evidence-based approach to assess each of these topics in depth. The book reviews general features of clinical examination and global evaluation techniques including the use of different imaging methods, e.g. x-rays, CT, MRI, stress x-rays, and bone scan. Various conservative and surgical treatment approaches for each of the three presentations - pain, instability, and arthritis - are then explained and assessed. Postoperative management and options in the event of failed surgery are also evaluated. Throughout, careful attention is paid to the literature in an attempt to establish the level of evidence for the efficacy of each imaging and treatment method. It is hoped that this book will serve as an informative guide for the practitioner when confronted with disorders of the patellofemoral joint. (orig.)

  15. Patellofemoral pain, instability, and arthritis. Clinical presentation, imaging, and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Zaffagnini, Stefano [Laboratorio di Biomeccanica, Bologna (Italy). Istituti Ortopedici Rizzoli; Dejour, David [Lyon-Ortho-Clinic (France). Knee Surgery Orthopaedic Dept.; Arendt, Elizabeth A. (eds.) [Minnesota Univ., Minneapolis, MN (United States). Dept. of Orthopaedics

    2010-07-01

    Despite numerous studies, a lack of consensus still exists over many aspects of patellofemoral pain, instability, and arthritis. This book adopts an evidence-based approach to assess each of these topics in depth. The book reviews general features of clinical examination and global evaluation techniques including the use of different imaging methods, e.g. x-rays, CT, MRI, stress x-rays, and bone scan. Various conservative and surgical treatment approaches for each of the three presentations - pain, instability, and arthritis - are then explained and assessed. Postoperative management and options in the event of failed surgery are also evaluated. Throughout, careful attention is paid to the literature in an attempt to establish the level of evidence for the efficacy of each imaging and treatment method. It is hoped that this book will serve as an informative guide for the practitioner when confronted with disorders of the patellofemoral joint. (orig.)

  16. Current Profile and Magnetic Structure Measurements through Tangential Soft X-Ray Imaging in Compact Tori

    International Nuclear Information System (INIS)

    Fonck, Raymond J.

    2004-01-01

    This report describes the fabrication and tests of a tangentially imaging soft X-ray (SXR) camera diagnostic for fusion energy plasma research. It can be used for the determination of the current distribution in strongly shaped toroidal magnetically confined plasmas, such as those found in spherical tori or advanced tokamaks. It included the development of both an appropriate imaging SXR camera and image analysis techniques necessary to deduce the plasma shape and current distribution. The basic camera concept consists of a tangentially viewing pinhole imaging system with thin-film SXR filters, a scintillator screen to provide SXR to visible conversion, a fast shuttering system, and an sensitive visible camera imaging device. The analysis approach consists of integrating the 2-D SXR image data into a Grad-Shafranov toroidal equilibrium solver code to provide strong constraints on the deduced plasma current and pressure profiles. Acceptable sensitivity in the deduced current profile can be obtained if the relative noise in the measured image can be kept in the range of 1% or less. Tests on the Pegasus Toroidal Experiment indicate very flat safety factor profiles in the plasma interior

  17. Comparison of clinical and physics scoring of PET images when image reconstruction parameters are varied

    International Nuclear Information System (INIS)

    Walsh, C.; Johnston, C.; Sheehy, N.; Reilly, G. O.

    2013-01-01

    In this study the quantitative and qualitative image quality (IQ) measurements with clinical judgement of IQ in positron emission tomography (PET) were compared. The limitations of IQ metrics and the proposed criteria of acceptability for PET scanners are discussed. Phantom and patient images were reconstructed using seven different iterative reconstruction protocols. For each reconstructed set of images, IQ was scored based both on the visual analysis and on the quantitative metrics. The quantitative physics metrics did not rank the reconstruction protocols in the same order as the clinicians' scoring of perceived IQ (R s = -0.54). Better agreement was achieved when comparing the clinical perception of IQ to the physicist's visual assessment of IQ in the phantom images (R s = +0.59). The closest agreement was seen between the quantitative physics metrics and the measurement of the standard uptake values (SUVs) in small tumours (R s = +0.92). Given the disparity between the clinical perception of IQ and the physics metrics a cautious approach to use of IQ measurements for determining suspension levels is warranted. (authors)

  18. Magnetic resonance electrical impedance tomography (MREIT): conductivity and current density imaging

    International Nuclear Information System (INIS)

    Seo, Jin Keun; Kwon, Ohin; Woo, Eung Je

    2005-01-01

    This paper reviews the latest impedance imaging technique called Magnetic Resonance Electrical Impedance Tomography (MREIT) providing information on electrical conductivity and current density distributions inside an electrically conducting domain such as the human body. The motivation for this research is explained by discussing conductivity changes related with physiological and pathological events, electromagnetic source imaging and electromagnetic stimulations. We briefly summarize the related technique of Electrical Impedance Tomography (EIT) that deals with cross-sectional image reconstructions of conductivity distributions from boundary measurements of current-voltage data. Noting that EIT suffers from the ill-posed nature of the corresponding inverse problem, we introduce MREIT as a new conductivity imaging modality providing images with better spatial resolution and accuracy. MREIT utilizes internal information on the induced magnetic field in addition to the boundary current-voltage measurements to produce three-dimensional images of conductivity and current density distributions. Mathematical theory, algorithms, and experimental methods of current MREIT research are described. With numerous potential applications in mind, future research directions in MREIT are proposed

  19. Rapid Measurement and Correction of Phase Errors from B0 Eddy Currents: Impact on Image Quality for Non-Cartesian Imaging

    Science.gov (United States)

    Brodsky, Ethan K.; Klaers, Jessica L.; Samsonov, Alexey A.; Kijowski, Richard; Block, Walter F.

    2014-01-01

    Non-Cartesian imaging sequences and navigational methods can be more sensitive to scanner imperfections that have little impact on conventional clinical sequences, an issue which has repeatedly complicated the commercialization of these techniques by frustrating transitions to multi-center evaluations. One such imperfection is phase errors caused by resonant frequency shifts from eddy currents induced in the cryostat by time-varying gradients, a phenomemon known as B0 eddy currents. These phase errors can have a substantial impact on sequences that use ramp sampling, bipolar gradients, and readouts at varying azimuthal angles. We present a method for measuring and correcting phase errors from B0 eddy currents and examine the results on two different scanner models. This technique yields significant improvements in image quality for high-resolution joint imaging on certain scanners. The results suggest that correction of short time B0 eddy currents in manufacturer provided service routines would simplify adoption of non-Cartesian sampling methods. PMID:22488532

  20. Terrestrial ring current - from in situ measurements to global images using energetic neutral atoms

    International Nuclear Information System (INIS)

    Roelof, E.C.; Williams, D.J.

    1988-01-01

    Electrical currents flowing in the equatorial magnetosphere, first inferred from ground-based magnetic disturbances, are carried by trapped energetic ions. Spacecraft measurements have determined the spectrum and composition of those currents, and the newly developed technique of energetic-neutral-atom imaging allows the global dynamics of that entire ion population to be viewed from a single spacecraft. 71 references

  1. Understanding Magnetic Resonance Imaging of Knee Cartilage Repair: A Focus on Clinical Relevance.

    Science.gov (United States)

    Hayashi, Daichi; Li, Xinning; Murakami, Akira M; Roemer, Frank W; Trattnig, Siegfried; Guermazi, Ali

    2017-06-01

    The aims of this review article are (a) to describe the principles of morphologic and compositional magnetic resonance imaging (MRI) techniques relevant for the imaging of knee cartilage repair surgery and their application to longitudinal studies and (b) to illustrate the clinical relevance of pre- and postsurgical MRI with correlation to intraoperative images. First, MRI sequences that can be applied for imaging of cartilage repair tissue in the knee are described, focusing on comparison of 2D and 3D fast spin echo and gradient recalled echo sequences. Imaging features of cartilage repair tissue are then discussed, including conventional (morphologic) MRI and compositional MRI techniques. More specifically, imaging techniques for specific cartilage repair surgery techniques as described above, as well as MRI-based semiquantitative scoring systems for the knee cartilage repair tissue-MR Observation of Cartilage Repair Tissue and Cartilage Repair OA Knee Score-are explained. Then, currently available surgical techniques are reviewed, including marrow stimulation, osteochondral autograft, osteochondral allograft, particulate cartilage allograft, autologous chondrocyte implantation, and others. Finally, ongoing research efforts and future direction of cartilage repair tissue imaging are discussed.

  2. Imaging and clinical characteristics of sporadic Creutzfeldt-Jakob disease

    Directory of Open Access Journals (Sweden)

    HAN Shun-chang

    2013-04-01

    Full Text Available Five patients with sporadic Creutzfeldt-Jakob disease (sCJD presented rapidly progressive dementia which were subacute onset from 1 to 4 months. Among these cases, periodic synchronous discharge (PSD of electroencephalography (EEG was seen in 2 patients. Besides, 4 patients obtained positive results in cerebrospinal fluid (CSF analysis for 14-3-3 protein. The cranial MRI examination showed symmetrical or asymmetrical colored-ribbon-shaped high signals in cerebral cortex or basal ganglia by diffusion weighted imaging (DWI, suggesting that DWI had high sensitivity and specificity for the diagnosis of sCJD as a preferred method in the clinical examination of sCJD.

  3. Atlas of Skeletal SPECT/CT Clinical Images

    International Nuclear Information System (INIS)

    2016-01-01

    The atlas focuses specifically on single photon emission computed tomography/computed tomography (SPECT/CT) in musculoskeletal imaging, and thus illustrates the inherent advantages of the combination of the metabolic and anatomical component in a single procedure. In addition, the atlas provides information on the usefulness of several sets of specific indications. The publication, which serves more as a training tool rather than a textbook, will help to further integrate the SPECT and CT experience in clinical practice by presenting a series of typical cases with many different patterns of SPECT/CT seen in bone scintigraphy

  4. Clinical and CT imaging features of abdominal fat necrosis

    International Nuclear Information System (INIS)

    Zhao Jinkun; Bai Renju

    2013-01-01

    Fat necrosis is a common pathological change at abdominal cross-sectional imaging, and it may cause abdominal pain, mimic pathological change of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Fat necrosis is actually the result of steatosis by metabolism or mechanical injury. Common processes that are present in fat necrosis include epiploic appendagitis, infarction of the greater omentum, pancreatitis, and fat necrosis related to trauma or ischemia. As a common fat disease, fat necrosis should be known by clinicians and radiologists. Main content of this text is the clinical symptoms and CT findings of belly fat necrosis and related diseases. (authors)

  5. Primary hyperoxaluria: spectrum of clinical and imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, Sara B.; Levin, Terry L. [Children' s Hospital of Montefiore Medical Center, Division of Pediatric Radiology, Department of Radiology, Bronx, NY (United States); Waltuch, Temima; Kaskel, Frederick [Children' s Hospital at Montefiore Medical Center, Division of Pediatric Nephrology, Bronx, NY (United States); Bivin, William [Allegheny General Hospital, Department of Pathology, Pittsburgh, PA (United States)

    2017-01-15

    Primary hyperoxaluria is a rare autosomal recessive inborn error of metabolism with three known subtypes. In primary hyperoxaluria type 1, the most common of the subtypes, a deficiency in the hepatic enzymes responsible for the metabolism of glycoxylate to glycine, leads to excessive levels of glyoxylate, which is converted to oxalate. The resultant elevation in serum and urinary oxalate that characterizes primary hyperoxaluria leads to calcium oxalate crystal deposition in multiple organ systems (oxalosis). We review the genetics, pathogenesis, variable clinical presentation and course of this disease as well as its treatment. Emphasis is placed on the characteristic imaging findings before and after definitive treatment with combined liver and renal transplantation. (orig.)

  6. Pre-clinical functional magnetic resonance imaging. Pt. I. The kidney

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Kalayciyan, Raffi; Chacon-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine

    2014-07-01

    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging.

  7. Pre-clinical functional magnetic resonance imaging. Pt. I. The kidney

    International Nuclear Information System (INIS)

    Zoellner, Frank G.; Kalayciyan, Raffi; Chacon-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R.

    2014-01-01

    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging.

  8. Image-guided surgery and therapy: current status and future directions

    Science.gov (United States)

    Peters, Terence M.

    2001-05-01

    Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

  9. Clinical applications of imaging reconstruction by virtual sonography

    International Nuclear Information System (INIS)

    Mori, Akihiro; Oohashi, Noritsugu; Maruyama, Takako; Tatebe, Hideharu; Fushimi, Nobutoshi; Asano, Takayuki; Inoue, Hiroshi; Okuno, Masataka

    2008-01-01

    One of the pitfalls in managing multiple liver tumors is the difficulty in identifying individual tumors on ultrasonography. Computed tomography (CT)-assisted virtual sonography has been shown to improve sonographic diagnosis, however it requires additional equipment and software. We have developed a simple reconstruction method of virtual sonography (SRVS). We reconstructed SRVS mimicking ultrasonographic images, utilizing a workstation software attached to a multi-detector row CT system without any additional program. We have performed SRVS in 32 patients with 41 liver tumors that could hardly be identify on ultrasonography. SRVS assisted the identification of malignant form non-pathologic ones and thereby contributed to the appropriate clinical strategy including radiofrequency ablation (RFA) (18 tumors), liver biopsy (2 tumors), other therapies (4 tumors) and follow-up (17 tumors). We have developed virtual sonography using conventional CT software. SRVS seems useful in the clinical practice in managing liver tumors. (author)

  10. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael

    2011-01-01

    PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIALS...... radiologists and one surgeon independent of each other and compared with surgical and pathological records. RESULTS: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14...... patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...

  11. A Survey of the Current Situation of Clinical Biobanks in China.

    Science.gov (United States)

    Li, Haiyan; Ni, Mingyu; Wang, Peng; Wang, Xiaomin

    2017-06-01

    The development of biomedical research urgently needs the support of a large number of high-quality clinical biospecimens. Therefore, human biobanks at different levels have been established successively in China and other countries at a significantly increasing pace in recent years. To better understand the general current state of clinical biobanks in China, we surveyed 42 clinical biobanks based in hospitals and collected information involving their management systems, sharing mechanisms, quality control systems, and informational management systems using closed questionnaire methods. Based on our current information, there has not been such a large-scale survey in China. An understanding of the status and challenges current clinical biobanks face will provide valuable insights for the construction and sustainable development of higher quality clinical biobanks.

  12. Optimising the diagnostic imaging process through clinical history documentation

    International Nuclear Information System (INIS)

    Egan, I.; Baird, M.

    2003-01-01

    In the United Kingdom the 1990s were characterised by radiographer role extension including radiographic reporting and the performance of a variety of contrast examinations. In Australia where a privatised health system constrains the role of radiographers, other ways need to be found to improve professional practice and enhance patient care. One such way is for radiographers to develop knowledge and skills in clinical history taking. The paper advocates the development of a formalised approach to clinical history taking that portrays the radiographer as a professional and advocate of patient rights and welfare. The paper examines history taking approaches used by other health care professionals and proposes a clinical history template using five key areas of interview: area and type of symptoms, current history, past history, special considerations and psychosocial/occupational history. Copyright (2003) Australian Institute of Radiography

  13. Sinusitis and intracranial sepsis: the CT imaging and clinical presentation

    International Nuclear Information System (INIS)

    Saxton, V.J.; Boldt, D.W.; Shield, L.K.

    1995-01-01

    The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the dagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) The routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethomoidal sinuses are abnormal and there is a high clinical supicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis. (orig.)

  14. Magnetic resonance imaging in the differential diagnosis of true placenta accreta: a clinical case

    Directory of Open Access Journals (Sweden)

    E. V. Tarachkova

    2016-01-01

    Full Text Available True placenta accreta is the attachment of chorionic villi to the myometrium, possibly penetrating into the thickness of the myometrium and its outside, including through the serous tunic. The main current diagnostic techniques are considered to be ultrasonography, laboratory diagnosis (elevated human chorionic gonadotropin and placental lactogen levels, and clinical data (pain and vaginal discharge. Magnetic resonance imaging is deemed to be an adjuvant technique. By using a clinical example, this paper considers the capabilities of magnetic resonance imaging to diagnose this abnormality and to choose a right treatment policy. The abnormality is compared with the conditions (trophoblastic tumor and myoma with lysis that are similar in their diagnosis and magnetic resonance pattern. The disorder in question is rather rare and its detailed consideration, determination of the capabilities of various techniques, and comparison with externally similar cases areimportant for the development of diagnostic opportunities.

  15. A survey of current clinical practice of permanent prostate brachytherapy in the United States

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Prete, James J.; Buchholz, Thomas A.; Friedland, Jay L.; Stock, Richard G.; Grimm, Peter D.; Bice, William S.

    1998-01-01

    Purpose: To help establish standards of care for transperineal interstitial permanent prostate brachytherapy (TIPPB) by obtaining data regarding current clinical practice among the most experienced TIPPB brachytherapists in the United States. Methods and Materials: The 70 brachytherapists who performed the greatest number of TIPPB cases in 1995 in the U.S. were surveyed. Each received a comprehensive four page questionnaire that included sections on training and experience, patient and isotope selection criteria, manpower, technique, and follow-up. Thirty-five (50%) surveys were ultimately returned after three mailings and follow-up phone calls. The cumulative experience of the 35 respondents represented approximately 45% of the total TIPPB volume in the U.S. for 1995. Respondents included 29 from the private sector and six from academic programs. Results: The median physician experience with TIPPB was reported as 4.9 years. Each performed an average of 73 TIPPB procedures in 1995 (range 40-300). This represented an increase in volume for most (74%) of the respondents. Sixty-three percent of the respondents attended a formal training course, 54% had TIPPB-specific residency training, and 31% had been proctored (16 had received two or more types of training experience). The most commonly reported selection criteria for implant alone was on Gleason score ≤7, PSA 125 I prescribed to 120 Gy (75%) or 103 Pd to 90 Gy (50%). Sixty percent reported using a Mick applicator, 46% prefer using preloaded needles, and (11%) use both techniques. Real-time imaging was usually performed with ultrasound (94%); most included fluoroscopy (60%). Definitions of PSA control varied widely. Conclusions: TIPPB clinical practice in the U.S. demonstrates similarities in technique, but differences in patient selection and definitions of biochemical control. It is, therefore, incumbent on those beginning TIPPB programs to carefully review the specific practice details of those institutions

  16. Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

    Science.gov (United States)

    Driscoll, Brandon; Jaffray, David; Coolens, Catherine

    2014-03-01

    Purpose: To provide clinicians & researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

  17. Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

    International Nuclear Information System (INIS)

    Driscoll, Brandon; Jaffray, David; Coolens, Catherine

    2014-01-01

    Purpose: To provide clinicians and researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

  18. Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research.

    Science.gov (United States)

    Bornstein, Michael M; Horner, Keith; Jacobs, Reinhilde

    2017-02-01

    Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Clinical evaluation of gadodiamide injection in paediatric MR imaging

    International Nuclear Information System (INIS)

    Hanquinet, S.; Christophe, C.; Greef, D. de; Gordon, P.; Perlmutter, N.

    1996-01-01

    The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82 %). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children. (orig.). With 3 figs., 1 tab

  20. Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options.

    Science.gov (United States)

    Matcuk, George R; Mahanty, Scott R; Skalski, Matthew R; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J

    2016-08-01

    Stress fracture, in its most inclusive description, includes both fatigue and insufficiency fracture. Fatigue fractures, sometimes equated with the term "stress fractures," are most common in runners and other athletes and typically occur in the lower extremities. These fractures are the result of abnormal, cyclical loading on normal bone leading to local cortical resorption and fracture. Insufficiency fractures are common in elderly populations, secondary to osteoporosis, and are typically located in and around the pelvis. They are a result of normal or traumatic loading on abnormal bone. Subchondral insufficiency fractures of the hip or knee may cause acute pain that may present in the emergency setting. Medial tibial stress syndrome is a type of stress injury of the tibia related to activity and is a clinical syndrome encompassing a range of injuries from stress edema to frank-displaced fracture. Atypical subtrochanteric femoral fracture associated with long-term bisphosphonate therapy is also a recently discovered entity that needs early recognition to prevent progression to a complete fracture. Imaging recommendations for evaluation of stress fractures include initial plain radiographs followed, if necessary, by magnetic resonance imaging (MRI), which is preferred over computed tomography (CT) and bone scintigraphy. Radiographs are the first-line modality and may reveal linear sclerosis and periosteal reaction prior to the development of a frank fracture. MRI is highly sensitive with findings ranging from periosteal edema to bone marrow and intracortical signal abnormality. Additionally, a brief description of relevant clinical management of stress fractures is included.

  1. The clinical application of nuclide bone imaging in malignant lymphomas

    International Nuclear Information System (INIS)

    Jin Xing; Tang Mingdeng; Lin Duanyu; Ni Leichun

    2006-01-01

    Objective: To evaluate the clinical application value of nuclide bone imaging in malignant lymphoma. Methods: 71 cases of patients were diagnosed by pathology as malignant lymphoma, among whom there were 8 cases of Hodgkin disease (HL) and 63 cases of non-Hodgkin disease (NHL). The examinations were performed from 2.5 to 6 hours later after the intravenous injection of 99m Tc-MDP (555-925 MBq). Results: 31 cases were bone-infiltrating lesions, including 3 cases of HL and 28 cases of NHL. The total number of the focus was 103, except 2 cases of bone lack, including 35 foci in vertebral column (34.65%), 30 foci in limb and joint (29.70%), 14 foci in rib (13.86%), 13 foci in elvis (12.0%), 5 foci in skull (4.95%) and 4 foci in sternum (3.96%). Conclusion: The nuclide bone imaging has a high value in the clinical stage, therapeutic observation and prognosis of bone-infiltrating malignant lymphoma. (authors)

  2. Clinical Nonlinear Laser Imaging of Human Skin: A Review

    Science.gov (United States)

    Pavone, Francesco Saverio

    2014-01-01

    Nonlinear optical microscopy has the potential of being used in vivo as a noninvasive imaging modality for both epidermal and dermal imaging. This paper reviews the capabilities of nonlinear microscopy as a noninvasive high-resolution tool for clinical skin inspection. In particular, we show that two-photon fluorescence microscopy can be used as a diagnostic tool for characterizing epidermal layers by means of a morphological examination. Additional functional information on the metabolic state of cells can be provided by measuring the fluorescence decay of NADH. This approach allows differentiating epidermal layers having different structural and cytological features and has the potential of diagnosing pathologies in a very early stage. Regarding therapy follow-up, we demonstrate that nonlinear microscopy could be successfully used for monitoring the effect of a treatment. In particular, combined two-photon fluorescence and second-harmonic generation microscopy were used in vivo for monitoring collagen remodeling after microablative fractional laser resurfacing and for quantitatively monitoring psoriasis on the basis of the morphology of epidermal cells and dermal papillae. We believe that the described microscopic modalities could find in the near future a stable place in a clinical dermatological setting for quantitative diagnostic purposes and as a monitoring method for various treatments. PMID:25250337

  3. Why choroid vessels appear dark in clinical OCT images

    Science.gov (United States)

    Kirby, Mitchell A.; Li, Chenxi; Choi, Woo June; Gregori, Giovanni; Rosenfeld, Philip; Wang, Ruikang

    2018-02-01

    With the onset of clinically available spectral domain (SD-OCT) and swept source (SS-OCT) systems, clinicians are now easily able to recognize sub retinal microstructure and vascularization in the choroidal and scleral regions. As the bloodrich choroid supplies nutrients to the upper retinal layers, the ability to monitor choroid function accurately is of vital importance for clinical assessment of retinal health. However, the physical appearance of the choroid blood vessels (darker under a healthy Retinal Pigmented Epithelium (RPE) compared to regions displaying an RPE atrophic lesion) has led to confusion within the OCT ophthalmic community. The differences in appearance between each region in the OCT image may be interpreted as different vascular patterns when the vascular networks are in fact very similar. To explain this circumstance, we simulate light scattering phenomena in the RPE and Choroid complexes using the finite difference time domain (FDTD) method. The simulation results are then used to describe and validate imaging features in a controlled multi-layered tissue phantom designed to replicate human RPE, choroid, and whole blood microstructure. Essentially, the results indicate that the strength of the OCT signal from choroidal vasculature is dependent on the health and function of the RPE, and may not necessarily directly reflect the health and function of the choroidal vasculature.

  4. Clinical application of positron emission tomography imaging in urologic tumors

    International Nuclear Information System (INIS)

    Tang Ganghua; Wu Guangyuan

    2007-01-01

    Positron emission tomography (PET) is an advanced noninvasive molecular imaging modality that is being investigated for use in the differentiation, diagnosis, and guiding therapy ora variety of cancer types. FDG PET has the unique clinical value in the differentiation, diagnosis, and monitoring therapy of prostate, such as bladder, renal, and testicle cancer. However, high false-positive and false-negative findings are observed in the detection of these tumors with FDG PET. 11 C-Choline (CH) and 11 C-acetate (AC) can overcome the pitfall of FDG, and appear to be more successful than FGD in imaging prostate cancer and bladder cancer. The short half-life of 11 C prevents the widespread use of CH and AC and 18 F-fluorocholine (FCH) and 18 F-fluoroacetate (FAC) seem to be potential tracers. Potential clinical value of the new PET tracers, such as 3'-deoxy-3'- 18 F-fluorothymidine (FLT), 18 F-fluorodihydrotestosterone (FDHT), and 9-(4- 18 F-3-hydroxymethylbutyl)-guanine( 18 F-FHBG) in the detection of urologic tumors, can deserve further study. (authors)

  5. Clinical feature and imaging findings of juvenile ankylosing spondylitis

    International Nuclear Information System (INIS)

    Zeng Hui; Liang Hongchang; Wang Weigang; Liu Hui; Huang Meiping; Zheng Junhui

    2003-01-01

    Objective: To analyze the clinical features and imaging findings of juvenile ankylosing spondylitis (JAS) in order to improve the diagnosis and the prognosis of JAS. Methods: Twelve cases were analyzed retrospectively and 14 cases, who were followed-up averagely for 2.3 years, were analyzed prospectively. Initially 10 were diagnosed as Still's disease and four were diagnosed as rheumatoid arthritis. Photography was performed in all cases, CT scan was done in 18 cases, and MRI in 8 cases. Lower extremity big joint disorders were observed in all cases and the small joints were reserved. The abnormalities of the sacroiliac joint were revealed in the early stage in 12 cases. The results were analyzed statistically. Results: The age of preliminary diagnosis was 9.3 years in average. There were statistical correlation between the age of the first episode and severity of the disease. And there were statistical correlation between the course of the illness and severity of the disease. The large joints of the lower extremities were most commonly involved. Conclusion: There were characteristic clinical features and imaging findings in the JAS. Early diagnosis and treatment improve the prognosis

  6. Clinical Nonlinear Laser Imaging of Human Skin: A Review

    Directory of Open Access Journals (Sweden)

    Riccardo Cicchi

    2014-01-01

    Full Text Available Nonlinear optical microscopy has the potential of being used in vivo as a noninvasive imaging modality for both epidermal and dermal imaging. This paper reviews the capabilities of nonlinear microscopy as a noninvasive high-resolution tool for clinical skin inspection. In particular, we show that two-photon fluorescence microscopy can be used as a diagnostic tool for characterizing epidermal layers by means of a morphological examination. Additional functional information on the metabolic state of cells can be provided by measuring the fluorescence decay of NADH. This approach allows differentiating epidermal layers having different structural and cytological features and has the potential of diagnosing pathologies in a very early stage. Regarding therapy follow-up, we demonstrate that nonlinear microscopy could be successfully used for monitoring the effect of a treatment. In particular, combined two-photon fluorescence and second-harmonic generation microscopy were used in vivo for monitoring collagen remodeling after microablative fractional laser resurfacing and for quantitatively monitoring psoriasis on the basis of the morphology of epidermal cells and dermal papillae. We believe that the described microscopic modalities could find in the near future a stable place in a clinical dermatological setting for quantitative diagnostic purposes and as a monitoring method for various treatments.

  7. Diffusion and Perfusion MR Imaging in Acute Stroke: Clinical Utility and Potential Limitations for Treatment Selection

    DEFF Research Database (Denmark)

    Bateman, Mathew; Slater, Lee-Anne; Leslie-Mazwi, Thabele M

    2017-01-01

    Magnetic resonance (MR) diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) offer unique insight into acute ischemic stroke pathophysiology. These techniques may offer the ability to apply pathophysiology to accurately individualize acute stroke reperfusion treatment, including ...... to be investigated in ongoing randomized controlled trials, and continued research into these techniques will help achieve the goal of tissue-based decision making and individualized acute stroke treatment....... extending the opportunity of reperfusion treatment to well beyond the current time-based treatment windows. This review examines the use of DWI and PWI in the major stroke trials, their current clinical utility, and potential limitations for reperfusion treatment selection. DWI and PWI continue...

  8. Resistive wall heating due to image current on the beam chamber for a superconducting undulator.

    Energy Technology Data Exchange (ETDEWEB)

    Kim, S. H. (Accelerator Systems Division (APS))

    2012-03-27

    The image-current heating on the resistive beam chamber of a superconducting undulator (SCU) was calculated based on the normal and anomalous skin effects. Using the bulk resistivity of copper for the beam chamber, the heat loads were calculated for the residual resistivity ratios (RRRs) of unity at room temperature to 100 K at a cryogenic temperature as the reference. Then, using the resistivity of the specific aluminum alloy 6053-T5, which will be used for the SCU beam chamber, the heat loads were calculated. An electron beam stored in a storage ring induces an image current on the inner conducting wall, mainly within a skin depth, of the beam chamber. The image current, with opposite charge to the electron beam, travels along the chamber wall in the same direction as the electron beam. The average current in the storage ring consists of a number of bunches. When the pattern of the bunched beam is repeated according to the rf frequency, the beam current may be expressed in terms of a Fourier series. The time structure of the image current is assumed to be the same as that of the beam current. For a given resistivity of the chamber inner wall, the application ofthe normal or anomalous skin effect will depend on the harmonic numbers of the Fourier series of the beam current and the temperature of the chamber. For a round beam chamber with a ratius r, much larger than the beam size, one can assume that the image current density as well as the density square, may be uniform around the perimeter 2{pi}r. For the SCU beam chamber, which has a relatively narrow vertical gap compared to the width, the effective perimeter was estimated since the heat load should be proportional to the inverse of the perimeter.

  9. Clinical applications of SPECT/CT in imaging the extremities

    International Nuclear Information System (INIS)

    Huellner, Martin W.; Strobel, Klaus

    2014-01-01

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  10. Clinical applications of SPECT/CT in imaging the extremities

    Energy Technology Data Exchange (ETDEWEB)

    Huellner, Martin W. [University Hospital Zurich, Department of Medical Radiology, Division of Nuclear Medicine, Zurich (Switzerland); Strobel, Klaus [Lucerne Cantonal Hospital, Department of Nuclear Medicine and Radiology, Lucerne (Switzerland)

    2014-05-15

    Today, SPECT/CT is increasingly used and available in the majority of larger nuclear medicine departments. Several applications of SPECT/CT as a supplement to or replacement for traditional conventional bone scintigraphy have been established in recent years. SPECT/CT of the upper and lower extremities is valuable in many conditions with abnormal bone turnover due to trauma, inflammation, infection, degeneration or tumour. SPECT/CT is often used in patients if conventional radiographs are insufficient, if MR image quality is impaired due to metal implants or in patients with contraindications to MR. In complex joints such as those in the foot and wrist, SPECT/CT provides exact anatomical correlation of pathological uptake. In many cases SPECT increases the sensitivity and CT the specificity of the study, increasing confidence in the final diagnosis compared to planar images alone. The CT protocol should be adapted to the clinical question and may vary from very low-dose (e.g. attenuation correction only), to low-dose for anatomical correlation, to normal-dose protocols enabling precise anatomical resolution. The aim of this review is to give an overview of SPECT/CT imaging of the extremities with a focus on the hand and wrist, knee and foot, and for evaluation of patients after joint arthroplasty. (orig.)

  11. A new method for electric impedance imaging using an eddy current with a tetrapolar circuit.

    Science.gov (United States)

    Ahsan-Ul-Ambia; Toda, Shogo; Takemae, Tadashi; Kosugi, Yukio; Hongo, Minoru

    2009-02-01

    A new contactless technique for electrical impedance imaging, using an eddy current managed along with the tetrapolar circuit method, is proposed. The eddy current produced by a magnetic field is superimposed on a constant current that is normally used in the tetrapolar circuit method, and thus is used to control the current distribution in the body. By changing the current distribution, a set of voltage differences is measured with a pair of electrodes. This set of voltage differences is used in the image reconstruction of the resistivity distribution. The least square error minimization method is used in the reconstruction algorithm. The principle of this method is explained theoretically. A backprojection algorithm was used to get 2-D images. Based on this principle, a measurement system was developed and model experiments were conducted with a saline-filled phantom. The estimated shape of each model in the reconstructed image was similar to that of the corresponding model. From the results of these experiments, it is confirmed that the proposed method is applicable to the realization of electrical conductivity imaging.

  12. Multishot echo-planar MREIT for fast imaging of conductivity, current density, and electric field distributions.

    Science.gov (United States)

    Chauhan, Munish; Vidya Shankar, Rohini; Ashok Kumar, Neeta; Kodibagkar, Vikram D; Sadleir, Rosalind

    2018-01-01

    Magnetic resonance electrical impedance tomography (MREIT) sequences typically use conventional spin or gradient echo-based acquisition methods for reconstruction of conductivity and current density maps. Use of MREIT in functional and electroporation studies requires higher temporal resolution and faster sequences. Here, single and multishot echo planar imaging (EPI) based MREIT sequences were evaluated to see whether high-quality MREIT phase data could be obtained for rapid reconstruction of current density, conductivity, and electric fields. A gel phantom with an insulating inclusion was used as a test object. Ghost artifact, geometric distortion, and MREIT correction algorithms were applied to the data. The EPI-MREIT-derived phase-projected current density and conductivity images were compared with simulations and spin-echo images as a function of EPI shot number. Good agreement among measures in simulated, spin echo, and EPI data was achieved. Current density errors were stable and below 9% as the shot number decreased from 64 to 2, but increased for single-shot images. Conductivity reconstruction relative contrast ratios were stable as the shot number decreased. The derived electric fields also agreed with the simulated data. The EPI methods can be combined successfully with MREIT reconstruction algorithms to achieve fast imaging of current density, conductivity, and electric field. Magn Reson Med 79:71-82, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  13. Lung scintigraphy in the diagnosis of pulmonary embolism: current methods and interpretation criteria in clinical practice

    International Nuclear Information System (INIS)

    Skarlovnik, Ajda; Hrastnik, Damjana; Fettich, Jure; Grmek, Marko

    2014-01-01

    In current clinical practice lung scintigraphy is mainly used to exclude pulmonary embolism (PE). Modified diagnostic criteria for planar lung scintigraphy are considered, as newer scitigraphic methods, especially single photon emission computed tomography (SPECT) are becoming more popular. Data of 98 outpatients who underwent planar ventilation/perfusion (V/Q) scintigraphy and 49 outpatients who underwent V/Q SPECT from the emergency department (ED) were retrospectively collected. Planar V/Q images were interpreted according to 0.5 segment mismatch criteria and revised PIOPED II criteria and perfusion scans according to PISA-PED criteria. V/Q SPECT images were interpreted according to the criteria suggested in EANM guidelines. Final diagnosis of PE was based on the clinical decision of an attending physician and evaluation of a 12 months follow-up period. Using 0.5 segment mismatch criteria and revised PIOPED II, planar V/Q scans were diagnostic in 93% and 84% of cases, respectively. Among the diagnostic planar scans readings specificity for 0.5 segment mismatch criteria was 98%, and 99% for revised PIOPED II criteria. V/Q SPECT showed a sensitivity of 100% and a specificity of 98%, without any non-diagnostic cases. In patients with low pretest probability for PE, planar V/Q scans assessed by 0.5 segment mismatch criteria were diagnostic in 92%, and in 85% using revised PIOPED II criteria, while perfusion scintigraphy without ventilation scans was diagnostic in 80%. Lung scintigraphy yielded diagnostically definitive results and is reliable in ruling out PE in patients from ED. V/Q SPECT has excellent specificity and sensitivity without any non-diagnostic results. Percentage of non-diagnostic results in planar lung scintigraphy is considerably smaller when 0.5 segment mismatch criteria instead of revised PIOPED II criteria are used. Diagnostic value of perfusion scintigraphy according to PISA-PED criteria is inferior to combined V/Q scintigraphy; the difference is

  14. A social-technological epistemology of clinical decision-making as mediated by imaging.

    Science.gov (United States)

    van Baalen, Sophie; Carusi, Annamaria; Sabroe, Ian; Kiely, David G

    2017-10-01

    In recent years there has been growing attention to the epistemology of clinical decision-making, but most studies have taken the individual physicians as the central object of analysis. In this paper we argue that knowing in current medical practice has an inherently social character and that imaging plays a mediating role in these practices. We have analyzed clinical decision-making within a medical expert team involved in diagnosis and treatment of patients with pulmonary hypertension (PH), a rare disease requiring multidisciplinary team involvement in diagnosis and management. Within our field study, we conducted observations, interviews, video tasks, and a panel discussion. Decision-making in the PH clinic involves combining evidence from heterogeneous sources into a cohesive framing of a patient, in which interpretations of the different sources can be made consistent with each other. Because pieces of evidence are generated by people with different expertise and interpretation and adjustments take place in interaction between different experts, we argue that this process is socially distributed. Multidisciplinary team meetings are an important place where information is shared, discussed, interpreted, and adjusted, allowing for a collective way of seeing and a shared language to be developed. We demonstrate this with an example of image processing in the PH service, an instance in which knowledge is distributed over multiple people who play a crucial role in generating an evaluation of right heart function. Finally, we argue that images fulfill a mediating role in distributed knowing in 3 ways: first, as enablers or tools in acquiring information; second, as communication facilitators; and third, as pervasively framing the epistemic domain. With this study of clinical decision-making in diagnosis and treatment of PH, we have shown that clinical decision-making is highly social and mediated by technologies. The epistemology of clinical decision-making needs

  15. Correlation of the clinical and physical image quality in chest radiography for average adults with a computed radiography imaging system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Beavis, A W; Saunderson, J R

    2013-07-01

    The purpose of this study was to examine the correlation between the quality of visually graded patient (clinical) chest images and a quantitative assessment of chest phantom (physical) images acquired with a computed radiography (CR) imaging system. The results of a previously published study, in which four experienced image evaluators graded computer-simulated postero-anterior chest images using a visual grading analysis scoring (VGAS) scheme, were used for the clinical image quality measurement. Contrast-to-noise ratio (CNR) and effective dose efficiency (eDE) were used as physical image quality metrics measured in a uniform chest phantom. Although optimal values of these physical metrics for chest radiography were not derived in this work, their correlation with VGAS in images acquired without an antiscatter grid across the diagnostic range of X-ray tube voltages was determined using Pearson's correlation coefficient. Clinical and physical image quality metrics increased with decreasing tube voltage. Statistically significant correlations between VGAS and CNR (R=0.87, pchest CR images acquired without an antiscatter grid. A statistically significant correlation has been found between the clinical and physical image quality in CR chest imaging. The results support the value of using CNR and eDE in the evaluation of quality in clinical thorax radiography.

  16. A Method for Eddy Current Field Measurement in Permanent Magnet Magnetic Resonance Imaging Systems

    Directory of Open Access Journals (Sweden)

    SONG Rui

    2018-03-01

    Full Text Available Magnetic resonance imaging (MRI is a widely used medical imaging technique. In MRI system, gradient magnetic fields are used to code spatial information. However, the fast-switching electric currents in the gradients coils used to generate gradient fields also induce vortex electric field, often referred as eddy current, in the surrounding metal conductors. In this paper, a method for eddy current field measurement was proposed. Based on the Faraday law of electromagnetic induction, an eddy current field measuring device was designed. Combining hardware acquisition and software processing, the eddy current field was obtained by subtracting the ideal gradient field from the magnetic field measured experimentally, whose waveform could be displayed in real time. The proposed method was verified by experimental results.

  17. Imaging in drug discovery and early clinical trials

    National Research Council Canada - National Science Library

    Rudin, M

    2005-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Imaging modalities: principles and information content Tobias Schaeffter ... 15 Magnetic resonance and fluorescence based molecular imaging technologies David...

  18. Clinical applications of cobalt-radionuclides in neuro-imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, H.M.L

    1998-04-01

    The aim of the studies embodied in this thesis was to investigate the clinical applicability of Co in euro-imaging using positron emission tomography (PET). To this purpose, a set of closely related pilot studies were performed in patients suffering from several neurological diseases affecting the brain. Chapter 2 discusses the physiological role of Co and both indications and complications of Co-administration in the past. The probable deposition mechanism of Co is described, potential (absence of) evidence of Co mimicking Ca in vivo is discussed, a comparison is made with other tracer-analogues (Ga, TI, Rb) and several hypotheses with respect to the pharmacokinetic behaviour of Co and the role of (inflammatory) proteins and cells are forwarded. The etiologic mechanism(s), clinical symptoms, Ca-related pathophysiology and (most recent) imaging techniques are reviewed of Multiple Sclerosis, cerebrovascular stroke, traumatic brain injury and primary brain tumours. The major goal of these respective reviews is both a rough outline of present insights and near-future developments and an assessment of the (im)possibilities in visualising the actual substrate of disease. Since Co is assumed to reflect (the common pathway of) Ca, an application of Co (based on cell-decay and inflammation) may be hypothesised in all of the diseases mentioned. These considerations served as a theoretical basis for our further studies in clinical practice. Chapter 3 (Original reprints) presents the actual results, whil Chapter 4 (General discussion) reflects on lessons that can be learned from the present work and consequently formulates some suggestions for future (extended) studies. The contours of possible new emerging areas of interest (dementia of the Alzheimer type; vascular dementia; stunned myocardium) are drawn in continuation of the foregoing studies. 47 refs.

  19. A review of methods of clinical image quality evaluation in mammography

    International Nuclear Information System (INIS)

    Li Yanpeng; Poulos, Ann; McLean, Donald; Rickard, Mary

    2010-01-01

    Purpose: Consistency in evaluation of mammography images in research and clinical practice is dependent on a standardised clinical image quality evaluation system. Currently two such systems are available-one developed by the American College of Radiology (ACR) and the other by the European Commission (EU guidelines). The purpose of this study was to review mammography clinical evaluation methods in research studies and their adherence to these systems. Method: A total of 23 research articles were reviewed from the period 2000-2006, 11 of these studies used digital images. The focus of the review was the criteria and rating scales used. Results: Only 5 studies used either the ACR (3) or EU guidelines (2). The remainder included aspects of these systems together with a range of other criteria and rating scales. Variation was found in the categories of criteria used, number of criteria, the descriptors of the criteria and the instructions used to evaluate the criteria. Instructions were frequently not specific and open to individual interpretation. Although breast density is an important criterion of image quality and contributes to perception of breast lesions, inclusion of this criterion was not universal, and even when used the area of breast density to be evaluated was not identified, thus enhancing inter-observer variability. Scales that were absolute or relative were used for evaluation, all of which incorporated inconsistent numbers of steps. Conclusion: Low adherence to ACR and EU Guidelines has resulted in considerable variation in the evaluation methods used in research studies. The implications of this variability are considerable both for evaluation of image quality in research outcomes and clinical practice.

  20. Clinical assessment of chest pain and guidelines for imaging

    International Nuclear Information System (INIS)

    Gruettner, J.; Henzler, T.; Sueselbeck, T.; Fink, C.; Borggrefe, M.; Walter, T.

    2012-01-01

    For many emergency facilities, risk assessment of patients with diffuse chest pain still poses a major challenge. In their currently valid recommendations, the international cardiological societies have defined a standardized assessment of the prognostically relevant cardiac risk criteria. Here the classic sequence of basic cardiac diagnostics including case history (cardiac risk factors), physical examination (haemodynamic and respiratory vital parameters), ECG (ST segment analysis) and laboratory risk markers (troponin levels) is paramount. The focus is, on the one hand, on timely indication for percutaneous catheterization, especially in patients at high cardiac risk with or without ST-segment elevation in the ECG, and, on the other hand, on the possibility of safely discharging patients with intermediate or low cardiac risk after non-invasive exclusion of a coronary syndrome. For patients in the intermediate or low risk group, physical or pharmacological stress testing in combination with scintigraphy, echocardiography or magnetic resonance imaging is recommended in addition to basic diagnostics. Moreover, the importance of non-invasive coronary imaging, primarily cardiac CT angiography (CCTA), is increasing. Current data show that in intermediate or low risk patients this method is suitable to reliably rule out coronary heart disease. In addition, attention is paid to the major differential diagnoses of acute coronary syndrome, particularly pulmonary embolism and aortic dissection. Here the diagnostic method of choice is thoracic CT, possibly also in combination with CCTA aiming at a triple rule-out.

  1. Clinical assessment of chest pain and guidelines for imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gruettner, J., E-mail: joachim.gruettner@umm.de [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Henzler, T. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Sueselbeck, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Borggrefe, M.; Walter, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany)

    2012-12-15

    For many emergency facilities, risk assessment of patients with diffuse chest pain still poses a major challenge. In their currently valid recommendations, the international cardiological societies have defined a standardized assessment of the prognostically relevant cardiac risk criteria. Here the classic sequence of basic cardiac diagnostics including case history (cardiac risk factors), physical examination (haemodynamic and respiratory vital parameters), ECG (ST segment analysis) and laboratory risk markers (troponin levels) is paramount. The focus is, on the one hand, on timely indication for percutaneous catheterization, especially in patients at high cardiac risk with or without ST-segment elevation in the ECG, and, on the other hand, on the possibility of safely discharging patients with intermediate or low cardiac risk after non-invasive exclusion of a coronary syndrome. For patients in the intermediate or low risk group, physical or pharmacological stress testing in combination with scintigraphy, echocardiography or magnetic resonance imaging is recommended in addition to basic diagnostics. Moreover, the importance of non-invasive coronary imaging, primarily cardiac CT angiography (CCTA), is increasing. Current data show that in intermediate or low risk patients this method is suitable to reliably rule out coronary heart disease. In addition, attention is paid to the major differential diagnoses of acute coronary syndrome, particularly pulmonary embolism and aortic dissection. Here the diagnostic method of choice is thoracic CT, possibly also in combination with CCTA aiming at a triple rule-out.

  2. Optical coherence tomography—current technology and applications in clinical and biomedical research

    DEFF Research Database (Denmark)

    Marschall, Sebastian; Sander, Birgit; Mogensen, Mette

    2011-01-01

    such as birefringence, motion, or the distributions of certain substances can be detected with high spatial resolution. Its main field of application is biomedical imaging and diagnostics. In ophthalmology, OCT is accepted as a clinical standard for diagnosing and monitoring the treatment of a number of retinal...

  3. Breast imaging using the Twente photoacoustic mammoscope (PAM): new clinical measurements

    Science.gov (United States)

    Heijblom, Michelle; Piras, Daniele; Ten Tije, Ellen; Xia, Wenfeng; van Hespen, Johan; Klaase, Joost; van den Engh, Frank; van Leeuwen, Ton; Steenbergen, Wiendelt; Manohar, Srirang

    2011-07-01

    Worldwide, yearly about 450,000 women die from the consequences of breast cancer. Current imaging modalities are not optimal in discriminating benign from malignant tissue. Visualizing the malignancy-associated increased hemoglobin concentration might significantly improve early diagnosis of breast cancer. Since photoacoustic imaging can visualize hemoglobin in tissue with optical contrast and ultrasound-like resolution, it is potentially an ideal method for early breast cancer imaging. The Twente Photoacoustic Mammoscope (PAM) has been developed specifically for breast imaging. Recently, a large clinical study has been started in the Medisch Spectrum Twente in Oldenzaal using PAM. In PAM, the breast is slightly compressed between a window for laser light illumination and a flat array ultrasound detector. The measurements are performed using a Q-switched Nd:YAG laser, pulsed at 1064 nm and a 1 MHz unfocused ultrasound detector array. Three-dimensional data are reconstructed using a delay and sum reconstruction algorithm. Those reconstructed images are compared with conventional imaging and histopathology. In the first phase of the study 12 patients with a malignant lesion and 2 patients with a benign cyst have been measured. The results are used to guide developments in photoacoustic mammography in order to pave the way towards an optimal technique for early diagnosis of breast cancer.

  4. Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience

    International Nuclear Information System (INIS)

    Federau, C.; Becce, F.; Maeder, P.; Meuli, R.; Sumer, S.; Wintermark, M.; O'Brien, K.

    2014-01-01

    Intravoxel incoherent motion (IVIM) imaging is an MRI perfusion technique that uses a diffusion-weighted sequence with multiple b values and a bi-compartmental signal model to measure the so-called pseudo-diffusion of blood caused by its passage through the microvascular network. The goal of the current study was to assess the feasibility of IVIM perfusion fraction imaging in patients with acute stroke. Images were collected in 17 patients with acute stroke. Exclusion criteria were onset of symptoms to imaging >5 days, hemorrhagic transformation, infratentorial lesions, small lesions 2 . Image quality was assessed by two radiologists, and quantitative analysis was performed in regions of interest placed in the stroke area, defined by thresholding the apparent diffusion coefficient maps, as well as in the contralateral region. IVIM perfusion fraction maps showed an area of decreased perfusion fraction f in the region of decreased apparent diffusion coefficient. Quantitative analysis showed a statistically significant decrease in both IVIM perfusion fraction f (0.026 ± 0.019 vs. 0.056 ± 0.025, p = 2.2 . 10 -6 ) and diffusion coefficient D compared with the contralateral side (3.9 ± 0.79 . 10 -4 vs. 7.5 ± 0.86 . 10 -4 mm 2 /s, p = 1.3 . 10 -20 ). IVIM perfusion fraction imaging is feasible in acute stroke. IVIM perfusion fraction is significantly reduced in the visible infarct. Further studies should evaluate the potential for IVIM to predict clinical outcome and treatment response. (orig.)

  5. Photoacoustic cystography using handheld dual modal clinical ultrasound photoacoustic imaging system

    Science.gov (United States)

    Sivasubramanian, Kathyayini; Periyasamy, Vijitha; Austria, Dienzo Rhonnie; Pramanik, Manojit

    2018-02-01

    Vesicoureteral reflux is the abnormal flow of urine from your bladder back up the tubes (ureters) that connect your kidneys to your bladder. Normally, urine flows only down from your kidneys to your bladder. Vesicoureteral reflux is usually diagnosed in infants and children. The disorder increases the risk of urinary tract infections, which, if left untreated, can lead to kidney damage. X-Ray cystography is used currently to diagnose this condition which uses ionising radiation, making it harmful for patients. In this work we demonstrate the feasibility of imaging the urinary bladder using a handheld clinical ultrasound and photoacoustic dual modal imaging system in small animals (rats). Additionally, we demonstrate imaging vesicoureteral reflux using bladder mimicking phantoms. Urinary bladder imaging is done with the help of contrast agents like black ink and gold nanoparticles which have high optical absorption at 1064 nm. Imaging up to 2 cm was demonstrated with this system. Imaging was done at a framerate of 5 frames per second.

  6. Clinical and Imaging Findings in Childhood Posterior Reversible Encephalopathy Syndrome

    Science.gov (United States)

    GUNGOR, Serdal; KILIC, Betul; TABEL, Yilmaz; SELIMOGLU, Ayse; OZGEN, Unsal; YILMAZ, Sezai

    2018-01-01

    Objective Posterior reversible encephalopathy syndrome (PRES) is characterized by typical radiologic findings in the posterior regions of the cerebral hemispheres and cerebellum. The symptoms include headache, nausea, vomiting, visual disturbances, focal neurologic deficits, and seizures. The aim of this study is to evaluate the clinical and radiological features of PRES in children and to emphasize the recognition of atypical features. Materials & Methods We retrospectively examined 23 children with PRES from Mar 2010-Apr 2015 in Inonu University Turgut Ozal Medical Center in Turkey. We compared the clinical features and cranial MRI findings between underlying diseases of PRES. Results The most common precipitating factors were hypertension (78.2%) and medications, namely immunosuppressive and antineoplastic agents (60.8%). Manifestations included mental changes (100%), seizures (95.6%), headache (60.8%), and visual disturbances (21.7%) of mean 3.6 (range 1-10) days' duration. Cranial magnetic resonance imaging (MRI) showed bilateral occipital lesions in all patients, associated in 82.6% with less typical distribution of lesions in frontal, temporal or parietal lobes, cerebellum, corpus callosum, basal ganglia, thalamus, and brain stem. Frontal involvement was predominant, observed in 56.5% of patients. Clinical recovery was followed by radiologic resolution in all patients. Conclusion PRES is often unsuspected by the clinician, thus radiologists may be the first to suggest this diagnosis on an MRI obtained for seizures or encephalopathy. Atypical MRI finding is seen quite often. Rapid diagnosis and treatment are required to avoid a devastating outcome. PMID:29379559

  7. Imaging studies and biomarkers to detect clinically meaningful vesicoureteral reflux

    Directory of Open Access Journals (Sweden)

    Michaella Maloney Prasad

    2017-06-01

    Full Text Available The work-up of a febrile urinary tract infection is generally performed to detect vesicoureteral reflux (VUR and its possible complications. The imaging modalities most commonly used for this purpose are renal-bladder ultrasound, voiding cystourethrogram and dimercapto-succinic acid scan. These studies each contribute valuable information, but carry individual benefits and limitations that may impact their efficacy. Biochemical markers are not commonly used in pediatric urology to diagnose or differentiate high-risk disease, but this is the emerging frontier, which will hopefully change our approach to VUR in the future. As it becomes more apparent that there is tremendous clinical variation within grades of VUR, the need to distinguish clinically significant from insignificant disease grows. The unfortunate truth about VUR is that recommendations for treatment may be inconsistent. Nuances in clinical decision-making will always exist, but opinions for medical versus surgical intervention should be more standardized, based on risk of injury to the kidney.

  8. Lumbar spinal imaging in radicular pain and related conditions. Understanding diagnostic images in a clinical context

    International Nuclear Information System (INIS)

    Wilmink, Jan T.

    2010-01-01

    There is general agreement that lumbosacral nerve root compression is a prime factor in the pathogenesis of sciatica and neurogenic claudication, although humoral and vascular factors certainly play a role as well. This book focuses on imaging of the various ways in which nerve root compression can come about, and assessing which anatomic features are reliably associated with the occurrence of radicular pain, as opposed to morphologic findings which are probably coincidental. After a discussion of the nature of radicular pain and related symptoms, spinal imaging techniques and options are reviewed, with emphasis on the role of MR myelography in assessing the condition of the intradural nerve roots. A chapter on normal topographic, sectional, and functional (dynamic) radiologic anatomy is followed by a presentation on pathologic anatomy, addressing the various mechanisms of nerve root compression. In the chapter on pre- and postoperative imaging, features which may help to predict the evolution of the symptoms are discussed, with an eye to selecting candidates for surgical treatment. This is followed by a discussion of the role and limitations of imaging studies in various adverse postoperative conditions. In illustrations involving patient studies, imaging features are linked where possible to the clinical symptoms and history of the individuals involved. (orig.)

  9. Lumbar spinal imaging in radicular pain and related conditions. Understanding diagnostic images in a clinical context

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, Jan T. [University Hospital Maastricht (Netherlands). Dept. Radiology

    2010-07-01

    There is general agreement that lumbosacral nerve root compression is a prime factor in the pathogenesis of sciatica and neurogenic claudication, although humoral and vascular factors certainly play a role as well. This book focuses on imaging of the various ways in which nerve root compression can come about, and assessing which anatomic features are reliably associated with the occurrence of radicular pain, as opposed to morphologic findings which are probably coincidental. After a discussion of the nature of radicular pain and related symptoms, spinal imaging techniques and options are reviewed, with emphasis on the role of MR myelography in assessing the condition of the intradural nerve roots. A chapter on normal topographic, sectional, and functional (dynamic) radiologic anatomy is followed by a presentation on pathologic anatomy, addressing the various mechanisms of nerve root compression. In the chapter on pre- and postoperative imaging, features which may help to predict the evolution of the symptoms are discussed, with an eye to selecting candidates for surgical treatment. This is followed by a discussion of the role and limitations of imaging studies in various adverse postoperative conditions. In illustrations involving patient studies, imaging features are linked where possible to the clinical symptoms and history of the individuals involved. (orig.)

  10. Clinical proteomics-driven precision medicine for targeted cancer therapy: current overview and future perspectives.

    Science.gov (United States)

    Zhou, Li; Wang, Kui; Li, Qifu; Nice, Edouard C; Zhang, Haiyuan; Huang, Canhua

    2016-01-01

    Cancer is a common disease that is a leading cause of death worldwide. Currently, early detection and novel therapeutic strategies are urgently needed for more effective management of cancer. Importantly, protein profiling using clinical proteomic strategies, with spectacular sensitivity and precision, offer excellent promise for the identification of potential biomarkers that would direct the development of targeted therapeutic anticancer drugs for precision medicine. In particular, clinical sample sources, including tumor tissues and body fluids (blood, feces, urine and saliva), have been widely investigated using modern high-throughput mass spectrometry-based proteomic approaches combined with bioinformatic analysis, to pursue the possibilities of precision medicine for targeted cancer therapy. Discussed in this review are the current advantages and limitations of clinical proteomics, the available strategies of clinical proteomics for the management of precision medicine, as well as the challenges and future perspectives of clinical proteomics-driven precision medicine for targeted cancer therapy.

  11. SU-E-J-181: Magnetic Resonance Image-Guided Radiation Therapy Workflow: Initial Clinical Experience

    International Nuclear Information System (INIS)

    Green, O; Kashani, R; Santanam, L; Wooten, H; Li, H; Rodriguez, V; Hu, Y; Mutic, S; Hand, T; Victoria, J; Steele, C

    2014-01-01

    Purpose: The aims of this work are to describe the workflow and initial clinical experience treating patients with an MRI-guided radiotherapy (MRIGRT) system. Methods: Patient treatments with a novel MR-IGRT system started at our institution in mid-January. The system consists of an on-board 0.35-T MRI, with IMRT-capable delivery via doubly-focused MLCs on three 60 Co heads. In addition to volumetric MR-imaging, real-time planar imaging is performed during treatment. So far, eleven patients started treatment (six finished), ranging from bladder to lung SBRT. While the system is capable of online adaptive radiotherapy and gating, a conventional workflow was used to start, consisting of volumetric imaging for patient setup using visible tumor, evaluation of tumor motion outside of PTV on cine images, and real-time imaging. Workflow times were collected and evaluated to increase efficiency and evaluate feasibility of adding the adaptive and gating features while maintaining a reasonable patient throughput. Results: For the first month, physicians attended every fraction to provide guidance on identifying the tumor and an acceptable level of positioning and anatomical deviation. Average total treatment times (including setup) were reduced from 55 to 45 min after physician presence was no longer required and the therapists had learned to align patients based on soft-tissue imaging. Presently, the source strengths were at half maximum (7.7K Ci each), therefore beam-on times will be reduced after source replacement. Current patient load is 10 per day, with increase to 25 anticipated in the near future. Conclusion: On-board, real-time MRI-guided RT has been incorporated into clinical use. Treatment times were kept to reasonable lengths while including volumetric imaging, previews of tumor movement, and physician evaluation. Workflow and timing is being continuously evaluated to increase efficiency. In near future, adaptive and gating capabilities of the system will be

  12. A new method of CCD dark current correction via extracting the dark Information from scientific images

    Science.gov (United States)

    Ma, Bin; Shang, Zhaohui; Hu, Yi; Liu, Qiang; Wang, Lifan; Wei, Peng

    2014-07-01

    We have developed a new method to correct dark current at relatively high temperatures for Charge-Coupled Device (CCD) images when dark frames cannot be obtained on the telescope. For images taken with the Antarctic Survey Telescopes (AST3) in 2012, due to the low cooling efficiency, the median CCD temperature was -46°C, resulting in a high dark current level of about 3e-/pix/sec, even comparable to the sky brightness (10e-/pix/sec). If not corrected, the nonuniformity of the dark current could even overweight the photon noise of the sky background. However, dark frames could not be obtained during the observing season because the camera was operated in frame-transfer mode without a shutter, and the telescope was unattended in winter. Here we present an alternative, but simple and effective method to derive the dark current frame from the scientific images. Then we can scale this dark frame to the temperature at which the scientific images were taken, and apply the dark frame corrections to the scientific images. We have applied this method to the AST3 data, and demonstrated that it can reduce the noise to a level roughly as low as the photon noise of the sky brightness, solving the high noise problem and improving the photometric precision. This method will also be helpful for other projects that suffer from similar issues.

  13. Development of eddy-current-free MR imaging system with 0.3-T permanent magnet

    International Nuclear Information System (INIS)

    Kuroda, M.; Takeuchi, H.; Nishimura, H.; Yanaka, S.; Takeshima, H.; Yoshino, H.; Miyamoto, T.; Sakurai, H.

    1990-01-01

    This paper reports on the eddy current induced by the magnetic gradient field which causes various problems associated with a permanent magnet, the permanent magnetic circuit with new pole pieces has been studied. The magnetic circuit was composed of a permanent magnet, a yoke, and pole pieces. The pole pieces were magnetically connected to the Nd-Fe-B permanent magnet. To study for eddy current, read-size magnetic circuits with pole pieces of various material, such as (a) steel, (b) divided steel, (c) toroidal-shaped silicon steel, and (d) composite material were assembled. The whole 0.3-T MR imaging system consists of only three units, Gantry with coach, MR unit, and operational console with image processor. We have evaluated the frequency characteristics, rise time, spatial homogeneity of magnetic field, and image quality with respect to real-size magnetic circuits with various pole pieces. We have obtained following order for frequency characteristics: (d), (c), (b), (a). We have also made an effort to adjust uniformity of magnetic field for magnetic circuits with toroidal-shaped silicon steel. We have obtained crisp and accurate images with use of the new pole pieces, without causing an eddy current. Especially, MR angio imaging, which is sensitive for eddy current, can be obtained with remarkable improvement

  14. Quadrature transmit coil for breast imaging at 7 tesla using forced current excitation for improved homogeneity.

    Science.gov (United States)

    McDougall, Mary Preston; Cheshkov, Sergey; Rispoli, Joseph; Malloy, Craig; Dimitrov, Ivan; Wright, Steven M

    2014-11-01

    To demonstrate the use of forced current excitation (FCE) to create homogeneous excitation of the breast at 7 tesla, insensitive to the effects of asymmetries in the electrical environment. FCE was implemented on two breast coils: one for quadrature (1) H imaging and one for proton-decoupled (13) C spectroscopy. Both were a Helmholtz-saddle combination, with the saddle tuned to 298 MHz for imaging and 75 MHz for spectroscopy. Bench measurements were acquired to demonstrate the ability to force equal currents on elements in the presence of asymmetric loading to improve homogeneity. Modeling and temperature measurements were conducted per safety protocol. B1 mapping, imaging, and proton-decoupled (13) C spectroscopy were demonstrated in vivo. Using FCE to ensure balanced currents on elements enabled straightforward tuning and maintaining of isolation between quadrature elements of the coil. Modeling and bench measurements confirmed homogeneity of the field, which resulted in images with excellent fat suppression and in broadband proton-decoupled carbon-13 spectra. FCE is a straightforward approach to ensure equal currents on multiple coil elements and a homogeneous excitation field, insensitive to the effects of asymmetries in the electrical environment. This enabled effective breast imaging and proton-decoupled carbon-13 spectroscopy at 7T. © 2014 Wiley Periodicals, Inc.

  15. System and method for magnetic current density imaging at ultra low magnetic fields

    Science.gov (United States)

    Espy, Michelle A.; George, John Stevens; Kraus, Robert Henry; Magnelind, Per; Matlashov, Andrei Nikolaevich; Tucker, Don; Turovets, Sergei; Volegov, Petr Lvovich

    2016-02-09

    Preferred systems can include an electrical impedance tomography apparatus electrically connectable to an object; an ultra low field magnetic resonance imaging apparatus including a plurality of field directions and disposable about the object; a controller connected to the ultra low field magnetic resonance imaging apparatus and configured to implement a sequencing of one or more ultra low magnetic fields substantially along one or more of the plurality of field directions; and a display connected to the controller, and wherein the controller is further configured to reconstruct a displayable image of an electrical current density in the object. Preferred methods, apparatuses, and computer program products are also disclosed.

  16. Quantitative imaging biomarkers: the application of advanced image processing and analysis to clinical and preclinical decision making.

    Science.gov (United States)

    Prescott, Jeffrey William

    2013-02-01

    The importance of medical imaging for clinical decision making has been steadily increasing over the last four decades. Recently, there has also been an emphasis on medical imaging for preclinical decision making, i.e., for use in pharamaceutical and medical device development. There is also a drive towards quantification of imaging findings by using quantitative imaging biomarkers, which can improve sensitivity, specificity, accuracy and reproducibility of imaged characteristics used for diagnostic and therapeutic decisions. An important component of the discovery, characterization, validation and application of quantitative imaging biomarkers is the extraction of information and meaning from images through image processing and subsequent analysis. However, many advanced image processing and analysis methods are not applied directly to questions of clinical interest, i.e., for diagnostic and therapeutic decision making, which is a consideration that should be closely linked to the development of such algorithms. This article is meant to address these concerns. First, quantitative imaging biomarkers are introduced by providing definitions and concepts. Then, potential applications of advanced image processing and analysis to areas of quantitative imaging biomarker research are described; specifically, research into osteoarthritis (OA), Alzheimer's disease (AD) and cancer is presented. Then, challenges in quantitative imaging biomarker research are discussed. Finally, a conceptual framework for integrating clinical and preclinical considerations into the development of quantitative imaging biomarkers and their computer-assisted methods of extraction is presented.

  17. Adrenal lesions encountered in current medical practice − a review of their radiological imaging

    Directory of Open Access Journals (Sweden)

    Vanesha Naidu

    2013-11-01

    Full Text Available Modern radiological technology has transformed the way that adrenal lesions are currently investigated. The contemporary radiologist has been catapulted to the forefront in the management of adrenal disease. With the increasing use of cross-sectional imaging, adrenal lesions are being serendipitously discovered in radiological studies undertaken for non-adrenal-related conditions – the so-called adrenal ‘incidentaloma’. This review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population.

  18. An Algorithm for Surface Current Retrieval from X-band Marine Radar Images

    Directory of Open Access Journals (Sweden)

    Chengxi Shen

    2015-06-01

    Full Text Available In this paper, a novel current inversion algorithm from X-band marine radar images is proposed. The routine, for which deep water is assumed, begins with 3-D FFT of the radar image sequence, followed by the extraction of the dispersion shell from the 3-D image spectrum. Next, the dispersion shell is converted to a polar current shell (PCS using a polar coordinate transformation. After removing outliers along each radial direction of the PCS, a robust sinusoidal curve fitting is applied to the data points along each circumferential direction of the PCS. The angle corresponding to the maximum of the estimated sinusoid function is determined to be the current direction, and the amplitude of this sinusoidal function is the current speed. For validation, the algorithm is tested against both simulated radar images and field data collected by a vertically-polarized X-band system and ground-truthed with measurements from an acoustic Doppler current profiler (ADCP. From the field data, it is observed that when the current speed is less than 0.5 m/s, the root mean square differences between the radar-derived and the ADCP-measured current speed and direction are 7.3 cm/s and 32.7°, respectively. The results indicate that the proposed procedure, unlike most existing current inversion schemes, is not susceptible to high current speeds and circumvents the need to consider aliasing. Meanwhile, the relatively low computational cost makes it an excellent choice in practical marine applications.

  19. Current status of PET imaging in Huntington's disease

    Energy Technology Data Exchange (ETDEWEB)

    Pagano, Gennaro; Niccolini, Flavia; Politis, Marios [King' s College London, Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Camberwell, London (United Kingdom)

    2016-06-15

    To review the developments of recent decades and the current status of PET molecular imaging in Huntington's disease (HD). A systematic review of PET studies in HD was performed. The MEDLINE, Web of Science, Cochrane and Scopus databases were searched for articles in all languages published up to 19 August 2015 using the major medical subject heading ''Huntington Disease'' combined with text and key words ''Huntington Disease'', ''Neuroimaging'' and ''PET''. Only peer-reviewed, primary research studies in HD patients and premanifest HD carriers, and studies in which clinical features were described in association with PET neuroimaging results, were included in this review. Reviews, case reports and nonhuman studies were excluded. A total of 54 PET studies were identified and analysed in this review. Brain metabolism ([{sup 18}F]FDG and [{sup 15}O]H{sub 2}O), presynaptic ([{sup 18}F]fluorodopa, [{sup 11}C]β-CIT and [{sup 11}C]DTBZ) and postsynaptic ([{sup 11}C]SCH22390, [{sup 11}C]FLB457 and [{sup 11}C]raclopride) dopaminergic function, phosphodiesterases ([{sup 18}F]JNJ42259152, [{sup 18}F]MNI-659 and [{sup 11}C]IMA107), and adenosine ([{sup 18}F]CPFPX), cannabinoid ([{sup 18}F]MK-9470), opioid ([{sup 11}C]diprenorphine) and GABA ([{sup 11}C]flumazenil) receptors were evaluated as potential biomarkers for monitoring disease progression and for assessing the development and efficacy of novel disease-modifying drugs in premanifest HD carriers and HD patients. PET studies evaluating brain restoration and neuroprotection were also identified and described in detail. Brain metabolism, postsynaptic dopaminergic function and phosphodiesterase 10A levels were proven to be powerful in assessing disease progression. However, no single technique may be currently considered an optimal biomarker and an integrative multimodal imaging approach combining different techniques should be developed

  20. Current technological advances in magnetic resonance with critical impact for clinical diagnosis and therapy.

    Science.gov (United States)

    Runge, Val M

    2013-12-01

    The last 5 years of technological advances with major impact on clinical magnetic resonance (MR) are discussed, with greater emphasis on those that are most recent. These developments have already had a critical positive effect on clinical diagnosis and therapy and presage continued rapid improvements for the next 5 years. This review begins with a discussion of 2 topics that encompass the breadth of MR, in terms of anatomic applications, contrast media, and MR angiography. Subsequently, innovations are discussed by anatomic category, picking the areas with the greatest development, starting with the brain, moving forward to the liver and kidney, and concluding with the musculoskeletal system, breast, and prostate. Two final topics are then considered, which will likely, with time, become independent major fields in their own right, interventional MR and MR positron emission tomography (PET).The next decade will bring a new generation of MR contrast media, with research focused on substantial improvements (>100-fold) in relaxivity (contrast effect), thus providing greater efficacy, safety, and tissue targeting. Magnetic resonance angiography will see major advances because of the use of compressed sensing, in terms of spatial and temporal resolution, with movement away from nondynamic imaging. The breadth of available techniques and tissue contrast has greatly expanded in brain imaging, benefiting both from the introduction of new basic categories of imaging techniques, such as readout-segmented echo planar imaging and 3D fast spin echo imaging with variable flip angles, and from new refinements specific to anatomic areas, such as double inversion recovery and MP2RAGE. Liver imaging has benefited from the development of techniques to easily and rapidly assess lipid, and will see, overall, a marked improvement in the next 5 years from new techniques on the verge of clinical introduction, such as controlled aliasing in parallel imaging results in higher acceleration

  1. Analysis of Cancer Metabolism by Imaging Hyperpolarized Nuclei: Prospects for Translation to Clinical Research

    Directory of Open Access Journals (Sweden)

    John Kurhanewicz

    2011-02-01

    Full Text Available A major challenge in cancer biology is to monitor and understand cancer metabolism in vivo with the goal of improved diagnosis and perhaps therapy. Because of the complexity of biochemical pathways, tracer methods are required for detecting specific enzyme-catalyzed reactions. Stable isotopes such as 13C or 15N with detection by nuclear magnetic resonance provide the necessary information about tissue biochemistry, but the crucial metabolites are present in low concentration and therefore are beyond the detection threshold of traditional magnetic resonance methods. A solution is to improve sensitivity by a factor of 10,000 or more by temporarily redistributing the populations of nuclear spins in a magnetic field, a process termed hyperpolarization. Although this effect is short-lived, hyperpolarized molecules can be generated in an aqueous solution and infused in vivo where metabolism generates products that can be imaged. This discovery lifts the primary constraint on magnetic resonance imaging for monitoring metabolism—poor sensitivity—while preserving the advantage of biochemical information. The purpose of this report was to briefly summarize the known abnormalities in cancer metabolism, the value and limitations of current imaging methods for metabolism, and the principles of hyperpolarization. Recent preclinical applications are described. Hyperpolarization technology is still in its infancy, and current polarizer equipment and methods are suboptimal. Nevertheless, there are no fundamental barriers to rapid translation of this exciting technology to clinical research and perhaps clinical care.

  2. Multiday Transcranial Direct Current Stimulation Causes Clinically Insignificant Changes in Childhood Dystonia: A Pilot Study.

    Science.gov (United States)

    Bhanpuri, Nasir H; Bertucco, Matteo; Young, Scott J; Lee, Annie A; Sanger, Terence D

    2015-10-01

    Abnormal motor cortex activity is common in dystonia. Cathodal transcranial direct current stimulation may alter cortical activity by decreasing excitability while anodal stimulation may increase motor learning. Previous results showed that a single session of cathodal transcranial direct current stimulation can improve symptoms in childhood dystonia. Here we performed a 5-day, sham-controlled, double-blind, crossover study, where we measured tracking and muscle overflow in a myocontrol-based task. We applied cathodal and anodal transcranial direct current stimulation (2 mA, 9 minutes per day). For cathodal transcranial direct current stimulation (7 participants), 3 subjects showed improvements whereas 2 showed worsening in overflow or tracking error. The effect size was small (about 1% of maximum voluntary contraction) and not clinically meaningful. For anodal transcranial direct current stimulation (6 participants), none showed improvement, whereas 5 showed worsening. Thus, multiday cathodal transcranial direct current stimulation reduced symptoms in some children but not to a clinically meaningful extent, whereas anodal transcranial direct current stimulation worsened symptoms. Our results do not support transcranial direct current stimulation as clinically viable for treating childhood dystonia. © The Author(s) 2015.

  3. Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings

    International Nuclear Information System (INIS)

    Robinson, P.; Barron, D.A.; Grainger, A.J.; O'Connor, P.J.; Parsons, W.; Schilders, E.M.G.

    2004-01-01

    To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman's correlation. Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist (P=0.009). All other features showed no significant correlation (P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present (n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium (P=0.048 and P=0.023) but not non-gadolinium sequences (P>0.05). The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes' current symptoms in chronic adductor-related groin pain. (orig.)

  4. A Review of Material Properties Estimation Using Eddy Current Testing and Capacitor Imaging

    Directory of Open Access Journals (Sweden)

    Mohd. Amri Yunus

    2009-01-01

    Full Text Available he non destructive testing applications based on inductive (eddy current testing and capacitive sensors are widely used for imaging of material properties. The simple structure, safe to use, low cost, non contact application, good response at medium range frequency of the sensors make them preferable to be used in the industries. The aim of this study is to talk about the material properties estimation applications using eddy current testing and capacitive sensing. The basic operations of eddy current testing and capacitive sensing with example of application in the non destructive testing are discussed. Next, the recent advancements of eddy current testing and capacitive testing in imaging technique are presented in this paper.

  5. SLAP lesions: Anatomy, clinical presentation, MR imaging diagnosis and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Debra [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); MedRay Imaging and Fraser Health Authority, Vancouver, BC (Canada)], E-mail: cbchung@ucsd.edu; Mohana-Borges, Aurea; Borso, Maya; Chung, Christine B. [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)

    2008-10-15

    ABSTRACT: Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.

  6. Clinical and imaging features of neonatal chlamydial pneumonia

    International Nuclear Information System (INIS)

    Cao Yongli; Peng Yun; Sun Guoqiang

    2012-01-01

    Objective: To study the clinical and imaging features of chlamydial pneumonia in newborns. Methods: Medical records,chest X-Ray and CT findings of 17 neonates with chlamydia pneumonia were reviewed. The age was ranged from 9.0 to 28.0 days with mean of (16.8 ± 5.8) days. There were 11 males and 6 females. Sixteen were full term infants and one was born post term. All babies were examined with chest X-ray film, and 13 patients also underwent chest CT scan. Serologic test using immunofluorescence method for Chlamydia IgG and IgM antibodies were performed in all patients. Results: All newborns presented with cough but without fever. Positive results of the serologic tests were demonstrated. Chest films showed bilateral hyperventilation in 10 patients, diffuse reticular nodules in 10 patients including nodules mimicking military tuberculosis in 7 patients, and accompanying consolidation in 9 patients. CT features included interstitial reticular nodules in 13 patients with size, density, and distribution varied. Subpleural nodules (11 patients) and fusion of nodules (10 patients) predominated. Bilateral hyperinflation was found in 10 patients, which combined with infiltration in 12 patients, thickening of bronchovascular bundles in 10 patients, and ground glass sign in 5 patients. No pleural effusion and lymphadenopathy was detected in any patient. Conclusions: Bilateral hyperinflation and diffuse interstitial reticular nodules were the most common imaging features of neonatal chlamydial pneumonia. The main clinical characteristic of neonatal chlamydial pneumonia is respiratory symptoms without fever, which is helpful to its diagnosis. (authors)

  7. Osseous metastases of chordoma: imaging and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie; Torriani, Martin; Bredella, Miriam [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Chebib, Ivan [Massachusetts General Hospital, Department of Pathology, Boston, MA (United States)

    2017-03-15

    To describe the imaging and clinical characteristics of chordoma osseous metastases (COM). Our study was IRB approved and HIPAA compliant. A retrospective search of our pathology database for pathology-proven COM yielded 15 patients who had undergone MRI, CT, bone scan, and/or FDG-PET/CT. The imaging and clinical features of the COMs were recorded. A control group of age and gender matched chordoma patients without osseous metastasis was evaluated. The COM mean maximal dimension was 6.4 ± 4.0 cm. The majority (60%) of patients had one lesion. Extra-osseous soft tissue component was present in 85% and was larger than intra-osseous component in 76%. On MRI the lesions were heterogeneous but predominantly T2 hyperintense with hypointense septae, and with variable enhancement. On CT the lesions were typically destructive or permeative; calcifications were rare. The extent of the soft tissue component was isodense to muscle on CT and therefore better evaluated on MRI. COM was in a body part contiguous to the site of the primary tumor. Compared to the controls, COM patients were more likely to have local recurrence (P = 0.0009) and positive resection margins (P = 0.002). At 1 year, 33% of COM patients were deceased and 13% had progressive metastases. COM are associated with large extra-osseous soft tissue components, which are better visualized by MRI. They are often located in a body part contiguous to the site of the primary tumor, portend poor prognosis, and are associated with positive resection margins and local recurrence. (orig.)

  8. Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.

    Science.gov (United States)

    Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A

    2015-02-01

    A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." Copyright © 2015. Published by Elsevier Inc.

  9. Image registration in the brain: a test of clinical accuracy

    International Nuclear Information System (INIS)

    Rosenman, Julian; Miller, Elizabeth P.; Rinker, Lillian; Mukherji, Suresh; Tracton, Gregg; Cullip, Tim J.; Muller, Keith E.; DeLuca, Marla C.; Major, Stacey A.; Sailer, Scott; Varia, Mahesh

    1997-01-01

    Purpose/Objective: Accurate localization of tumor and normal structures is a critical step in the radiation treatment planning processes and has direct implications for tumor control success as well as normal tissue morbidity. We conducted a study to determine the accuracy of transferring tumor information from diagnostic images to the simulation films and planning CT with conventional methods using the best clinical judgment and compared that to tumor localization using 3D registration software. Materials and Methods: We measured the accuracy with which experienced clinicians could localize tumor volume from diagnostic images to either simulation films or a planning CT, with and without 3D registration software. To obtain absolute registration truth we used the method of identical pairs wherein a CT data set was duplicated and one copy resliced along a different plane than the original while maintaining the exact mathematical transformation between them. A tumor was then added to the resliced CT which became the surrogate diagnostic image. Because we were concerned that a CT/CT pair might be too easy to register, a simulated MR made by re-colorizing the resliced CT (to become a facsimile MR or fMR) was also used as a surrogate diagnostic image. Finally we studied the registration accuracy when a CT/(real)MR pair was used. The registration in this case could not be guaranteed to be exact, but the studies were obtained under carefully controlled conditions and were registered from bony landmarks using commercial radiosurgery software. A team of experts then placed the tumor from the resliced CT, fMR, or real MR to an AP and lateral 'isocenter simulation film' (a digitally reconstructed radiograph made from the unmarked CT) and to the 'planning CT' - also the unmarked CT. A registration of the data sets (CT/CT, CT/fMR and CT/MR) was also done using our 3D registration software. A total of thirty-six tasks on four subjects were performed. Four analyses (each with

  10. Current status and future prospects of the development of clinical Pharmacy in China: A SWOT analysis.

    Science.gov (United States)

    Rao, Yuefeng; Zhao, Qingwei; Zhang, Xiangyi; Yang, Hongyu; Lou, Yan; Zhang, Xingguo

    2016-03-01

    In many industrialized countries, clinical pharmacy has developed into a separate discipline and become a vital part of inpatient care in hospitals. However, as compared to many established branches of medicine, clinical pharmacy is still in its infancy, with much room for growth, improvement, and recognition by both the medical community and patients. In this study, a widely-recognized development strategy analysis tool, Strength, Weakness, Opportunity and Threat (SWOT), was used to systematically address several key issues to the development of clinical pharmacy in China. This analysis aims to provide feasible recommendations for the development of clinical pharmacy in China by identifying current problems and growth opportunities. Full development of clinical pharmacy as a mature clinical discipline will help promote the rational use of drugs by both clinicians and patients and lead to enhanced drug efficacy and safety.

  11. Preclinical magnetic resonance imaging and systems biology in cancer research: current applications and challenges.

    Science.gov (United States)

    Albanese, Chris; Rodriguez, Olga C; VanMeter, John; Fricke, Stanley T; Rood, Brian R; Lee, YiChien; Wang, Sean S; Madhavan, Subha; Gusev, Yuriy; Petricoin, Emanuel F; Wang, Yue

    2013-02-01

    Biologically accurate mouse models of human cancer have become important tools for the study of human disease. The anatomical location of various target organs, such as brain, pancreas, and prostate, makes determination of disease status difficult. Imaging modalities, such as magnetic resonance imaging, can greatly enhance diagnosis, and longitudinal imaging of tumor progression is an important source of experimental data. Even in models where the tumors arise in areas that permit visual determination of tumorigenesis, longitudinal anatomical and functional imaging can enhance the scope of studies by facilitating the assessment of biological alterations, (such as changes in angiogenesis, metabolism, cellular invasion) as well as tissue perfusion and diffusion. One of the challenges in preclinical imaging is the development of infrastructural platforms required for integrating in vivo imaging and therapeutic response data with ex vivo pathological and molecular data using a more systems-based multiscale modeling approach. Further challenges exist in integrating these data for computational modeling to better understand the pathobiology of cancer and to better affect its cure. We review the current applications of preclinical imaging and discuss the implications of applying functional imaging to visualize cancer progression and treatment. Finally, we provide new data from an ongoing preclinical drug study demonstrating how multiscale modeling can lead to a more comprehensive understanding of cancer biology and therapy. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  12. The left ventricle in aortic stenosis--imaging assessment and clinical implications.

    Science.gov (United States)

    Călin, Andreea; Roşca, Monica; Beladan, Carmen Cristiana; Enache, Roxana; Mateescu, Anca Doina; Ginghină, Carmen; Popescu, Bogdan Alexandru

    2015-04-29

    Aortic stenosis has an increasing prevalence in the context of aging population. In these patients non-invasive imaging allows not only the grading of valve stenosis severity, but also the assessment of left ventricular function. These two goals play a key role in clinical decision-making. Although left ventricular ejection fraction is currently the only left ventricular function parameter that guides intervention, current imaging techniques are able to detect early changes in LV structure and function even in asymptomatic patients with significant aortic stenosis and preserved ejection fraction. Moreover, new imaging parameters emerged as predictors of disease progression in patients with aortic stenosis. Although proper standardization and confirmatory data from large prospective studies are needed, these novel parameters have the potential of becoming useful tools in guiding intervention in asymptomatic patients with aortic stenosis and stratify risk in symptomatic patients undergoing aortic valve replacement.This review focuses on the mechanisms of transition from compensatory left ventricular hypertrophy to left ventricular dysfunction and heart failure in aortic stenosis and the role of non-invasive imaging assessment of the left ventricular geometry and function in these patients.

  13. A new fiducial marker for Image-guided radiotherapy of prostate cancer: Clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Hoejkjaer Larsen, Erik; Fabrin, Knud; Fisker, Rune V. (Dept. of Medical Physics, Oncology, Aalborg Hospital (Denmark))

    2008-08-15

    Background. A new fiducial marker for image guided radiotherapy (IGRT) based on a removable prostate stent made of Ni Ti has been developed during two previous clinical feasibility studies. The marker is currently being evaluated for IGRT treatment in a third clinical study. Method. The new marker is used to co-register MR and planning CT scans with high accuracy in the region around the prostate. The co-registered MR-CT volumes are used for delineation of GTV before planning. In each treatment session the IGRT system is used to position the patient before treatment. The IGRT system use a stereo pair of kV images matched to corresponding Digital Reconstructed Radiograms (DRR) from the planning CT scan. The match is done using mutual gray scale information. The pair of DRR's for positioning is created in the IGRT system with a threshold in the Look Up Table (LUT). The resulting match provides the necessary shift in couch coordinates to position the stent with an accuracy of 1-2 mm within the planned position. Results. At the present time 39 patients have received the new marker. Of the 39 one has migrated to the bladder. Deviations of more than 5 mm between CTV outlined on CT and MR are seen in several cases and in anterior-posterior (AP), left-right (LR) and cranial-caudal (CC) directions. Intra-fraction translation movements up to +/- 3 mm are seen as well. As the stent is also clearly visible on images taken with high voltage x-rays using electronic portal images devices (EPID), the positioning has been verified independently of the IGRT system. Discussion. The preliminary result of an on going clinical study of a Ni Ti prostate stent, potentially a new fiducial marker for image guided radiotherapy, looks promising. The risk of migration appears to be much lower compared to previous designs

  14. A new fiducial marker for Image-guided radiotherapy of prostate cancer: clinical experience.

    Science.gov (United States)

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Højkjaer Larsen, Erik; Fabrin, Knud; Fisker, Rune V

    2008-01-01

    A new fiducial marker for image guided radiotherapy (IGRT) based on a removable prostate stent made of Ni Ti has been developed during two previous clinical feasibility studies. The marker is currently being evaluated for IGRT treatment in a third clinical study. The new marker is used to co-register MR and planning CT scans with high accuracy in the region around the prostate. The co-registered MR-CT volumes are used for delineation of GTV before planning. In each treatment session the IGRT system is used to position the patient before treatment. The IGRT system use a stereo pair of kV images matched to corresponding Digital Reconstructed Radiograms (DRR) from the planning CT scan. The match is done using mutual gray scale information. The pair of DRR's for positioning is created in the IGRT system with a threshold in the Look Up Table (LUT). The resulting match provides the necessary shift in couch coordinates to position the stent with an accuracy of 1-2 mm within the planned position. At the present time 39 patients have received the new marker. Of the 39 one has migrated to the bladder. Deviations of more than 5 mm between CTV outlined on CT and MR are seen in several cases and in anterior-posterior (AP), left-right (LR) and cranial-caudal (CC) directions. Intra-fraction translation movements up to +/- 3 mm are seen as well. As the stent is also clearly visible on images taken with high voltage x-rays using electronic portal images devices (EPID), the positioning has been verified independently of the IGRT system. The preliminary result of an on going clinical study of a Ni Ti prostate stent, potentially a new fiducial marker for image guided radiotherapy, looks promising. The risk of migration appears to be much lower compared to previous designs.

  15. A new fiducial marker for Image-guided radiotherapy of prostate cancer: Clinical experience

    International Nuclear Information System (INIS)

    Carl, Jesper; Nielsen, Jane; Holmberg, Mats; Hoejkjaer Larsen, Erik; Fabrin, Knud; Fisker, Rune V.

    2008-01-01

    Background. A new fiducial marker for image guided radiotherapy (IGRT) based on a removable prostate stent made of Ni Ti has been developed during two previous clinical feasibility studies. The marker is currently being evaluated for IGRT treatment in a third clinical study. Method. The new marker is used to co-register MR and planning CT scans with high accuracy in the region around the prostate. The co-registered MR-CT volumes are used for delineation of GTV before planning. In each treatment session the IGRT system is used to position the patient before treatment. The IGRT system use a stereo pair of kV images matched to corresponding Digital Reconstructed Radiograms (DRR) from the planning CT scan. The match is done using mutual gray scale information. The pair of DRR's for positioning is created in the IGRT system with a threshold in the Look Up Table (LUT). The resulting match provides the necessary shift in couch coordinates to position the stent with an accuracy of 1-2 mm within the planned position. Results. At the present time 39 patients have received the new marker. Of the 39 one has migrated to the bladder. Deviations of more than 5 mm between CTV outlined on CT and MR are seen in several cases and in anterior-posterior (AP), left-right (LR) and cranial-caudal (CC) directions. Intra-fraction translation movements up to +/- 3 mm are seen as well. As the stent is also clearly visible on images taken with high voltage x-rays using electronic portal images devices (EPID), the positioning has been verified independently of the IGRT system. Discussion. The preliminary result of an on going clinical study of a Ni Ti prostate stent, potentially a new fiducial marker for image guided radiotherapy, looks promising. The risk of migration appears to be much lower compared to previous designs

  16. Clinical Characteristics and Current Treatment of Age-Related Macular Degeneration

    Science.gov (United States)

    Yonekawa, Yoshihiro; Kim, Ivana K.

    2015-01-01

    Age-related macular degeneration (AMD) is a multifactorial degeneration of photoreceptors and retinal pigment epithelium. The societal impact is significant, with more than 2 million individuals in the United States alone affected by advanced stages of AMD. Recent progress in our understanding of this complex disease and parallel developments in therapeutics and imaging have translated into new management paradigms in recent years. However, there are many unanswered questions, and diagnostic and prognostic precision and treatment outcomes can still be improved. In this article, we discuss the clinical features of AMD, provide correlations with modern imaging and histopathology, and present an overview of treatment strategies. PMID:25280900

  17. Significance of breast boost volume changes during radiotherapy in relation to current clinical interobserver variations

    International Nuclear Information System (INIS)

    Hurkmans, Coen; Admiraal, Marjan; Sangen, Maurice van der; Dijkmans, Ingrid

    2009-01-01

    Background and purpose: Nowadays, many departments introduce CT images for breast irradiation techniques, aiming to obtain a better accuracy in the definition of the relevant target volumes. However, the definition of the breast boost volume based on CT images requires further investigation, because it may not only vary between observers, but it may also change during the course of treatment. This study aims to quantify the variability of the CT based visible boost volume (VBV) during the course of treatment in relation to the variability between observers. Materials and methods: Ten patients with stage T1-2 invasive breast cancer treated with breast conservative surgery and post surgical radiotherapy were included in this study. In addition to the regular planning CT which is obtained several days prior to radiotherapy, three additional CT scans were acquired 3, 5 and 7 weeks after the planning CT scan. Four radiation oncologists delineated the VBV in all scans. Conformity of the delineations was analysed both between observers, and between scans taken at different periods of the radiotherapy treatment. Results: The VBV averaged over all patients decreased during the course of the treatment from an initial 40 cm 3 to 28 cm 3 , 27 cm 3 and 25 cm 3 after 3, 5 and 7 weeks, respectively. Assuming the VBV to be spherical, this corresponds to a reduction in diameter of 5-6 mm. More detailed analysis revealed that this reduction was more pronounced when radiotherapy started within 30 days after surgery. These boost volume changes over time were found to be significant (p = 0.02) even in the presence of interobserver variations. Moreover, the conformity index (CI) for the volume changes was of the same magnitude as the conformity index for the interobserver variation (0.25 and 0.31, respectively). Conclusions: Breast boost volume variations during a course of radiotherapy are significant in relation to current clinical interobserver variations. This is an important

  18. Late whiplash syndrome: a clinical and magnetic resonance imaging study.

    Science.gov (United States)

    Bonuccelli, U; Pavese, N; Lucetti, C; Renna, M R; Gambaccini, G; Bernardini, S; Canapicchi, R; Carrozzi, L; Murri, L

    1999-01-01

    Cervical hyperextension injuries are common and are associated with significant morbidity. Clinically two syndromes are described: "acute" whiplash syndrome and "late" whiplash syndrome (in which the patients are still symptomatic after six months despite normal physical and radiological examination). In order to clarify the pathology of the persistent pain in late whiplash syndrome we performed a cervical spine magnetic resonance imaging (MRI) in 33 consecutive patients suffering from this condition. Twenty-six patients (78.8%) showed MRI abnormalities, the most common MRI finding (57.6%) was pre-existent spondylosis. Indeed, the group of patients with spondylosis and other MRI changes had higher clinical scores than those without MRI abnormalities as measured by a three-point grading system based upon the symptoms and signs shown. Several MRI changes, most of them already demonstrable by standard X-ray were seen among 33 patients suffering from late whiplash syndrome. Although no one of these findings appears to be specific and certainly related to the previous neck injury, they could represent a risk factor for a longer pain duration.

  19. The artificial object detection and current velocity measurement using SAR ocean surface images

    Science.gov (United States)

    Alpatov, Boris; Strotov, Valery; Ershov, Maksim; Muraviev, Vadim; Feldman, Alexander; Smirnov, Sergey

    2017-10-01

    Due to the fact that water surface covers wide areas, remote sensing is the most appropriate way of getting information about ocean environment for vessel tracking, security purposes, ecological studies and others. Processing of synthetic aperture radar (SAR) images is extensively used for control and monitoring of the ocean surface. Image data can be acquired from Earth observation satellites, such as TerraSAR-X, ERS, and COSMO-SkyMed. Thus, SAR image processing can be used to solve many problems arising in this field of research. This paper discusses some of them including ship detection, oil pollution control and ocean currents mapping. Due to complexity of the problem several specialized algorithm are necessary to develop. The oil spill detection algorithm consists of the following main steps: image preprocessing, detection of dark areas, parameter extraction and classification. The ship detection algorithm consists of the following main steps: prescreening, land masking, image segmentation combined with parameter measurement, ship orientation estimation and object discrimination. The proposed approach to ocean currents mapping is based on Doppler's law. The results of computer modeling on real SAR images are presented. Based on these results it is concluded that the proposed approaches can be used in maritime applications.

  20. Magnetic resonance imaging in psoriatic arthritis -- update on current status and future perspectives

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Poggenborg, René Panduro

    2012-01-01

    and future development of MRI and other modern imaging modalities in PsA. This review, presented at the GRAPPA 2010 annual meeting, describes the current status of MRI in PsA, with a focus on its use in diagnosis, monitoring, and prediction of the disease course and treatment response. Important areas...... for future research are also outlined....

  1. Current techniques in postmortem imaging with specific attention to paediatric applications

    International Nuclear Information System (INIS)

    Sieswerda-Hoogendoorn, Tessa; Rijn, Rick R. van

    2010-01-01

    In this review we discuss the decline of and current controversies regarding conventional autopsies and the use of postmortem radiology as an adjunct to and a possible alternative for the conventional autopsy. We will address the radiological techniques and applications for postmortem imaging in children. (orig.)

  2. Current techniques in postmortem imaging with specific attention to paediatric applications

    Energy Technology Data Exchange (ETDEWEB)

    Sieswerda-Hoogendoorn, Tessa; Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam Zuid-Oost (Netherlands); Netherlands Forensic Institute, Department of Pathology and Toxicology, The Hague (Netherlands)

    2010-02-15

    In this review we discuss the decline of and current controversies regarding conventional autopsies and the use of postmortem radiology as an adjunct to and a possible alternative for the conventional autopsy. We will address the radiological techniques and applications for postmortem imaging in children. (orig.)

  3. Particle image velocimetry measurements and numerical modeling of a saline density current

    CSIR Research Space (South Africa)

    Gerber, G

    2011-03-01

    Full Text Available Particle image velocimetry scalar measurements were carried out on the body of a stably stratified density current with an inlet Reynolds number of 2,300 and bulk Richardson number of 0.1. These measurements allowed the mass and momentum transport...

  4. Current Brachytherapy Quality Assurance Guidance: Does It Meet the Challenges of Emerging Image-Guided Technologies?

    International Nuclear Information System (INIS)

    Williamson, Jeffrey F.

    2008-01-01

    In the past decade, brachytherapy has shifted from the traditional surgical paradigm to more modern three-dimensional image-based planning and delivery approaches. The role of intraoperative and multimodality image-based planning is growing. Published American Association of Physicists in Medicine, American College of Radiology, European Society for Therapeutic Radiology and Oncology, and International Atomic Energy Agency quality assurance (QA) guidelines largely emphasize the QA of planning and delivery devices rather than processes. These protocols have been designed to verify compliance with major performance specifications and are not risk based. With some exceptions, complete and clinically practical guidance exists for sources, QA instrumentation, non-image-based planning systems, applicators, remote afterloading systems, dosimetry, and calibration. Updated guidance is needed for intraoperative imaging systems and image-based planning systems. For non-image-based brachytherapy, the American Association of Physicists in Medicine Task Group reports 56 and 59 provide reasonable guidance on procedure-specific process flow and QA. However, improved guidance is needed even for established procedures such as ultrasound-guided prostate implants. Adaptive replanning in brachytherapy faces unsolved problems similar to that of image-guided adaptive external beam radiotherapy

  5. The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

    DEFF Research Database (Denmark)

    Keall, Paul J.; Aun Ng, Jin; O'Brien, Ricky

    2015-01-01

    on September 16, 2014. Methods: KIM uses current and prior 2D x-ray images to estimate the 3D target position during cancer radiotherapy treatment delivery. KIM software was written to process kilovoltage (kV) images streamed from a standard C-arm linear accelerator with a gantry-mounted kV x-ray imaging...... system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal......, and regulatory requirements were met for this clinical study. The quality assurance processes were completed and peer reviewed. Results: During treatment, a prostate position offset of nearly 3 mm in the posterior direction was observed with KIM. This position offset did not trigger a gating event. After...

  6. Imaging tissue hypoxia: clinical and pre-clinical experience with {sup 123}IAZA

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, L.I. [University of Alberta, Edmonton (Canada). Noujaim Institute for Pharmaceutical Oncology Research, Faculty of Pharmacy and Pharmaceutical Sciences

    1997-10-01

    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for {sup 123}IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of {sup 123} I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with {sup 99m}Tc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of {sup 123}I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for `2{sup 123}I- IAZA in normal volunteers 27 refs., 1 fig.

  7. Imaging tissue hypoxia: clinical and pre-clinical experience with 123IAZA

    International Nuclear Information System (INIS)

    Wiebe, L.I.

    1997-01-01

    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for 123 IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of 123 I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with 99m Tc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of 123 I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for '2 123 I- IAZA in normal volunteers

  8. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

  9. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    International Nuclear Information System (INIS)

    Rim, Chai Hong; Seong, Jin Sil

    2016-01-01

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy

  10. Imaging of current distributions in superconducting thin film structures; Abbildung von Stromverteilungen in supraleitenden Duennfilmstrukturen

    Energy Technology Data Exchange (ETDEWEB)

    Doenitz, D.

    2006-10-31

    Local analysis plays an important role in many fields of scientific research. However, imaging methods are not very common in the investigation of superconductors. For more than 20 years, Low Temperature Scanning Electron Microscopy (LTSEM) has been successfully used at the University of Tuebingen for studying of condensed matter phenomena, especially of superconductivity. In this thesis LTSEM was used for imaging current distributions in different superconducting thin film structures: - Imaging of current distributions in Josephson junctions with ferromagnetic interlayer, also known as SIFS junctions, showed inhomogeneous current transport over the junctions which directly led to an improvement in the fabrication process. An investigation of improved samples showed a very homogeneous current distribution without any trace of magnetic domains. Either such domains were not present or too small for imaging with the LTSEM. - An investigation of Nb/YBCO zigzag Josephson junctions yielded important information on signal formation in the LTSEM both for Josephson junctions in the short and in the long limit. Using a reference junction our signal formation model could be verified, thus confirming earlier results on short zigzag junctions. These results, which could be reproduced in this work, support the theory of d-wave symmetry in the superconducting order parameter of YBCO. Furthermore, investigations of the quasiparticle tunneling in the zigzag junctions showed the existence of Andreev bound states, which is another indication of the d-wave symmetry in YBCO. - The LTSEM study of Hot Electron Bolometers (HEB) allowed the first successful imaging of a stable 'Hot Spot', a self-heating region in HEB structures. Moreover, the electron beam was used to induce an - otherwise unstable - hot spot. Both investigations yielded information on the homogeneity of the samples. - An entirely new method of imaging the current distribution in superconducting interference

  11. Target volume definition for external beam partial breast radiotherapy: Clinical, pathological and technical studies informing current approaches

    International Nuclear Information System (INIS)

    Kirby, Anna M.; Coles, Charlotte E.; Yarnold, John R.

    2010-01-01

    Partial breast irradiation (PBI) is currently under investigation in several phase III trials and, following a recent consensus statement, its use off-study may increase despite ongoing uncertainty regarding optimal target volume definition. We review the clinical, pathological and technical evidence for target volume definition in external beam partial breast irradiation (EB-PBI). The optimal method of tumour bed (TB) delineation requires X-ray CT imaging of implanted excision cavity wall markers. The definition of clinical target volume (CTV) as TB plus concentric 15 mm margins is based on the anatomical distribution of multifocal and multicentric disease around the primary tumour in mastectomy specimens, and the clinical locations of local tumour relapse (LR) after breast conservation surgery. If the majority of LR originate from foci of residual invasive and/or intraduct disease in the vicinity of the TB after complete microscopic resection, CTV margin logically takes account of the position of primary tumour within the surgical resection specimen. The uncertain significance of independent primary tumours as sources of preventable LR, and of wound healing responses in stimulating LR, increases the difficulties in defining optimal CTV. These uncertainties may resolve after long-term follow-up of current PBI trials. By contrast, a commonly used 10 mm clinical to planning target volume (PTV) margin has a stronger evidence base, although departmental set-up errors need to be confirmed locally. A CTV-PTV margin >10 mm may be required in women with larger breasts and/or large seromas, whilst the role of image-guided radiotherapy with or without TB markers in reducing CTV-PTV margins needs to be explored.

  12. Current therapeutic interventions in the glycation pathway: evidence from clinical studies.

    Science.gov (United States)

    Engelen, L; Stehouwer, C D A; Schalkwijk, C G

    2013-08-01

    The increased formation of advanced glycation endproducts (AGEs) constitutes a potential mechanism of hyperglycaemia-induced micro- and macrovascular disease in diabetes. In vitro and animal experiments have shown that various interventions can inhibit formation and/or actions of AGEs, in particular the specific AGE inhibitor aminoguanidine and the AGEs crosslink breaker alagebrium, and the B vitamins pyridoxamine and thiamine, and the latter's synthetic derivative, benfotiamine. The potential clinical value of these interventions, however, remains to be established. The present review provides, from the clinical point of view, an overview of current evidence on interventions in the glycation pathway relating to (i) the clinical benefits of specific AGE inhibitors and AGE breakers and (ii) the potential AGE-inhibiting effects of therapies developed for purposes unrelated to the glycation pathway. We found that safety and/or efficacy in clinical studies with the specific AGE inhibitor, aminoguanidine and the AGE breaker, alagebrium, appeared to be a concern. The clinical evidence on the potential AGE-inhibiting effects of B vitamins is still limited. Finally, current evidence for AGE inhibition by therapies developed for purposes unrelated to glycation is limited due to a large heterogeneity in study designs and/or measurement techniques, which have often been sub-optimal. We conclude that, clinical evidence on interventions to inhibit formation and/or action of AGEs is currently weak and unconvincing. © 2012 Blackwell Publishing Ltd.

  13. Joint Probability Models of Radiology Images and Clinical Annotations

    Science.gov (United States)

    Arnold, Corey Wells

    2009-01-01

    Radiology data, in the form of images and reports, is growing at a high rate due to the introduction of new imaging modalities, new uses of existing modalities, and the growing importance of objective image information in the diagnosis and treatment of patients. This increase has resulted in an enormous set of image data that is richly annotated…

  14. A comparison between clinical assessment and magnetic resonance imaging of acute hamstring injuries

    NARCIS (Netherlands)

    Schneider-Kolsky, Michal E.; Hoving, Jan Lucas; Warren, Price; Connell, David A.

    2006-01-01

    BACKGROUND: Physicians evaluating hamstring strains in professional football players are increasingly turning to magnetic resonance imaging to support the clinical diagnosis and management of the injury. However, little information is available to assess how magnetic resonance imaging compares with

  15. Current globalization of drug interventional clinical trials: characteristics and associated factors, 2011-2013.

    Science.gov (United States)

    Jeong, Sohyun; Sohn, Minji; Kim, Jae Hyun; Ko, Minoh; Seo, Hee-Won; Song, Yun-Kyoung; Choi, Boyoon; Han, Nayoung; Na, Han-Sung; Lee, Jong Gu; Kim, In-Wha; Oh, Jung Mi; Lee, Euni

    2017-06-21

    Clinical trial globalization is a major trend for industry-sponsored clinical trials. There has been a shift in clinical trial sites towards emerging regions of Eastern Europe, Latin America, Asia, the Middle East, and Africa. Our study objectives were to evaluate the current characteristics of clinical trials and to find out the associated multiple factors which could explain clinical trial globalization and its implications for clinical trial globalization in 2011-2013. The data elements of "phase," "recruitment status," "type of sponsor," "age groups," and "design of trial" from 30 countries were extracted from the ClinicalTrials.gov website. Ten continental representative countries including the USA were selected and the design elements were compared to those of the USA. Factors associated with trial site distribution were chosen for a multilinear regression analysis. The USA, Germany, France, Canada, and United Kingdom were the "top five" countries which frequently held clinical trials. The design elements from nine continental representative countries were quite different from those of the USA; phase 1 trials were more prevalent in India (OR 1.517, p globalization of clinical trials in the emerging regions of Asia, South Africa, and Eastern Europe developed in parallel with the factors of economic drive, population for recruitment, and regulatory constraints.

  16. Clinical application of MR susceptibility weighted imaging in cerebrovascular diseases

    International Nuclear Information System (INIS)

    Zhu Wenzhen; Qi Jianpin; Shen Hao; Wang Chengyuan; Xia Liming; Hu Junwu; Feng Dingyi

    2007-01-01

    Objective: To assess clinical application value of susceptibility weighted imaging (SWI) in cerebrovascular diseases. Method: Twenty-three patients with cerebrovascular disease were investigated, including 7 cases of cavernoma, 4 of venous hemangioma, 3 of small AVM, 1 of Sturge-Weber Syndrome, 2 of cerebral venous sinus thrombosis and 6 of chronic cerebral infarction. All patients underwent standard Mill and SWI, and most of them also underwent enhanced T 1 WI and MRA. The corrected phase (CP) values were obtained at the lesions and control areas. Results: The average CP values of the lesions and the control areas were -0.112±0.032 and -0.013±0.004, respectively (t=2.167, P 2 WI. The cavemoma could be differentiated from the hemorrhage within lesions. Moreover, multiple microcavernomas were detected on SWI. In 4 cases of venous hemangioma, SWI detected spider-like lesions with more hair-thin pulp veins adjacent to the dilated draining vein than contrast MRI. In 3 cases of small AVM, SWI was more advantageous than MRA in clearly detecting the small feeding artery. In 1 case of Sturge-Weber Syndrome, SWI demonstrated large areas of calcification and the abnormal vessels on the cerebral surface and the deep part of the cerebrum at the same time. In 2 cases of cerebral venous sinus thrombosis, the deep draining veins and superficial venous rete were generally dilated and winding, and the hemorrhagic lesions could be detected earlier than conventional MR images in one case. In 6 eases of cerebral infarction, old hemorrhage was clearly displayed within the lesions. Conclusion: SWI has more predominant advantages than conventional MRI and MRA in detecting the low-flow cerebral vascular malformations, identifying microbleeds and cerebral infarction accompanying hemorrhage, and the dilation of cerebral deep or superficial veins in patients with cerebral venous sinus thrombosis. Moreover, SWI can show the phase contrast between the lesions and the control areas. (authors)

  17. A clinical trial with combined transcranial direct current stimulation and alcohol approach bias retraining

    NARCIS (Netherlands)

    den Uyl, T.E.; Gladwin, T.E.; Rinck, M.; Lindenmeyer, J.; Wiers, R.W.

    2017-01-01

    Two studies showed an improvement in clinical outcomes after alcohol approach bias retraining, a form of Cognitive Bias Modification (CBM). We investigated whether transcranial direct current stimulation (tDCS) could enhance effects of CBM. TDCS is a neuromodulation technique that can increase

  18. Delivering Communication Strategy Training for People with Aphasia: What Is Current Clinical Practice?

    Science.gov (United States)

    Beckley, Firle; Best, Wendy; Beeke, Suzanne

    2017-01-01

    Background: Communication strategy training (CST) is a recognized part of UK speech and language therapists' (SLTs) role when working with a person with aphasia. Multiple CST interventions have been published but, to date, there are no published studies exploring clinical practice in this area. Aims: To investigate UK SLTs' current CST practices.…

  19. Imaging of Myocardial Fibrosis in Patients with End-Stage Renal Disease: Current Limitations and Future Possibilities

    Directory of Open Access Journals (Sweden)

    M. P. M. Graham-Brown

    2017-01-01

    Full Text Available Cardiovascular disease in patients with end-stage renal disease (ESRD is driven by a different set of processes than in the general population. These processes lead to pathological changes in cardiac structure and function that include the development of left ventricular hypertrophy and left ventricular dilatation and the development of myocardial fibrosis. Reduction in left ventricular hypertrophy has been the established goal of many interventional trials in patients with chronic kidney disease, but a recent systematic review has questioned whether reduction of left ventricular hypertrophy improves cardiovascular mortality as previously thought. The development of novel imaging biomarkers that link to cardiovascular outcomes and that are specific to the disease processes in ESRD is therefore required. Postmortem studies of patients with ESRD on hemodialysis have shown that the extent of myocardial fibrosis is strongly linked to cardiovascular death and accurate imaging of myocardial fibrosis would be an attractive target as an imaging biomarker. In this article we will discuss the current imaging methods available to measure myocardial fibrosis in patients with ESRD, the reliability of the techniques, specific challenges and important limitations in patients with ESRD, and how to further develop the techniques we have so they are sufficiently robust for use in future clinical trials.

  20. A 16-channel receive, forced current excitation dual-transmit coil for breast imaging at 7T.

    Directory of Open Access Journals (Sweden)

    Samantha By

    Full Text Available To enable high spatial and temporal breast imaging resolution via combined use of high field MRI, array coils, and forced current excitation (FCE multi channel transmit.A unilateral 16-channel receive array insert was designed for use in a transmit volume coil optimized for quadrature operation with dual-transmit RF shimming at 7 T. Signal-to-noise ratio (SNR maps, g-factor maps, and high spatial and temporal resolution in vivo images were acquired to demonstrate the utility of the coil architecture.The dual-transmit FCE coil provided homogeneous excitation and the array provided an increase in average SNR of 3.3 times (max 10.8, min 1.5 compared to the volume coil in transmit/receive mode. High resolution accelerated in vivo breast imaging demonstrated the ability to achieve isotropic spatial resolution of 0.5 mm within clinically relevant 90 s scan times, as well as the ability to perform 1.0 mm isotropic resolution imaging, 7 s per dynamics, with the use of bidirectional SENSE acceleration of up to R = 9.The FCE design of the transmit coil easily accommodates the addition of a sixteen channel array coil. The improved spatial and temporal resolution provided by the high-field array coil with FCE dual-channel transmit will ultimately be beneficial in lesion detection and characterization.

  1. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: elcha@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd, E-mail: inbal@heh.regionh.dk [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Achiam, Michael, E-mail: micach01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Nielsen, Yousef W., E-mail: yujwni01@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Adamsen, Sven, E-mail: svad@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Gocht-Jensen, Peter, E-mail: petgoc01@heh.reginh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Brisling, Steffen K., E-mail: stkibr01@heh.regionh.dk [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke B., E-mail: viloe@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S., E-mail: heth@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)

    2011-08-15

    Purpose: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. Materials and methods: The prospective study included 48 consecutive patients (29 female, 19 male, 18-70 years old, mean age = 37.1 years). MRI examination was designed to be comfortable and fast; no contrast was administered. The sequences were performed during quiet respiration. The MRI findings were reviewed by two radiologists and one surgeon independent of each other and compared with surgical and pathological records. Results: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14 patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate ({kappa} = 0.51) and fair ({kappa} = 0.31) interobserver agreements in the MR diagnosis of acute appendicitis were found between the reviewers. Sensitivity, specificity and accuracy values for overall performance of MRI in detecting pelvic abnormalities were 100%, 75% (3 of 4 healthy patients were identified by MRI) and 98%, respectively. Conclusion: Unenhanced fast MRI is feasible as an additional fast screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths.

  2. Current clinical magnetoencephalography practice across Europe: Are we closer to use MEG as an established clinical tool?

    Science.gov (United States)

    De Tiège, Xavier; Lundqvist, Daniel; Beniczky, Sándor; Seri, Stefano; Paetau, Ritva

    2017-08-01

    This comprehensive survey aims at characterizing the current clinical use of magnetoencephalography (MEG) across European MEG centres. Forty-four MEG centres across Europe were contacted in May 2015 via personalized e-mail to contribute to survey. The web-based survey was available on-line for 1 month and the MEG centres that did not respond were further contacted to maximize participation. Among the 57% of responders, 12 centres from 10 different countries reported to use MEG for clinical applications. A total of 524 MEG investigations were performed in 2014 for the pre-surgical evaluation of epilepsy, while in the same period 244 MEG investigations were performed for pre-surgical functional brain mapping. Seven MEG centres located in different European countries performed ≥50 MEG investigations for epilepsy mapping in 2014, both in children and adults. In those centres, time from patient preparation to MEG data reporting tends to be lower than those investigating a lower annual number of patients. This survey demonstrates that there is in Europe an increasing and widespread expertise in the field of clinical MEG. These findings should serve as a basis to harmonize clinical MEG procedures and promote the clinical added value of MEG across Europe. MEG should now be considered in Europe as a mature clinical neurophysiological technique that should be used routinely in two specific clinical indications, i.e, the pre-surgical evaluation of refractory focal epilepsy and functional brain mapping. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Self-amplified CMOS image sensor using a current-mode readout circuit

    Science.gov (United States)

    Santos, Patrick M.; de Lima Monteiro, Davies W.; Pittet, Patrick

    2014-05-01

    The feature size of the CMOS processes decreased during the past few years and problems such as reduced dynamic range have become more significant in voltage-mode pixels, even though the integration of more functionality inside the pixel has become easier. This work makes a contribution on both sides: the possibility of a high signal excursion range using current-mode circuits together with functionality addition by making signal amplification inside the pixel. The classic 3T pixel architecture was rebuild with small modifications to integrate a transconductance amplifier providing a current as an output. The matrix with these new pixels will operate as a whole large transistor outsourcing an amplified current that will be used for signal processing. This current is controlled by the intensity of the light received by the matrix, modulated pixel by pixel. The output current can be controlled by the biasing circuits to achieve a very large range of output signal levels. It can also be controlled with the matrix size and this permits a very high degree of freedom on the signal level, observing the current densities inside the integrated circuit. In addition, the matrix can operate at very small integration times. Its applications would be those in which fast imaging processing, high signal amplification are required and low resolution is not a major problem, such as UV image sensors. Simulation results will be presented to support: operation, control, design, signal excursion levels and linearity for a matrix of pixels that was conceived using this new concept of sensor.

  4. Clinical practice of image-guided spine radiosurgery - results from an international research consortium

    Directory of Open Access Journals (Sweden)

    Guckenberger Matthias

    2011-12-01

    Full Text Available Abstract Background Spinal radiosurgery is a quickly evolving technique in the radiotherapy and neurosurgical communities. However, the methods of spine radiosurgery have not been standardized. This article describes the results of a survey about the methods of spine radiosurgery at five international institutions. Methods All institutions are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided radiosurgery. The questionnaire consisted of 75 items covering all major steps of spine radiosurgery. Results Strong agreement in the methods of spine radiosurgery was observed. In particular, similarities were observed with safety and quality assurance playing an important role in the methods of all institutions, cooperation between neurosurgeons and radiation oncologists in case selection, dedicated imaging for target- and organ-at-risk delineation, application of proper safety margins for the target volume and organs-at-risk, conformal planning and precise image-guided treatment delivery, and close clinical and radiological follow-up. In contrast, three major areas of uncertainty and disagreement were identified: 1 Indications and contra-indications for spine radiosurgery; 2 treatment dose and fractionation and 3 tolerance dose of the spinal cord. Conclusions Results of this study reflect the current practice of spine radiosurgery in large academic centers. Despite close agreement was observed in many steps of spine radiosurgery, further research in form of retrospective and especially prospective studies is required to refine the details of spinal radiosurgery in terms of safety and efficacy.

  5. Current and future diagnostic tools for traumatic brain injury: CT, conventional MRI, and diffusion tensor imaging.

    Science.gov (United States)

    Brody, David L; Mac Donald, Christine L; Shimony, Joshua S

    2015-01-01

    Brain imaging plays a key role in the assessment of traumatic brain injury. In this review, we present our perspectives on the use of computed tomography (CT), conventional magnetic resonance imaging (MRI), and newer advanced modalities such as diffusion tensor imaging. Specifically, we address assessment for immediately life-threatening intracranial lesions (noncontrast head CT), assessment of progression of intracranial lesions (noncontrast head CT), documenting intracranial abnormalities for medicolegal reasons (conventional MRI with blood-sensitive sequences), presurgical planning for post-traumatic epilepsy (high spatial resolution conventional MRI), early prognostic decision making (conventional MRI with diffusion-weighted imaging), prognostic assessment for rehabilitative planning (conventional MRI and possibly diffusion tensor imaging in the future), stratification of subjects and pharmacodynamic tracking of targeted therapies in clinical trials (specific MRI sequences or positron emission tomography (PET) ligands, e.g., diffusion tensor imaging for traumatic axonal injury). We would like to emphasize that all of these methods, especially the newer research approaches, require careful radiologic-pathologic validation for optimal interpretation. We have taken this approach in a mouse model of pericontusional traumatic axonal injury. We found that the extent of reduction in the diffusion tensor imaging parameter relative anisotropy directly correlated with the number of amyloid precursor protein (APP)-stained axonal varicosities (r(2)=0.81, p<0.0001, n=20 injured mice). Interestingly, however, the least severe contusional injuries did not result in APP-stained axonal varicosities, but did cause reduction in relative anisotropy. Clearly, both the imaging assessments and the pathologic assessments will require iterative refinement. © 2015 Elsevier B.V. All rights reserved.

  6. Central endoscopy reads in inflammatory bowel disease clinical trials: The role of the imaging core lab.

    Science.gov (United States)

    Ahmad, Harris; Berzin, Tyler M; Yu, Hui Jing; Huang, Christopher S; Mishkin, Daniel S

    2014-08-01

    Clinical trials in inflammatory bowel disease (IBD) are evolving at a rapid pace by employing central reading for endoscopic mucosal assessment in a field that was, historically, largely based on assessments by local physicians. This transition from local to central reading carries with it numerous technical, operational, and scientific challenges, many of which can be resolved by imaging core laboratories (ICLs), a concept that has a longer history in clinical trials in a number of diseases outside the realm of gastroenterology. For IBD trials, ICLs have the dual goals of providing objective, consistent assessments of endoscopic findings using central-reading paradigms whilst providing important expertise with regard to operational issues and regulatory expectations. This review focuses on current approaches to using ICLs for central endoscopic reading in IBD trials. © The Author(s) 2014. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

  7. Imaging technique and current status of valvular heart disease using cardiac MRI

    International Nuclear Information System (INIS)

    Lotz, J.; Sohns, J.M.

    2013-01-01

    The main indications for cardiac magnetic resonance imaging (MRI) in the evaluation of valvular heart disease are pathologies of the aortic and pulmonary valve. For mitral and tricuspid valve pathologies MRI is not the first line modality as these are usually well visualized by echocardiography. The advantages of MRI in valvular heart disease are a high reliability in the evaluation of ventricular volumes and function as well as the assessment of the perivalvular arterial or atrial structures. This reliability and the limitless access to any imaging plane partially compensates for the lower temporal and spatial resolution in comparison to echocardiography. In patients with congenital heart disease, cardiac MRI is established as a valuable diagnostic tool in daily clinical management, especially for the evaluation of pulmonary valve defects. Nevertheless, echocardiography remains the first-line diagnostic imaging tool for the foreseeable future. (orig.) [de

  8. 76 FR 51993 - Draft Guidance for Industry on Standards for Clinical Trial Imaging Endpoints; Availability

    Science.gov (United States)

    2011-08-19

    ... clinical trials of therapeutic drugs and biological products. The draft guidance describes standards... important imaging endpoint is used in a clinical trial of a therapeutic drug or biological product... Services to the Chairman of [[Page 51994

  9. Current status of PET imaging of neuroendocrine tumours ([18F]FDOPA, [68Ga]traces, [11C/[18F]-HTP)

    International Nuclear Information System (INIS)

    Ambrosini, A.; Morgini, J.J.; Nanni, C.; Castellucci, P.; Fanti, S.

    2015-01-01

    Neuroendocrine neoplasms (NEN) functional imaging is an evolving field that witnessed major advances in the past two decades. The routine use of PET/CT with an array of new radiotracers to specifically study NEN resulted in an increase in lesions detection. Currently, PET radiopharmaceuticals for NEN imaging include both metabolic ([18F]DOPA, [18F]FDG, [11C]/[18F]-HTP) and receptor-mediated compounds ([68Ga]DOTA-peptides). Discussion is still on-going regarding the clinical setting that may benefit the most from the use of one tracer over the other. [68Ga]DOTA-peptides are accurate for the detection of well differentiated NEN and are increasingly employed. Moreover, providing data on somatostatin receptors expression on NEN cells, they represent a fundamental procedure to be performed before starting therapy, as well as to guide treatment, with either hot or cold somatostatin analogues. The easy and economic synthesis process also favours their clinical employment even in centres without an on-site cyclotron. [18F]DOPA is accurate for studying well differentiated tumours however the difficult and expensive synthesis have limited its clinical employment. It currently can be successfully used for imaging tumours with variable to low expression of SSR (medullary thyroid carcinoma, neuroblastoma, pheocromocytoma), that cannot be accurately studied with [68Ga]DOTA-peptides. [11C]/[18F]-HTP has also been proposed to image well differentiated NEN, on the basis of serotonin pathway activity, for which [11C]/[18F]-HTP can be used as precursor. However, although preliminary data are encouraging, the feasibility of its widespread clinical use is still under discussion, mainly limited by a complex synthesis process and more proven advantages over other currently employed compounds. This review aims to provide an overview of the current status and clinical application of PET tracers to image well differentiated NEN and to focus on the still open-issues of debate

  10. Magnetic resonance imaging- physical principles and clinical application

    International Nuclear Information System (INIS)

    Tavri, O.J.

    1996-01-01

    The advances in imaging techniques for better and efficient diagnosis have become possible with the advent of Magnetic Resonance Imaging (MRI). The modalities of MRI technique for indication and diagnosis are mentioned in with typical examples. (author)

  11. Digital Breast Imaging Warehouse for Research and Clinical Decision Support

    National Research Council Canada - National Science Library

    Zhang, Hong

    2001-01-01

    Breast imaging is used intensively for breast cancer detection. As routine screening examination becomes more popular for women over 40, tremendous amount of breast imaging data has been accumulated...

  12. Carotid and vertebral artery dissections: clinical aspects, imaging features and endovascular treatment

    International Nuclear Information System (INIS)

    Flis, Christine M.; Jaeger, H.R.; Sidhu, Paul S.

    2007-01-01

    Extracranial arterial dissections are a recognised cause of stroke, particularly in young adults. Clinical diagnosis may be difficult, and the classical triad of symptoms is uncommon. Imaging plays a pivotal role in the diagnosis of extracranial arterial dissections, and this review provides a detailed discussion of the relative merits and limitations of currently available imaging modalities. Conventional arteriography has been the reference standard for demonstrating an intimal flap and double lumen, which are the hallmarks of a dissection, and for detecting complications such as stenosis, occlusion or pseudoaneurysm. Noninvasive vascular imaging methods, such as ultrasound (US), magnetic resonance angiography (MRA) and computed tomography angiography (CTA) are increasingly replacing conventional angiography for the diagnosis of carotid and vertebral dissections. Ultrasound provides dynamic and ''real-time'' information regarding blood flow. Source data of MRA and CTA and additional cross-sectional images can provide direct visualisation of the mural haematoma and information about the vessel lumen. Anticoagulation to prevent strokes is the mainstay of medical treatment, but randomised trials to define the optimal treatment regime are lacking. Surgery has a limited role in management of dissections, but endovascular procedures are gaining importance for treatment of complications and if medical management fails. (orig.)

  13. Identification of radiation induced dark current sources in pinned photodiode CMOS image sensors

    International Nuclear Information System (INIS)

    Goiffon, V.; Virmontois, C.; Magnan, P.; Cervantes, P.; Place, S.; Estribeau, M.; Martin-Gonthier, P.; Gaillardin, M.; Girard, S.; Paillet, P.

    2012-01-01

    This paper presents an investigation of Total Ionizing Dose (TID) induced dark current sources in Pinned Photodiodes (PPD) CMOS Image Sensors based on pixel design variations. The influence of several layout parameters is studied. Only one parameter is changed at a time enabling the direct evaluation of its contribution to the observed device degradation. By this approach, the origin of radiation induced dark current in PPD is localized on the pixel layout. The PPD peripheral shallow trench isolation does not seem to play a role in the degradation. The PPD area and a transfer gate contribution independent of the pixel dimensions appear to be the main sources of the TID induced dark current increase. This study also demonstrates that applying a negative voltage on the transfer gate during integration strongly reduces the radiation induced dark current. (authors)

  14. Eddy current imaging for electrical characterization of silicon solar cells and TCO layers

    Science.gov (United States)

    Hwang, Byungguk; Hillmann, Susanne; Schulze, Martin; Klein, Marcus; Heuer, Henning

    2015-03-01

    Eddy Current Testing has been mainly used to determine defects of conductive materials and wall thicknesses in heavy industries such as construction or aerospace. Recently, high frequency Eddy Current imaging technology was developed. This enables the acquirement of information of different depth level in conductive thin-film structures by realizing proper standard penetration depth. In this paper, we summarize the state of the art applications focusing on PV industry and extend the analysis implementing achievements by applying spatially resolved Eddy Current Testing. The specific state of frequency and complex phase angle rotation demonstrates diverse defects from front to back side of silicon solar cells and characterizes homogeneity of sheet resistance in Transparent Conductive Oxide (TCO) layers. In order to verify technical feasibility, measurement results from the Multi Parameter Eddy Current Scanner, MPECS are compared to the results from Electroluminescence.

  15. Image-guided drug delivery: preclinical applications and clinical translation

    NARCIS (Netherlands)

    Ojha, Tarun; Rizzo, Larissa; Storm, Gerrit; Kiessling, Fabian; Lammers, Twan Gerardus Gertudis Maria

    2015-01-01

    Image-guided drug delivery refers to the combination of drug targeting and imaging. Preclinically, image-guided drug delivery can be used for several different purposes, including for monitoring biodistribution, target site accumulation, off-target localization, drug release and drug efficacy.

  16. The effects of bismuth breast shields in conjunction with automatic tube current modulation in CT imaging

    International Nuclear Information System (INIS)

    Servaes, Sabah; Zhu, Xiaowei

    2013-01-01

    There are mechanisms within CT scanners and shielding that can be used to lower dose to patients. The objective of our study was to evaluate the dose changes and image quality with and without a breast shield for multidetector CT of the chest with angular tube current modulation. An anthropomorphic 5-year-old phantom was scanned with and without bismuth breast shielding and with and without angular tube current modulation. Image quality was assessed by measuring signal-to-noise ratio and contrast-to-noise ratio as well as measuring qualitatively. ANOVA single-factor p-value analysis of paired datasets was used for the statistical analysis. The breast shielding and angular tube current modulation resulted in a dose reduction to 85% for the breast and 90% overall. Although no qualitative differences were noted with and without the breast shielding used with angular tube current modulation, there were statistically significant differences in the contrast-to-noise ratio and CT numbers. When used with angular tube current modulation, breast shields influence the contrast-to-noise ratio and CT numbers, and therefore should not be used for chest CT. Greater dose reduction can be obtained by reducing the reference mAs (or reference noise index). (orig.)

  17. Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

    DEFF Research Database (Denmark)

    O'Brien, P.J.; Fournel-Fleury, C.; Bolliger, Adrian Marc

    2007-01-01

    congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges......After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP)was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has......; currently there are 18 resident trainingprograms inEurope; 3) administration of 3 annual board-certifying examinations thus far,wit