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Sample records for intra-arterial digital subtraction

  1. Clinical application of cerebral circulation time measured by intra-arterial digital subtraction angiography

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    Okada, Yoshikazu; Shima, Takeshi; Nishida, Masahiro; Yamane, Kanji; Okita, Shinji; Yoshida, Akira; Naoe, Yasutaka; Shiga, Naoko (Chugoku Rosai Hospital, Hiroshima (Japan))

    1994-08-01

    Digital subtraction angiography (DSA) made it possible not only to visualize the intracranial fine vasculature but also measure the density of contrast medium at the arbitrary region of interest (ROI). In this study we applied this intra-arterial DSA (IA-DSA) to measure cerebral circulation time by obtaining time-density curve at the two ROI's at the C3-C4 portion and the Rolandic vein. Circulation time was defined by the time difference between the peak optical density time at the two sites. The control value of circulation time was 3.4 sec on the average, which correlated with the age of cases. In patients with occlusive cerebrovascular diseases such as carotid arterial occlusion or with mass lesions such as hematoma and brain tumor, circulation time was significantly delayed. On the contrary, circulation time in arteriovenous malformation was demonstrated to be very short. Additionally circulation time was investigated in subarachnoid hemorrhage due to ruptured aneurysm. Circulation time in patients with none, slight to moderate and severe vasospasm following subarachnoid hemorrhage were 3.6, 4.3 and 6.8 sec on the average, respectively. And ten patients presenting with low densitity area on CT scans showed significantly long circulation time, 7.0 sec on the average. From these studies cerebral circulation time by IA-DSA would be one of the useful methods to clarify cerebral hemodynamics. (author).

  2. Cost-Effectiveness of Magnetic Resonance Angiography Versus Intra-arterial Digital Subtraction Angiography to Follow-Up Patients With Coiled Intracranial Aneurysms

    NARCIS (Netherlands)

    Schaafsma, Joanna D.; Koffijberg, Hendrik; Buskens, Erik; Velthuis, Birgitta K.; van der Graaf, Yolanda; Rinkel, Gabriel J. E.

    Background and Purpose-To follow up patients with coiled intracranial aneurysms, magnetic resonance angiography (MRA) is a promising noninvasive alternative to current standard intra-arterial digital subtraction angiography (IA-DSA). MRA test results do not always concord with those of IA-DSA, and

  3. Cost-effectiveness of magnetic resonance angiography versus intra-arterial digital subtraction angiography to follow-up patients with coiled intracranial aneurysms

    NARCIS (Netherlands)

    Schaafsma, Joanna D.; Koffijberg, Hendrik; Buskens, Erik; Velthuis, Birgitta K.; van der Graaf, Yolanda; Rinkel, Gabriël J.E.

    Background and Purpose-: To follow up patients with coiled intracranial aneurysms, magnetic resonance angiography (MRA) is a promising noninvasive alternative to current standard intra-arterial digital subtraction angiography (IA-DSA). MRA test results do not always concord with those of IA-DSA, and

  4. Advantages and limitation of intra-arterial digital subtraction angiography (i.a. DSA)

    International Nuclear Information System (INIS)

    Beduhn, D.

    1986-01-01

    Among 3000 digital subtraction angiographies which have been performed in our institute, 850 patients have been examined intraarterially. The advantage of i.a. DSA is due to the excellent demonstration of vessels in survey angiograms by small amounts of contrast medium (10-20 ml in the aorta), without risk of selective catheterisation into the neck vessels, the saving of expensive film series, the short duration of vessel examinations and the small complication rate. i.a. DSA can be carried out on outpatients also, using the 4/5 F-catheter, which saves hospital charges. Impressive examples show the advantages of i.a. DSA. (orig.) [de

  5. Intra-Arterial MR Perfusion Imaging of Meningiomas: Comparison to Digital Subtraction Angiography and Intravenous MR Perfusion Imaging.

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    Mark A Lum

    Full Text Available To evaluate the ability of IA MR perfusion to characterize meningioma blood supply.Studies were performed in a suite comprised of an x-ray angiography unit and 1.5T MR scanner that permitted intraprocedural patient movement between the imaging modalities. Patients underwent intra-arterial (IA and intravenous (IV T2* dynamic susceptibility MR perfusion immediately prior to meningioma embolization. Regional tumor arterial supply was characterized by digital subtraction angiography and classified as external carotid artery (ECA dural, internal carotid artery (ICA dural, or pial. MR perfusion data regions of interest (ROIs were analyzed in regions with different vascular supply to extract peak height, full-width at half-maximum (FWHM, relative cerebral blood flow (rCBF, relative cerebral blood volume (rCBV, and mean transit time (MTT. Linear mixed modeling was used to identify perfusion curve parameter differences for each ROI for IA and IV MR imaging techniques. IA vs. IV perfusion parameters were also directly compared for each ROI using linear mixed modeling.18 ROIs were analyzed in 12 patients. Arterial supply was identified as ECA dural (n = 11, ICA dural (n = 4, or pial (n = 3. FWHM, rCBV, and rCBF showed statistically significant differences between ROIs for IA MR perfusion. Peak Height and FWHM showed statistically significant differences between ROIs for IV MR perfusion. RCBV and MTT were significantly lower for IA perfusion in the Dural ECA compared to IV perfusion. Relative CBF in IA MR was found to be significantly higher in the Dural ICA region and MTT significantly lower compared to IV perfusion.

  6. Three-dimensional CT-angiography after cerebral aneurysm clipping. Comparison with intra-arterial digital subtraction angiography

    International Nuclear Information System (INIS)

    Sakuma, Ikuo; Tomura, Noriaki; Takahashi, Satoshi; Omachi, Koichi; Otani, Takahiro; Watarai, Jiro; Kinouchi, Hiroyuki; Mizoi, Kazuo

    2004-01-01

    To assess the significance of three-dimensional CT-angiography (3D-CTA) in detecting remnant necks after cerebral aneurysm clipping, 3D-CTA was compared with intra-arterial digital subtraction angiography (IADSA). Fifty-nine patients (79 aneurysms) underwent both IADSA and 3D-CTA after cerebral aneurysm clipping. A single detector spiral scanner was used for 3D-CTA. Shaded surface display (SSD) and volume rendered (VR) images were produced from each data set. Two blinded observers independently evaluated the presence of remnant necks on SSD images, VR images and IADSA. Results jointly evaluated by three observers were applied as the gold standard to assess diagnostic accuracy of each image. Diagnostic performance of each image was evaluated using receiver operating characteristic (ROC) analysis. Mean sensitivity and specificity of SSD images for detecting remnant necks were 50.0% and 74.2%, respectively. VR images displayed a mean sensitivity and specificity of 63.3% and 82.8%, respectively. IADSA demonstrated a mean sensitivity and specificity of 93.3% and 92.2%, respectively. Under ROC analysis, IADSA displayed excellent diagnostic performance (mean Az [area under ROC curve]=0.97). While 3D-CTA demonstrated good diagnostic performance (0.68 and 0.76 for SSD and VR, respectively), it was significantly inferior to IADSA (P<.001). Mean Az for VR imaging was significantly superior to that for SSD imaging (P<.001). Following clipping surgery for cerebral aneurysms, 3D-CTA, and particularly VR imaging, is useful for postoperative evaluation. As a noninvasive alternative, 3D-CTA could be recommended for routine use. However, IADSA should still be performed when 3D-CTA yields uncertain results. (author)

  7. Magnetic resonance evaluation of renal artery stenosis in a swine model: performance of low-dose gadobutrol versus gadoterate meglumine in comparison with digital subtraction intra-arterial catheter angiography.

    Science.gov (United States)

    Morelli, John N; Runge, Val M; Ai, Fei; Zhang, Wei; Li, Xiaoming; Schmitt, Peter; McNeal, Gary; Miller, Matthew; Lennox, Mark; Wusten, Oliver; Schoenberg, Stefan O; Attenberger, Ulrike I

    2012-06-01

    The aim of this study was to compare low-dose imaging with gadobutrol and gadoterate meglumine (Gd-DOTA) for evaluation of renal artery stenosis with 3-T magnetic resonance angiography (MRA) in a swine model. A total of 12 experimental animals were evaluated using equivalently dosed gadobutrol and Gd-DOTA for time-resolved and static imaging. For time-resolved imaging, the time-resolved imaging with stochastic trajectories (TWIST) technique (temporal footprint, 4.4 seconds) was used; a dose of 1 mL of gadobutrol was injected at 2 mL/s and a dose of 2 mL of Gd-DOTA was injected at both 2 and 4 mL/s. For a separate static acquisition, doses were doubled. The static scans were used for stenosis gradation and the time-resolved scans for comparison of enhancement dynamics, signal-to-noise ratio (SNR), and qualitative assessments. The average magnitude of difference in the stenosis measurements with static gadobutrol scans relative to digital subtraction intra-arterial catheter angiography (mean [SD], 7.4% [5.6%]) was less than with both the 2 mL/s (10.6% [6.2%]) and 4 mL/s (11.5% [7.8%]) Gd-DOTA MRA protocols. On time-resolved scans, peak signal-to-noise ratio was greatest with the gadobutrol protocol (P < 0.05), and the gadobutrol TWIST scan was preferred to the TWIST Gd-DOTA scan in terms of image quality and stenosis visualization in every case for every reader. Low-dose gadobutrol (~0.05 mmoL/kg) contrast-enhanced MRA results in improved accuracy of renal artery stenosis assessments relative to equivalently dosed Gd-DOTA at 3 T.

  8. Intra-arterial thrombolysis of digital artery occlusions in a patient with polycythemia vera.

    Science.gov (United States)

    Jud, Philipp; Hafner, Franz; Gary, Thomas; Ghanim, Leyla; Lipp, Rainer; Brodmann, Marianne

    2017-01-01

    There are limited therapeutic options for the resolution of digital artery occlusions. Intra-arterial thrombolysis with anticoagulative and thrombolytic drugs successfully restored the blood flow in the affected digital arteries.

  9. Intra-arterial digital angiography of the liver

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    Dalla Palma, L.; Stacul, F.; Maffessanti, M.; Pozzi-Mucelli, R.

    1983-08-01

    The authors report the preliminary results of the intraarterial digital angiography of the liver. A series of 30 patients were examined comparing conventional and digital technique following the injection of the coeliac, splenic, hepatic and mesenteric arteries. The results obtained with the digital technique have been of good quality and sometimes even better in spite of significant dilution of the contrast medium. It is concluded that intraarterial digital angiography of the liver gives some advantages compared with the conventional technique, that is the use of a much lower concentrated contrast medium, the better visualization of the portal branches and its collaterals and the very low cost of the film material.

  10. Acute subarachnoid haemorrhage: 3D time-of-flight MR angiography versus intra-arterial digital angiography

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    Anzalone, N. [Dept. of Neuroradiology, Scientific Inst. H. S. Raffaele, Milan (Italy); Triulzi, F. [Dept. of Neuroradiology, Scientific Inst. H. S. Raffaele, Milan (Italy); Scotti, G. [Dept. of Neuroradiology, Scientific Inst. H. S. Raffaele, Milan (Italy)

    1995-05-01

    To evaluate the efficacy and reliability of 3D time-of-flight MR angiography (TOF MRA) as a noninvasive procedure, 27 patients with acute subarachnoid haemorrhage (SAH) were studied with MRA immediately before or after intra-arterial digital subtraction angiography (DSA). 3DTOF MRA was performed with an axial slab of 60 mm centred on the circle of Willis and isotropic voxels. DSA showed 22 aneurysms and 1 dural arteriovenous fistula in 21 patients; the aneurysms ranged in size from 2 to 8 mm. MRA failed to show 2 small aneurysms, at the origin of the posterior and anterior communicating arteries. The 3D display of the intracranial vessels obtained with maximum intensity projection (MIP) or targetted MIP sometimes rendered the aneurysms better than DSA. However, due to its high spatial resolution, DSA more clearly defined the overall anatomy of the walls of the normal and abnormal vessels. (orig.)

  11. Digital subtraction angiography in ischemic cerebrovascular accidents

    International Nuclear Information System (INIS)

    Manelfe, C.; Bonafe, A.; Ducos de Lahitte, M.; Rascol, A.; Prere, J.; Guiraud, B.; Marc-Vergnes, J.P.

    1983-01-01

    Recent advances in computer and radiological technology have permitted reassessment of intravenous angiography in the evaluation of cerebrovascular disorders. Although digital subtraction angiography is a relatively new technique, it has rapidly gained a widespread acceptance. It has extended the use of angiography to outpatients and to people in whom conventional angiography is contraindicated. This reliable, safe, and relatively noninvasive technique offers the user two benefits: real-time subtraction and enhanced image quality. The system allows angiographic evaluation of the extracranial and intracranial vessels by means of intravenous injection of contrast material. Extracranial studies clearly demonstrate stenoses and occlusions of the major cervicocephalic arteries. Intracranial studies usually detect major cerebrovascular occlusions and provide insight into the collateral flow patterns. Intravenous digital subtraction angiography permits accurate assessment of cervicocephalic vessels after surgical repair. Although intravenous digital subtraction angiography obviates the need for conventional angiography in many cases, movements from the patients, or superimposition of vascular structures can substantially degrade the quality of the images. Digital subtraction angiography with intra-arterial injection of contrast medium will be contemplated in patients with poor intravenous digital subtraction angiography studies prior to surgery [fr

  12. Digital subtraction angiography (DSA)

    International Nuclear Information System (INIS)

    Lackner, K.; Janson, R.; Franken, T.; Harder, T.; Thurn, P.

    1983-01-01

    Digital subtraction angiography is an advanced subtraction technique and a new field in which i.v. injection of contrast media is required. Conventional techniques involving i.v. injection of contrast media have the following drawbacks: 1. High amounts of contrast media; 2. simultaneous injection into the brachial veins of both arms; 3. poor imaging of blood vessels in regions with strongly varying X-ray absorption characteristics of the background; 4. no possibility of contrast amplification. In conventional subtraction techniques, image processing takes place as a second step after the examination, so that results are not immediately available for interpretation. Digital subtraction angiography largely avoids these drawbacks. (orig./MG) [de

  13. Development of Shimadzu digital subtraction system

    International Nuclear Information System (INIS)

    Nishioka, Hiroyuki; Shibata, Koichi; Shimizu, Yasumitsu; Shibata, Kenji; Wani, Hidenobu

    1985-01-01

    Shimadzu has recently developed a digital subtraction system. It can perform intra-arterial digital subtraction angiography (DSA) using low concentration of contrast medium, or can visualize arteries with intravenuous injection. It can extremely reduce patient's pain in angiography. Image quality of DSA has been much improved by the development of high quality image amplifiers, improvement of signal-to-noise ratio of the x-ray television unit and the development of digital disk recorders. The peak-hold subtraction method that is now under clinical study presents images of blood vessels as the trace of the flow of contrast medium. The maximum-hold memory where the maximum value of the brightness in some period is stored for every picture element is subtracted from the minimum-hold memory where the minimum value is stored, and thus images of blood vessels can be obtained. Hardware of this method is rather simple and it is expected that the amount of contrast medium may be reduced or x-ray dose of the patient may be decreased. (author)

  14. Intraarterial digital subtraction angiography

    International Nuclear Information System (INIS)

    Davis, P.C.

    1987-01-01

    Digital subtraction angiography (DSA) refers to a radiographic technique of amplifying low levels of contrast from intravascular iodine into an acceptable image of vascular anatomy. Initial enthusiasm suggested that DSA using intravenous injections (IV-DSA) would eliminate most conventional film-screen angiographic studies. It was soon apparent, however, that IV-DSA examinations were often compromised in those patients who most needed a less invasive study. Indeed, only a 70 to 85 percent accuracy rate was achieved with IV-DSA, primarily due to motion artifact, poor cardiac output, overlap of pertinent vessels, and inability to resolve smaller vessels

  15. Intraarterial digital subtraction angiography in bronchogenic carcinoma treated with bronchial artery infusion

    International Nuclear Information System (INIS)

    Gao-Jun Teng; Xi-Lei Chai; Guang-Ru Gao; Cheng-Fong Chu; Xian-Guang Zhou; Zhu-Yi Zhang; Ru-Li Xiang

    1991-01-01

    Intra-arterial digital subtraction angiography (IADSA) has been used with advantage for control of the results of bronchial artery infusion of drugs for primarily unresectable bronchogenic carcinoma. The IADSA has been performed as road mapping prior to therapy. Drug treatment has been performed with 4 different regimes, depending on tumour type. Debulking and in some cases complete healing are the results, which are superior to other reported treatments. (author). 7 refs.; 4 figs.; 3 tabs

  16. Digital subtraction angiography of inferior gluteal artery through the infusion catheter of chemotherapy for bladder cancer

    International Nuclear Information System (INIS)

    Ishikawa, Satoru; Noguchi, Ryosuke; Kanoh, Shori; Shimazui, Toru; Uchida, Katsunori; Nemoto, Ryosuke; Koiso, Kenkichi

    1987-01-01

    More than fifty patients of invasive bladder cancer had been treated by selective intra-arterial chemotherapy through the inferior or superior gluteal arteries. The distribution of infused drugs had been evaluated by RI-angiography through a thin arterial infusion catheter. This time we performed digital subtraction angiography (DSA) through an infusion catheter in order to know the precise distribution of infused materials in seven patients with locally advanced bladder cancer. Pharmaco-DSA with norepinephrine was also done in four patients. Satisfactory spatial and contrast resolution were gained in four patients and pharmaco-DSA showed better quality. In our experience DSA through intra-arterial infusion catheter was a useful procedure in the evaluation of distribution of infused drugs. (author)

  17. Exercise intravenous digital subtraction angiography

    International Nuclear Information System (INIS)

    Yiannikas, J.

    1986-01-01

    Attempts to use exercise ventriculography have been made, not only to give diagnostic and perhaps even prognostic information in patients with coronary artery disease, but also in patients with valvular heart disease both before and after surgical intervention. Clearly an accurate method of assessing ventricular function under conditions of stress in various cardiac diseases would provide important information that would help in patient management. Exercise ventriculography using gated blood pool equilibrium technetium studies are widely used, but are limited by spatial resolution and by the foreshortening affects of visualizing the left ventricular chamber in the left anterior oblique view. First pass radionuclide studies have the added advantage of being able to visualize the ventricular chamber in the anterior or even the right anterior oblique view, but are even more limited by their spatial resolution problems. Several investigations have shown that digital subtraction angiography produces left ventricular images with a spatial resolution almost identical to that of conventional contrast ventriculography, but without the inherent problems of cardiac arrhythmias, which often limit the assessment of left ventricular function. Because of its ability to accurately delineate wall motion abnormalities, the technique may provide an adequate assessment of global and regional left ventricular function after exercise. Digital subtraction angiography may identify ischemic wall motion abnormalities produced by exercise in patients who already had significant permanent left ventricular damage from myocardial infarction

  18. Digital subtraction angiography in 105 living renal transplant donors

    International Nuclear Information System (INIS)

    Suh, Ho Jong; Oh, Kyung Seung; Kim, So Sun; Huh, Jin Do; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duck

    1989-01-01

    In order to analyze the number and length of the renal arteries and to evaluate abnormalities of the renal parenchyma and vessel, digital subtraction angiogram images of 105 potential renal donors (45 men and 60 women aged 17-66 years) were studied retrospectively. For the entire series, 31 donors had multiple renal arteries on one side (15 on the left, 11 on the right) and 5 donors on the both sides. 89 donors were family related either parents or siblings of recipients. The estimation of the length of the renal artery was based on the mean height of the second lumbar vertebral body (L2). The right renal artery is significant longer than on the left and measured more than the height of L2 vertebral body in 84 cases on the right and 60 cases on the left. Twenty two donors underwent right nephrectomy due to presence of multiple renal arteries on the left (N=14), proximal bifurcation of left main renal artery (N=3), and young females in reproductive age (N=5). Unexpected abnormalities found with angiogram were seen in 7 cases and they include renal artery stenosis (N=2), renal cysts (N=4) and focal infarction (N=1). In cases of the renal cysts and focal infarction, there were no serious complications related to the abnormalities. It is conclude that intra-arterial digital subtraction angiography is safe and efficient method to image renal anatomy of the potential renal donors

  19. Digital subtraction angiography of the heart and lungs

    International Nuclear Information System (INIS)

    Moodie, D.S.; Yiannikas, J.

    1986-01-01

    This book contains 12 chapters. Some of the chapter titles are: Physical Principles of Cardiac Digital Subtraction Angiography, The Use of Intravenous Digital Subtraction Angiography in Evaluating Patients with Complex Congenital Heart Disease, Exercise Intravenous Digital Subtraction Angiograpny, Cardiomyopathic and Cardiac Neoplastic Disease, Digital Subtraction Angiography in the Catheterization Laboratory, and Cardiac Digital Subtraction Angiography - Future Directions

  20. Digital subtraction angiography system evaluation with phantoms

    International Nuclear Information System (INIS)

    Wenstrup, R.S.; Sweeney, K.P.; Scholz, F.J.

    1985-01-01

    Advances in digital subtraction angiography imaging demonstrate the need for critical evaluation of the performance of digital subtraction equipment. The design of a phantom set for noninvasive assessment of the imaging quality of digital subtraction equipment is described; components include a remotely controlled transport system and individual patterns to evaluate the contrast and detail properties of the image intensifier, low-contrast sensitivity and resolution of the system, geometric distortion of image, linearity, mechanical and electronic stability of equipment, and effects of bone and bowel gas on iodine perception. The performance of an add-on digital radiographic system is presented, along with radiation exposure levels at the image intensifier for a range of radiographic techniques

  1. Intra-arterial Ultra-low-Dose CT Angiography of Lower Extremity in Diabetic Patients

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    Özgen, Ali, E-mail: draliozgen@hotmail.com [Yeditepe University Hospital, Department of Radiology (Turkey); Sanioğlu, Soner [Yeditepe University Hospital, Department of Cardiovascular Surgery (Turkey); Bingöl, Uğur Anıl [Yeditepe University Hospital, Department of Plastic Surgery (Turkey)

    2016-08-15

    PurposeTo image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).Materials and MethodsThree cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatinine levels were followed for possible CIN.ResultsIntra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.ConclusionIntra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.

  2. Digital subtraction angiography of carotid bifurcation

    International Nuclear Information System (INIS)

    Vries, A.R. de.

    1984-01-01

    This study demonstrates the reliability of digital subtraction angiography (DSA) by means of intra- and interobserver investigations as well as indicating the possibility of substituting catheterangiography by DSA in the diagnosis of carotid bifurcation. Whenever insufficient information is obtained from the combination of non-invasive investigation and DSA, a catheterangiogram will be necessary. (Auth.)

  3. Digital subtraction angiography: myths and reality

    International Nuclear Information System (INIS)

    Levin, D.C.

    1984-01-01

    Some of the claims made about digital subtraction angiography (DSA) when it was first developed have turned out to be greatly exaggerated, and some members of the radiologic community have become disillusioned with its capabilities. The author discusses some of the limitations of DSA, and concludes that the advantages of DSA outweigh its limitations

  4. Intravenous digital subtraction angiography of the lower limbs combined with field movement (2-field DSA)

    International Nuclear Information System (INIS)

    Fritschy, P.; Terrier, F.

    1988-01-01

    We evaluated a bolus-chase technique designed to reduce the volume of contrast material and to shorten examination time during intravenous digital subtraction angiography (IV-DSA) of the lower limbs. With this technique, after a single injection of contrast material, two contiguous fields can be sequentially imaged (two-field DAS) using a step translated X-ray tube. 67 patients with peripheral vascular disease were studied. All examinations provided diagnostic information, so that in no instance additional intra-arterial injections were required. With the two-field DSA only 3.49 injections were needed in the average for five fields examined in each patient, resulting in a 30% reduction of contrast agent used. (orig.) [de

  5. Physical principles of cardiac digital subtraction angiography

    International Nuclear Information System (INIS)

    Buonocore, E.; Pavlicek, W.

    1986-01-01

    Advances in the applications of computers with standard radiologic equipment have resulted in the development of electronic, or so-called ''film-less'' imaging. This technique, discussed by the authors, has become of particular value in the visualization of the central vascular system and has become known as digital subtraction angiography (DSA). Commercial products have become increasingly available and are capable of converting T.V. signals, obtained by conventional fluorography, to a computed array of digital values. Addition, subtraction, and averaging of this data, result in images with adequate signal-to-noise ratios that achieve detection of low concentrations of contrast media not possible with conventional screen film techniques. Computer subtraction of unnecessary background information improves the conspicuity of the opacified vessels to permit detection of vascular structures containing a concentration of no more than 1-3 percent of contrast media. This improved visualization is possible even with intravenous peripheral injections or reduced amounts of contrast media given intraarterially. With either method of contrast media administration, DSDA has become an excellent means of anatomic demonstration of the heart and great vessels with decreased morbidity and at lower cost

  6. Digital subtraction angiography of the thoracic aorta

    International Nuclear Information System (INIS)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-01-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram

  7. Digital subtraction angiography of the thoracic aorta

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    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  8. Digital Subtraction Radiography - A Technique Revisited

    Directory of Open Access Journals (Sweden)

    Anshul Mehra

    2007-01-01

    Full Text Available Digital imaging has changed the scenario of medical and dental imaging as it has been able to address many limitations associated with traditional film based radiograph. However, subtle changes on the image are still difficult to appreciate by the human eye because the changes are buried in a background of normal anatomic structures, and are not clearly evident. Digital subtraction radiography is one of the image enhancing technique which addresses this problem and has found its use in various fields of dentistry in the recent past. However, there is lack of review in the literature regarding this widely used technique. The purpose of this article is to present an overview of this technique and its uses in various fields of dentistry.

  9. Digital Subtraction Angiography (DSA) "Road Map": An Angiographic Tool

    Science.gov (United States)

    Turski, P. A.; Stieghorst, M. F.; Strother, C. M.; Crummy, A. B.; Lieberman, R. P.; Mistretta, C. A.

    1982-12-01

    Continuous Digital subtraction combined with intraarterial injections of contrast medium permits the display of arterial structures during real time fluoroscopy. This DSA "road map" facilitates selective catheterization and has proved useful in interventional procedures.

  10. Digital contrast subtraction radiography for proximal caries diagnosis

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    Kang, Byung Cheol; Yoon, Suk Ja [Department of Dental Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2002-06-15

    To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Thirty-six teeth with 57 proximal surfaces were radiographied using a size no.2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

  11. Digital contrast subtraction radiography for proximal caries diagnosis

    International Nuclear Information System (INIS)

    Kang, Byung Cheol; Yoon, Suk Ja

    2002-01-01

    To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Thirty-six teeth with 57 proximal surfaces were radiographied using a size no.2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

  12. [A digital subtraction angiography system based on LUT algorithms].

    Science.gov (United States)

    Chen, Xiangan; Li, Kaiyang; Zhou, Li; Chen, Jiansheng

    2006-04-01

    Look-up table (LUT) algorithms have been widely used in digital signal processing, but the article on the application of LUT algorithms in digital subtraction angiography was rarely reported. In this article, the effect of different LUT algorithms on digital subtraction angiography images is introduced. The result reveals that different LUT algorithms can bring about different effects of image. Based on analysis and comparison, we deem it possible to acquire improved images of DSA by use of some LUT algorithms with image processing.

  13. Digital subtraction radiography in the study of the lacrimal system

    International Nuclear Information System (INIS)

    Falaschi, F.; Pieri, L.; Perri, G.; Signorini, G.; Genovese Ebert, F.

    1988-01-01

    The authors emphasize the usefulness of digital dacrycystography (DCG), as compared with various current technoques. Utilizing a radiographic unit equipped with a video-fluoroscopic system and interfaced to a digital video-processor, several digitalized images are acquired before, during and after the injection of contrast medium. Final images are obtained by subtraction of suitable pairs of source frames. Twenty-six patients affected by epiphora have been examined so far. In 21 cases digital subtraction DCG allowed an accurate visualization of the lacrimal system; in the other five patients the amount of information was acceptable. This methodology allows the assessment of both the normal anatomy of the lacrimal passages and their pathological patterns, such as obstructions, stenoses, fistulas, chronic dacrycystites, lacrimal stones. The examination is easy and quick to perform, with no discomfort for the patient. Digital subtraction DCG proves thus to be a very valuable technique thanks to its possible electronic elaboration - i.e. the subtraction and the magnification of images - to its better contrast resolution, and to the possibility it yields of dynamic studies under radioscopic control

  14. Digital subtraction angiography in the diagnosis of Fallot's tetralogy

    International Nuclear Information System (INIS)

    Ivanitskij, A.V.; Tereshkin, Ya.A.; Sobolev, A.V.; Stolyar, V.L.; Slyunyastikov, M.A.

    1995-01-01

    The authors analyze the efficacy of digital subtraction angiography (DSA) in the diagnosis of Fallot's tetralogy (FT); this method helps simplity and cut down their scope of investigations but does not deteriorate their informative value. DSA findings in 120 patients with TF are analyzed. 5 refs.; 6 figs

  15. Pulmonary ventilation in children digital subtraction study

    International Nuclear Information System (INIS)

    Schmit, P.; Faure, C.; Sardet, A.; Bacques, O.

    1985-01-01

    Digital technique such as used in digital angiography can be used to study areas which lucency varies with time. A TID technique (time interval difference) has been used to study the lucency variation of the lung in children. This method has been used in 130 children with a mean age of 2 years and 8 months. In 85 children, the TID was normal: 5 false negative studies were found in this group. In the other 47 cases, the anomaly of the TID was due to a perfusion or a ventilation anomaly or both. No false positive are found. In 13 patients, comparison between the TID findings and the perfusion and ventilation nuclear scan was possible. In 9 patients, the correlation was excellent, the TID giving more some informations about the pulmonary mixic [fr

  16. Method and apparatus for performing digital intravenous subtraction angiography

    International Nuclear Information System (INIS)

    Stein, J.A.

    1986-01-01

    This invention relates to digital intravenous subtraction angiography (DISA), and more particularly concerns novel apparatus and techniques for providing high resolution angiograms with equipment that coacts with existing standard medical X-ray equipment. A typical medical X-ray generator provides low mA, continuous X-ray exposures illuminating a standard image intensifier producing an image scanned by a conventional television camera to produce a video signal. An analog-to-digital converter digitizes the signal, and adding means adds the digital frame signals together in real time to provide an intermediate digital signal representing the addition of 5 to 20 frames. Digital storage means store the intermediate image signals. Preferably there are two system memories with means for summing a subsequent intermediate image in the second memory while a previously-formed intermediate image is being transferred to disk storage

  17. Digital subtraction angiography in the assessment of cardiovascular disease

    International Nuclear Information System (INIS)

    Harrington, D.P.; Boxt, L.M.

    1985-01-01

    Digital subtraction angiography (DSA) is a new radiographic method for evaluating the cardiovascular system. It represents another in a continuing series of computer-assisted diagnostic imaging modalities. The advantages of this technique are its relatively noninvasive nature combined with diagnostically acceptable angiographic images of a variety of cardiovascular structures. Major clinical applications of DSA include its use in imaging of localized regions of peripheral arterial disease and as a screening procedure in evaluating extracranial carotid and vertebral artery disease and renovascular hypertension. Cardiac applications of DSA include assessment of ventricular function, recognition and quantification of intracardiac shunts, visualization of coronary artery bypass grafts, and the study of complex congenital cardiac malformations. Digital subtraction angiography may also be used to evaluate intracranial aneurysms and vascular tumors

  18. Intravenous digital subtraction angiography investigation of reversible cerebral ischemia

    International Nuclear Information System (INIS)

    Pistolesi, G.F.; Maso, R.; Filosto, L.; Piovan, E.; Morgante, D.; Taddei, G.; Tonegutti, M.; Portuese, A.

    1986-01-01

    The brachio-cephalic, carotid, vertebral and intra-cranial vessels of 497 patients presenting reversible ischemic attacks (R.I.A) were evaluated with venous digital subtraction angiography (V.D.S.A.). Alterations of the vascular wall were observed in 289/497 (58.2%) patients, of whom 60% presented multiple locations (539 lesions): obstruction (12%), stenosis >50% (29%), stenosis 50%. The incidence of vascular lesions was higher (p [fr

  19. Digital subtraction angiography in pediatric cerebrovascular occlusive disease

    International Nuclear Information System (INIS)

    Faerber, E.N.; Griska, L.A.B.; Swartz, J.D.; Capitanio, M.A.; Popky, G.L.

    1984-01-01

    While conventional angiography has been used to demonstrate cerebrovascular occlusive disease in the past, digital subtraction angiography (DSA) is capable of showing progressive vascular involvement with ease, simplicity, and extremely low morbidity, making it particularly well suited for children and outpatients either alone or coordinated with computed tomography. The authors discuss the usefulness and advantages of DSA as demonstrated in 7 infants and children with hemiplegia, 4 of whom had sickle-cell disease

  20. Use of an Intra-Arterial Catheter as a Provisional Conduit for Regulated Outflow Management in the Setting of Artery-Only Digital Replantation.

    Science.gov (United States)

    DeFazio, Michael V; Han, Kevin D; Paryavi, Ebrahim

    2017-12-01

    Successful replantation of distal digital segments necessitates the establishment of sufficient outflow to minimize congestion and progressive tissue necrosis. In cases where only arterial anastomosis is feasible, an artificial outlet must be provided to maintain physiological requirements until microvenous circulation regenerates. This can be accomplished using any number of "exsanguination techniques" designed to facilitate egress through ongoing passive blood loss. Although reportedly effective, these measures are imprecise and carry a substantial risk of infection, scarring, and/or uncontrolled hemorrhage. Herein, we describe a preemptive alternative for provisional venous drainage, whereby direct catheterization of a distal arterial branch is used to enhance the precision of outflow management following artery-only digital replantation. The establishment of intravascular access, using the technique described, permits remote manipulation of the microcirculatory environment through timed administration of heparinized saline and regulated removal of controlled volumes of blood.

  1. Digital Subtraction Fluoroscopic System With Tandem Video Processing Units

    Science.gov (United States)

    Gould, Robert G.; Lipton, Martin J.; Mengers, Paul; Dahlberg, Roger

    1981-07-01

    A real-time digital fluoroscopic system utilizing two video processing units (Quantex) in tandem to produce continuous subtraction images of peripheral and internal vessels following intravenous contrast media injection has been inves-tigated. The first processor subtracts a mask image consisting of an exponentially weighted moving average of N1 frames (N1 = 2k where k = 0.7) from each incoming video frame, divides by N1, and outputs the resulting difference image to the second processor. The second unit continuously averages N2 incoming frames (N2 = 2k) and outputs to a video monitor and analog disc recorder. The contrast of the subtracted images can be manipulated by changing gain or by a non-linear output transform. After initial equipment adjustments, a subtraction sequence can be produced without operator interaction with the processors. Alternatively, the operator can freeze the mask and/or the subtracted output image at any time during the sequence. Raw data is preserved on a wide band video tape recorder permitting retrospective viewing of an injection sequence with different processor settings. The advantage of the tandem arrangement is that it has great flexibility in varying the duration and the time of both the mask and injection images thereby minimizing problems of registration between them. In addition, image noise is reduced by compiling video frames rather than by using a large radiation dose for a single frame, which requires a wide dynamic range video camera riot commonly available in diagnostic x-ray equipment. High quality subtraction images of arteries have been obtained in 15 anesthetized dogs using relatively low exposure rates (10-12 μR/video frame) modest volumes of contrast medium (0.5-1 ml/kg), and low injection flow rates (6-10 ml/sec). The results/ achieved so far suggest that this system has direct clinical applications.

  2. Introduction to the principles of Digital Subtraction Angiography (DSA)

    International Nuclear Information System (INIS)

    Kaplanis, P.

    1997-01-01

    Medical applications of advanced technology have rapidly become more sophisticated and more widespread. The field of diagnostic imaging is by no means an exception. There has been a number of breathtaking developments in the field of medical imaging in recent years. Today higher quality, greater clarity and more minute precision are considered not advantages but necessities. Hence new developments are concentrated in the data acquisition and image processing based on the microprocessor controlled modules interfaced with state of the art radiological imaging equipment. One such development is the subtraction of x-rays vis a computer for better visualization of blood vessels, cavities of the heart and of the coronary and pulmonary vascular system. This procedure is termed Digital Subtraction Angiography (DSA). (author)

  3. Assessment of simulated internal resorption cavities using digital and digital subtraction radiography: a comparative study.

    Science.gov (United States)

    Stephanopoulos, Georgios; Mikrogeorgis, Georgios; Lyroudia, Kleoniki

    2011-10-01

    To compare the diagnostic accuracy of digital radiography with that of digital subtraction radiography in the detection of simulated internal resorption cavities. Simulated internal resorption cavities of varying sizes were created using round burs in 18 single-rooted teeth with visible pulp chamber, which had been extracted from dentate dry mandibles and split into two halves in a mesio-distal direction. Resorption cavities were created in the buccal half of the root in the cervical, middle, and apical third. Digital radiographs were taken from three different horizontal view angles before and after the creation of the cavities. This process was followed by digital subtraction radiography to evaluate their detection. Seven experienced observers and all specialists in endodontics were asked to examine the digital and digital subtraction images for the presence of the cavities. The data were analyzed using SPSS 14. The overall sensitivity of digital subtraction radiography was superior to digital radiography and with statistically better results for all cavities regardless of their location (cervical, middle, apical third) (P < 0.05). The detection of the cavities was affected by the root third in which they were located. Cavities in the apical third were more easily detected compared with those in the middle or cervical third of the root. Small-sized lesions (0.5 mm, 0.6 mm) in the middle and apical third were more frequent and more easily detected using subtraction imaging. Digital subtraction radiography is superior to digital radiography for the detection and monitoring of the progress of internal root resorption. © 2011 John Wiley & Sons A/S.

  4. Evaluation and quality control of digital subtraction angiography systems

    International Nuclear Information System (INIS)

    Louisot, P.

    1986-04-01

    After reviewing the development of systems used in angiography, we rewind the medical interest and describe the steps of an angiographic examination. The following chapter is dedicated to the techniques used for the digitalization of video images. The components of the system involved in the image acquisition are thoroughly investigated in chapter 4. Then, we analyse the capabilities of the machines available in France in 1985. Chapter 6 is devoted to the criteria of quality in digital imaging. In order to assign qualitative values to the above criteria, we design a control procedure which is described in chapter 7. The procedure thus allows the estimate of the physical performances of angiographic digital subtraction systems [fr

  5. Evaluation of left ventricular function using digital subtraction ventriculography

    International Nuclear Information System (INIS)

    Yiannikas, J.; Detrano, R.

    1986-01-01

    Digital subtraction ventriculography following injections of contrast via peripheral veins provides excellent images to assess left ventricular function. The images are essentially identical to those following DCV, but allow more uniform mixing of contrast in the left ventricular chamber. Furthermore, few, if any, cardiac arrhythmias occur, hence obviating difficulties that arise from DCV. The spatial resolution of the method is such that regional wall motion assessment of ventricular function is more accurate than that of other noninvasive imaging methods. The use of video-densitometry allows accurate assessment of left ventricular function even when the left ventricular cavity is nonsymmetrically deformed and aneurysmal. In the setting of the cardiac catheterization laboratory, digital ventriculography may provide a safer means of assessing left ventricular function when critical coronary or myocardial disease is present and allows multiple assessments of ventricular function during the same study. Although excellent correlations with standard ventriculography have been noted by all workers, significant discrepancies still exist in individual patients, particularly in the calculations of end diastolic volumes. In the authors experience and in those of most workers, the largest discrepancies existed in patients in whom suboptimal studies are included for analysis. The most frequent reason for the occasional suboptimal study as with all digital subtraction work is the misregistration that results from motion

  6. [Design and development of the DSA digital subtraction workstation].

    Science.gov (United States)

    Peng, Wen-Xian; Peng, Tian-Zhou; Xia, Shun-Ren; Jin, Guang-Bo

    2008-05-01

    According to the patient examination criterion and the demands of all related departments, the DSA digital subtraction workstation has been successfully designed and is introduced in this paper by analyzing the characteristic of video source of DSA which was manufactured by GE Company and has no DICOM standard interface. The workstation includes images-capturing gateway and post-processing software. With the developed workstation, all images from this early DSA equipment are transformed into DICOM format and then are shared in different machines.

  7. Real-time digital x-ray subtraction imaging

    International Nuclear Information System (INIS)

    Mistretta, C.A.; Kruger, R.A.; Houk, T.L.

    1982-01-01

    A method of producing visible difference images derived from an x-ray image of an anatomical subject is described. X-rays are directed through the subject, and the image is converted into television fields comprising trains of analog video signals. The analog signals are converted into digital signals, which are then integrated over a predetermined time corresponding to several television fields. Difference video signals are produced by performing a subtraction between the ongoing video signals and the corresponding integrated signals, and are converted into visible television difference images representing changes in the x-ray image

  8. Digital subtraction angiography in head and neck radiology

    Energy Technology Data Exchange (ETDEWEB)

    Carmody, R.F.; Seeger, J.F.; Smith, R.L.; Horsley, W.W.; Miller, R.W.

    1984-07-01

    Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally.

  9. Digital subtraction angiography in head and neck radiology

    International Nuclear Information System (INIS)

    Carmody, R.F.; Seeger, J.F.; Smith, R.L.; Horsley, W.W.; Miller, R.W.

    1984-01-01

    Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally. (orig.)

  10. IMPROVED BACKGROUND SUBTRACTION FOR THE SLOAN DIGITAL SKY SURVEY IMAGES

    International Nuclear Information System (INIS)

    Blanton, Michael R.; Kazin, Eyal; Muna, Demitri; Weaver, Benjamin A.; Price-Whelan, Adrian

    2011-01-01

    We describe a procedure for background subtracting Sloan Digital Sky Survey (SDSS) imaging that improves the resulting detection and photometry of large galaxies on the sky. Within each SDSS drift scan run, we mask out detected sources and then fit a smooth function to the variation of the sky background. This procedure has been applied to all SDSS-III Data Release 8 images, and the results are available as part of that data set. We have tested the effect of our background subtraction on the photometry of large galaxies by inserting fake galaxies into the raw pixels, reanalyzing the data, and measuring them after background subtraction. Our technique results in no size-dependent bias in galaxy fluxes up to half-light radii r 50 ∼ 100 arcsec; in contrast, for galaxies of that size the standard SDSS photometric catalog underestimates fluxes by about 1.5 mag. Our results represent a substantial improvement over the standard SDSS catalog results and should form the basis of any analysis of nearby galaxies using the SDSS imaging data.

  11. Real-time digital X-ray subtraction imaging

    International Nuclear Information System (INIS)

    Mistretta, C.A.; Kruger, R.A.; Houk, T.L.

    1979-01-01

    A diagnostic anatomical X-ray apparatus comprising a converter and a television camera for converting an X-ray image of a subject into a series of television fields of video signals is described in detail. A digital memory system stores and integrates the video signals over a time interval corresponding to a plurality of successive television fields. The integrated video signals are recovered from storage and fed to a digital or analogue subtractor, the resulting output being displayed on a television monitor. Thus the display represents on-going changes in the anatomical X-ray image. In a modification, successive groups of fields are stored and integrated in three memories, cyclically, and subtractions are performed between successive pieces of integrated signals to provide a display of successive alterations in the X-ray image. For investigations of the heart, the integrating interval should be of the order of one cardiac cycle. (author)

  12. Utility of time-resolved three-dimensional magnetic resonance digital subtraction angiography without contrast material for assessment of intracranial dural arterio-venous fistula

    International Nuclear Information System (INIS)

    Hori, Masaaki; Aoki, Shigeki; Nakanishi, Atsushi; Shimoji, Keigo; Kamagata, Koji; Houshito, Haruyoshi; Kuwatsuru, Ryohei; Oishi, Hidenori; Arai, Hajime

    2011-01-01

    Background: Intracranial dural arteriovenous fistula (DAVF) is an arteriovenous shunting disease of the dura. Magnetic resonance angiography (MRA) is expected to be a safer alternative method in evaluation of DAVF, compared with invasive intra-arterial digital subtraction angiography (IADSA). Purpose: To evaluate the diagnostic use of time-spatial labeling inversion pulse (Time-SLIP) three-dimensional (3D) magnetic resonance digital subtraction angiography (MRDSA) without contrast material in six patients with DAVF. Material and Methods: Images for 3D time-of-flight MRA, which has been a valuable tool for the diagnosis of DAVF but provide little or less hemodynamic information, and Time-SLIP 3D MRDSA, were acquired for each patient. The presence, side, and grade of the disease were evaluated according to IADSA. Results: In all patients, the presence and side of the DAVF were correctly identified by both 3D time-of-flight MRA and Time-SLIP 3D MRDSA. Cortical reflux present in a patient with a grade 2b DAVF was not detected by Time-SLIP 3D MRDSA, when compared with IADSA findings. Conclusion: Time-SLIP 3D MRDSA provides hemodynamic information without contrast material and is a useful complementary tool for diagnosis of DAVF

  13. Combined nuclear and digital subtraction contrast arthrography in painful knee prosthesis

    Energy Technology Data Exchange (ETDEWEB)

    Namasivayam, J.; Forrester, A. (Royal Infirmary, Glasgow (United Kingdom). Dept. of Radiology); Poon, F.W.; Cuthbert, G.F.; McKillop, J.H. (Royal Infirmary, Glasgow (United Kingdom). Dept. of Nuclear Medicine); Bryan, A.S.

    1992-06-01

    The evaluation of a painful knee prosthesis remains a difficult problem for both orthopaedic surgeons and radiologists. We have compared digital subtraction arthrography with nuclear-arthrography in 7 patients with a painful knee prosthesis. Three patients showed a loose tibial component, demonstrated by both digital subtraction and nuclear arthrography. All 3 underwent revision of their prosthesis. One patient had an equivocal digital subtraction arthrogram and negative nuclear arthrogram, while both studies were negative in the 3 remaining patients. Nuclear arthrography is a simple procedure and can provide useful additional information when combined with digital subtraction arthrography. (orig.).

  14. Using a digital signal processor as a data stream controller for digital subtraction angiography

    International Nuclear Information System (INIS)

    Meng, J.D.; Katz, J.E.

    1991-10-01

    High speed, flexibility, and good arithmetic abilities make digital signal processors (DSP) a good choice as input/output controllers for real time applications. The DSP can be made to pre-process data in real time to reduce data volume, to open early windows on what is being acquired and to implement local servo loops. We present an example of a DSP as an input/output controller for a digital subtraction angiographic imaging system. The DSP pre-processes the raw data, reducing data volume by a factor of two, and is potentially capable of producing real-time subtracted images for immediate display

  15. Digital subtraction CT angiography for the detection of posterior inferior cerebellar artery aneurysms: comparison with digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Guo Zhong; Luo, Song; Zhou, Chang Sheng; Zhang, Long Jiang; Lu, Guang Ming [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China)

    2017-09-15

    To evaluate the diagnostic accuracy of digital subtraction CT angiography (DS-CTA) in detecting posterior inferior cerebellar artery (PICA) aneurysms with digital subtraction angiography (DSA) as reference standard. A total of 115 patients, including 56 patients diagnosed with PICA aneurysms by CTA or DSA and 59 non-PICA-aneurysm patients were included in this retrospective study. All patients underwent DS-CTA and DSA. The site of PICA aneurysms and the pattern of haemorrhage were analysed. Sensitivity and specificity of DS-CTA without and with combining haemorrhage pattern in diagnosing PICA aneurysms were evaluated on a per patient and per aneurysm basis with DSA. Of 115 patients, 56 patients (48.7%) had 61 PICA aneurysms (size range, 1.1-13.5 mm; mean size, 4.9 ± 2.8 mm) on DSA. The sensitivity and specificity in depicting PICA aneurysms were 89.3% and 96.6% on a per patient basis and 90.2% and 93.4% on a per aneurysm basis, while the corresponding values were 94.6% and 96.6% on a per patient basis and 95.1% and 93.4% on a per aneurysm basis when combining with haemorrhage site. DS-CTA has a high sensitivity and specificity in detecting PICA aneurysms compared with DSA. It may be helpful for clinical diagnosis of PICA aneurysms to combine with haemorrhage sites. (orig.)

  16. Intra-arterial Autologous Bone Marrow Cell Transplantation in a Patient with Upper-extremity Critical Limb Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Madaric, Juraj, E-mail: jurmad@hotmail.com [National Institute of Cardiovascular Diseases (NUSCH) and Slovak Medical University, Department of Cardiology and Angiology (Slovakia); Klepanec, Andrej [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia); Mistrik, Martin [Clinic of Hematology and Transfusiology, Faculty Hospital (Slovakia); Altaner, Cestmir [Slovak Academy of Science, Institute of Experimental Oncology (Slovakia); Vulev, Ivan [National Institute of Cardiovascular Diseases, Department of Diagnostic and Interventional Radiology (Slovakia)

    2013-04-15

    Induction of therapeutic angiogenesis by autologous bone marrow mononuclear cell transplantation has been identified as a potential new option in patients with advanced lower-limb ischemia. There is little evidence of the benefit of intra-arterial cell application in upper-limb critical ischemia. We describe a patient with upper-extremity critical limb ischemia with digital gangrene resulting from hypothenar hammer syndrome successfully treated by intra-arterial autologous bone marrow mononuclear cell transplantation.

  17. Intravenous digital subtraction angiography in patients with cerebral ischaemia

    International Nuclear Information System (INIS)

    Mantoni, M.; Neergaard, K.

    1989-01-01

    Over a two-year period, 167 patients with symptoms of transient ischaemic attacks or suspected minor stroke underwent intravenous digital subtraction angiography (DSA) of the carotid arteries. There were no major complications. Ninety-six patients had abnormal angiograms, 60 normal studies, and in 11 patients (7%) the examination was not of diagnostic quality, mostly because of motion artifacts. In 86 patients no therapeutic consequences resulted from the DSA examination. Twenty-six patients were referred for vascular surgery, and 34 patients had either anticoagulation or aspirin therapy. In 10 patients a primary medical cause was found for their cerebral vascular symptoms. It is concluded that intravenous DSA of the carotid arteries in patients with transient ischaemic attack is a safe, diagnostically useful procedure, that can also be used on an outpatient basis. (orig.)

  18. Real-time digital x-ray subtraction imaging

    International Nuclear Information System (INIS)

    Mistretta, C.A.

    1982-01-01

    The invention provides a method of producing visible difference images derived from an X-ray image of an anatomical subject, comprising the steps of directing X-rays through the anatomical subject for producing an image, converting the image into television fields comprising trains of on-going video signals, digitally storing and integrating the on-going video signals over a time interval corresponding to several successive television fields and thereby producing stored and integrated video signals, recovering the video signals from storage and producing integrated video signals, producing video difference signals by performing a subtraction between the integrated video signals and the on-going video signals outside the time interval, and converting the difference signals into visible television difference images representing on-going changes in the X-ray image

  19. Digital fluorography and computed tomography in a department of neuroradiology - a comparative study

    International Nuclear Information System (INIS)

    Fawcitt, R.A.; Freer, C.; Jarvis, H.; Occleshaw, J.V.; Isherwood, I.

    1984-01-01

    Digital Subtraction Angiography (DSA) has the ability to display the intracranial circulation following an intravenous or intra-arterial injection of contrast medium. A study was performed in 57 patients with neurological disorders undergoing DSA, either by Digital Intravenous Injection Angiography (DIVA) or Digital Intra-arterial Injection Angiography (DART) to assess the ability of DIVA to replace DART, the latter being carried out by digital fluorography or by conventional film screen methods, and also to establish the role of DSA in relation to Computed Tomography. (U.K.)

  20. A case of aortitis syndrome diagnosed by digital subtraction angiography

    International Nuclear Information System (INIS)

    Tamaki, Atsushi; Sakai, Masashi; Yano, Kimio

    1984-01-01

    A 45-year-old female was admitted to our hospital with complaints of anemia, hypertension, and a dull, throbbing pain in the right side of the neck. On physical examination, a pulsating tumor in the right side of the neck and a ''to-and-fro'' murmur at the right 2nd intercostal space were noted. Laboratory tests revealed ESR 90 mm/hour and CRP 5+. Digital subtraction angiography (DSA) showed an aneurysm distal to the narrowing of the right common carotid artery, in addition to winding and narrowing of the right vertebral and the left common carotid arteries. These findings are typical of Type I aortitis syndrome. Aortogram showed aortic regurgitation (AR). Furthermore, we found the presence of HLA Bw52 and a conspicuous increase of tromboxane B 2 . Treatment involving a combination of prednisolone, azathioprine and estriol was effective, resulting in marked improvement of the patient's general condition as well as laboratory test results. In cases of aortitis syndrome combined with an aneurysm of a large artery and AR, direct opacification of the aorta with a catheter is occasionally hazardous and is difficult to perform repeatedly. DSA is useful in such circumstances because it can be performed repeatedly with little risk and it offers an image as clear as these obtained by direct injection of contrast medium in the aorta. (author)

  1. 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

  2. Radiation doses to patients from digital subtraction angiography

    International Nuclear Information System (INIS)

    Goni, H.; Tsalafoutas, I. A.; Tzortzis, G.; Pappas, P.; Bouzas, N.; Loulakas, J.; Georgiou, A.; Georgiou, E.; Yakoumakis, E. N.

    2005-01-01

    This investigation determined patient doses during digital subtraction angiography (DSA). Fluoroscopy time, dose-area product (DAP) and entrance surface air kerma (ESAK) were analysed from 263 DSA examinations, classified into seven categories: (1) abdominal aorta, iliac, femoral, popliteal and leg arteries; (2) abdominal aorta and super-selective DSA of renal arteries; (3) combination of (1) and (2); (4) super-selective DSA of common carotid and vertebral arteries, intracranial branches in face and profile projections; (5) super-selective DSA of hepatic, splenic, superior and inferior mesenteric arteries; (6) combination of (1) and (4); and (7) celiac trunk and branches. Median DAP values were 67.7, 92.9, 76.6, 53.6, 105.7, 76.1 and 2.6 Gy cm 2 , respectively. With the exception of one examination, ESAK values were below 2 Gy: the limit for erythema. Compared with published data, DAP values were within the range reported for (1) and (4), slightly larger for (2) and (5), whereas no references were identified for the remaining three categories. (authors)

  3. Robotic digital subtraction angiography systems within the hybrid operating room.

    Science.gov (United States)

    Murayama, Yuichi; Irie, Koreaki; Saguchi, Takayuki; Ishibashi, Toshihiro; Ebara, Masaki; Nagashima, Hiroyasu; Isoshima, Akira; Arakawa, Hideki; Takao, Hiroyuki; Ohashi, Hiroki; Joki, Tatsuhiro; Kato, Masataka; Tani, Satoshi; Ikeuchi, Satoshi; Abe, Toshiaki

    2011-05-01

    Fully equipped high-end digital subtraction angiography (DSA) within the operating room (OR) environment has emerged as a new trend in the fields of neurosurgery and vascular surgery. To describe initial clinical experience with a robotic DSA system in the hybrid OR. A newly designed robotic DSA system (Artis zeego; Siemens AG, Forchheim, Germany) was installed in the hybrid OR. The system consists of a multiaxis robotic C arm and surgical OR table. In addition to conventional neuroendovascular procedures, the system was used as an intraoperative imaging tool for various neurosurgical procedures such as aneurysm clipping and spine instrumentation. Five hundred one neurosurgical procedures were successfully conducted in the hybrid OR with the robotic DSA. During surgical procedures such as aneurysm clipping and arteriovenous fistula treatment, intraoperative 2-/3-dimensional angiography and C-arm-based computed tomographic images (DynaCT) were easily performed without moving the OR table. Newly developed virtual navigation software (syngo iGuide; Siemens AG) can be used in frameless navigation and in access to deep-seated intracranial lesions or needle placement. This newly developed robotic DSA system provides safe and precise treatment in the fields of endovascular treatment and neurosurgery.

  4. Selective intra-arterial administration of 18F-FDG to the rat brain - effects on hemispheric uptake

    International Nuclear Information System (INIS)

    Arnberg, Fabian; Samen, Erik; Lundberg, Johan; Grafstroem, Jonas; Soederman, Michael; Stone-Elander, Sharon; Holmin, Staffan; Lu, Li

    2014-01-01

    The purpose of this study was to investigate the radioligand uptake and iodine contrast distribution in the intra- and extracranial circulation of the rat, after intra-arterial injections to the common carotid artery and different parts of the internal carotid artery. All animal experiments were carried out in accordance with Karolinska Institutet's guidelines and were approved by the local laboratory animal ethics committee. We used clinical neurointerventional systems to place microcatheters in the extra- or intracranial carotid artery of 15 Sprague-Dawley rats. Here, injection dynamics of iodine contrast was assessed using digital subtraction angiography. Maintaining the catheter position, the animals were placed in a micro PET and small-animal positron emission tomography (PET) was used to analyze injections [2- 18 F]-2-fluoro-2-deoxy-d-glucose ( 18 F-FDG). Microcatheters had to be placed in the intracranial carotid artery (iICA) for the infusate to distribute to the brain. Selective injection via the iICA resulted in a 9-fold higher uptake of 18 F-FDG in the injected hemisphere (p < 0.005) compared to both intravenous and more proximal carotid artery injections. Furthermore, selective injection gave a dramatically improved contrast between the brain and extracranial tissue. Intra-arterial injection increases the cerebral uptake of a radiotracer dramatically compared to systemic injection. This technique has potential applications for endovascular treatment of malignancies allowing intra-interventional modifications of injection strategy, based on information on tumor perfusion and risk to surrounding normal parenchyma. Furthermore the technique may increase diagnostic sensitivity and avoid problems due to peripheral pharmacological barriers and first passage metabolism of labile tracers. (orig.)

  5. Selective intra-arterial administration of {sup 18}F-FDG to the rat brain - effects on hemispheric uptake

    Energy Technology Data Exchange (ETDEWEB)

    Arnberg, Fabian; Samen, Erik; Lundberg, Johan; Grafstroem, Jonas; Soederman, Michael; Stone-Elander, Sharon; Holmin, Staffan [Karolinska Institutet, Department of Clinical Neuroscience, Stockholm (Sweden); Karolinska University Hospital-Solna, Department of Neuroradiology, Stockholm (Sweden); Lu, Li [Karolinska University Hospital-Solna, KERIC, Stockholm (Sweden)

    2014-05-15

    The purpose of this study was to investigate the radioligand uptake and iodine contrast distribution in the intra- and extracranial circulation of the rat, after intra-arterial injections to the common carotid artery and different parts of the internal carotid artery. All animal experiments were carried out in accordance with Karolinska Institutet's guidelines and were approved by the local laboratory animal ethics committee. We used clinical neurointerventional systems to place microcatheters in the extra- or intracranial carotid artery of 15 Sprague-Dawley rats. Here, injection dynamics of iodine contrast was assessed using digital subtraction angiography. Maintaining the catheter position, the animals were placed in a micro PET and small-animal positron emission tomography (PET) was used to analyze injections [2-{sup 18}F]-2-fluoro-2-deoxy-d-glucose ({sup 18}F-FDG). Microcatheters had to be placed in the intracranial carotid artery (iICA) for the infusate to distribute to the brain. Selective injection via the iICA resulted in a 9-fold higher uptake of {sup 18}F-FDG in the injected hemisphere (p < 0.005) compared to both intravenous and more proximal carotid artery injections. Furthermore, selective injection gave a dramatically improved contrast between the brain and extracranial tissue. Intra-arterial injection increases the cerebral uptake of a radiotracer dramatically compared to systemic injection. This technique has potential applications for endovascular treatment of malignancies allowing intra-interventional modifications of injection strategy, based on information on tumor perfusion and risk to surrounding normal parenchyma. Furthermore the technique may increase diagnostic sensitivity and avoid problems due to peripheral pharmacological barriers and first passage metabolism of labile tracers. (orig.)

  6. Digital subtraction arthrography in preoperative evaluation of painful total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ginai, A.Z. [Dept. of Radiology, Univ. Hospital Dijkzigt, Rotterdam (Netherlands); Biezen, F.C. van [Dept. of Orthopaedics, Univ. Hospital Dijkzigt and Erasmus Univ., Rotterdam (Netherlands); Kint, P.A.M. [Dept. of Radiology, Univ. Hospital Dijkzigt, Rotterdam (Netherlands); Oei, H.Y. [Dept. of Nuclear Medicine, Univ. Hospital Dijkzigt and Erasmus Univ., Rotterdam (Netherlands); Hop, W.C.J. [Dept. of Biostatistics, Univ. Hospital Dijkzigt and Erasmus Univ., Rotterdam (Netherlands)

    1996-05-01

    Digital subtraction arthrograms, scintigrams and plain radiographs of 70 consecutive patients who underwent revision hip arthroplasty were scored individually and in masked fashion for the presence or absence of features indicating loosening of femoral and/or acetabular components. The operative findings acted as the gold standard. Digital subtraction arthrography was best for predicting a loose acetabular component, while no significant additional predictive value was found for plain radiographs and scintigraphy. Digital subtraction arthrography was also the most important modality for predicting a loose femoral component, while the plain radiograph was of significant additional value and scintigraphy was of no additional value on multivariate analysis. (orig./MG)

  7. Digital subtraction arthrography in preoperative evaluation of painful total hip arthroplasty

    International Nuclear Information System (INIS)

    Ginai, A.Z.; Biezen, F.C. van; Kint, P.A.M.; Oei, H.Y.; Hop, W.C.J.

    1996-01-01

    Digital subtraction arthrograms, scintigrams and plain radiographs of 70 consecutive patients who underwent revision hip arthroplasty were scored individually and in masked fashion for the presence or absence of features indicating loosening of femoral and/or acetabular components. The operative findings acted as the gold standard. Digital subtraction arthrography was best for predicting a loose acetabular component, while no significant additional predictive value was found for plain radiographs and scintigraphy. Digital subtraction arthrography was also the most important modality for predicting a loose femoral component, while the plain radiograph was of significant additional value and scintigraphy was of no additional value on multivariate analysis. (orig./MG)

  8. Mental Computation or Standard Algorithm? Children's Strategy Choices on Multi-Digit Subtractions

    Science.gov (United States)

    Torbeyns, Joke; Verschaffel, Lieven

    2016-01-01

    This study analyzed children's use of mental computation strategies and the standard algorithm on multi-digit subtractions. Fifty-eight Flemish 4th graders of varying mathematical achievement level were individually offered subtractions that either stimulated the use of mental computation strategies or the standard algorithm in one choice and two…

  9. Comparison of high-resolution contrast-enhanced 3D MRA with digital subtraction angiography in the evaluation of hepatic arterial anatomy

    International Nuclear Information System (INIS)

    Matoba, M.; Tonami, H.; Kuginuki, M.; Yokota, H.; Takashima, S.; Yamamoto, I.

    2003-01-01

    AIM: To evaluate the validity of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography (MRA) in defining hepatic arterial anatomy and to compare this with digital subtraction angiography (DSA). MATERIALS AND METHODS: MRA and DSA were performed in 30 patients. MRA was performed with breath-hold, gadolinium-enhanced, three-dimensional, fast low-angle shot sequence with a 512 pixel matrix. MRA was compared with DSA in terms of image quality and depiction of hepatic arterial anatomy. The agreement in image quality between MRA and DSA was determined with the kappa statistic. RESULTS: With respect to image quality, there was excellent or good correlation between MRA and DSA for the common hepatic artery (κ=0.85), proper hepatic artery (κ=0.72), gastroduodenal artery (κ=0.70), left hepatic artery (κ=0.49), left gastric artery (κ=0.50), splenic artery (κ=0.84), and superior mesenteric artery (κ=0.88). Poor correlation was found for the right hepatic artery (κ=0.18) and right gastric artery (κ=0.38). With regard to hepatic arterial anatomy, MRA correlated correctly with DSA in 28 of the 29 cases, i.e. 97% of patients. CONCLUSION: MRA is a useful technique for the evaluation of the hepatic artery, and for the vast majority of patients, MRA can replace intra-arterial DSA

  10. Gadobutrol-enhanced moving-table magnetic resonance angiography in patients with peripheral vascular disease: a prospective, multi-centre blinded comparison with digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hentsch, Annette [Schering AG, Berlin (Germany); Aschauer, Manuela A.; Ebner, Franz [Department of Magnetic Resonance, University of Graz, Graz (Austria); Balzer, Joern O.; Davis, Kirsten [Department of Diagnostic and Interventional Radiology, University of Frankfurt/Main, Frankfurt/Main (Germany); Brossmann, Joachim; Schaefer, Fritz K.W. [Department of Diagnostic Radiology, University of Kiel, Kiel (Germany); Busch, Hans P. [Krankenhaus der Barmherzigen Brueder, Trier (Germany); Douek, Philippe [Department of Diagnostic Radiology, University of Lyon (France); Engelshoven, Jos M.A. van; Leiner, Tim [Department of Radiology, Cardiovascular Research Institute, University of Maastricht, Maastricht (Netherlands); Gregor, Michaela; Reimer, Peter [Department of Radiology, Staedtisches Klinikum, Karlsruhe (Germany); Kersting, Christian [Department of Diagnostic Radiology, University of Muenster, Muenster (Germany); Knuesel, Patrick R. [Institute of Diagnostic Radiology, University Hospital Zurich, MRI Center, Zurich (Switzerland); Leen, Edward [Department of X-ray, Glasgow Royal Infirmary, Glasgow (United Kingdom); Loewe, Christian; Thurnher, Siegfried A. [Section of Angiography and Interventional Radiology, Department of Radiology' ' University of Vienna, Vienna (Austria); McPherson, Simon [Department of Radiology, University of Leeds, Leeds (United Kingdom); Taupitz, Matthias [Department of Radiology, Humboldt University of Berlin (Charite), Berlin (Germany); Tombach, Bernd; Wegener, Robin; Weishaupt, Dominik; Meaney, James F.M.

    2003-09-01

    The purpose of this study was to compare moving-table three-dimensional contrast-enhanced magnetic resonance angiography (CE MRA), using 1.0-mol gadobutrol, with intra-arterial digital subtraction angiography (i.a. DSA) for evaluation of pelvic and peripheral arteries in patients with peripheral arterial occlusive disease. A total of 203 patients were examined in a prospective, multi-centre study at 1.0/1.5 T. Ten vessel segments of one leg were evaluated on-site and by three independent blinded reviewers off-site. One hundred eighty-two patients were evaluable in blinded reading. For pelvis and thigh, there was statistically significant diagnostic agreement between CE MRA and i.a. DSA on-site (94%) and off-site (86-88%). Overall, for detection of clinically significant stenoses, 93% sensitivity and 90% specificity were achieved in on-site evaluation, with 71-76 and 87-93% off-site; for detection of occlusion, sensitivity and specificity on-site were 91 and 97%, with 75-82 and 94-98% off-site. Evaluation was more sensitive on-site than off-site for detection of stenoses and occlusion, whereas specificity was similar. The CE MRA with 1.0-mol gadobutrol gave results comparable to those of i.a. DSA for the larger arteries of pelvis and thigh. Results for calf arteries were compromised by spatial resolution and technical limitations. (orig.)

  11. Digital subtraction radiographic evaluation of the standardize periapical intraoral radiographs

    International Nuclear Information System (INIS)

    Cho, Bong Hae; Nah, Kyung Soo

    1993-01-01

    The geometrically standardized intraoral radiographs using 5 occlusal registration material were taken serially from immediate, 1 day, 2, 4, 8, 12 and 16 weeks after making the bite blocks. The qualities of those subtracted images were evaluated to check the degree of reproducibility of each impression material. The results were as follows: 1. The standard deviations of the grey scales of the overall subtracted images were 4.9 for Exaflex, 7.2 for Pattern resin, 9.0 for Tooth Shade Acrylic, 12.2 for XCP only, 14.8 for Impregum. 2. The standard deviation of the grey scales of the overall subtracted images were grossly related to those of the localized horizontal line of interest. 3. Exaflex which showed the best subtracted image quality had 15 cases of straight, 14 cases of wave, 1 case of canyon shape. Impregum which showed the worst subtracted image quality had 4 cases of straight, 8 cases of wave, 18 cases of canyon shape respectively.

  12. Intra-arterial thrombolysis for acute ischemic stroke

    International Nuclear Information System (INIS)

    Burnette, W.C.; Nesbit, G.M.

    2001-01-01

    Intra-arterial thrombolysis is a maturing treatment for acute thromboembolic stroke that shows promise in restoring cerebral blood supply. Reviewed evidence suggests that intra-arterial treatment has a longer window for treatment than intravenous t-PA and does improve outcome. A favorable outcome is dependent on careful patient selection aimed at avoiding intracranial hemorrhage. This article describes features to evaluate for patient selection and highlights factors along the treatment algorithm to maximize success. (orig.)

  13. Proximal caries detection using digital subtraction radiography in the artificial caries activity model

    International Nuclear Information System (INIS)

    Park, Jong Hoon; Lee, Gi Ja; Choi, Sam Jin; Park, Young Ho; Kim, Kyung Soo; Jin, Hyun Seok; Hong, Kyung Won; Oh, Berm Seok; Park, Hun Kuk; Choi, Yong Suk; Hwang, Eui Hwan

    2009-01-01

    The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Digital radiographs of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size no.2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. In artificial caries activity model, the range of lesional depth was 572-1,374 μm and the range of lesional area was 36.95-138.52 mm 2 . The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

  14. Proximal caries detection using digital subtraction radiography in the artificial caries activity model

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Hoon; Lee, Gi Ja; Choi, Sam Jin; Park, Young Ho; Kim, Kyung Soo; Jin, Hyun Seok; Hong, Kyung Won; Oh, Berm Seok; Park, Hun Kuk [Department of Biomedical Engineering, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2009-03-15

    The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Digital radiographs of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size no.2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. In artificial caries activity model, the range of lesional depth was 572-1,374 {mu}m and the range of lesional area was 36.95-138.52 mm{sup 2}. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

  15. Imaging of the digital arteries: Digital subtraction angiography versus conventional angiography

    International Nuclear Information System (INIS)

    Menanteau, B.P.; Treutenaere, J.M.; Marcus, C.; Ladam, V.; Gausserand, F.

    1986-01-01

    The authors report their experience with the use of digital subtraction angiography (DSA) and conventional angiography of the hand. Of the 95 patients in the study group, 80 underwent conventional angiography and 15 underwent DSA. They analyzed the studies with regard to the type and amount of contrast agent used, the number of radiographs needed, and the diagnostic quality of the images. Conventional angiography often requires general anesthesia, magnification, and pharmaco-angiographic techniques to improve the image-based diagnosis. In comparison with conventional angiography, intraarterial DSA is characterized by improved contrast sensitivity and inferior spatial resolution. However, DSA provides images as acceptable as those of conventional angiography. Smaller catheters can be used, and the examination is performed under local anesthesia. The authors conclude that intraarterial DSA is now the technique of choice for examining patients with chronic ischemia of the hand

  16. Videodensitometric ejection fraction from intravenous digital subtraction right ventriculograms: correlation with first pass radionuclide ejection fraction

    Energy Technology Data Exchange (ETDEWEB)

    Detrano, R.; MacIntyre, W.; Salcedo, E.E.; O' Donnell, J.; Underwood, D.A.; Simpfendorfer, C.; Go, R.T.; Butters, K.; Withrow, S.

    1985-06-01

    Thirty-one consecutive patients undergoing intravenous blurred mask digital subtraction right ventriculography were submitted to first pass radionuclide angiography. Second order mask resubtraction of end-diastolic and end-systolic right ventricular digital image frames was executed using preinjection end-diastolic and end-systolic frames to rid the digital subtraction images of mis-registration artifact. End-diastolic and end-systolic perimeters were drawn manually by two independent observers with a light pen. Ejection fractions calculated from the integrated videodensitometric counts within these perimeters correlated well with those derived from the first pass radionuclide right ventriculogram (r = 0.84) and the interobserver correlation was acceptable (r = 0.91). Interobserver differences occurred more frequently in patients with atrial fibrillation and in those whose tricuspid valve planes were difficult to discern on the digital subtraction right ventriculograms. These results suggest that videodensitometric analysis of digital subtraction right ventriculograms is an accurate method of determining right ventricular ejection fraction and may find wide clinical applicability.

  17. Preliminary study of lateral cerebral angiography with reverse rotation in the digital image registration and subtraction

    International Nuclear Information System (INIS)

    Shen Zhenglin; Liu Dongyang; Shen Zhenghai; Li Shuping; Zhang Ziyan; Wu Yongjuan; Liu Peijun

    2012-01-01

    Objective: Investigate the value and feasibility of image registration with reverse rotation in lateral cerebral DSA. Methods: (1) Experimental study: the target images were subtracted directly, and subtracted again after reverse rotation. Software of registration and subtraction with reverse rotation edited by the author utilizing Visual Basic. The function of the automatic angle detection by the software were evaluated to see whether it detected the angle of line. The subtraction function of DSA by the software was evaluated. (2) Clinical retrospective study: the untreated mask and target images of 15 patients with motion along vertical axis during lateral cerebral DSA were uploaded to the software. The target images were processed with and without the software to get two sets of images. (3) Evaluation: four experienced radiologists read and compared the two sets of the images,and graded their findings. Results: (1) The automatic detection by the software suggested that the target images should be rotated counterclockwise 1.3°. The subtraction result of the software was satisfactory. (2) In the 15 sets of images, there were only three sets of images deemed optimal after traditional subtraction. After reverse rotation, artifacts were significantly reduced and the image sharper. There were ten cases with significant artifacts after traditional subtraction, and those images were sharper and showed more peripheral vessels after reverse rotation. The traditional subtraction images of two sets could not be interpreted,the reverse rotation registration images reached the diagnostic quality. (3) Subjective evaluation: there were more information and less noise and distortion in the registration images with reverse rotation than in the traditional subtraction. But the image resolution decreased slightly after reverse rotation registration. Conclusion: The registration of digital angiography with reverse rotation can improve the image quality in lateral cerebral DSA

  18. Intra-arterial injection of Tc-99m MDP

    Directory of Open Access Journals (Sweden)

    Ebru Salmanoglu

    2016-03-01

    Full Text Available Bone scintigraphy is applied to evaluate abnormalities of axial skeleton and appendicular skeleton including osteomyelitis, prosthesis infection, prosthesis loosening, avascular necrosis, stress fracture, bone metastasis. Technetium-99m methylene diphosphonate (Tc-99m MDP is most common used radiopharmaceutical. Injection of Tc-99m MDP should be done intravenous but it can be done intra-arterial, accidentally. After intra-arterial injection of Tc-99m MDP, it cause prominent soft tissue uptake distal to the injection site. This situation can create confusion in the scintigraphic images. Usually, it imitate reflex sympathetic dystrophy, so differential diagnosis is important. The aim of this report is to present the appearance of inadvertent intra-arterial injection of Tc-99m MDP. [Cukurova Med J 2016; 41(0.100: 79-82

  19. Role of digital tomosynthesis and dual energy subtraction digital radiography in detecting pulmonary nodules

    International Nuclear Information System (INIS)

    Kumar, Sarvana G.; Garg, Mandeep Kumar; Khandelwal, Niranjan; Gupta, Pankaj; Gupta, Dheeraj; Aggarwal, Ashutosh Nath; Bansal, Subash Chand

    2015-01-01

    Highlights: • Accuracy of digital tomosynthesis for nodule detection is substantially higher. • Improvement in diagnostic accuracy is most pronounced for nodules <10 mm. • There is five times increase in radiation dose compared to DR. - Abstract: Objective: Digital tomosynthesis (DT) and dual-energy subtraction digital radiography (DES-DR) are known to perform better than conventional radiography in the detection of pulmonary nodules. Yet the comparative diagnostic performances of DT, DES-DR and digital radiography (DR) is not known. The present study compares the diagnostic performances of DT, DES-DR and DR in detecting pulmonary nodules. Subjects and methods: The institutional Review Board approved the study and informed written consent was obtained. Fifty-five patients (30 with pulmonary nodules, 25 with non-nodular focal chest pathology) were included in the study. DT and DES-DR were performed within14 days of MDCT. Composite images acquired at high kVp as part of DES-DR were used as DR images. Images were analyzed for presence of nodules and calcification in nodules. Interpretations were assigned confidence levels from 1 to 5 according to Five-Point rating scale. Areas under the receiver operating characteristic curves were compared using Z test. Results: A total of 110 (88 non-calcified, 22 calcified) nodules were identified on MDCT. For detection of nodules, DR showed cumulative sensitivity and specificity of 25.45% and 67.97%, respectively. DT showed a cumulative sensitivity and specificity of 60.9% and 85.07%, respectively. The performance was significantly better than DR (p < 0.003). DES-DR showed sensitivity and specificity of 27.75% and 82.64%, not statistically different from those of DR (p—0.92). In detection of calcification, there was no statistically significant difference between DT, DES-DR and DR. Conclusions: DT performs significantly better than DES-DR and DR at the cost of moderate increase in radiation dose

  20. Application of digital subtraction angiography in disease of large cardiac vessel

    International Nuclear Information System (INIS)

    Arisawa, Jun; Sone, Shusuke; Morimoto, Shizuo; Ikezoe, Junpei; Higashibara, Tokuro; Hanayama, Masayuki

    1983-01-01

    Digital subtraction angiography (DSA) was performed in 31 cases of disease of large cardiac vessel. DSA was useful for the diagnosis of aortic aneurysm and malformation of large vessels, follow-up after A-C bypass operation and Blalock's shunt operation for tetralogy of Fallot and as an adjuvant modality in cardiac catheterization. (Chiba, N.)

  1. Application of digital subtraction angiography in disease of large cardiac vessel

    Energy Technology Data Exchange (ETDEWEB)

    Arisawa, Jun; Sone, Shusuke; Morimoto, Shizuo; Ikezoe, Junpei; Higashibara, Tokuro; Hanayama, Masayuki

    1983-06-01

    Digital subtraction angiography (DSA) was performed in 31 cases of disease of large cardiac vessel. DSA was useful for the diagnosis of aortic aneurysm and malformation of large vessels, follow-up after A-C bypass operation and Blalock's shunt operation for tetralogy of Fallot and as an adjuvant modality in cardiac catheterization.

  2. Digital subtraction angiography - a new approach to brain death determination in the newborn

    International Nuclear Information System (INIS)

    Albertini, A.; Schonfeld, S.; Hiatt, M.; Hegyi, T.

    1993-01-01

    The diagnosis of brain death in the newborn infants is elusive and often difficult. The lack of cerebral blood flow has become an identified criterion for loss of cerebral function. The diagnosis can be obtained by the technique of digital subtraction angiography, which is presented in two case reports demonstrating the utility of this technique. (orig.)

  3. Digital subtraction angiography and intraarterial contrast medium injection for coronary examinations

    Energy Technology Data Exchange (ETDEWEB)

    Tobio, R.; Kallmeyer, C.; Castello, J.

    1985-01-01

    Digital subtraction angiography (DSA) is an established method of vasography, most extensively used as i.v. DSA. Intraarterial injection, however, applying selective or non-selective contrast medium injection, seems to be at least as important a technique although it has not yet met with corresponding interest. The article explains advantages of the technique for angiographic examinations, in particular of coronary angiography.

  4. Rescue localized intra-arterial thrombolysis for hyperacute MCA ischemic stroke patients after early non-responsive intravenous tissue plasminogen activator therapy

    International Nuclear Information System (INIS)

    Kim, Dong Joon; Kim, Dong Ik; Kim, Seo Hyun; Lee, Kyung Yeol; Heo, Ji Hoe; Han, Sang Won

    2005-01-01

    The outcome of patients who show no early response to intravenous (i.v.) tissue plasminogen activator (tPA) therapy is poor. The objective of this study was to evaluate the feasibility of rescue localized intra-arterial thrombolysis (LIT) therapy for acute ischemic stroke patients after an early non-responsive i.v. tPA therapy. Patients with proximal MCA occlusions who were treated by LIT (n=10) after failure of early response [no improvement or improvement of National Institute of Health Stroke Scale (NIHSS) scores of ≤3] to i.v. tPA therapy (0.9 mg/kg - 10% bolus and 90% i.v. infusion over 60 min) were selected. The recanalization rates, incidence of post-thrombolysis hemorrhage and clinical outcomes [baseline and discharge NIHSS scores, mortality, 3 months Barthel index (BI) and modified Rankin score (mRS)] were evaluated. Rescue LIT therapy was performed on ten MCA occlusion patients (male:female=3:7, mean age 71 years). The mean time between the initiation of i.v. tPA therapy and the initiation of intra-arterial urokinase (i.a. UK) was 117±25.0 min [time to i.v. tPA 137±32 min; time to digital subtraction angiography (DSA) 221±42 min; time to i.a. UK 260±46 min]. The baseline NIHSS scores showed significant improvement at discharge (median from 18 to 6). Symptomatic hemorrhage and, consequent, mortality were noted in 2/10 (20%) patients. Three months good outcome was noted in 4/10 (40%, mRS 0-2) and 3/10 (30%, BI ≥95). In conclusion, rescue LIT therapy can be considered as a treatment option for patients not showing early response to full dose i.v. tPA therapy. Larger scale studies for further validation of this protocol may be necessary. (orig.)

  5. Value of Single-Dose Contrast-Enhanced Magnetic Resonance Angiography Versus Intraarterial Digital Subtraction Angiography in Therapy Indications in Abdominal and Iliac Arteries

    International Nuclear Information System (INIS)

    Schaefer, Philipp J.; Schaefer, Fritz K. W.; Mueller-Huelsbeck, Stefan; Both, Markus; Heller, Martin; Jahnke, Thomas

    2007-01-01

    The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy. Patients suspected of having abdominal or iliac artery stenosis were included in this study. A positive vote of the local Ethics Committee was given. After written informed consent was obtained, 37 patients were enrolled, of which 34 were available for image evaluation. Both 3D ceMRA and i.a. DSA were performed for each patient. The dosage for 3D ceMRA was 0.1 mmol/kg body weight in a 1.5-T scanner with a phased-array coil. The parameters of the 3D-FLASH sequence were as follows: TR/TE 4.6/1.8 ms, effective thickness 3.5 mm, matrix 512 x 200, flip angle 30 o , field of view 420 mm, TA 23 s, coronal scan orientation. Totally, 476 vessel segments were evaluated for stenosis degree by two radiologists in a consensus fashion in a blinded read. For each patient, a therapy was proposed, if clinically indicated. Sensitivity, specificity, positive and negative predictive values, and accuracy for stenoses ≥50% were 68%, 92%, 44%, 97%, and 90%, respectively. In 13/34 patients, a discrepancy was found concerning therapy decisions based on MRA findings versus therapy decisions based on the reference standard DSA. The results showed that the used MRA imaging technique of abdominal and iliac arteries is not competitive to i.a. DSA, with a high rate of misinterpretation of the MRAs resulting in incorrect therapies

  6. Intra-arterial nimodipine for cerebral vasospasm after subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Bashir, Asma; Andresen, Morten; Bartek, Jiri

    2016-01-01

    Intra-arterial nimodipine (IAN) has shown a promising effect on cerebral vasospasm (CV) after aneurysmal subarachnoid haemorrhage. At our institution, Rigshospitalet, IAN treatment has been used since 2009, but the short- and long-term clinical efficacy of IAN has not yet been assessed. The purpo...

  7. Digital image comparison by subtracting contextual transformations—percentile rank order differentiation

    Science.gov (United States)

    Wehde, M. E.

    1995-01-01

    The common method of digital image comparison by subtraction imposes various constraints on the image contents. Precise registration of images is required to assure proper evaluation of surface locations. The attribute being measured and the calibration and scaling of the sensor are also important to the validity and interpretability of the subtraction result. Influences of sensor gains and offsets complicate the subtraction process. The presence of any uniform systematic transformation component in one of two images to be compared distorts the subtraction results and requires analyst intervention to interpret or remove it. A new technique has been developed to overcome these constraints. Images to be compared are first transformed using the cumulative relative frequency as a transfer function. The transformed images represent the contextual relationship of each surface location with respect to all others within the image. The process of differentiating between the transformed images results in a percentile rank ordered difference. This process produces consistent terrain-change information even when the above requirements necessary for subtraction are relaxed. This technique may be valuable to an appropriately designed hierarchical terrain-monitoring methodology because it does not require human participation in the process.

  8. Evaluation of coronary blood flow using digital subtraction technique and cine coronary angiography

    International Nuclear Information System (INIS)

    Uwatoko, Masashi; Miyagi, Yutaka; Nomura, Masanori

    1988-01-01

    To evaluate coronary circulation in ischemic heart disease, digital image processing with cine coronary angiography was performed. Using time-density curves obtained from individual pixels, images showing the distribution of contrast density and transit time were obtained. To record angiograms, contrast medium was injected into the coronary artery in a steady manner during right atrial pacing. Frames in the end-diastolic phase immediately before the P wave were selected, and digitized into a 512 x 512 x 8 bit matrix using a system composed of a video camera, an analog-to-digital converter, and a computer. These digitized images were then stored in a disk memory. A mask image was prepared before the injection of contrast medium. Subtraction was performed using the mask image and a series of images following contrast injection. The subtracted images were of sufficient quality to permit clear observation of the individual coronary arterial branches. Time-density curves were then determined from these subtracted images. From these curves, time from the onset of contrast injection to its peak density (Tp), time from the peak density to the half peak density (T1/2) and the attenuation factor of the curves (τ) were derived. Their distributions were expressed as color images. Examples of normal control and a case of inferior infarction were demonstrated. Blood flow function images with good spatial resolution were thus obtained. This method is useful for evaluating coronary blood flow. (author)

  9. Deep vein thrombosis of the upper extremity: intra- and interobserver study of digital subtraction venography

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, Henk J.; Delden, Otto M. van; Bakker, Ad J.; Reekers, Jim A. [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Beek, Edwin J.R. van [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Section of Academic Radiology, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF (United Kingdom); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2003-02-01

    Our objective was to assess the inter-observer and intra-observer agreement in the interpretation of digital subtraction venography (DSV) in patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Prospectively, 62 consecutive DSV studies in 54 patients with clinically suspected DVTUE were included. Hard copies were presented without demographic data or original report. All venograms were read twice, at 3-month intervals, by an interventional vascular radiologist (observer 1) and an experienced general radiologist (observer 2). Consensus reading took place in the presence of a third experienced interventional radiologist. Inter-observer and intra-observer agreement were assessed using kappa statistics. Initial reading in 62 venograms showed an inter-observer agreement of 71% (kappa 0.48). The inter-observer agreement of the second reading was 83% (kappa 0.71). The agreement with the consensus report ranged from 76 to 94%. The intra-observer agreement for the first and second observer was 94% (kappa 0.89) and 76% (kappa 0.56), respectively (p<0.01). Digital subtraction venography has moderate to excellent intra- and inter-observer agreement, suggesting that digital subtraction venography is reliable for the diagnosis of DVTUE. (orig.)

  10. Digital subtraction radiography evaluation of longitudinal bone density changes around immediate loading implants: a pilot study.

    Science.gov (United States)

    Carneiro, L S; da Cunha, H A; Leles, C R; Mendonça, E F

    2012-03-01

    The aim of this study was to assess longitudinal quantitative changes in bone density around different implant loading protocols and implant surfaces measured by digital subtraction radiography (DSR). 12 patients received bilateral homologous standard and TiUnite® (Nobel Biocare, Kloten, Switzerland) single-tooth implants under 2 implant-loading protocols: immediate loading (8 patients, 16 implants, 12 maxillary) and conventional loading (4 patients, 8 implants, 4 maxillary). Standardized periapical radiographs were taken immediately after implant placement (baseline image) and at the 3-month, 6-month and 12-month follow ups. Radiographic images were digitized and submitted to digital subtraction using the DSR system® (Electro Medical System, Nyon, Switzerland), resulting in three subtracted images. Quantitative analysis of bone density was performed using Image Tool® software (University of Texas Health Science Centre, San Antonio, TX) to assess pixel value changes in five areas around the implants (crestal, subcrestal, medial third, apical-lateral and apical). Repeated-measures analysis of variance showed that grey levels were significantly influenced by follow-up time and implant-loading protocol. A linear increase in grey levels was found for immediate loading (IML) implants and a significant decrease in grey levels was observed in the 12-month follow up for conventional loading implants. No effect of implant surface treatment was observed. In conclusion, IML protocol induced mineral bone gain around single-tooth implants after the first year under function for cases with favourable bone conditions.

  11. Dissociated brain organization for two-digit addition and subtraction: an fMRI investigation.

    Science.gov (United States)

    Yi-Rong, Ni; Si-Yun, Shu; Zhou-Yi, Guo; Si-Run, Liu; Yun, Bao; Song-Hao, Liu; Chan, Wood Yee

    2011-11-25

    The present study compared the patterns of brain activation elicited by two-digit addition and subtraction problems. Thirty-two Chinese undergraduates of the same educational background and of similar age were asked to assess whether arithmetic operations were true or false during functional magnetic resonance imaging. Results showed that both complex addition and subtraction were supported by the broad neural system that involved regions within the inferior parietal lobule, the precuneus, and the inferior occipital gyrus, as well as some subcortical structures. Nevertheless, complex problems involving addition elicited more activation mainly in the bilateral medial frontal gyrus, whereas problems involving subtraction had more activation in the precentral gyrus and the thalamus in the right hemisphere, as well as the inferior parietal lobule in the left hemisphere. This pattern of dissociated activation suggests that partially separate neuronal networks might support these different operations. It also suggests that complex addition has a greater reliance on the fronto-parietal cortical circuit and subtraction on the parieto-subcortical circuit. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Image processing of images from peripheral-artery digital subtraction angiography (DSA) studies

    International Nuclear Information System (INIS)

    Wilson, D.L.; Tarbox, L.R.; Cist, D.B.; Faul, D.D.

    1988-01-01

    A system is being developed to test the possibility of doing peripheral, digital subtraction angiography (DSA) with a single contrast injection using a moving gantry system. Given repositioning errors that occur between the mask and contrast-containing images, factors affecting the success of subtractions following image registration have been investigated theoretically and experimentally. For a 1 mm gantry displacement, parallax and geometric image distortion (pin-cushion) both give subtraction errors following registration that are approximately 25% of the error resulting from no registration. Image processing techniques improve the subtractions. The geometric distortion effect is reduced using a piece-wise, 8 parameter unwarping method. Plots of image similarity measures versus pixel shift are well behaved and well fit by parabola, leading to the development of an iterative, automatic registration algorithm that uses parabolic prediction of the new minimum. The registration algorithm converges quickly (less than 1 second on a MicroVAX) and is relatively immune to the region of interest (ROI) selected

  13. Intra-artery thrombolytic therapy for acute ischemic cerebral infarction

    International Nuclear Information System (INIS)

    Du Wei; Shao Chengmin; Wang Jianlin; Lei Jin; Jia Fan; Cao Lanfang; Chai Ruchang; Su Wei; Gu Jinchuan

    2004-01-01

    Objective: To evaluate the clinical effects of intra-arterial thrombolytic therapy for acute ischemic cerebral infarction and analyze the factors influencing the clinical prognosis. Methods: 32 patients were treated with intra-arterial thrombolysis using urokinase (median dose, 65 x 10 4 U) within 2-20 hours, after the onset. The patient's condition was assessed by neurologists using National Institutes of Health Stroke Scale (NIHSS) score right at the admission. Clinical outcome was assessed after 3 months and graded as good for Modified Rankin Scale (MRS) scores of 0 to 3 and poor for MRS scores of 4 or 5 and death. Results: Follow up cerebral angiography of 14 cases treated within 6 hours after onset showed complete/partial recanalization in 13 cases. Other 18 patients whose treatment started beyond 6 hours after onset out-came with complete/partial in 7. 20 (62.5%) of the 32 patients had good out-come, 12(37.5%) had poor outcome and two patients(9.4%) died. Cerebral hemorrhage occurred in 2 of the 32 patients. Good outcome was associated with an initial NIHSS score of <20 (P<0.01) and vascular recanalization (P<0.025). Recanalization was more likely to be obtained if thrombolysis began within 6 hours (P<0.05). Conclusion: Intra-arterial thrombolysis is a safe and effective therapy for acute ischemic cerebral infarction. (authors)

  14. Bone marrow edema pattern identification in patients with lytic bone lesions using digital subtraction angiography-like bone subtraction on large-area detector computed tomography.

    Science.gov (United States)

    Gondim Teixeira, Pedro Augusto; Hossu, Gabriela; Lecocq, Sophie; Razeto, Marco; Louis, Matthias; Blum, Alain

    2014-03-01

    The objective of this study was to evaluate the performance of digital subtraction angiography (DSA)-like bone subtraction with 2 different registration methods for the identification of bone marrow edema pattern (BMEP) in patients with lytic bone lesions, using magnetic resonance imaging as the criterion standard. Fifty-five patients with a lytic bone lesion were included in this prospective study with approval from the ethics committee. All patients underwent magnetic resonance imaging and low-dose computed tomographic (CT) perfusion after signing an informed consent. Two CT volumes were used for bone subtraction, which was performed with 2 different algorithms (rigid and nonrigid). Enhancement at the nonlytic bone marrow was considered as a sign of BMEP. Two readers evaluated the images blindly. The presence of BMEP on bone-subtracted CT images was evaluated subjectively and quantitatively. Image quality was assessed. Magnetic resonance imaging was used as the criterion standard. Using a rigid registration method, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT with DSA-like bone subtraction BMEP was 77%, 100%, 100%, 68%, and 85%, respectively. The interobserver agreement was good (κ, 0.782). Image quality was better using a nonrigid registration. With this algorithm, artifacts interfered with image interpretation in only 5% of cases. However, there was a noticeable drop in sensitivity and negative predictive value when a nonrigid algorithm was used: 56% and 52%, respectively. The interobserver agreement was average with a nonrigid subtraction algorithm. Computed tomography with DSA-like bone subtraction is sensitive and highly specific for the identification of BMEP associated with lytic bone lesions. Rigid registering should be preferred, but nonrigid algorithms can be used as a second option when artifacts interfere with image interpretation.

  15. Reproducibility of and file format effect on digital subtraction radiography of simulated external root resorptions.

    Science.gov (United States)

    Gegler, A; Mahl, Cew; Fontanella, V

    2006-01-01

    To evaluate, in simulated external root resorptions (ERR), two factors that may affect results of digital subtraction radiography (DSR): (1) intraobserver and interobserver reproducibility and (2) effects of digital file formats (TIFF, BMP and JPEG) on the estimation of mineral loss. Eleven incisors were radiographed three times (NR, no resorption; SR, small--#1/4 round bur; and LR, large--#2 round bur) on standardized projections. The resulting images were reproduced and saved as TIFF, JPEG and BMP file formats. The pairs of TIFF images (NR x SR and NR x LR) were subtracted three times at 1 week intervals by three observers. One observer subtracted pairs of images (NR x SR and NR x LR) for all file formats. For each subtraction the resorption area was selected and mean pixel density values were calculated. Analysis of variance (ANOVA) (P = 0.05) showed no statistical differences for intraobserver and interobserver values. Mean pixel density values were: observer A, 121.60 +/- 2.56 (NR x SR) and 111.84 +/- 4.04 (NR x LR); observer B, 121.86 +/- 2.50 (NR x SR) and 110.92 +/- 3.36 (NR x LR); and observer C, 121.70 +/- 2.39 (NR x SR) and 111.10 +/- 2.67 (NR x LR). Also, no statistical differences were found between file formats for LR (TIFF, 110.88 +/- 2.79; JPEG, 111.35 +/- 3.35; BMP, 111.00 +/- 2.70) and for SR between TIFF (121.30 +/- 2.34) and JPEG (120.46 +/- 1.51) or BMP (121.67 +/- 2.18) file formats. Differences were found between the JPEG and BMP groups. DSR is reproducible in simulated ERR, and JPEG or BMP file formats do not affect results.

  16. Accuracy of digital subtraction radiography in combination with a contrast media in assessment of proximal caries depth

    Directory of Open Access Journals (Sweden)

    Farzad Esmaeili

    2008-07-01

    Full Text Available Background and aims. Radiography is used to diagnose the demineralization process and carious lesions; however, conventional radiography and direct digital images do not show these lesions when the amount of demineralization is less than 40%. Digital subtraction radiography has recently been used to improve the diagnostic quality of these lesions. The purpose of this study was to compare the caries depth estimated by digital subtraction radiography in combination with barium sulfate in diagnosing proximal dental caries with histopathologic evaluation. Materials and methods. In this study 30 molars and premolars (24 demineralized lesions with cavity, 8 without cavity were studied. Direct digital images were taken (kVp: 68, mA: 8; t: 0.12 for premolars and t: 0.16 for molars whereas the position of X-ray tube and CCD receptor and teeth was fixed. To prepare the second images 135 gr/L barium sulfate was used. The images obtained with the same exposure and geometry and then subtracted. The depth of the lesions in direct digital and subtracted images were assessed and compared with the depth measured in histopathologic assessments. Results. The mean depths (± SD of the lesions were 1.80 ± 0.77 mm in direct digital radiography, 2.32 ± 0.76 mm in subtracted images after barium sulfate treatment, and 2.51 ± 0.43 mm in histopathologic sections. The statistical difference between direct digital radiography and the other methods was significant (P < 0.05. However, the differences were not statistically significant between subtracted images and histopathologic sections. The average intra-class correlation coefficient was 0.7241 (CI: 95%. Conclusion. The present study has demonstrated that digital subtraction radiography images have the potential to measure the depth of proximal caries with no significant difference with histopathologic evaluation.

  17. Digital Subtraction Phonocardiography (DSP applied to the detection and characterization of heart murmurs

    Directory of Open Access Journals (Sweden)

    Ali Akbari Mohammad

    2011-12-01

    Full Text Available Abstract Background During the cardiac cycle, the heart normally produces repeatable physiological sounds. However, under pathologic conditions, such as with heart valve stenosis or a ventricular septal defect, blood flow turbulence leads to the production of additional sounds, called murmurs. Murmurs are random in nature, while the underlying heart sounds are not (being deterministic. Innovation We show that a new analytical technique, which we call Digital Subtraction Phonocardiography (DSP, can be used to separate the random murmur component of the phonocardiogram from the underlying deterministic heart sounds. Methods We digitally recorded the phonocardiogram from the anterior chest wall in 60 infants and adults using a high-speed USB interface and the program Gold Wave http://www.goldwave.com. The recordings included individuals with cardiac structural disease as well as recordings from normal individuals and from individuals with innocent heart murmurs. Digital Subtraction Analysis of the signal was performed using a custom computer program called Murmurgram. In essence, this program subtracts the recorded sound from two adjacent cardiac cycles to produce a difference signal, herein called a "murmurgram". Other software used included Spectrogram (Version 16, GoldWave (Version 5.55 as well as custom MATLAB code. Results Our preliminary data is presented as a series of eight cases. These cases show how advanced signal processing techniques can be used to separate heart sounds from murmurs. Note that these results are preliminary in that normal ranges for obtained test results have not yet been established. Conclusions Cardiac murmurs can be separated from underlying deterministic heart sounds using DSP. DSP has the potential to become a reliable and economical new diagnostic approach to screening for structural heart disease. However, DSP must be further evaluated in a large series of patients with well-characterized pathology to determine

  18. The potential for neurovascular intravenous angiography using K-edge digital subtraction angiography

    International Nuclear Information System (INIS)

    Schueltke, E.; Fiedler, S.; Kelly, M.; Griebel, R.; Juurlink, B.; LeDuc, G.; Esteve, F.; Le Bas, J.-F.; Renier, M.; Nemoz, C.; Meguro, K.

    2005-01-01

    Background: Catheterization of small-caliber blood vessels in the central nervous system can be extremely challenging. Alternatively, intravenous (i.v.) administration of contrast agent is minimally invasive and therefore carries a much lower risk for the patient. With conventional X-ray equipment, volumes of contrast agent that could be safely administered to the patient do not allow acquisition of high-quality images after i.v. injection, because the contrast bolus is extremely diluted by passage through the heart. However, synchrotron-based digital K-edge subtraction angiography does allow acquisition of high-quality images after i.v. administration of relatively small doses of contrast agent. Materials and methods: Eight adult male New Zealand rabbits were used for our experiments. Animals were submitted to both angiography with conventional X-ray equipment and synchrotron-based digital subtraction angiography. Results: With conventional X-ray equipment, no contrast was seen in either cerebral or spinal blood vessels after i.v. injection of iodinated contrast agent. However, using K-edge digital subtraction angiography, as little as 1 ml iodinated contrast agent, when administered as i.v. bolus, yielded images of small-caliber blood vessels in the central nervous system (both brain and spinal cord). Conclusions: If it would be possible to image blood vessels of the same diameter in the central nervous system of human patients, the synchrotron-based technique could yield high-quality images at a significantly lower risk for the patient than conventional X-ray imaging. Images could be acquired where catheterization of feeding blood vessels has proven impossible

  19. The potential for neurovascular intravenous angiography using K-edge digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Schueltke, E. [University of Saskatchewan, Saskatoon, SK (Canada) and Walton Medical Centre, University of Liverpool (United Kingdom)]. E-mail: els433@duke.usask.ca; Fiedler, S. [EMBL, Hamburg (Germany); Kelly, M. [University of Saskatchewan, Saskatoon, SK (Canada); Griebel, R. [University of Saskatchewan, Saskatoon, SK (Canada); Juurlink, B. [University of Saskatchewan, Saskatoon, SK (Canada); LeDuc, G. [ESRF, Grenoble (France); Esteve, F. [INSERM U647-ESRF, Grenoble (France); Le Bas, J.-F. [INSERM U647-ESRF, Grenoble (France); Renier, M. [ESRF, Grenoble (France); Nemoz, C. [ESRF, Grenoble (France); Meguro, K. [University of Saskatchewan, Saskatoon, SK (Canada)

    2005-08-11

    Background: Catheterization of small-caliber blood vessels in the central nervous system can be extremely challenging. Alternatively, intravenous (i.v.) administration of contrast agent is minimally invasive and therefore carries a much lower risk for the patient. With conventional X-ray equipment, volumes of contrast agent that could be safely administered to the patient do not allow acquisition of high-quality images after i.v. injection, because the contrast bolus is extremely diluted by passage through the heart. However, synchrotron-based digital K-edge subtraction angiography does allow acquisition of high-quality images after i.v. administration of relatively small doses of contrast agent. Materials and methods: Eight adult male New Zealand rabbits were used for our experiments. Animals were submitted to both angiography with conventional X-ray equipment and synchrotron-based digital subtraction angiography. Results: With conventional X-ray equipment, no contrast was seen in either cerebral or spinal blood vessels after i.v. injection of iodinated contrast agent. However, using K-edge digital subtraction angiography, as little as 1 ml iodinated contrast agent, when administered as i.v. bolus, yielded images of small-caliber blood vessels in the central nervous system (both brain and spinal cord). Conclusions: If it would be possible to image blood vessels of the same diameter in the central nervous system of human patients, the synchrotron-based technique could yield high-quality images at a significantly lower risk for the patient than conventional X-ray imaging. Images could be acquired where catheterization of feeding blood vessels has proven impossible.

  20. Mycotic aneurysms in intravenous drug abusers: the utility of intravenous digital subtraction angiography

    International Nuclear Information System (INIS)

    Shetty, P.C.; Krasicky, G.A.; Sharma, R.P.; Vemuri, B.R.; Burke, M.M.

    1985-01-01

    Two-hundred thirteen intravenous digital subtraction angiographic (DSA) examinations were performed on 195 intravenous drug abusers to rule out the possibility of a mycotic aneurysm in a groin, neck, or upper extremity infection. Twenty-three surgically proved cases of mycotic aneurysm were correctly identified with no false positive results. In addition, six cases of major venous occlusion were documented. The authors present the results of their experience and conclude that DSA is an effective and cost-efficient method of examining this high risk patient population

  1. Assessment of maximal myocardial perfusion by ECG-triggered digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Pijls, N.H.J.; Uijen, G.J.H.; Werf, T. van der (Katholieke Univ. Nijmegen (Netherlands). Cardiology Dept.)

    1991-01-01

    Early studies about calculation of coronary blood flow by analysis of contrast agent passage on the coronary arteriogram were reported more than 2 decades ago by Rutishauser et al. and Smith et al. Thereafter is was shown that visualization of contrast passage through the myocardium could be enhanced by ECG-triggered digital subtraction imaging and it was suggested that myocardial flow could be calculated by studying the temporal changes in contrast intensity in a myocardial region of interest (ROI) as a function of time: the time density curve (TDC). (orig./GDG).

  2. Improved artifact rejection and isolation of compound action potentials by means of digital subtraction.

    Science.gov (United States)

    Kiss, I; Shizgal, P

    1989-12-01

    When recording compound action potentials (CAPs) elicited by stimulating near the recording site, it may prove difficult to distinguish the CAP from the shock artifact because of their overlap in time. This problem is compounded when a pair of stimulation pulses is delivered because the CAP elicited by the test pulse (T pulse) may be partially superimposed on the artifact and response elicited by the conditioning pulse (C pulse) as well as on the T pulse artifact. Methods based on digital subtraction were used to address these problems. A record was obtained with the C-T interval adjusted to be slightly less than the absolute refractory period so that the T pulse would fail to elicit a CAP. A record consisting of a C pulse artifact and response was subtracted from this record to yield a 'pure' shock artifact. In principle, subtracting this 'artifact-only' record from records obtained with single pulses removes the shock artifact and yields a 'pure' response. An extension of this method was used to isolate T pulse responses from the C pulse artifact, C pulse response, and T pulse artifact. These methods proved effective in improving the isolation of the CAPs of interest from other features of the raw records. Limitations of the techniques and their complementarity with other methods of artifact reduction are discussed.

  3. Intra-arterial DSA in hypervascular bone neoplasms

    Energy Technology Data Exchange (ETDEWEB)

    Arlart, I.P.; Merk, J.; Baehren, W.

    1984-11-01

    In order to evaluate intra-arterial DSA in malignant bone tumors (osteosarcoma n=2, aggressive osteoblastoma n=1) three patients were examined angiographically including conventional arteriography and DSA. Compared with conventional angiograms DSA imaging demonstrated a reduced peripheral vascular information due to reduced spatial resolution. Advantages of DSA were an improved visualization of tumor blush and atypical venous return and in addition a reduction of volume rsp. concentration of the contrast material using a iodine concentration of 200 mg/ml for preoperative vascular mapping and of 300 mg/ml for diagnostic tumor imaging.

  4. Intra-arterial DSA in hypervascular bone neoplasms

    International Nuclear Information System (INIS)

    Arlart, I.P.; Merk, J.; Baehren, W.

    1984-01-01

    In order to evaluate intra-arterial DSA in malignant bone tumors (osteosarcoma n=2, aggressive osteoblastoma n=1) three patients were examined angiographically including conventional arteriography and DSA. Compared with conventional angiograms DSA imaging demonstrated a reduced peripheral vascular information due to reduced spatial resolution. Advantages of DSA were an improved visualization of tumor blush and atypical venous return and in addition a reduction of volume rsp. concentration of the contrast material using a iodine concentration of 200 mg/ml for preoperative vascular mapping and of 300 mg/ml for diagnostic tumor imaging. (orig.) [de

  5. Update on Intra-Arterial Chemotherapy for Retinoblastoma

    Directory of Open Access Journals (Sweden)

    Mario Zanaty

    2014-01-01

    Full Text Available The tools for managing retinoblastoma have been increasing in the past decade. While globe-salvage still relies heavily on intravenous chemotherapy, tumors in advanced stage that failed chemotherapy are now referred for intra-arterial chemotherapy (IAC to avoid enucleation. However, IAC still has many obstacles to overcome. We present an update on the indications, complications, limitations, success, and technical aspects of IAC. Given its safety and high efficacy, it is expected that IAC will replace conventional strategies and will become a first-line option even for tumors that are amenable for other strategies.

  6. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Sharma, Madhurima; Sandhu, Manavjit Singh; Gorsi, Ujjwal; Gupta, Dheeraj; Khandelwal, Niranjan

    2015-01-01

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  7. Role of digital tomosynthesis and dual energy subtraction digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Madhurima, E-mail: madhurimashrm88@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Sandhu, Manavjit Singh, E-mail: manavjitsandhu@yahoo.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gorsi, Ujjwal, E-mail: ujjwalgorsi@gmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India); Gupta, Dheeraj, E-mail: dheeraj1910@gmail.com [Department of Pulmonary Medicine, PGIMER, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012 (India)

    2015-09-15

    Highlights: • Digital tomosynthesis and dual energy subtraction digital radiography are modifications of digital radiography. • These modalities perform better than digital radiography in detection of parenchymal lesions in active pulmonary tuberculosis. • Digital tomosynthesis has a sensitivity of 100% in detection of cavities. • Centrilobular nodules seen on CT in active pulmonary tuberculosis, were also demonstrated on digital tomosynthesis in our study. • Digital tomosynthesis can be used for diagnosis and follow up of patients in pulmonary tuberculosis, thereby reducing the number of CT examinations. - Abstract: Objective: To assess the role of digital tomosynthesis (DTS) and dual energy subtraction digital radiography (DES-DR) in detection of parenchymal lesions in active pulmonary tuberculosis (TB) and to compare them with digital radiography (DR). Materials and methods: This prospective study was approved by our institutional review committee. DTS and DES-DR were performed in 62 patients with active pulmonary TB within one week of multidetector computed tomography (MDCT) study. Findings of active pulmonary TB, that is consolidation, cavitation and nodules were noted on digital radiography (DR), DTS and DES-DR in all patients. Sensitivity, specificity, positive and negative predictive values of all 3 modalities was calculated with MDCT as reference standard. In addition presence of centrilobular nodules was also noted on DTS. Results: Our study comprised of 62 patients (33 males, 29 females with age range 18–82 years). Sensitivity and specificity of DTS for detection of nodules and cavitation was better than DR and DES-DR. Sensitivity and specificity of DTS for detection of consolidation was comparable to DR and DES-DR. DES-DR performed better than DR in detection of nodules and cavitation. DTS was also able to detect centrilobular nodules with sensitivity and specificity of 57.4% and 86.5% respectively. Conclusion: DTS and DES-DR perform better

  8. Evaluation of Bone Change by Digital Subtraction Radiography After Implantation of Tooth ash-plaster Mixture

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk; Kim, Kwang Won; Cho, Young Gon; Kim, Dong Kie; Choi, Eui Hwan [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University and Oral Biology Research Center, Kwangju (Korea, Republic of)

    1999-08-15

    To assess the methods for the clinical evaluation of the longitudinal bone changes after implantation of tooth ash-plaster mixture into the defect area of human jaws. Tooth ash-plaster mixtures were implanted into the defects of 8 human jaws. 48 intraoral radiograms taken with copper step wedge as reference at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture were used. X-ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner were digitized and analyzed by NIH image program. Cu-equivalent values were measured at the implanted sites from the periodic digital images. Analysis was performed by the bidirectional subtraction with color enhancement and the surface plot of resliced contiguous image. The obtained results by the two methods were compared with Cu-equivalent value changes. The average determination coefficient of Cu-equivalent equations was 0.9988 and the coefficient of variation of measured Cu values ranged from 0.08-0.10. The coefficient of variation of Cu-equivalent values measured at the areas of the mixture and the bone by the conversion equation ranged from 0.06-0.09. The analyzed results by the bidirectional subtraction with color enhancement were coincident with the changes of Cu-equivalent values. The surface plot of the resliced contiguous image showed the three dimensional view of the longitudinal bone changes on one image and also coincident with Cu-equivalent value changes after implantation. The bidirectional subtraction with color enhancement and the surface plot of the resliced contiguous image was very effective and reasonable to analyze clinically and qualitatively the longitudinal bone change. These methods are expected to be applicable to the non-destructive test in other fields.

  9. Videodensitometric assessment of right and left ventricular functions by digital subtraction angiography

    International Nuclear Information System (INIS)

    Ikeda, Hisao; Yoshiga, Osamu; Shibao, Keigo

    1987-01-01

    Intravenous digital subtraction (DS) ventriculography was performed in a series of 50 patients with heart diseases to determine right and left ventricular volumes and systolic indices. Right ventricular volume and right ventricular ejection fraction obtained by DS ventriculography were well correlated with those by geometric methods. In 43 patients with left ventricular ejection fraction of 55 % or greater, end-diastolic volume, stroke volume, and ejection fraction in the right ventricle did not differ from those in the left ventricle ; however, both the 1/3 ejection fraction and the peak ejection rate of the right ventricle were significantly lower than those of the left ventricle, suggesting the different modes of left and right ventricular contraction. In the other seven patients with chronic left ventricular failure, right ventricular systolic function may be preserved, even when left ventricular function is severely impaired. Digital subtraction ventriculography has proved to be a simple, useful method in the quanlitative and quantitative assessments of the right and left ventricles. (Namekawa, K.)

  10. Comparison of the diagnostic accuracy of direct digital radiography system, filtered images, and subtraction radiography

    Directory of Open Access Journals (Sweden)

    Wilton Mitsunari Takeshita

    2013-01-01

    Full Text Available Background: To compare the diagnostic accuracy of three different imaging systems: Direct digital radiography system (DDR-CMOS, four types of filtered images, and a priori and a posteriori registration of digital subtraction radiography (DSR in the diagnosis of proximal defects. Materials and Methods: The teeth were arranged in pairs in 10 blocks of vinyl polysiloxane, and proximal defects were performed with drills of 0.25, 0.5, and 1 mm diameter. Kodak RVG 6100 sensor was used to capture the images. A posteriori DSR registrations were done with Regeemy 0.2.43 and subtraction with Image Tool 3.0. Filtered images were obtained with Kodak Dental Imaging 6.1 software. Images (n = 360 were evaluated by three raters, all experts in dental radiology. Results: Sensitivity and specificity of the area under the receiver operator characteristic (ROC curve (Az were higher for DSR images with all three drills (Az = 0.896, 0.979, and 1.000 for drills 0.25, 0.5, and 1 mm, respectively. The highest values were found for 1-mm drills and the lowest for 0.25-mm drills, with negative filter having the lowest values of all (Az = 0.631. Conclusion: The best method of diagnosis was by using a DSR. The negative filter obtained the worst results. Larger drills showed the highest sensitivity and specificity values of the area under the ROC curve.

  11. Large renal angiomyolipomas: digital subtraction angiographic grading and presentation with bleeding

    International Nuclear Information System (INIS)

    Rimon, U.; Duvdevani, M.; Garniek, A.; Golan, G.; Bensaid, P.; Ramon, J.; Morag, B.

    2006-01-01

    AIM: To investigate whether a grading system of renal AMLs based on digital subtraction angiography (DSA) and computerized tomography (CT), could help to select patients for embolization. MATERIALS AND METHODS: Thirty patients with 35 renal angiomyolipomas (size range 4-20cm, mean 9.9cm) underwent both digital subtraction angiography (DSA) and computed tomography (CT). Based on the DSA appearance the tumours were graded into three grades: grade I, minimal vascularity; grade II, moderate vascularity; grade III, marked vascularity. RESULTS: There were seven grade I (mean 9.3cm, range 4.5-20cm), 18 grade II (mean 8.9cm, range 5-18cm) and 10 grade III tumours (mean 12.1cm, range 4-20cm). Five grade I tumours did not cause symptoms (71%) and two caused flank pain and haematuria, respectively (14.3% each). Nine of the grade II tumours were asymptomatic (50%), seven caused bleeding (39%) and two caused flank pain (11%). Four grade III tumours were asymptomatic (40%), five caused bleeding (50%) and one pain (10%). CONCLUSIONS: According to our criteria, large angiomyolipomas with minimal vascularity are less likely to bleed, and do not need prophylactic treatment. This needs to be confirmed in larger studies

  12. Clinical and radiological of acute ischemic stroke patients without angiographic occlusion on digital subtraction angiogram. A pooled analysis of case series

    International Nuclear Information System (INIS)

    Shah, Qaisar A.; Memon Zeeshan, Muhammad; Vazquez, Gabriela; Suri, M. Fareed K.; Hussein, Haitham M.; Qureshi, Adnan I.; Mohammad, Yousef M.

    2008-01-01

    Approximately 20-30% of the patients with acute ischemic stroke do not have any occlusion demonstrated on initial digital subtraction angiography (DSA). We sought to determine the risk and rates of cerebral infarction and favorable neurological outcome in this group of acute ischemic stroke patients. Patients were identified from a prospectively maintained stroke database and from literature search of MEDLINE, PubMed, and Cochrane databases. All patients had initial neurological assessment on National Institutes of Health Stroke Scale (NIHSS). Patients then underwent DSA after initial head computed tomography (CT) scans. Follow-up radiological assessment at 24-72 h was performed with CT and magnetic resonance imaging scans. Association of stroke risk factors with clinical and radiological outcomes was estimated. A total of 81 patients was analyzed (mean age 63 years; 28 were women). The median NIHSS score was 8 (range 2-25). None of the patients received either intravenous or intra-arterial thrombolytic. Cerebral infarction was detected in 62 (76%) of the 81 patients. Twenty-four to 48-h NIHSS was available for 51 patients only. Neurological improvement was observed in 22 (43%) of the 51 patients. Favorable outcome ascertained at 3-month follow-up was seen in 48 (59%) of the 81 patients. After adjusting for age, sex, and baseline NIHSS, male patients [odds ratio (OR) 4.5 (1.4-14.3), p value=0.01] and patients with age≥ =65 [OR 4.3 (1.2-16.2), p value=0.03] have a higher risk of cerebral infarcts on the follow-up imaging. Similarly, patients who presented with 10 NIHSS [OR 0.21 (0.08-0.61), p value=0.004]. Ischemic stroke patients without arterial occlusion on DSA have a higher risk of cerebral infarction and disability particularly in men, patients over 65 years of age and with NIHSS≥=10. The cause of infarction may have been arterial obstruction with spontaneous recanalization or small vessel occlusion not visible on DSA

  13. Simultaneous intra-arterial chemotherapy and radiotherapy for carcinoma of oropharynx without neck metastasis

    International Nuclear Information System (INIS)

    Tomita, Kichinobu; Higaki, Yuichiro

    2000-01-01

    We evaluated the usefulness of simultaneous intra-arterial chemotherapy and radiotherapy for oropharyngeal cancer without neck metastasis. Fifty eight cases without neck metastasis out of previously untreated 117 patients with oropharyngeal cancer treated at National Kyushu Cancer Center from 1972 to 1995 were examined. Seventeen patients were in T1, 27 in T2, 10 in T3, 4 in T4. Fourteen patients of 58 patients were treated by simultaneous intra-arterial chemotherapy and radiation therapy. The 5-year survival rate by Kaplan-Meier method for intra-arterial infusion group and non intra-arterial infusion group were 86% and 71%, respectively. Thirty one patients were treated with irradiation without surgery. In 31 cases without surgery, the 5-year survival rate for intra-arterial infusion group (13 cases) was 85%, while that for non intra-arterial infusion group (18 cases) was 60%, and the local control rate for intra-arterial infusion group is 92%, while that for non intra-arterial infusion group was 56%. Simultaneous intra-arterial chemotherapy and radiotherapy for oropharyngeal cancer without neck metastasis is useful to improve the prognosis with preserving the function. (author)

  14. The reduction of motion artifacts in digital subtraction angiography by geometrical image transformation

    International Nuclear Information System (INIS)

    Fitzpatrick, J.M.; Pickens, D.R.; Mandava, V.R.; Grefenstette, J.J.

    1988-01-01

    In the diagnosis of arteriosclerosis, radio-opaque dye is injected into the interior of the arteries to make them visible. Because of its increased contrast sensitivity, digital subtraction angiography has the potential for providing diagnostic images of arteries with reduced dye volumes. In the conventional technique, a mask image, acquired before the introduction of the dye, is subtracted from the contrast image, acquired after the dye is introduced, to produce a difference image in which only the dye in the arteries is visible. The usefulness of this technique has been severely limited by the image degradation caused by patient motion during image acquisition. This motion produces artifacts in the difference image that obscure the arteries. One technique for dealing with the problem is to reduce the degradation by means of image registration. The registration is carried out by means of a geometrical transformation of the mask image before subtraction so that it is in registration with the contrast image. This paper describes a technique for determining an optimal transformation. The authors employ a one-to-one elastic mapping and the Jacobian of that mapping to produce a geometrical image transformation. They choose a parameterized class of such mappings and use a heuristic search algorithm to optimize the parameters to minimize the severity of the motion artifacts. To increase the speed of the optimization process they use a statistical image comparison technique that provides a quick approximate evaluation of each image transformation. They present the experimental results of the application of their registration system to mask-contrast pairs, for images acquired from a specially designed phantom, and for clinical images

  15. Assessment of blood supply to intracranial pathologies in children using MR digital subtraction angiography

    International Nuclear Information System (INIS)

    Chooi, Weng Kong; Coley, Stuart C.; Connolly, Dan J.A.; Griffiths, Paul D.

    2006-01-01

    MR digital subtraction angiography (MR-DSA) is a contrast-enhanced MR angiographic sequence that enables time-resolved evaluation of the cerebral circulation. We describe the feasibility and technical success of our attempts at MR-DSA for the assessment of intracranial pathology in children. We performed MR-DSA in 15 children (age range 5 days to 16 years) referred for MR imaging because of known or suspected intracranial pathology that required a dynamic assessment of the cerebral vasculature. MR-DSA consisted of a thick (6-10 mm) slice-selective RF-spoiled fast gradient-echo sequence (RF-FAST) acquired before and during passage of an intravenously administered bolus of Gd-DTPA. The images were subtracted and viewed as a cine loop. MR-DSA was performed successfully in all patients. High-flow lesions were shown in four patients; these included vein of Galen aneurysmal malformation, dural fistula, and two partially treated arteriovenous malformations (AVMs). Low-flow lesions were seen in three patients, all of which were tumours. Normal flow was confirmed in eight patients including two with successfully treated AVMs, and in three patients with cavernomas. Our early experience suggests that MR-DSA is a realistic, non-invasive alternative to catheter angiography in certain clinical settings. (orig.)

  16. Intraarterial digital subtraction angiography after plastic surgery by thin-needle puncture

    Energy Technology Data Exchange (ETDEWEB)

    Langer, M.; Fiegler, W.; Claussen, C.; Koehler, D.; Felix, R.; Hepp, W.

    1984-06-01

    Over the period of a year (1983), 44 intraarterial digital subtraction angiographies (DSA) via direct thin-needle puncture of a vascular bypass or following vascular graft were carried the rough. The only complication that occurred: paravasal injection, was clinically insignificant and could be avoided by a change in the puncture-technique. It was possible to carry through the investigation in out-patients. In all cases, diagnostically useful picture material for a possible surgical intervention was obtained. The pictures always were high-grade, independently of the patient's circulation time. Because this is a simple investigation and because of the small risk of complications, it has come to be regularly carried through as a routine in the authors' clinic. According to investigations carried through on the collective of patients of a vascular surgery department, occlusions or anastomotic aneurismus account for most of the angiological disorders.

  17. Intraarterial digital subtraction angiography after plastic surgery by thin-needle puncture

    International Nuclear Information System (INIS)

    Langer, M.; Fiegler, W.; Claussen, C.; Koehler, D.; Felix, R.; Hepp, W.

    1984-01-01

    Over the period of a year (1983), 44 intraarterial digital subtraction angiographies (DSA) via direct thin-needle puncture of a vascular bypass or following vascular graft were carried the rough. The only complication that occured: paravasal injection, was clinically insignificant and could be avoided by a change in the puncture-technique. It was possible to carry through the investigation in out-patients. In all cases, diagnostically useful picture material for a possible surgical intervention was obtained. The pictures always were high-grade, independently of the patient's circulation time. Because this is a simple investigation and because of the small risk of complications, it has come to be regularly carried through as a routine in the authors' clinic. According to investigations carried through on the collective of patients of a vascular surgery department, occlusions or anastomotic aneurismus account for most of the angiological disorders. (orig.) [de

  18. Digital subtraction angiography of lower limb arteries using and automatic table translation. Feasibility. Preliminary results

    International Nuclear Information System (INIS)

    Seka, R.; Amiel, M.; Boller, A.; Chapelon, C.; Clermont, A.; Revel, D.; Pinet, F.

    1988-01-01

    Digital subtraction angiography (DSA) as a method of evaluating lower limb arteries required examination of one limb at a time up to now. Moreover repeated injections of contrast material were necessary. This problem was mainly due to the relative small image intensifier field available and to the difficulty of repositionning the patient between mask and image acquisition. The preliminary results obtained with 24 patients studied on angiographic unit equipped with: a DSA system (DG 300-CGR) using 512x512 matrix size, an angiographic table (Angix M 200) allowing an automatic sequantial translation, a removable image intensifier using a 16 inch field below the table, are reported. Thus, all those characteristics allow DSA of lower limb arteries. Only one injection of contrast material (Ioxaglate: 80 ml at 8-10 ml/second) was used per procedure. This, usually, allows good quality examination of lower limb arteries [fr

  19. Evaluation of graft patency by intravenous digital subtraction angiography after vascular reconstruction

    International Nuclear Information System (INIS)

    Kuribayashi, Sachio; Ootaki, Makoto; Watabe, Tsuneya; Matsuyama, Seiya

    1985-01-01

    Intravenous digital subtraction angiography (IVDSA) was employed to evaluate graft patency after reconstructive vascular surgery in 45 cases with various vascular diseases. IVDSA offered equally valuable information about the patency of the graft, compared with conventional arteriography. In the peripheral vascular disease, IVDSA readily demonstrated patency or occlusion of the graft, even in the complex one, and the result of evaluation by IVDSA correlated well with that inferred by postoperative change in ankle pressure index measured by Doppler ultrasound technique. In the aortic disease, IVDSA was effective to rule out stenosis or leakage at the anastomotic site of the graft, and was also useful in the detection of the patency of the reconstructed inferior mesenteric artery after surgery for abdominal aortic aneurysm. The procedure in IVDSA is simple and safe, and it can be performed on an outpatient basis. IVDSA is a reliable and valuable approach in the evaluation of the graft patency after reconstructive vascular surgery. (author)

  20. Idiopathic Thrombus in the Common Carotid Artery on Digital Subtraction Angiography

    Directory of Open Access Journals (Sweden)

    Anand Alurkar

    2012-01-01

    Full Text Available In the present study, we discuss the accuracy of digital subtraction angiography (DSA in diagnosis of thrombus in the common carotid artery and its role in the medical management of this disorder. Between 2006 and 2011, four patients (age group ranging from 26 to 48 years presented to our institution with symptoms of stroke. DSA in all these patients showed cigar-shaped filling defect in the common carotid artery. All the patients were managed successfully with anticoagulation treatment. Follow-up Duplex scan was done in all the patients. DSA is the gold standard to diagnose free floating thrombus in the common carotid artery. Medical management can be effective in these patients but a multidisciplinary team approach is needed for appropriate management.

  1. Evaluation of the superior vena cava system in children with digital subtraction angiography

    International Nuclear Information System (INIS)

    Pariente, D.; Lacombe, P.

    1986-01-01

    The authors report a new pediatric application of digital subtraction angiography (DSA) that is the evaluation of the superior vena cava system. 22 children have been explored. All of them had a history of previous central venous catheter placement for parenteral nutrition (13), hemodialysis (5), chemotherapy or antibiotic therapy (4). The aim of the examination was to obtain a venous mapping before a new catheter placement (14 cases) or to look for a venous thrombosis origin of superior vena cava syndrom or septicemia (8 cases). Except failure of two examinations because of absence of venous injection site, DSA showed thrombosis of one vein in 7 cases and of multiple veins in 11 cases. A pulmonary embolus was also discovered. The authors conclude that this non invasive method yields very valuable information on superior vena cava system [fr

  2. [Affine transformation-based automatic registration for peripheral digital subtraction angiography (DSA)].

    Science.gov (United States)

    Kong, Gang; Dai, Dao-Qing; Zou, Lu-Min

    2008-07-01

    In order to remove the artifacts of peripheral digital subtraction angiography (DSA), an affine transformation-based automatic image registration algorithm is introduced here. The whole process is described as follows: First, rectangle feature templates are constructed with their centers of the extracted Harris corners in the mask, and motion vectors of the central feature points are estimated using template matching technology with the similarity measure of maximum histogram energy. And then the optimal parameters of the affine transformation are calculated with the matrix singular value decomposition (SVD) method. Finally, bilinear intensity interpolation is taken to the mask according to the specific affine transformation. More than 30 peripheral DSA registrations are performed with the presented algorithm, and as the result, moving artifacts of the images are removed with sub-pixel precision, and the time consumption is less enough to satisfy the clinical requirements. Experimental results show the efficiency and robustness of the algorithm.

  3. Combined use of intraarterial digital subtraction angiography with conventional retrograde brachial vertebral angiography

    International Nuclear Information System (INIS)

    Yamaguchi, Tatsuo; Ogawa, Toshihide; Inugami, Atsushi; Kawata, Yasushi; Shishido, Fumio; Uemura, Kazuo

    1985-01-01

    For 102 patients who had the examination of conventional bilaterally retrograde brachial vertebral angiography (retrograde VAG), intraarterial digital subtraction angiography (DSA) was successively performed to investigate steno-occlusive lesions of proximal vertebral and subclavian arteries. All the patients had no complication due to the DSA procedure. In 50% of 72 ischemic stroke cases, positive findings were found either in the origin of the vertebral artery or in the subclavian artery. Stenosis of more than 50% of the lumen of the vertebral artery were found in 14% of the cases at the origin of the right one and also in 14% in the left one. Occlusion of the vertebral artery was found in 4% in the left side only. In 30 cases with non-ischemic brain diseases, positive findings were noted in 10%. Intraarterial DSA combined with retrograde VAG was thought to be useful, especially in the examination for ischemic stroke. (author)

  4. Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Kocasarac, Husniye Demirturk [Dept. of Comprehensive Dentistry, The University of Texas Health Science Center, San Antonio (United States); Celenk, Peruze [Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun (Turkmenistan)

    2017-06-15

    Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images.

  5. Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

    Science.gov (United States)

    Celenk, Peruze

    2017-01-01

    Purpose Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Materials and Methods Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. Results The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. Conclusion The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (Ppanoramic images. PMID:28680846

  6. Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

    International Nuclear Information System (INIS)

    Kocasarac, Husniye Demirturk; Celenk, Peruze

    2017-01-01

    Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images

  7. Diagnosis of vertical root fractures in endodontically treated teeth utilising Digital Subtraction Radiography: A case series report.

    Science.gov (United States)

    Mikrogeorgis, Georgios; Eirinaki, Eleni; Kapralos, Vasileios; Koutroulis, Andreas; Lyroudia, Kleoniki; Pitas, Ioannis

    2017-12-11

    Vertical root fractures are commonly associated with root-filled teeth. Diagnosis is challenging because the clinical signs are not completely pathognomonic, and conventional periapical radiography is often unreliable. Digital subtraction radiography (DSR) is able to detect small radiographic changes between two successive radiographs by subtracting out consistent radiographic elements. Its use could possibly assist in the diagnostic procedure. Four cases are presented to demonstrate the potential use of DSR in the detection of vertical root fractures in endodontically treated teeth. After the digital subtractions had been carried out, a dark line in the body of the roots was distinguishable, raising the possibility of the presence of a vertical root fracture. The use of contrast enhancement and pseudocolouring techniques assisted with the diagnosis of vertical root fractures. DSR proved to be a useful diagnostic tool for the detection of vertical root fractures in these four clinical cases. © 2017 Australian Society of Endodontology Inc.

  8. Pilot study: digital subtraction radiography as a tool to assess alveolar bone changes in periodontitis patients under treatment with subantimicrobial doses of doxycycline

    NARCIS (Netherlands)

    Goren, A.D.; Dunn, S.M.; Wolff, M.; van der Stelt, P.F.; Colosi, D.C.; Golub, L.M.

    2008-01-01

    Background Subtle changes in marginal alveolar bone level can be demonstrated using digital subtraction of sequential radiographs. Objective We aimed to evaluate the practical application of geometrically corrected digital subtraction in a clinical study of alveolar bone response to a drug

  9. Evaluation of chronic periapical lesions by digital subtraction radiography by using Adobe Photoshop CS: a technical report.

    Science.gov (United States)

    Carvalho, Fabiola B; Gonçalves, Marcelo; Tanomaru-Filho, Mário

    2007-04-01

    The purpose of this study was to describe a new technique by using Adobe Photoshop CS (San Jose, CA) image-analysis software to evaluate the radiographic changes of chronic periapical lesions after root canal treatment by digital subtraction radiography. Thirteen upper anterior human teeth with pulp necrosis and radiographic image of chronic periapical lesion were endodontically treated and radiographed 0, 2, 4, and 6 months after root canal treatment by using a film holder. The radiographic films were automatically developed and digitized. The radiographic images taken 0, 2, 4, and 6 months after root canal therapy were submitted to digital subtraction in pairs (0 and 2 months, 2 and 4 months, and 4 and 6 months) choosing "image," "calculation," "subtract," and "new document" tools from Adobe Photoshop CS image-analysis software toolbar. The resulting images showed areas of periapical healing in all cases. According to this methodology, the healing or expansion of periapical lesions can be evaluated by means of digital subtraction radiography by using Adobe Photoshop CS software.

  10. A comparative study on the accuracy of digital subtraction radiography according to the acquisition methods of reconstructed images

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Young June; Jeon, In Seong; Heo, Min Suk; Park, Tae Won [College of Dentistry, Seoul National University, Seoul (Korea, Republic of); Lee, Sam Sun; Choi, Soon Chul [Department of Dentistry, Inje University Sanggyepaik Hospital, Seoul (Korea, Republic of); Kim, Jong Dae [Division of Information and Communication Engineering, Hallym University, Chuncheon (Korea, Republic of)

    2002-06-15

    To compare the accuracy of digital subtraction images acquired by two different methods different in positioning four reference points for geometrical standardization. A total of 36 digital radiographic images of 6 volunteers were taken at the areas of the incisor, premolar, and molar of both the maxilla and mandible using the Digora system. Each image was moved 4 mm vertically and horizontally. Four oral and maxillofacial radiologists performed digital subtraction radiography between the paired images before and after movement using Emago (Oral Diagnostic Systems, Amsterdam, The Netherlands) and Sunny (Biomedisys Co., Seoul, Korea). The standard deviation of the internal gray value in Region of Interest (ROI) was statistically analyzed between the two programs using the paired t-test. The standard deviation of pixel gray values from the digital subtraction images using the Sunny program were lower than that of the Emago program (p<0.05). All observers showed significant differences between each other when the Sunny program was used (p<0.05), but one observer showed a significantly higher score than other observers when they used Emago (p<0.05). The standard deviations of premolar area from both Sunny and Emago programs were significantly higher than those of anterior and molar regions (p<0.05). The subtracted images using the Sunny program were more accurate and sensitive than those taken using the Emago program.

  11. Digital subtraction radiography evaluation of the bone repair process of chronic apical periodontitis after root canal treatment.

    Science.gov (United States)

    Benfica e Silva, J; Leles, C R; Alencar, A H G; Nunes, C A B C M; Mendonça, E F

    2010-08-01

    To monitor radiographically the progress of bone repair within chronic periapical lesions after root canal treatment using digital subtraction radiography (DSR). Twelve patients with 17 single-rooted teeth with chronic apical periodontitis associated with an infected necrotic pulp were selected for root canal treatment. Periapical radiographs were taken before treatment (baseline) and immediately post-treatment, 45, 90, 135 and 180 days after treatment. The radiographic protocol included the use of individualized film holders with silicone bite blocks. The six radiographic images were digitized and submitted to digital subtraction using DSR software, resulting in five subtracted images (SI). Quantitative analysis of these SI was performed using Image Tool software to assess pixel value changes, considering a step-wedge as the gold standard and a cut-off value of 128 pixels. The aim was to identify any increase or decrease in mineral density in the region of the periapical lesion. A minor decrease in mineral density at the canal filling session and a significant progressive mineral gain in the following evaluations (P < 0.001) occurred. Pairwise comparison of pixel grey values revealed that only the 180-day follow-up differed significantly from the previous SI. Digital subtraction radiography is a useful method for evaluating the progress of bone repair after root canal treatment. Noticeable mineral gain was observed approximately 90 days after root canal filling and definite bone repair after 180 days.

  12. A digital subtraction radiography based tool for periodontal bone resorption analysis

    Energy Technology Data Exchange (ETDEWEB)

    Schiabel, Homero; Rodrigues, Eveline B., E-mail: homero@sc.usp.br [University of Sao Paulo (EESC/USP), Sao Carlos, SP (Brazil). Dept. of Electrical Engineering; Rubira-Bullen, Izabel R.F. [University of Sao Paulo (USP), Bauru, SP (Brazil). Bauru Dentistry School

    2011-07-01

    The aim of this paper was to describe an aided diagnosis scheme for periodontal bone resorption so that the dentist can make an early diagnosis of the periodontal disease and establish the best treatment plan to increase the success of healing. Three ways of displaying the results are provided: qualitative, simple quantitative and colored-percentage quantitative views. A total of 72 pairs of in vitro radiographic images were used. The main procedure registers the images perspective projection aimed to align them in rotation and translation, and is followed by the application of a contrast correction technique. The results from the subtraction were evaluated firstly by the comparison between the actual and the digital sizes corresponding to the holes made by drills in phantoms. The mean error was 4.2%. The method was also applied to actual tooth radiographic images and could detect clearly the effect of treatment of periodontal diseases. It is dependent on the reproducibility of the process of radiographs acquisition and digitization, but the calculated mean error allows to conclude its better efficacy compared to usual procedures in this field. (author)

  13. A digital subtraction radiography based tool for periodontal bone resorption analysis

    International Nuclear Information System (INIS)

    Schiabel, Homero; Rodrigues, Eveline B.; Rubira-Bullen, Izabel R.F.

    2011-01-01

    The aim of this paper was to describe an aided diagnosis scheme for periodontal bone resorption so that the dentist can make an early diagnosis of the periodontal disease and establish the best treatment plan to increase the success of healing. Three ways of displaying the results are provided: qualitative, simple quantitative and colored-percentage quantitative views. A total of 72 pairs of in vitro radiographic images were used. The main procedure registers the images perspective projection aimed to align them in rotation and translation, and is followed by the application of a contrast correction technique. The results from the subtraction were evaluated firstly by the comparison between the actual and the digital sizes corresponding to the holes made by drills in phantoms. The mean error was 4.2%. The method was also applied to actual tooth radiographic images and could detect clearly the effect of treatment of periodontal diseases. It is dependent on the reproducibility of the process of radiographs acquisition and digitization, but the calculated mean error allows to conclude its better efficacy compared to usual procedures in this field. (author)

  14. Intra-arterial chemotherapy for invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ozono, Seiichiro; Kim, Sung-Chul; Takashima, Kenji [Nara Medical Univ., Kashihara (Japan)] [and others

    1999-02-01

    The present investigation was conducted to examine the effects of intra-arterial chemotherapy (IAC) for patients with invasive bladder cancer. A total of 37 patients were treated with IAC at Nara Medical University and its affiliated hospitals between January, 1993 and August, 1997. There were 27 patients in the poor risk group. The remaining 10 patients underwent anti-tumor IAC. Thirty of the 37 patients received chemotherapeutic agents via a reservoir, and the remaining 7 patients received a one-shot injection of agents followed by transcatheter arterial embolization (TAE). In the reservoir group, there were 18 patients who received IAC in combination with radiation therapy. As a result, reduction of tumor size was noted in 53%, and the 3-year cause-specific survival rate was 54% in all cases. There was a significant difference in the 3-year survival rate between the radiation-treated group and the group without radiation. The adverse events included anemia, leukopenia, thrombocytopenia and gastrointestinal symptoms, but none of them were severe. The results of the present study indicate that IAC is useful in the treatment of invasive bladder cancer for poor risk patients. (author)

  15. Intra-arterial mitomycin C treatment of unresectable liver tumours

    International Nuclear Information System (INIS)

    Starkhammar, H.; Haakansson, L.; Morales, O.; Svedberg, J.; Linkoeping Univ.; Linkoeping Univ.

    1987-01-01

    Regional chemotherapy might be more efficient if the cytostatic drug is injected together with degradable starch microspheres (DSM), which induce temporary blockage of arterioles and trap the co-injected drug in tumour. Eighteen patients with non-resectable liver cancer were included. Mitomycin C (15 mg/m 2 ) was injected intra-arterially mixed with 900 mg of DSM every six weeks. For estimation of the effect of DSM in the liver a radiolabelled tracer was injected via the same route. Its passage through the liver to the systemic circulation was continuously measured by a detector situated over peripheral blood vessels. The effect of DSM on the tracer passage varied considerably between different patients. The study also indicated opening of new vascular pathways some minutes after the initial injection. The dose of DSM for total blockage of the arterial blood flow, indicated by angiography, also varied. In some patients 540 mg induced total occlusion. In others neither angiographic nor tracer passage were affected by the microspheres although 900 mg (or even more) were injected. Factors such as size of the vascular bed, portal and arterial blood flow and arterio-venous shunting seemed to be of great importance and should be controlled in order to optimize the use of DSM in conjunction with chemotherapy of liver tumours. (orig.)

  16. Intra-arterial delivery of mesenchymal stem cells

    Directory of Open Access Journals (Sweden)

    Mitsuyoshi Watanabe

    2016-01-01

    Full Text Available While treatments have been developed to combat stroke, such as intravenous recombinant tissue plasminogen activator and endovascular recanalization therapies, their ability to decrease the long-term disability that accompanies stroke is limited. Currently, stem cell research focused on mesenchymal stem cells (MSCs. MSCs are multipotent, nonhematopoietic stem cells found in the stromal fraction of the bone marrow, along with the connective tissue of most organs. MSCs are an increasingly appealing cell source due to the relative ease in which they can be retrieved, developed, and handled in vitro. Despite the fact that numerous paths of stem cell transport to the brain in acute ischemic stroke (AIS exist, the intra-arterial (IA route of stem cell transport is most attractive. This is due to its great potential for clinical translation, especially considering the growing clinical application of endovascular treatment for AIS. Here, we evaluate research examining IA delivery of MSCs to the stroke region. The results of the study revealed the maximum tolerated dose and that the optimal time for administration was 24 h, following cerebral ischemia. It is important that future translational studies are performed to establish IA administration of MSCs as a widely used treatment for AIS.

  17. Drug selection principles in intra-arterial infusion chemotherapy

    International Nuclear Information System (INIS)

    Wang Gefang; Cheng Yongde

    2009-01-01

    The intra-arterial infusion chemotherapy is an effective treatment for malignant tumors. The following ten principles should be taken into account when the choice of infusion medication is to be made. (1) The tumor-sensitive drugs should be selected. (2) Pay attention to the compatibility of medicines. (3) Select the type of drug compatibility and drug interactions. (4) Concentration-dependent drugs are the drugs of first choice. (5) Pay attention to side effects when anti-cancer drug compatibility is considered.(6) The perfusion anti-cancer drugs exert their killing effect on the tumor cells in their prototype. (7) Pay attention to the administration order of the drugs and the intervals of treatment. (8) The medication should be individualized as the physical condition and tumor's heterogeneity are different from patient to patient. It is one of the fundamental principles to formulate a specific scheme for every given patient. (9) Make full use of the pharmacokinetics features of the anti-cancer drugs in clinical practice. (10) To be familiar with commonly used drugs and common tumor chemotherapeutic formulae is a matter of cardinal significance. (authors)

  18. Experience with intravenous digital subtraction angiography following shunting in 4 cases of congenital heart diseases

    Energy Technology Data Exchange (ETDEWEB)

    Higashidate, Masafumi; Konno, Susumu; Sumitomo, Naokata; Ito, Sango; Kobayashi, Hiroshi

    1985-01-01

    Intravenous digital subtraction angiography (IV-DSA) was performed in two patients with Fallot's tetralogy who underwent Blalock-Taussing operation, a patient with coarctation of the aortic arch who underwent extra-anastomic bypass between the ascending aorta and the descending aorta, and a patient with stenosis of the tricuspid valve who underwent Fontan type operation (anastomosis between the right atrium and the pulmonary artery). The conventional cardiac angiography was also performed for the comparison with IV-DSA in all patients. IV-DSA revealed the thickness of the subclavian artery anastomosed by Blaloch-Taussing operation, but failed to determine the accurate thickness of the pulmonary artery required for PA-index for radical surgery in cases of Fallot's tetralogy. Bypass from the ascending aorta to the descending aorta was well visualized by IV-DSA because the heart did not overlap on the image. In cases of Fontan type operation, IV-DSA permitted the visualization of blood flow from the right atrium to the pulmonary artery and the shape of the pulmonary artery. It is concluded that IV-DSA is a less invasive, simple technique to evaluate patients' condition following shunting for congenital heart diseases, as compared to the conventional method. (Namekawa, K.).

  19. Experience with intravenous digital subtraction angiography following shunting in 4 cases of congenital heart diseases

    International Nuclear Information System (INIS)

    Higashidate, Masafumi; Konno, Susumu; Sumitomo, Naokata; Ito, Sango; Kobayashi, Hiroshi

    1985-01-01

    Intravenous digital subtraction angiography (IV-DSA) was performed in two patients with Fallot's tetralogy who underwent Blalock-Taussing operation, a patient with coarctation of the aortic arch who underwent extra-anastomic bypass between the ascending aorta and the descending aorta, and a patient with stenosis of the tricuspid valve who underwent Fontan type operation (anastomosis between the right atrium and the pulmonary artery). The conventional cardiac angiography was also performed for the comparison with IV-DSA in all patients. IV-DSA revealed the thickness of the subclavian artery anastomosed by Blaloch-Taussing operation, but failed to determine the accurate thickness of the pulmonary artery required for PA-index for radical surgery in cases of Fallot's tetralogy. Bypass from the ascending aorta to the descending aorta was well visualized by IV-DSA because the heart did not overlap on the image. In cases of Fontan type operation, IV-DSA permitted the visualization of blood flow from the right atrium to the pulmonary artery and the shape of the pulmonary artery. It is concluded that IV-DSA is a less invasive, simple technique to evaluate patients' condition following shunting for congenital heart diseases, as compared to the conventional method. (Namekawa, K.)

  20. Developmental venous anomalies: appearance on whole-brain CT digital subtraction angiography and CT perfusion

    International Nuclear Information System (INIS)

    Hanson, Eric H.; Roach, Cayce J.; Ringdahl, Erik N.; Wynn, Brad L.; DeChancie, Sean M.; Mann, Nathan D.; Diamond, Alan S.; Orrison, William W.

    2011-01-01

    Developmental venous anomalies (DVA) consist of dilated intramedullary veins that converge into a large collecting vein. The appearance of these anomalies was evaluated on whole-brain computed tomography (CT) digital subtraction angiography (DSA) and CT perfusion (CTP) studies. CT data sets of ten anonymized patients were retrospectively analyzed. Five patients had evidence of DVA and five age- and sex-matched controls were without known neurovascular abnormalities. CT angiograms, CT arterial-venous views, 4-D CT DSA and CTP maps were acquired on a dynamic volume imaging protocol on a 320-detector row CT scanner. Whole-brain CTP parameters were evaluated for cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and delay. DSA was utilized to visualize DVA anatomy. Radiation dose was recorded from the scanner console. Increased CTP values were present in the DVA relative to the unaffected contralateral hemisphere of 48%, 32%, and 26%; and for the control group with matched hemispheric comparisons of 2%, -10%, and 9% for CBF, CBV, and MTT, respectively. Average effective radiation dose was 4.4 mSv. Whole-brain DSA and CTP imaging can demonstrate a characteristic appearance of altered DVA hemodynamic parameters and capture the anomalies in superior cortices of the cerebrum and the cerebellum. Future research may identify the rare subsets of patients at increased risk of adverse outcomes secondary to the altered hemodynamics to facilitate tailored imaging surveillance and application of appropriate preventive therapeutic measures. (orig.)

  1. Evaluation of the cardiovascular system by digital subtraction angiography in 246 patients

    Energy Technology Data Exchange (ETDEWEB)

    Higuma, Kikuhiko; Ohta, Takashi; Hiroto, Seiji

    1987-07-01

    Usefulness of intravenous digital subtraction angiography (DSA) was examined in 246 patients with cardiovascular disorders. This examination was done by centrally intravenous DSA (CIVDSA) in all patients to reduce the risks and discomforts by peripheral intravenous DSA. 1) CIVDSA could be done safely in patients aged 18 to 81 years. 2) The good diagnostic quality by CIVDSA was obtained in 81.3% of patients. These images were classified into 7 groups according to the cardiovascular system, that is, the jugular arteries, the upper extremity arteries, the thoracic aorta, the left ventricle, the abnominal aorta, the renal arteries, and the lower extremity arteries, whose rate of good diagnostic quality were 100%, 70%, 67.7%, 79.5%, 84.8%, 87%, and 71.4% respectively. 3) The poor diagnostic quality was obtained in 18.7%. 4) The severe complications were not found in any case during this examination. Our results indicate that DSA is the safe, simple and useful method to obtain the diagnostic quality image of the cardiovascular system, especially, of the occulsive arterial disease, the aortic aneurisma, the renovascular stenosis and the cardiac function of postmyocardial infarction, even in aged patients.

  2. Computed tomography versus digital subtraction angiography for the diagnosis of obscure gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Wildgruber, Moritz; Wrede, Christian E.; Zorger, Niels; Müller-Wille, René; Hamer, Okka W.; Zeman, Florian; Stroszczynski, Christian; Heiss, Peter

    2017-01-01

    Purpose: The diagnostic yield of computed tomography angiography (CTA) compared to digital subtraction angiography (DSA) for major obscure gastrointestinal bleeding (OGIB) is not known. Aim of the study was to prospectively evaluate the diagnostic yield of CTA versus DSA for the diagnosis of major OGIB. Material and methods: The institutional review board approved the study and informed consent was obtained from each patient. Patients with major OGIB were prospectively enrolled to undergo both CTA and DSA. Two blinded radiologists each reviewed the CTA and DSA images retrospectively and independently. Contrast material extravasation into the gastrointestinal lumen was considered diagnostic for active bleeding. Primary end point of the study was the diagnostic yield, defined as the frequency a technique identified an active bleeding or a potential bleeding lesion. The diagnostic yield of CTA and DSA were compared by McNemar's test. Results: 24 consecutive patients (11 men; median age 64 years) were included. CTA and DSA identified an active bleeding or a potential bleeding lesion in 92% (22 of 24 patients; 95% CI 72%–99%) and 29% (7 of 24 patients; 95% CI 12%–49%) of patients, respectively (p < 0.001). CTA and DSA identified an active bleeding in 42% (10 of 24; 95% CI 22%–63%) and 21% (5 of 24; 95% CI 7%–42%) of patients, respectively (p = 0.06). Conclusion: Due to the lower invasiveness and higher diagnostic yield CTA should be favored over DSA for the diagnosis of major OGIB.

  3. Computed tomography versus digital subtraction angiography for the diagnosis of obscure gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Wildgruber, Moritz, E-mail: moritzwildgruber@ukmuenster.de [Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, D-93053 Regensburg (Germany); Institut für klinische Radiologie, Universitätsklinikum Münster, D-48149 Münster (Germany); Wrede, Christian E. [Notfallzentrum, Helios Klinikum Berlin-Buch, D-13125 Berlin (Germany); Zorger, Niels [Institut für Radiologie, Neuroradiologie und Nuklearmedizin, Krankenhaus Barmherzige Brüder, D-93049 Regensburg (Germany); Müller-Wille, René; Hamer, Okka W. [Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, D-93053 Regensburg (Germany); Zeman, Florian [Zentrum für Klinische Studien, Universitätsklinikum Regensburg, D-93053 Regensburg (Germany); Stroszczynski, Christian; Heiss, Peter [Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, D-93053 Regensburg (Germany)

    2017-03-15

    Purpose: The diagnostic yield of computed tomography angiography (CTA) compared to digital subtraction angiography (DSA) for major obscure gastrointestinal bleeding (OGIB) is not known. Aim of the study was to prospectively evaluate the diagnostic yield of CTA versus DSA for the diagnosis of major OGIB. Material and methods: The institutional review board approved the study and informed consent was obtained from each patient. Patients with major OGIB were prospectively enrolled to undergo both CTA and DSA. Two blinded radiologists each reviewed the CTA and DSA images retrospectively and independently. Contrast material extravasation into the gastrointestinal lumen was considered diagnostic for active bleeding. Primary end point of the study was the diagnostic yield, defined as the frequency a technique identified an active bleeding or a potential bleeding lesion. The diagnostic yield of CTA and DSA were compared by McNemar's test. Results: 24 consecutive patients (11 men; median age 64 years) were included. CTA and DSA identified an active bleeding or a potential bleeding lesion in 92% (22 of 24 patients; 95% CI 72%–99%) and 29% (7 of 24 patients; 95% CI 12%–49%) of patients, respectively (p < 0.001). CTA and DSA identified an active bleeding in 42% (10 of 24; 95% CI 22%–63%) and 21% (5 of 24; 95% CI 7%–42%) of patients, respectively (p = 0.06). Conclusion: Due to the lower invasiveness and higher diagnostic yield CTA should be favored over DSA for the diagnosis of major OGIB.

  4. Normal anatomy and variations in the confluence of sinuses using digital subtraction angiography.

    Science.gov (United States)

    Cheng, Yaqin; Li, William A; Fan, Xingjuan; Li, Xiaohua; Chen, Jian; Wu, Yan; Meng, Ran; Ji, Xunming

    2017-06-01

    The configuration of the confluence of sinuses differs not only between individuals, but also between the two brain hemispheres, making the anatomical classification of this region difficult. In this study, we evaluated the anatomy of the confluence of sinuses and ascertained the accuracy and usefulness of digital subtraction angiography (DSA) in the evaluation of cerebral veins. Bilateral carotid and vertebral artery angiographies were performed in 500 adult patients to evaluate the anatomy of the confluence of sinuses and contributory venous sinuses. We appraised the anatomy of the sinuses adjacent to the confluence, the lateralization of venous draining into the transverse sinuses (TSs), the communications between the TSs, and the presentation of the occipital sinus (OS). Based on the anatomical descriptions of Osborn's Brain (Diagnostic Cerebral Angiography, 2nd edition), we delineated 10 different configurations of the confluence of sinuses that showed connections among the superior sagittal sinus, the straight sinus, and the left and right TSs. Right side dominant transverse sinus accounted for 49% of the cases. Direct communication between the TSs accounted for 46.4% of the cases. Indirect communication accounted for 51.6% of the case, and absence of communication between the left and the right TS accounted for 2%. Lastly, the presence of OS was observed in 6% of the cases. DSA promises to be an effective technique for studying the anatomy and normal variations of the confluence of sinuses, providing useful information for the diagnosis of cerebral venous diseases, and ensuring safer surgical procedures.

  5. Analysis of the venous channel within the clivus using multidetector computed tomography digital subtraction venography.

    Science.gov (United States)

    Mizutani, Katsuhiro; Toda, Masahiro; Kurasawa, Jun; Akiyama, Takenori; Fujiwara, Hirokazu; Jinzaki, Masahiro; Yoshida, Kazunari

    2017-03-01

    Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. Eighteen emissary veins were identified in 14 (28.0%) cases. A half of the emissary veins connected the inferior petrosal sinus with the inferior petro-occipital vein (IPOV) in the middle clivus. The clival diploic vein (CDV) was identified in 14.0% of cases, 42.9% of which had the clivus of the presellar type. The CDV was connected to the posterior intercavernous sinus or the rostral end of the basilar plexus superiorly, and was connected to the IPOV, anterior condylar vein, marginal sinus, or the anterior condylar confluence. The CDV provides collateral channels between the cavernous sinus and the internal jugular vein and the inferior petrosal sinus and the IPOV. Understanding of the emissary veins in the clivus and the CDV is valuable for skull base surgery, especially for endonasal endoscopic skull base procedures.

  6. Remapping of digital subtraction angiography on a standard fluoroscopy system using 2D-3D registration

    Science.gov (United States)

    Alhrishy, Mazen G.; Varnavas, Andreas; Guyot, Alexis; Carrell, Tom; King, Andrew; Penney, Graeme

    2015-03-01

    Fluoroscopy-guided endovascular interventions are being performing for more and more complex cases with longer screening times. However, X-ray is much better at visualizing interventional devices and dense structures compared to vasculature. To visualise vasculature, angiography screening is essential but requires the use of iodinated contrast medium (ICM) which is nephrotoxic. Acute kidney injury is the main life-threatening complication of ICM. Digital subtraction angiography (DSA) is also often a major contributor to overall patient radiation dose (81% reported). Furthermore, a DSA image is only valid for the current interventional view and not the new view once the C-arm is moved. In this paper, we propose the use of 2D-3D image registration between intraoperative images and the preoperative CT volume to facilitate DSA remapping using a standard fluoroscopy system. This allows repeated ICM-free DSA and has the potential to enable a reduction in ICM usage and radiation dose. Experiments were carried out using 9 clinical datasets. In total, 41 DSA images were remapped. For each dataset, the maximum and averaged remapping accuracy error were calculated and presented. Numerical results showed an overall averaged error of 2.50 mm, with 7 patients scoring averaged errors < 3 mm and 2 patients < 6 mm.

  7. Comparative experimental study of dual energy subtraction and conventional digital radiography on chest

    International Nuclear Information System (INIS)

    Huang Rui; Feng Gansheng; Li Lin; Wei Qinghai

    2005-01-01

    Objective: To compare the efficiency of dual energy subtraction and conventional direct digital radiography in signal detecting ability. Methods: 200 plastic balls which were 4 mm in diameter were taken as signals and were placed on a 10 cm thick plastic board and the right upper thorax of a healthy volunteer. The signals were examined by DES and CDR separately and were estimated by 3 radiologists with 5-value-differentiation method. ROC curve analysis was made by ROC kit software. Results: when signals on plastic board were detected by CDR and DES, ROC curve analysis indicated that there was no significant difference (P=0.4851 > 0.05, two-tailed) between the area under the ROC curves of the two methods (Az=0.9931 for CDR and Az=0.9879 for DES). The difference was significant (P=0.0002 <0.01, two-tailed) between the area under the ROC curves of CDR and DES (Az=0.7276 for CDR and Az=0.8561 for DES), when the signals on the right upper thorax of a volunteer were detected by the two methods. Conclusion: DES surpasses CDR in detecting signals on thorax without superposition of ribs. There is good outlook in the application of DES in thorax examination. (authors)

  8. Patient radiation dose from computed tomography angiography and digital subtraction angiography of the brain

    Science.gov (United States)

    Netwong, Y.; Krisanachinda, A.

    2016-03-01

    The 64-row multidetector computed tomography angiography (64-MDCTA) provides vascular image quality of the brain similar to digital subtraction angiography (DSA), but the effective dose of CTA is lower than DSA studied in phantom. The purpose of this study is to evaluate the effective dose from 64-MDCTA and DSA. Effective dose (according to ICRP 103) from 64-MDCTA and DSA flat panel detector for cerebral vessels examination of the brain using standard protocols as recommended by the manufacturer was calculated for 30 cases of MDCTA (15 male and 15 female).The mean patient age was 49.5 (23-89) yrs. 30 cases of DSA (14 male and 16 female), the mean patient age was 46.8 (21-81) yrs. For CTA, the mean effective dose was 3.7 (2.82- 5.19) mSv. For DSA, the mean effective dose was 5.78 (3.3-10.06) mSv. The effective dose of CTA depends on the scanning protocol and scan length. Low tube current can reduce patient dose whereas the number of exposures and number of series in 3D rotational angiography (3D RA) resulted in increasing effective dose in DSA patients.

  9. Value of infusion-DSA (Digital Subtraction Angiography) in diagnosis of primary hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kwon, Jeong Mi; Kim, So Sun; Huh, Jin Do; Kim, Ho Joon; Chun, Byung Hee; Joh, Young Duk

    1991-01-01

    In order to evaluate diagnostic effectiveness of the infusion-study, the authors prospectively evaluated hepatic digital subtraction angiography of bolus and infusion studies in 71 patients with hepatocellular carcinoma. In contrast to Bolus-DSA, which involves a 2 second injection of 10cc of contrast medium, the Infusion-DSA uses a protracted (10sec) injection, a lower injection rate, and larger total dose of contrast medium (20cc). The information yield of arterial and capillary phases of Infusion-DSA was compared with that of Bolus-DSA and graded as 'improved(+)', 'equivalent( ± )', or 'poor(-)'. Also, the contribution of Infusion-DSA to the diagnosis was classified into one of five in a graded system. In 29 hepatocellular patients, the Infusion-DSA was helpful in detecting daughter nodules, fibrous capsule and arteriovenous shunt. Infusion-DSA is a useful complementary technique in the diagnosis of hepatocellular carcinoma and was also helpful in determining the selection of the therapeutic modality of hepatocellular carcinoma

  10. A LabVIEW Platform for Preclinical Imaging Using Digital Subtraction Angiography and Micro-CT

    Directory of Open Access Journals (Sweden)

    Cristian T. Badea

    2013-01-01

    Full Text Available CT and digital subtraction angiography (DSA are ubiquitous in the clinic. Their preclinical equivalents are valuable imaging methods for studying disease models and treatment. We have developed a dual source/detector X-ray imaging system that we have used for both micro-CT and DSA studies in rodents. The control of such a complex imaging system requires substantial software development for which we use the graphical language LabVIEW (National Instruments, Austin, TX, USA. This paper focuses on a LabVIEW platform that we have developed to enable anatomical and functional imaging with micro-CT and DSA. Our LabVIEW applications integrate and control all the elements of our system including a dual source/detector X-ray system, a mechanical ventilator, a physiological monitor, and a power microinjector for the vascular delivery of X-ray contrast agents. Various applications allow cardiac- and respiratory-gated acquisitions for both DSA and micro-CT studies. Our results illustrate the application of DSA for cardiopulmonary studies and vascular imaging of the liver and coronary arteries. We also show how DSA can be used for functional imaging of the kidney. Finally, the power of 4D micro-CT imaging using both prospective and retrospective gating is shown for cardiac imaging.

  11. Magnetization spoiling in radial FLASH contrast-enhanced MR digital subtraction angiography.

    Science.gov (United States)

    Vakil, Parmede; Ansari, Sameer A; Hurley, Michael C; Bhat, Himanshu; Batjer, H Hunt; Bendok, Bernard R; Eddleman, Christopher S; Carroll, Timothy J

    2012-07-01

    To increase the in-plane spatial resolution and image update rates of 2D magnetic resonance (MR) digital subtraction angiography (DSA) pulse sequences to 0.57 × 0.57 mm and 6 frames/sec, respectively, for intracranial vascular disease applications by developing a radial FLASH protocol and to characterize a new artifact, not previously described in the literature, which arises in the presence of such pulse sequences. The pulse sequence was optimized and artifacts were characterized using simulation and phantom studies. With Institutional Review Board (IRB) approval, the pulse sequence was used to acquire time-resolved images from healthy human volunteers and patients with x-ray DSA-confirmed intracranial vascular disease. Artifacts were shown to derive from inhomogeneous spoiling due to the nature of radial waveforms. Gradient spoiling strategies were proposed to eliminate the observed artifact by balancing gradient moments across TR intervals. The resulting radial 2D MR DSA sequence (2.6 sec temporal footprint, 6 frames/sec with sliding window factor 16, 0.57 × 0.57 mm in-plane) demonstrated small vessel detail and corroborated x-ray DSA findings in intracranial vascular imaging studies. Appropriate gradient spoiling in radial 2D MR DSA pulse sequences improves intracranial vascular depiction by eliminating circular banding artifacts. The proposed pulse sequence may provide a useful addition to clinically applied 2D MR DSA scans. Copyright © 2012 Wiley Periodicals, Inc.

  12. Predictive value of digital subtraction angiography in patients with tuberculous meningitis

    International Nuclear Information System (INIS)

    Rojas-Echeverri, L.A.; Soto-Hernandez, J.L.; Garza, S.; Martinez-Zubieta, R.; Miranda, L.I.; Garcia-Ramos, G.; Zenteno, M.

    1996-01-01

    Digital subtraction angiography (DSA) was performed in 24 adults with tuberculous meningitis (TBM) and results were correlated with 24 admission and 16 follow-up CT examinations. 19 MRI studies and clinical outcome at a mean follow-up of 44 weeks. DSA was abnormal in 11 patients. Abnormal DSA was associated with advenced clinical stages of the Medical Research Council classification, admission CT with hydrocephalus or gyral cortical enhancement. MRI disclosed brain infarcts not seen on initial CT in 8 cases. Of seven patients who died, 4 had abnormal and 3 normal DSA. Among patients who survived, those with normal DSA had a better functional outcome by Karnofsky scores. During follow-up infarcts were evident in 16 patients. Abnormal DSA in relation to brain infarcts had a sensitivity of 0.56, specificity 0.75, positive predictive value 0.82 and negative predictive value 0.46. A single arteriogram does not predict the outcome in patients with TBM and its value is limited in the assessment of vascular complications of TBM. Angiography in TBM is justified only in specific clinical trials to assess new therapeutic modalities against infarcts. (orig.)

  13. Describable ability of blood vessels in head and neck by intravenous digital subtraction angiography

    International Nuclear Information System (INIS)

    Minakuchi, Kazuo; Takada, Keiji; Nakamura, Kenji

    1989-01-01

    Ninety-four patients with various symptoms of the head and neck were studied by intravenous digital subtraction angiography (IV-DSA). Abnormal findings were obesrved in 12 patients; one with aneurysm in the left internal carotid artery, and 11 with obstruction in the right middle cerebral artery (2), the right internal carotid artery (one), the left subclavian artery (one), the right vertebral artery (6), and the left vertebral artery (one). Motion artifacts were observed in 2 patients. The vertebral arteries were bilaterally equal in size in 42%, and the left vertebral artery was bigger than the right one in 38%. The superior sagittal dural sinus was clearly imaged in 94%. The incidence of excellent images was higher in the right sided than the left sided vein -- 85% vs 50% for the transverse dural sinus, 84% vs 54% for the sigmoid dural sinus, and 88% vs 57% for the jugular vein. Sites of excellent images were all of the dural sinuses and veins (37 cases), confined to the right side (37), confined to the left side (8), and undefined (12). (N.K.)

  14. A LabVIEW Platform for Preclinical Imaging Using Digital Subtraction Angiography and Micro-CT.

    Science.gov (United States)

    Badea, Cristian T; Hedlund, Laurence W; Johnson, G Allan

    2013-01-01

    CT and digital subtraction angiography (DSA) are ubiquitous in the clinic. Their preclinical equivalents are valuable imaging methods for studying disease models and treatment. We have developed a dual source/detector X-ray imaging system that we have used for both micro-CT and DSA studies in rodents. The control of such a complex imaging system requires substantial software development for which we use the graphical language LabVIEW (National Instruments, Austin, TX, USA). This paper focuses on a LabVIEW platform that we have developed to enable anatomical and functional imaging with micro-CT and DSA. Our LabVIEW applications integrate and control all the elements of our system including a dual source/detector X-ray system, a mechanical ventilator, a physiological monitor, and a power microinjector for the vascular delivery of X-ray contrast agents. Various applications allow cardiac- and respiratory-gated acquisitions for both DSA and micro-CT studies. Our results illustrate the application of DSA for cardiopulmonary studies and vascular imaging of the liver and coronary arteries. We also show how DSA can be used for functional imaging of the kidney. Finally, the power of 4D micro-CT imaging using both prospective and retrospective gating is shown for cardiac imaging.

  15. Evaluation of the cardiovascular system by digital subtraction angiography in 246 patients

    International Nuclear Information System (INIS)

    Higuma, Kikuhiko; Ohta, Takashi; Hiroto, Seiji

    1987-01-01

    Usefulness of intravenous digital subtraction angiography (DSA) was examined in 246 patients with cardiovascular disorders. This examination was done by centrally intravenous DSA (CIVDSA) in all patients to reduce the risks and discomforts by peripheral intravenous DSA. 1) CIVDSA could be done safely in patients aged 18 to 81 years. 2) The good diagnostic quality by CIVDSA was obtained in 81.3 % of patients. These images were classified into 7 groups according to the cardiovascular system, that is, the jugular arteries, the upper extremity arteries, the thoracic aorta, the left ventricle, the abnominal aorta, the renal arteries, and the lower extremity arteries, whose rate of good diagnostic quality were 100 %, 70 %, 67.7 %, 79.5 %, 84.8 %, 87 %, and 71.4 % respectively. 3) The poor diagnostic quality was obtained in 18.7 %. 4) The severe complications were not found in any case during this examination. Our results indicate that DSA is the safe, simple and useful method to obtain the diagnostic quality image of the cardiovascular system, especially, of the occulsive arterial disease, the aortic aneurisma, the renovascular stenosis and the cardiac function of postmyocardial infarction, even in aged patients. (author)

  16. DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE ANGIOGRAPHY FOR UNRUPTURED CEREBRAL ANEURYSMS IN CORRELATION WITH DIGITAL SUBTRACTION ANGIOGRAPHY

    Directory of Open Access Journals (Sweden)

    Aleksandra Aracki-Trenkić

    2015-09-01

    Full Text Available Intracranial aneurysm is a focal, abnormal dilation of an artery of the brain. Magnetic resonance angiography (MRA is a non-invasive technique for vascular imaging and is thus widely used for screening for intracranial vascular lesions. The aim of the study was to show the diagnostic accuracy of 3D Time-of-Flight (3D TOF MRA in the detection of unruptured cerebral aneurysms with the use of digital subtraction angiography (DSA as the gold standard. A total of 2.612 consecutive patients underwent 3DTOF MRA. It showed unruptured aneurysms in 94 (3.6% patients. They included 68 women and 26 men ranging in age from 29 to 76 years (mean, 52.5 years. Twenty-six of them, 20 women and 6 men, underwent DSA. The Mann-Whitney U test was used for the correlation of size. Fisher’s test was used for the correlation of location. The statistical level of significance was set at p0.05 of aneurysms between TOF MRA and DSA. MRA is an accurate and non-invasive method for diagnosis of unruptured intracranial aneurysms. The results of study show the compatibility of MRA findings, the location and the size of an aneurysm in comparison with the “gold standard” – cerebral DSA.

  17. Developmental venous anomalies: appearance on whole-brain CT digital subtraction angiography and CT perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Hanson, Eric H. [Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); University of Nevada Las Vegas, Department of Health Physics and Diagnostic Sciences, 4505 Maryland Parkway, Box 453037, Las Vegas, NV (United States); Amigenics, Inc, Las Vegas, NV (United States); Roach, Cayce J. [Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); University of Nevada Las Vegas, School of Life Sciences, Las Vegas, NV (United States); Ringdahl, Erik N. [University of Nevada Las Vegas, Department of Psychology, Las Vegas, NV (United States); Wynn, Brad L. [Family Medicine Spokane, Spokane, WA (United States); DeChancie, Sean M.; Mann, Nathan D. [Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); Diamond, Alan S. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); Orrison, William W. [Touro University Nevada College of Osteopathic Medicine, Henderson, NV (United States); University of Nevada Las Vegas, Department of Health Physics and Diagnostic Sciences, 4505 Maryland Parkway, Box 453037, Las Vegas, NV (United States); CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); University of Nevada School of Medicine, Department of Medical Education, Reno, NV (United States)

    2011-05-15

    Developmental venous anomalies (DVA) consist of dilated intramedullary veins that converge into a large collecting vein. The appearance of these anomalies was evaluated on whole-brain computed tomography (CT) digital subtraction angiography (DSA) and CT perfusion (CTP) studies. CT data sets of ten anonymized patients were retrospectively analyzed. Five patients had evidence of DVA and five age- and sex-matched controls were without known neurovascular abnormalities. CT angiograms, CT arterial-venous views, 4-D CT DSA and CTP maps were acquired on a dynamic volume imaging protocol on a 320-detector row CT scanner. Whole-brain CTP parameters were evaluated for cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and delay. DSA was utilized to visualize DVA anatomy. Radiation dose was recorded from the scanner console. Increased CTP values were present in the DVA relative to the unaffected contralateral hemisphere of 48%, 32%, and 26%; and for the control group with matched hemispheric comparisons of 2%, -10%, and 9% for CBF, CBV, and MTT, respectively. Average effective radiation dose was 4.4 mSv. Whole-brain DSA and CTP imaging can demonstrate a characteristic appearance of altered DVA hemodynamic parameters and capture the anomalies in superior cortices of the cerebrum and the cerebellum. Future research may identify the rare subsets of patients at increased risk of adverse outcomes secondary to the altered hemodynamics to facilitate tailored imaging surveillance and application of appropriate preventive therapeutic measures. (orig.)

  18. Comparison of 3D magnetic resonance imaging and digital subtraction angiography for intracranial artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Eun; Jung, Seung Chai; Kim, Ho Sung; Choi, Choong-Gon; Kim, Sang Joon; Lee, Deok Hee [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of); Lee, Sang Hun; Kwon, Sun U.; Kang, Dong-Wha; Kim, Jong S. [University of Ulsan College of Medicine, Department of Neurology, Ulsan (Korea, Republic of); Jeon, Ji Young [Gachon University, Department of Radiology, Gil Medical Center, Incheon (Korea, Republic of); Lee, Ji Ye [Soonchunhyang University Bucheon Hospital, Department of Radiology, Bucheon (Korea, Republic of); Kim, Seon-Ok [University of Ulsan College of Medicine, Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul (Korea, Republic of)

    2017-11-15

    To compare three-dimensional high-resolution magnetic resonance imaging (3D HR-MRI) and digital subtraction angiography (DSA) for diagnosing and evaluating stenosis in the entire circle of Willis. The study included 516 intracranial arteries from 43 patients with intracranial artery stenosis (ICAS) who underwent both 3D HR-MRI and DSA within 1 month. Two readers independently diagnosed atherosclerosis, dissection, moyamoya disease and vasculitis, rated their diagnostic confidence for each vessel and measured the luminal diameters. Reference standard was made from clinico-radiologic diagnosis. Diagnostic accuracy, diagnostic confidence, the degree of stenosis and luminal diameter were assessed and compared between both modalities. For atherosclerosis, 3D HR-MRI showed better diagnostic accuracy (P =.03-.003), sensitivity (P =.006-.01) and positive predictive value (P ≤.001-.006) compared to DSA. Overall, the readers were more confident of their diagnosis of ICAS when using 3D HR-MRI (reader 1, P ≤.001-.007; reader 2, P ≤.001-.015). 3D HR-MRI showed similar degree of stenosis (P >.05) and higher luminal diameter (P <.05) compared to DSA. 3D HR-MRI might be useful to evaluate atherosclerosis, with better diagnostic confidence and comparable stenosis measurement compared to DSA in the entire circle of Willis. (orig.)

  19. In vivo optical imaging of amblyopia: Digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography.

    Science.gov (United States)

    Guo, Lei; Tao, Jun; Xia, Fan; Yang, Zhi; Ma, Xiaoli; Hua, Rui

    2016-09-01

    Amblyopia is a visual impairment that is attributed to either abnormal binocular interactions or visual deprivation. The retina and choroids have been shown to be involved in the development of amblyopia. The purpose of this study was to investigate the retinal and choroidal microstructural abnormalities of amblyopia using digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography (SSADA) approaches. This prospective study included 44 eyes of 22 patients with unilateral amblyopia. All patients who received indirect ophthalmoscopy, combined depth imaging spectral domain optical coherence tomography (OCT), SSADA-OCT, and macular blue light (BL-) and near-infrared (NIR-) autofluorescences underwent pupil dilation. The subfoveal choroidal thickness (SFCT) was measured. BL- and NIR-autofluorescences were determined for all patients and used to generate subtraction images with ImageJ software. The superficial, deep layers of the retina, and inner choroid layer were required for SSADA-OCT. For the normal eyes, a regularly increasing signal was observed in the central macula based on the subtraction images. In contrast, a decreased signal for the central patch or a reduced peak was detected in 16 of 22 amblyopic eyes (72.7%). The mean SFCT of the amblyopic eyes was greater than that of the fellow normal eyes (399.25 ± 4.944 µm vs. 280.58 ± 6.491 µm, respectively, P amblyopia using SSADA-OCT and digital subtraction images of autofluorescence. The mechanistic relationship of a thicker choroid and choroidal capillary atrophy with amblyopia remains to be described. The digital subtraction image confirmed the changes in the microstructure of the amblyopic retina as a supplementary approach to detect the progression of amblyopia. Lasers Surg. Med. 48:660-667, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Regional myocardial coronary blood flow reserve in hypertrophic cardiomyopathy assessed by digital subtraction coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Terashima, Satoshi; Nakamura, Takashi; Furukawa, Keizo (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1992-01-01

    Using digital subtraction coronary angiography (DSA), we evaluated the regional myocardial coronary blood flow reserve (rMFR) in 18 patients with hypertrophic cardiomyopathy (HCM). There were 13 patients with asymmetrical septal hypertrophy (ASH), and 5 with asymmetrical apical hypertrophy (AAH). Eight subjects without apparent cardiac abnormality served as controls. Relations between the rMFR and regional wall thickness, as determined by echocardiography, were also investigated. Peak contrast density (Cm) and time to Cm (Tm) were measured from digital angiograms at the middle and distal ventricular septum (VS) and at the apical and left ventricular posterior wall (PW). The rMFR of each region of interest was expressed as the ratio of Cm/Tm at the baseline and at peak hyperemic response induced by intracoronary administration of papaverine. The rMFR was significantly lower at the VS and apex in HCM than in controls: middle VS, 1.9[+-]0.5 vs 3.9[+-]0.5, p<0.001; distal VS, 2.0[+-]0.5 vs 4.4[+-]0.9, p<0.001; and the apex, 2.0[+-]0.7 vs 4.5[+-]1.6, p<0.01. However, it did not differ at the PW; 2.6[+-]0.9 vs 3.0[+-]0.9 between the 3 groups. The middle VS and apex, where the wall was the thickest, had the lowest rMFR in ASH and AAH. Furthermore, at the VS and apex, a curvilinear relationship was observed between the rMFR and wall thickness (rMFR=-0.88 ln WT+2.39, r=-0.57, p<0.001). These results indicated that disproportionate hypertrophy contributes to impairment of the rMFR, and that the decreased rMFR may be one of the significant causes of reversible myocardial ischemia in patients with HCM. (author).

  1. Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

    International Nuclear Information System (INIS)

    Yoon, Sang Jin; Shim, Hyung Jin; Jung, Hun Young; Choi, Yong Ho; Kim, Yang Soo; Song, In Sup; Kwak, Byung Kook

    1999-01-01

    To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

  2. The comparative study on diagnostic validity of cerebral aneurysm by computed tomography angiography versus digital subtraction angiography after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-01-01

    Full Text Available Background: In order to declare the preoperative diagnostic value of brain aneurysms, two radiological modalities, computed tomographic angiography and digital subtraction angiography were compared. Methods: In this descriptive analytic study, diagnostic value of computed tomographic angiography (CTA was com-pared with digital subtraction angiography (DSA. Sensitivity, specificity, positive and negative predictive values were calculated and compared between the two modalities. All data were analyzed with SPSS software, version 16. Results: Mean age of patients was 49.5 ± 9.13 years. 57.9 % of subjects were female. CTA showed 89% sensitivity and 100% specificity whereas DSA demonstrated 74% sensitivity and 100% specificity. Positive predictive value of both methods was 100%, but negative predictive value of CTA and DSA was 85% and 69%, respectively. Conclusions: Based on our data, CTA is a valuable diagnostic modality for detection of brain aneurysm and su-barachnoid hemorrhage.

  3. Comparative study of conducting iliac angioplasties with digital subtraction and conventional angiography. Incidence on true (consumable) costs

    International Nuclear Information System (INIS)

    Brenot, P.; Raynaud, A.; Pernes, J.M.; Parola, J.L.; Gaux, J.C.

    1986-01-01

    Differences in time and cost were evaluated between the performance of iliac angioplasty with conventional (AC) and digital subtraction (AN) angiography, after a total of 27 angioplasties (13 with AC and 14 with AN). Excluding amortization of material and personnel costs, findings confirmed a certain number of advantages for AN: gain in time of about 34%, decrease of about 14% in charges, and notably of 83% in expenditure on films and 50% on contrast media [fr

  4. Multi-section CT angiography compared with digital subtraction angiography in diagnosing major arterial hemorrhage in inflammatory pancreatic disease

    International Nuclear Information System (INIS)

    Hyare, Harpreet; Desigan, Sharmini; Nicholl, Helen; Guiney, Michael J.; Brookes, Jocelyn A.; Lees, William R.

    2006-01-01

    Purpose: Major arterial hemorrhage is an uncommon but serious complication of pancreatitis with high morbidity and mortality. Digital subtraction angiography (DSA) has long been the gold standard for the detection of a visceral artery pseudoaneurysm or for the site of active bleeding in patients with pancreatitis. Multi-section CT angiography is a minimally invasive technique which can provide high-resolution and high-contrast images of the arterial lumen and wall, with a much lower risk of complication and morbidity compared to DSA. The aim of this study was to determine the accuracy of multi-section CT angiography for the diagnosis of arterial complications of inflammatory pancreatitic disease. Materials and methods: A retrospective analysis of all patients undergoing visceral angiography for major bleeding as a complication of pancreatitis between 1998 and 2004 was performed. Twenty-nine studies in 25 patients (20 males, 5 females) with a mean age of 50.9 years (range 11-67 years) were identified where multi-section CT angiography was performed in the 24 h preceding the digital subtraction angiogram. Results: Digital subtraction angiography detected a pseudoaneurysm or contrast extravasation in 19 studies and no bleeding was demonstrated in 9 studies. CT angiography correctly identified the site and type of bleeding in 18 of the 19 positive studies. CT angiography detected extravasation of contrast in one study that was not demonstrated on digital subtraction angiography. The sensitivity and specificity for multi-section CT angiography for the detection of major arterial bleeding on a background of pancreatitis were 0.947 and 0.900, respectively. Conclusion: Multi-section CT angiography is a sensitive and accurate technique for the detection of major arterial hemorrhage in inflammatory pancreatic disease and should be considered as the first investigation in the management of these patients

  5. Intra-arterial thrombolysis in acute embolic stroke

    International Nuclear Information System (INIS)

    Shi Mingchao; Fang Shaokuan; Li Dong; Zhu Hui; Pang Meng; Wu Jiang; Wang Shouchun

    2008-01-01

    Objective: To evaluate the efficacy and safety of intra-arterial thrombolysis in acute embolic stroke (AES). Methods: 21 patients with AES were undertaken urokinase or recombinated tissue plasminogen activator through percutaneous femoral intraarterial thrombolysis (IAT) as the treated group, and another 42 patients without thrombolytic treatment were assigned as the control group, which were matched to the baseline National Institutes of Health Stroke Scale (NIHSS) scores with selected gender and age. 24 h NIHSS scores, 90 d modified Rankin Scale (mRS) scores, incidences of hemorrhagic transformation (HT) and mortalities of the two groups were compared after the treatment. Results: (1) The results of cerebral angiography showed that the total re-perfusion rate was 61.90%. The middle cerebral artery (MCA), the internal carotid artery (ICA) and the basilar artery (BA) re-perfusion rates were 83.33%, 28.57% and 50.00%, respectively. (2) The NIHSS scores after 24 h were lower in the treated (IAT) group than those in the control group (12.05±5.61 vs, 14.83±4.05, P<0.05). A favorable outcome (mRS of 0-2) was more frequently observed in the 1AT group (66.67%) than that in the control group (35.71%, P<0.05). (3) There was no significant difference between the rates of HT (28.57% vs. 16.77%) and also the similar mortality rates (19.05% vs. 16.67%) not significant between the two groups. No patient died of HT in both two groups. Conclusion: IAT may be an effective treatment for AES with comparative safety. (authors)

  6. Intra-arterial chemotherapy for locally advanced bladder cancer

    International Nuclear Information System (INIS)

    Aota, Yasuhiro; Yoshida, Kazuhiko

    1999-01-01

    A total of 83 patients with locally advanced bladder cancer (T1, n=5; T2, n=28; T3a, n=21; T3b, n=21; T4, n=8) were treated with intra-arterial (i.a.) cisplatin and adriamycin (or epirubicin) chemotherapy. In 51 of the 83 cases, we combined this treatment with radiotherapy. The pathological complete response (CR) rate was 68% for all patients, 84% for i.a. chemotherapy combined with radiotherapy and only 41% for i.a. chemotherapy. The 5-year survival rate was 57% for all patients, 71% for i.a. chemotherapy combined with radiotherapy and only 44% for i.a. chemotherapy. The 5-year survival as a function of the clinical stage was 82% for T1+T2, 66% for T3a, 28% for T3b, 25% for T4 (T1+T2 vs. T3b: p<0.001, T1+T2 vs. T4: p<0.0001, T3a vs. T3b: p<0.0263, T3a vs. T4: p<0.0214, T3b vs. T4: p<0.029). In 46% of all patients, we succeeded in preserving the bladder; especially noteworthy, is that in 65% of the patients undergoing i.a. chemotherapy combined with radiotherapy, we succeeded in preserving the bladder. These results demonstrate that i.a. chemotherapy combined with radiotherapy is a useful method for locally advanced bladder cancer which may make preservation of the bladder function feasible. (author)

  7. Intra-arterial chemotherapy for retinoblastoma: First Indian report

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2015-01-01

    Full Text Available Aim: To describe treatment outcomes and complications of selective intra-arterial chemotherapy (IAC for retinoblastoma (RB in Indian eyes. Materials and Methods: Single center, retrospective interventional case series of 6 eyes with RB who underwent IAC using Melphalan (3 mg/5 mg/7.5 mg and topetecan (1 mg (n = 4 or melphalan (3 mg/5 mg/7.5 mg alone (n = 2 between December 2013 and June 2014. In all, 17 IAC procedures were performed using selective ophthalmic artery cannulation. Treatment outcomes were evaluated in terms of tumor control, vitreous and subretinal seeds control and globe salvage rates. Results: IAC was employed as primary (n = 1 or secondary (n = 5 modality of treatment. Each eye received mean 3 IAC sessions (median: 3; range: 1-4 sessions. Eyes were classified according to international classification of RB as Group B (n = 1, C (n = 1, D (n = 2 and E (n = 2. Following IAC, complete regression of the main tumor was seen in 3 cases (50%, partial regression in 2 (33%, while 1 case (15% showed no response. Of 4 eyes with subretinal seeds, 1 (25% eye had complete regression while 3 (75% eyes had partial regression. Of 5 eyes with vitreous seeds, 2 (40% eyes had complete regression while 3 (60% eyes had a partial response. Globe salvage was achieved in 5 of 6 eyes (83%. Diffuse choroidal atrophy and vitreous hemorrhage were observed in 1 (17% eye, each. No hematologic toxicity or cerebro-vascular events were observed. Mean follow-up period was 5.5 months (median: 6 months, range: 1-6 months. Conclusion: IAC is an effective therapy for globe preservation in eyes with RB. Larger studies with longer follow-up are required to validate these results.

  8. Intra-Arterial Thrombolysis for Deep Vein Thrombosis of the Lower Extremity: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Moo Sang; Roh, Byung Suk [Dept. of Radiology, Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2011-09-15

    If the appropriate catheterization of the affected vein was not possible because of a narrowed or thrombus-filled venous lumen, successful treatment gets into trouble during catheter directed regional thrombolysis for treatment of deep vein thrombosis. In this situation, intra-arterial thrombolysis can be considered as an alternative treatment, but to the best of our knowledge, only two reports have been described. We present here cases of successful intra-arterial thrombolysis in patients with deep vein thrombosis.

  9. Spontaneously resolving periocular erythema and ciliary madarosis following intra-arterial chemotherapy for retinoblastoma

    OpenAIRE

    Marr Brian; Gobin Pierre; Dunkel Ira; Brodie Scott; Abramson David

    2010-01-01

    Purpose and Design: To describe an unusual clinical finding seen in children undergoing intra-arterial chemotherapy for retinoblastoma. Materials and Methods: A retrospective review of 69 eyes of 63 patients receiving intra-arterial chemotherapy over a 3-year period. Charts and photographs of 69 consecutive cases were reviewed, and data were collected on patients with clinical evidence of a hyperemic cutaneous periocular abnormality following the procedure. Results: A blanching erythemat...

  10. Successful Intra-Arterial Thrombolysis for Acute Ischemic Stroke in the Immediate Postpartum Period: Case Report

    International Nuclear Information System (INIS)

    Mendez, Jose C.; Masjuan, J.; Garcia, N.; Lecinana, M. de

    2008-01-01

    Stroke in pregnancy and the puerperium is a rare but potentially devastating event. We present the case of a previously healthy woman who underwent a cesarean delivery and experienced a middle cerebral artery thrombosis in the immediate postpartum period that was subsequently lysed with intra-arterial urokinase. The patient made a complete neurologic recovery. To the best of our knowledge, this is the first reported case of successful intra-arterial thrombolysis for ischemic stroke in the postpartum period

  11. Intra-arterial injection, a rare but serious complication of sclerotherapy.

    Science.gov (United States)

    Hafner, F; Froehlich, H; Gary, T; Brodmann, M

    2013-03-01

    Intra-arterial injections represent the most feared complication of sclerotherapy for varicose veins. We present a case of an inadvertent intra-arterial injection of polidocanol at the left medial calf in a 59-year-old woman with subsequent arterial occlusions of the posterior tibial artery and foot arteries. Despite several therapeutic interventions, lower-limb amputation could not be prevented. We conducted a PubMed search for articles reporting arterial complications related to sclerotherapy, in order to evaluate aetiology, clinical presentation, therapeutic management and outcome of sclerotherapy-associated intra-arterial injections during the past 50 years. Intra-arterial injection of a sclerosing solution was reported in 63 cases, mostly after injection near the ankle region or the distal medial calf. Clinical presentation was frequently characterized by immediate pain during injection and distal ischaemia with subsequent tissue loss. Despite several treatment approaches, amputation could not be prevented in 31 cases (52.5%). The pathophysiology of arterial complications related to intra-arterial injection and advisable therapeutic interventions are discussed. Inadvertent intra-arterial injection represents a limb-threatening complication of sclerotherapy. Target-oriented and prompt therapy seems inevitable in order to reduce the risk of permanent tissue loss and amputation.

  12. Classification-based summation of cerebral digital subtraction angiography series for image post-processing algorithms.

    Science.gov (United States)

    Schuldhaus, D; Spiegel, M; Redel, T; Polyanskaya, M; Struffert, T; Hornegger, J; Doerfler, A

    2011-03-21

    X-ray-based 2D digital subtraction angiography (DSA) plays a major role in the diagnosis, treatment planning and assessment of cerebrovascular disease, i.e. aneurysms, arteriovenous malformations and intracranial stenosis. DSA information is increasingly used for secondary image post-processing such as vessel segmentation, registration and comparison to hemodynamic calculation using computational fluid dynamics. Depending on the amount of injected contrast agent and the duration of injection, these DSA series may not exhibit one single DSA image showing the entire vessel tree. The interesting information for these algorithms, however, is usually depicted within a few images. If these images would be combined into one image the complexity of segmentation or registration methods using DSA series would drastically decrease. In this paper, we propose a novel method automatically splitting a DSA series into three parts, i.e. mask, arterial and parenchymal phase, to provide one final image showing all important vessels with less noise and moving artifacts. This final image covers all arterial phase images, either by image summation or by taking the minimum intensities. The phase classification is done by a two-step approach. The mask/arterial phase border is determined by a Perceptron-based method trained from a set of DSA series. The arterial/parenchymal phase border is specified by a threshold-based method. The evaluation of the proposed method is two-sided: (1) comparison between automatic and medical expert-based phase selection and (2) the quality of the final image is measured by gradient magnitudes inside the vessels and signal-to-noise (SNR) outside. Experimental results show a match between expert and automatic phase separation of 93%/50% and an average SNR increase of up to 182% compared to summing up the entire series.

  13. Comparison of CT angiography and digital subtraction angiography in the evaluation of intracranial aneurysmal neck

    International Nuclear Information System (INIS)

    Kim, Yoo Kyung; Baik, Seung Kug; Shin, Mi Jeong; Choi, Han Yong

    2001-01-01

    To compare the usefulness of three-dimensional multislice CT angiography(CTA) and digital subtraction angiography (DSA) in the evaluation of intracranial aneurysmal neck. Nineteen patients with intracranial aneurysm (23 cases) underwent DSA and subsequent CTA. Using a multislice CT scanner and the SSD(shaded surface display) technique, clipping, cutting and the MPR technique, three-dimensional images were obtained. These were (a) external, (b) internal, from the direction of the parent artery, (c) internal, from the direction of the aneurysmal dome, and (d) an aneurysmal cutting image. The CTA findings were retrospectively compared with the DSA images. Twenty aneurysms were small and three were large. In eleven cases aneurysm neck was small, in nine it was wide, and in three it was relatively wide. For aneurysmal neck evaluation, CTA was superior to DSA in six of nine wide-neck aneurysms and all three large-sized wide-neck aneurysms. In small neck aneurysms 8 of 11 cases and in relatively wide neck all 3 cases showed similarly good images by both modalities. Of the 23 cases demonstrated by four different images, 14 cases showed the best image in internal image from parent artery direction and 6 cases showed similarly good image in both aneurysmal cutting image and internal image from parent artery direction. In the evaluation of wide neck aneurysms, 7 of 9 cases showed the best image at internal image from parent artery direction, compared with other three different images. In two cases of aneurysms, calcification was visible in the aneurysmal wall, so it was difficult to evaluate the aneurysmal neck. CTA was superior to DSA in the evaluating the intracranial aneurysmal neck. CTA maybe an additional available modality to evaluate the aneurysmal neck which is difficult to detect by the DSA. And the information of intracranial aneurysmal neck through CTA will be of value in surgical and endovascular treatment

  14. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    International Nuclear Information System (INIS)

    Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan

    2009-01-01

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 μm 2 ). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0±5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCO DSA =CO Fick . Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  15. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan [Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States)

    2009-11-15

    Purpose: The use of preclinical rodent models of disease continues to grow because these models help elucidate pathogenic mechanisms and provide robust test beds for drug development. Among the major anatomic and physiologic indicators of disease progression and genetic or drug modification of responses are measurements of blood vessel caliber and flow. Moreover, cardiopulmonary blood flow is a critical indicator of gas exchange. Current methods of measuring cardiopulmonary blood flow suffer from some or all of the following limitations--they produce relative values, are limited to global measurements, do not provide vasculature visualization, are not able to measure acute changes, are invasive, or require euthanasia. Methods: In this study, high-spatial and high-temporal resolution x-ray digital subtraction angiography (DSA) was used to obtain vasculature visualization, quantitative blood flow in absolute metrics (ml/min instead of arbitrary units or velocity), and relative blood volume dynamics from discrete regions of interest on a pixel-by-pixel basis (100x100 {mu}m{sup 2}). Results: A series of calibrations linked the DSA flow measurements to standard physiological measurement using thermodilution and Fick's method for cardiac output (CO), which in eight anesthetized Fischer-344 rats was found to be 37.0{+-}5.1 ml/min. Phantom experiments were conducted to calibrate the radiographic density to vessel thickness, allowing a link of DSA cardiac output measurements to cardiopulmonary blood flow measurements in discrete regions of interest. The scaling factor linking relative DSA cardiac output measurements to the Fick's absolute measurements was found to be 18.90xCO{sub DSA}=CO{sub Fick}. Conclusions: This calibrated DSA approach allows repeated simultaneous visualization of vasculature and measurement of blood flow dynamics on a regional level in the living rat.

  16. Detection of intracranial aneurysms with 64 channel multidetector row computed tomography: comparison with digital subtraction angiography.

    Science.gov (United States)

    Pozzi-Mucelli, Fabio; Bruni, Stefano; Doddi, Marco; Calgaro, Antonio; Braini, Massimiliano; Cova, Maria

    2007-10-01

    To compare the contribution of 64 channel multidetector row computed tomography angiography (64MDCT-angiography) with digital subtraction angiography (DSA) in the detection of intracranial aneurysms. Twenty-nine patients (10 males and 19 females, age: 40-84 years; average: 61.9 years) with clinical and imaging findings strongly suggesting the presence of subaracnoid hemorrhage underwent 64MDCT-angiography and DSA with a short interval between the two examinations (less than 12 h-5 days). CT parameters were: 64 mm x 0.5 mm collimation, pitch-0.828 and helical pitch-53. DSA were performed with standard technique (four vessel catheterization) and multiple projections. Axial CT scans as well as maximum intensity projection, volume rendering and multiplanar reformations and angiographic views were independently reviewed by four readers (two for 64MDCT-angiography and two for DSA). Consensus was reached for discordant cases. DSA was considered as the standard of reference. In 29 patients, 28 aneurysms were found (14 patients had 1 aneurysm, 4 patients had 2 aneurysms and 2 patients had 3 aneurysms; in 9 patients no aneurysm were found). 64MDCT-angiography detected 26/28 aneurysms. No false-positive sites were recognized. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were, respectively, 92.8, 100, 100, 99.4 and 99.5%. 64MDCT-angiography is helpful in detecting intracranial aneurysms with results similar to those of DSA but with less discomfort and risks for the patients and can be considered for the first line imaging technique. Conventional angiography is still needed in doubtful cases or negative MDCT-angiography associated with a strong clinical suspect.

  17. Comparisons of images simultaneously documented by digital subtraction coronary arteriography and cine coronary arteriography

    International Nuclear Information System (INIS)

    Kimura, Koji; Takamiya, Makoto; Yamamoto, Kazuo; Ohta, Mitsushige; Naito, Hiroaki

    1988-01-01

    Using an angiography apparatus capable of simultaneously processing digital subtraction angiograms and cine angiograms, the diagnostic capabilities of both methods for the coronary arteries (DSCAG and Cine-CAG) were compared. Twenty stenotic lesions of the coronary arteries of 11 patients were evaluated using both modalities. The severity of stenosis using DSCAG with a 512x512x8 bit matrix was semiautomatically measured on the cathode ray tube (CRT) based on enlarged images on the screen of a Vanguard cine projector which were of the same size as those of or 10 times larger than images of Cine-CAG. The negative and positive hard copies of DSCAG images were also compared with those of Cine-CAG. The correlation coefficients of the severity of stenosis by DSCAG and Cine-CAG were as follows: (1) the same size DSCAG images on CRT to Cine-CAG, 0.95, (2) 10 times enlarged DSCAG images on CRT to Cine-CAG, 0.96, and (3) the same size DSCAG images on negative and positive hard copies to Cine-CAG, 0.97. The semiautomatically measured values of 10 times enlarged DSCAG images on CRT and the manually measured values of the same size negative and positive DSCAG images in hard copy closely correlated with the values measured using Cine-CAG. When the liver was superimposed in the long-axis projection, the diagnostic capabilities of DSCAG and Cine-CAG were compared. The materials included 10 left coronary arteriograms and 11 right coronary arteriograms. Diagnostically, DSCAG was more useful than Cine-CAG in the long-axis projection. (author)

  18. Classification-based summation of cerebral digital subtraction angiography series for image post-processing algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Schuldhaus, D; Spiegel, M; Polyanskaya, M; Hornegger, J [Pattern Recognition Lab, University Erlangen-Nuremberg (Germany); Redel, T [Siemens AG Healthcare Sector, Forchheim (Germany); Struffert, T; Doerfler, A, E-mail: martin.spiegel@informatik.uni-erlangen.de [Department of Neuroradiology, University Erlangen-Nuremberg (Germany)

    2011-03-21

    X-ray-based 2D digital subtraction angiography (DSA) plays a major role in the diagnosis, treatment planning and assessment of cerebrovascular disease, i.e. aneurysms, arteriovenous malformations and intracranial stenosis. DSA information is increasingly used for secondary image post-processing such as vessel segmentation, registration and comparison to hemodynamic calculation using computational fluid dynamics. Depending on the amount of injected contrast agent and the duration of injection, these DSA series may not exhibit one single DSA image showing the entire vessel tree. The interesting information for these algorithms, however, is usually depicted within a few images. If these images would be combined into one image the complexity of segmentation or registration methods using DSA series would drastically decrease. In this paper, we propose a novel method automatically splitting a DSA series into three parts, i.e. mask, arterial and parenchymal phase, to provide one final image showing all important vessels with less noise and moving artifacts. This final image covers all arterial phase images, either by image summation or by taking the minimum intensities. The phase classification is done by a two-step approach. The mask/arterial phase border is determined by a Perceptron-based method trained from a set of DSA series. The arterial/parenchymal phase border is specified by a threshold-based method. The evaluation of the proposed method is two-sided: (1) comparison between automatic and medical expert-based phase selection and (2) the quality of the final image is measured by gradient magnitudes inside the vessels and signal-to-noise (SNR) outside. Experimental results show a match between expert and automatic phase separation of 93%/50% and an average SNR increase of up to 182% compared to summing up the entire series.

  19. A 2D driven 3D vessel segmentation algorithm for 3D digital subtraction angiography data

    Energy Technology Data Exchange (ETDEWEB)

    Spiegel, M; Hornegger, J [Pattern Recognition Lab, University Erlangen-Nuremberg, Erlangen (Germany); Redel, T [Siemens AG Healthcare Sector, Forchheim (Germany); Struffert, T; Doerfler, A, E-mail: martin.spiegel@informatik.uni-erlangen.de [Department of Neuroradiology, University Erlangen-Nuremberg, Erlangen (Germany)

    2011-10-07

    Cerebrovascular disease is among the leading causes of death in western industrial nations. 3D rotational angiography delivers indispensable information on vessel morphology and pathology. Physicians make use of this to analyze vessel geometry in detail, i.e. vessel diameters, location and size of aneurysms, to come up with a clinical decision. 3D segmentation is a crucial step in this pipeline. Although a lot of different methods are available nowadays, all of them lack a method to validate the results for the individual patient. Therefore, we propose a novel 2D digital subtraction angiography (DSA)-driven 3D vessel segmentation and validation framework. 2D DSA projections are clinically considered as gold standard when it comes to measurements of vessel diameter or the neck size of aneurysms. An ellipsoid vessel model is applied to deliver the initial 3D segmentation. To assess the accuracy of the 3D vessel segmentation, its forward projections are iteratively overlaid with the corresponding 2D DSA projections. Local vessel discrepancies are modeled by a global 2D/3D optimization function to adjust the 3D vessel segmentation toward the 2D vessel contours. Our framework has been evaluated on phantom data as well as on ten patient datasets. Three 2D DSA projections from varying viewing angles have been used for each dataset. The novel 2D driven 3D vessel segmentation approach shows superior results against state-of-the-art segmentations like region growing, i.e. an improvement of 7.2% points in precision and 5.8% points for the Dice coefficient. This method opens up future clinical applications requiring the greatest vessel accuracy, e.g. computational fluid dynamic modeling.

  20. Parametric color coding of digital subtraction angiography in the evaluation of carotid cavernous fistulas.

    Science.gov (United States)

    Gölitz, P; Struffert, T; Lücking, H; Rösch, J; Knossalla, F; Ganslandt, O; Deuerling-Zheng, Y; Doerfler, A

    2013-06-01

    Angiographic assessment of carotid cavernous fistulas (CCFs) can be complex. Our purpose was to examine whether the use of parametric color coding in the postprocessing of DSA series is advantageous in the evaluation of CCFs. We enrolled 16 patients with angiographically proven CCFs. Endovascular treatment was performed in 14 cases. For postprocessing of digital subtraction angiography (DSA) series, a newly implemented algorithm of parametric color coding was used, turning sequential images of two-dimensional (2D)-DSA series into a single color-coded image. Angiographic data of initial, interventional, and postinterventional 2D-DSA series were compared with color-coded images. Whether parametric color coding could facilitate evaluation of fistula architecture and provide a more precise estimation of fistula venous drainage patterns as well as whether flow analysis could reveal objective changes during and after treatment were investigated. In 56 % of the cases, parametric color coding was observed to facilitate visualization of fistula angioarchitecture. Estimation of fistula drainage flow patterns was considered to be improved in 31 % of the cases. For assessment of hemodynamic changes during and after treatment, parametric color coding was assumed to be helpful in 21 % of the cases, especially because revealing flow changes that were not visible on 2D-DSA series were now visible. Parametric color coding is a fast application tool that might provide additional support in the angiographic evaluation of CCFs. Visualization of complex fistula architecture could be facilitated, and flow analysis might improve assessment of venous drainage patterns, thereby increasing overall diagnostic confidence. During and after treatment, hemodynamic changes that were not visible on 2D-DSA series could now be depicted.

  1. A 2D driven 3D vessel segmentation algorithm for 3D digital subtraction angiography data

    International Nuclear Information System (INIS)

    Spiegel, M; Hornegger, J; Redel, T; Struffert, T; Doerfler, A

    2011-01-01

    Cerebrovascular disease is among the leading causes of death in western industrial nations. 3D rotational angiography delivers indispensable information on vessel morphology and pathology. Physicians make use of this to analyze vessel geometry in detail, i.e. vessel diameters, location and size of aneurysms, to come up with a clinical decision. 3D segmentation is a crucial step in this pipeline. Although a lot of different methods are available nowadays, all of them lack a method to validate the results for the individual patient. Therefore, we propose a novel 2D digital subtraction angiography (DSA)-driven 3D vessel segmentation and validation framework. 2D DSA projections are clinically considered as gold standard when it comes to measurements of vessel diameter or the neck size of aneurysms. An ellipsoid vessel model is applied to deliver the initial 3D segmentation. To assess the accuracy of the 3D vessel segmentation, its forward projections are iteratively overlaid with the corresponding 2D DSA projections. Local vessel discrepancies are modeled by a global 2D/3D optimization function to adjust the 3D vessel segmentation toward the 2D vessel contours. Our framework has been evaluated on phantom data as well as on ten patient datasets. Three 2D DSA projections from varying viewing angles have been used for each dataset. The novel 2D driven 3D vessel segmentation approach shows superior results against state-of-the-art segmentations like region growing, i.e. an improvement of 7.2% points in precision and 5.8% points for the Dice coefficient. This method opens up future clinical applications requiring the greatest vessel accuracy, e.g. computational fluid dynamic modeling.

  2. Decreasing radiation doses in digital subtraction angiographies consecutively performed by trainees

    International Nuclear Information System (INIS)

    Xu, G.; Zhao, W.; Zheng, L.; Fan, X.; Yin, Q.; Liu, X.

    2012-01-01

    Digital subtraction angiography (DSA) performed by trainees may be related to increased radiation exposure. This study was aimed to investigate and quantify this learning effect, with fluoroscopy time and dose-area product (DAP) as parameters. We collected procedure data of the first to the fortieth cerebral DSA consecutively performed by 13 trainees in a training centre. DAP, procedure time, fluoroscopy time, number of cine-frames of the first 20 DSA procedures performed by these trainees were compared with that of the second 20 procedures. There was no significant difference concerning the procedure time between the first and the second 20 procedures (56.3 ±29.5 vs 51.5±20.2 min, p = 0.113). Numbers of cine-frames were very similar between the first and the second 20 procedures (750.7 ±290.3 vs 744.5 ±188.7, p = 0.830). Fluoroscopy time of the first 20 procedures was significantly longer than that of the second 20 procedures (17.8 ±15.4 vs 12.6 ±9.0, p = 0.001). DAP of the first 20 procedures was significantly higher than that of the second 20 procedures (6.4 ±4.9 vs 3.8 ±1.8, p < 0.001). DAP was correlated significantly with the performer's experience (R = -0.288, p < 0.001). There exists a learning effect of radiation exposure during cerebral DSA procedures performed by trainees. The learning effect is significant during the first 20 procedures, and becomes insignificant after 20 procedures. Insufficient catheter skills in novice trainees may be one reason for this effect. (authors)

  3. Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

    National Research Council Canada - National Science Library

    Li, Christina M

    2007-01-01

    .... The purpose of this project is to determine the feasibility of using temporal subtraction on DBT phantom images to allow for easier and earlier detection of breast cancer than with either technique alone...

  4. Combined chemotherapy and intra-arterial chemotherapy of retinoblastoma

    Directory of Open Access Journals (Sweden)

    Saerom Choi

    2013-06-01

    Full Text Available &lt;b&gt;Purpose:&lt;/b&gt; Retinoblastoma (RB is the most common primary malignant intraocular tumor in children. Although systemic chemotherapy has been the primary treatment, intra-arterial chemotherapy (IAC represents a new treatment option. Here, we performed alternate systemic chemotherapy and IAC and retrospectively reviewed the efficacy and safety of this approach. &lt;b&gt;Methods:&lt;/b&gt; Patients diagnosed with intraocular RB between January 2000 and December 2011 at Severance Children’s Hospital, Yonsei University, were reviewed. Before February 2010, the primary treatment for RB was chemotherapy (non-IAC/CTX. Since February 2010, the primary treatment for RB has been IAC (IAC/CTX. External beam radiotherapy or high-dose chemotherapy (HDCTX were used as “last resort” treatments just prior to enucleation at the time of progression or recurrence during primary treatment. Enucleation-free survival (EFS and progression-free survival were assessed. &lt;b&gt; Results:&lt;/b&gt; We examined 19 patients (median age, 11.9 months; range, 1.4 to 75.6 months with a sum of 25 eyes, of which, 60.0% were at advanced Reese Ellsworth (RE stages. The enucleation rate was 33.3% at early RE stages and 81.8% at advanced RE stages (P =0.028. At 36 months, EFS was significantly higher in the IAC/CTX group than in the non-IAC/CTX group (100.0% vs. 40.0%, P=0.016. All 5 patients treated with IAC achieved eye preservation, although most patients were at advanced RE stages (IV-V. &lt;b&gt;Conclusion:&lt;/b&gt; Despite the limitation of a small sample size, our work shows that an alternative combined approach using IAC and CTX may be safe and effective for eye preservation in advanced RB.

  5. [Intra-arterial thrombolytic therapy of lower limb ischemia].

    Science.gov (United States)

    Juhan, C; Haupert, S; Miltgen, G; Dulac, P; Girard, N; Barthélémy, P; Raybaud, C

    1990-02-01

    Between 1984 and 1989, 35 patients with recent arterial or graft occlusions have been treated with intra-arterial infusion using sequential association of Urokinase (U.K.) and Lys-Plasminogen. Occlusion was thrombotic in 68.5% of the cases ans embolic in 31.5%, involving 28 native arteries and 7 bypass grafts. The mean duration was 16 days (2 to 90). Continuous infusion of U.K.: 84,000 U.I./H and bolus of Lys-Plasminogen 15 microKatals every 30 minutes were delivered through a catheter embedded into the clot. Intra-venous heparin was always associated. The mean duration of lytic drug infusion was 8 H. Complementary arterial reconstruction by vascular surgery of percutaneous transluminal angioplasty was performed in 23% of the patients. Patients with recent alimentary tract bleeding, hemorragic stroke in the last six months or severe high blood pressures were contra-indicated. Complete lysis was obtained in 23 cases (66%), partial lysis in 7 (20%) and no lysis in 5 (14%). The clinical result was excellent in 24 cases (68.5%), good in 3 (8.5%) and bad in 8 (23%) in which amputation was always necessary. 5 local hematoma (14%) treated by surgery or transfusion and one death (3%) due to neurological complication occurring 24 hours after the end of the procedure were observed. The literature survey has shown that the results of low doses of Streptokinase (S.K.) local infusions were not better, and that higher doses of S.K. or U.K. delivered during a shorter infusion time increased the efficacy of lysis and decreased the rate of hemorragic complications. We have proposed the local thrombolytic treatment to the limb threatening ischemic cases when the traditional medical or surgical techniques where thought to be associated to a high risk of failure or complication. The specific indications are the acute or sub-acute ischemic situation due to atheromatous artery thrombosis, distal or old embolism where the Fogarty catheter is inefficient, and graft thrombosis. Severe

  6. Comparison of conventional panoramic radiography and panoramic digital subtraction radiography in detection of simulated lesions of mandibular condyle

    Directory of Open Access Journals (Sweden)

    Panjnoush M.

    2008-12-01

    Full Text Available "n  "nBackground and Aim: Digital subtraction Radiography (DSR is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl. "nMaterials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test. "nResults: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9% (p<0.0001. "nConclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.

  7. Automatic flow analysis of digital subtraction angiography using independent component analysis in patients with carotid stenosis.

    Directory of Open Access Journals (Sweden)

    Han-Jui Lee

    Full Text Available Current time-density curve analysis of digital subtraction angiography (DSA provides intravascular flow information but requires manual vasculature selection. We developed an angiographic marker that represents cerebral perfusion by using automatic independent component analysis.We retrospectively analyzed the data of 44 patients with unilateral carotid stenosis higher than 70% according to North American Symptomatic Carotid Endarterectomy Trial criteria. For all patients, magnetic resonance perfusion (MRP was performed one day before DSA. Fixed contrast injection protocols and DSA acquisition parameters were used before stenting. The cerebral circulation time (CCT was defined as the difference in the time to peak between the parietal vein and cavernous internal carotid artery in a lateral angiogram. Both anterior-posterior and lateral DSA views were processed using independent component analysis, and the capillary angiogram was extracted automatically. The full width at half maximum of the time-density curve in the capillary phase in the anterior-posterior and lateral DSA views was defined as the angiographic mean transient time (aMTT; i.e., aMTTAP and aMTTLat. The correlations between the degree of stenosis, CCT, aMTTAP and aMTTLat, and MRP parameters were evaluated.The degree of stenosis showed no correlation with CCT, aMTTAP, aMTTLat, or any MRP parameter. CCT showed a strong correlation with aMTTAP (r = 0.67 and aMTTLat (r = 0.72. Among the MRP parameters, CCT showed only a moderate correlation with MTT (r = 0.67 and Tmax (r = 0.40. aMTTAP showed a moderate correlation with Tmax (r = 0.42 and a strong correlation with MTT (r = 0.77. aMTTLat also showed similar correlations with Tmax (r = 0.59 and MTT (r = 0.73.Apart from vascular anatomy, aMTT estimates brain parenchyma hemodynamics from DSA and is concordant with MRP. This process is completely automatic and provides immediate measurement of quantitative peritherapeutic brain parenchyma

  8. Simultaneous optical digital half-subtraction and -addition using SOAs and a PPLN waveguide.

    Science.gov (United States)

    McGeehan, John E; Kumar, Saurabh; Willner, Alan E

    2007-04-30

    We demonstrate an optical half-subtracter and half-adder module that performs simultaneous bit-wise subtraction and addition of two 5 Gbit/s RZ data streams. We generate Borrow (/X*Y) and Difference/Sum (X plus sign in circleY, or XOR) outputs using cross-gain modulation (XGM) in two parallel SOAs. Taking advantage of the gain saturation inherent to SOAs, we generate two signals, /X*Y, and X*/Y, and combine them using a passive optical coupler to generate the XOR Difference/Sum output. We use difference-frequency-generation-based lambda-conversion in a PPLN waveguide to generate the Carry (X*Y) output. The PPLN waveguide allows bit-synchronous wavelength shifting, is wide-bandwidth, and offers no intrinsic chirp. Our module uses three active elements to perform simultaneous half-subtraction and addition, and carries a maximum power penalty of 1.0 dB.

  9. Digital subtraction radiographic analysis of the combination of bioabsorbable membrane and bovine morphogenetic protein pool in human periodontal infrabony defects

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Machado Guimarães

    2010-08-01

    Full Text Available OBJECTIVES: This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. MATERIAL AND METHODS: Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites or collagen membrane only (control sites. The periodontal healing was clinically and radiographically monitored for six months. Standardized pre-surgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05. RESULTS: As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm² in the test group and 2 mm² in the control group (p>0.05. Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05. CONCLUSIONS: The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions.

  10. [X-ray semiotics of sialolithiasis in functional digital subtraction sialography].

    Science.gov (United States)

    Iudin, L A; Kondrashin, S A; Afanas'ev, V V; Shchipskiĭ, A V

    1995-01-01

    Twenty-seven patients with sialolithiasis were examined using functional subtraction sialography developed by the authors. Differential diagnostic signs characterizing the degree of involvement of the salivary gland were defined. High efficacy of the method helps correctly plan the treatment strategy.

  11. Visualization of the renal venous system by renal arteriography with digital subtraction angiography

    International Nuclear Information System (INIS)

    Nagai, Jun

    1989-01-01

    The purpose of this study was to obtain vivid and precise images of intrarenal venous branching using DSA for renal arteriography. The type of system used was an ADAC DPS-4100C with 70-80 kVp, and 320 mA, 25-50 msec at 6 frames/sec. The duration was 10 sec and the matrix size was 512x512. In order to retain clear subtracted images of intrarenal venous branching with minimal noise the three frames were selected on the time-density curve of DSA: (Fig.3). 1) a frame on which renal arteries disappear (frame X), 2) the frame with highest renal venous density value as (frame Y), 3) the difference of the nephrogram density between X and Y frames in which only the density of the nephrogram decreases (frame Z). The mask image is the image subtracted by the equation of the weighted averaging method on X and Z frame and is subtracted from the image of Y frame in the final step. By this method, 40 kidneys in 36 patients were studied, and the intrarenal venous branches up to the interlobar vein was clearly demonstrated in 28 of these cases (70%). This method is useful to estimate the extent of intrarenal lesions and detect abnormal renal blood flow compared with conventional temporal subtraction method. (author)

  12. Intra-arterial chemotherapy as a treatment for intraocular retinoblastoma: alternatives to direct ophthalmic artery catheterization.

    Science.gov (United States)

    Klufas, M A; Gobin, Y P; Marr, B; Brodie, S E; Dunkel, I J; Abramson, D H

    2012-09-01

    Intra-arterial chemotherapy is a very effective treatment option for intraocular retinoblastoma. However, direct catheterization of the OA is not always possible. The purpose of this work was to report our initial results with intra-arterial chemotherapy for intraocular retinoblastoma when delivery of the drug was not via direct catheterization of the OA. Retrospective review of 110 eyes (89 patients) undergoing a total of 351 intra-arterial treatments at our institution between 2006 and 2010 identified 18 eyes (14 patients) that received at least 1 infusion via a vascular route other than direct OA catheterization. Alternatives included catheterization of the orbital branch of the MMA and temporary balloon occlusion of the ICA. Tumor control was observed in 17 of 18 eyes at a mean follow-up of 18.9 months (median, 17.5 months; range, 8-36 months). The mean number of intra-arterial infusions was 3.7 per eye (median, 3; range, 2-9). Treatment routes included the following: MMA only, 3 eyes; MMA + OA, 4 eyes; MMA + balloon, 2 eyes; balloon only, 1 eye; balloon + OA, 7 eyes; balloon + OA + MMA, 1 eye. Intra-arterial chemotherapies included melphalan, topotecan, and carboplatin. Complications were all transient. ERG readings were the following: stable, 10 eyes; improved, 3 eyes; reduced, 5 eyes. One patient died from a second malignancy (pinealoblastoma). This initial experience shows that when direct OA catheterization is not possible, using alternative routes of intra-arterial chemotherapy saves eyes and preserves vision with acceptable side effects.

  13. Preoperative Localization of Mediastinal Parathyroid Adenoma with Intra-arterial Methylene Blue.

    Science.gov (United States)

    Salman, Rida; Sebaaly, Mikhael G; Wehbe, Mohammad Rachad; Sfeir, Pierre; Khalife, Mohamad; Al-Kutoubi, Aghiad

    2017-06-01

    Ectopic parathyroid is found in 16% of patients with hyperparathyroidism. 2% of ectopic parathyroid adenomas are not accessible to standard cervical excision. In such cases, video-assisted thoracoscopic resection is the recommended definitive treatment. We present a case of mediastinal parathyroid adenoma localized preoperatively by injecting methylene blue within a branch of the internal mammary artery that is supplying the adenoma. Intra-arterial methylene blue injection facilitated visualization and resection of the adenoma. The preoperative intra-arterial infusion of methylene blue appears to be an effective and safe method for localization of ectopic mediastinal parathyroid adenomas and allows rapid identification during thoracoscopic resection.

  14. Preoperative Localization of Mediastinal Parathyroid Adenoma with Intra-arterial Methylene Blue

    Energy Technology Data Exchange (ETDEWEB)

    Salman, Rida; Sebaaly, Mikhael G. [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon); Wehbe, Mohammad Rachad; Sfeir, Pierre; Khalife, Mohamad [American University of Beirut Medical Center, Department of General Surgery (Lebanon); Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon)

    2017-06-15

    Ectopic parathyroid is found in 16% of patients with hyperparathyroidism. 2% of ectopic parathyroid adenomas are not accessible to standard cervical excision. In such cases, video-assisted thoracoscopic resection is the recommended definitive treatment. We present a case of mediastinal parathyroid adenoma localized preoperatively by injecting methylene blue within a branch of the internal mammary artery that is supplying the adenoma. Intra-arterial methylene blue injection facilitated visualization and resection of the adenoma. The preoperative intra-arterial infusion of methylene blue appears to be an effective and safe method for localization of ectopic mediastinal parathyroid adenomas and allows rapid identification during thoracoscopic resection.

  15. Comparison of Accuracy of Conventional Periapical Radiography and Direct Digital Subtractions Radiography with or without Image Enhancement in the Diagnosis of Density Changes

    Directory of Open Access Journals (Sweden)

    Tahmineh Razi

    2012-04-01

    Full Text Available Background and aims. In periapical radiographic technique, the changes will be visible only after considerable deposition or resorption while digital subtraction technique visualizes slight density changes. This study was aimed to compare visualization of density changes in conventional periapical radiographs and digital subtraction technique with or without image enhancement. Materials and methods. Three dry human mandibles with unspecified age and gender were selected. Conventional periapical and direct digital radiographs were taken from the anterior, and right and left posterior regions by step-wise placement of aluminum plates until the image of the plate was clearly visible. The radiographs taken with the direct digital technique were subtracted from the first radiograph using Photoshop software. Three observers evaluated the radiographs and the digital subtraction images with or without image enhancement. The density was recorded in each radiograph in which the image of the aluminum plate was completely visible. Results. In all mandibles, the differences in diagnosis of density changes between the conventional periapical radiographic technique and the direct digital subtraction radiographic technique with or without image enhancement were statistically significant irrespective of the region under study (p<0.001. There were no significant differences in the diagnosis of density changes in all the three mandibles in the left and right posterior regions between the two radiographic techniques. However, the differences in the anterior region were statistically significant (p<0.001. Conclusion. Direct digital subtraction radiographic technique with or without image enhancement is a more efficacious technique in exhibiting minor density changes compared to conventional periapical radiographic technique

  16. Chemoradiotherapy using retrograde superselective intra-arterial infusion for advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Iwai, Toshinori; Mitsunaga, Sachiyo

    2011-01-01

    Concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion demonstrates good local control and overall survival rates due to the advantage of simultaneous infusion of anticancer agent with the synergistic effects of chemotherapy and radiotherapy. This study evaluated the therapeutic results, overall survival and local control rates in patients with advanced oral cancer treated with definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. A total of 688 patients with carcinoma of the head and neck were referred to our institution between January 2001 and December 2006. Among them, 175 patients with carcinoma of the oral cavity underwent definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m 2 , cisplatin, total 125-150 mg/m 2 ) and daily concurrent radiotherapy (total 50-60 Gy) for 5-6 weeks. Four weeks after the completion of all treatments, patients underwent biopsy of the primary lesion and radiological examinations. Complete response (CR) of the primary site was achieved in 160 (91.4%) of the 175 patients. Residual disease at the primary site was seen in 15 patients (8.6%), and 14 patients (8.0%) showed local recurrence during follow-up. Five-year survival and local control rates were 71.6% and 82.2%, respectively. (author)

  17. Endovascular Hypothermia in Acute Ischemic Stroke: Pilot Study of Selective Intra-Arterial Cold Saline Infusion

    NARCIS (Netherlands)

    Chen, Jian; Liu, Liqiang; Zhang, Hongqi; Geng, Xiaokun; Jiao, Liqun; Li, Guilin; Coutinho, Jonathan M.; Ding, Yuchuan; Liebeskind, David S.; Ji, Xunming

    2016-01-01

    We conducted a pilot feasibility and safety study of selective brain cooling with intra-arterial infusion of cold saline combined with endovascular reperfusion for acute ischemic stroke. Patients with large-vessel occlusion within 8 hours after symptom onset were enrolled. All patients received

  18. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy for gingival carcinoma

    International Nuclear Information System (INIS)

    Mukai, Y.; Hata, M.; Koike, I.; Inoue, T.; Mitsudo, K.; Koizumi, T.; Oguri, S.; Kioi, M.; Tohnai, I.; Omura, M.

    2014-01-01

    The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy in the treatment of gingival carcinoma. In all, 34 patients (21 men and 13 women) with squamous cell carcinoma of the gingiva underwent radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy. Treatment consisted of daily external irradiation and concurrent retrograde superselective intra-arterial infusion with cisplatin and docetaxel. A median total dose of 60 Gy in 30 fractions was delivered to tumors. Of the 34 patients, 29 (85 %) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis 1-15 months after treatment. Twenty-six of the 36 patients had survived at a median follow-up time of 36 months (range 12-79 months); 4 died of cancer and 4 died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79 % and the cause-specific survival rates were 85 %. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma. (orig.) [de

  19. Local intra-arterial thrombolysis in a 4-year-old male with vertebrobasilar artery thrombosis

    NARCIS (Netherlands)

    Janmaat, Mirjam; Gravendeel, Joost P; Uyttenboogaart, Maarten; Vroomen, Patrick C; Brouwer, Oebele F; Luijckx, Gert-Jan

    We report the case of a 4-year-old male with vertebrobasilar artery thrombosis for which he was treated with local intra-arterial urokinase 60 hours after onset of symptoms. Initially the patient had dysarthria and dysphagia. Brain magnetic resonance imaging (MRI) in a community hospital showed

  20. Repeated Intra-Arterial Thrombectomy within 72 Hours in a Patient with a Clear Contraindication for Intravenous Thrombolysis

    Directory of Open Access Journals (Sweden)

    Mona Laible

    2015-01-01

    Full Text Available Introduction. Treating patients with acute ischemic stroke, proximal arterial vessel occlusion, and absolute contraindication for administering intravenous recombinant tissue plasminogen activator (rtPA poses a therapeutic challenge. Intra-arterial thrombectomy constitutes an alternative treatment option. Materials and Methods. We report a case of a 57-year-old patient with concomitant gastric adenocarcinoma, who received three intra-arterial thrombectomies in 72 hours due to repeated occlusion of the left medial cerebral artery (MCA. Findings. Intra-arterial recanalization of the left medial cerebral artery was performed three times with initially good success. However, two days later, the right medial cerebral artery became occluded. Owing to the overall poor prognosis at that time and knowing the wishes of the patient, we decided not to perform another intra-arterial recanalization procedure. Conclusion. To our knowledge, this is the first case illustrating the use of repeated intra-arterial recanalization in early reocclusion of intracranial vessels.

  1. Pulmonary arteriography by digital subtraction angiographic method in cyanotic heart disease with pulmonary stenosis or pulmonary atresia

    International Nuclear Information System (INIS)

    Kobayashi, Junjiro; Hirose, Hajime; Nakano, Susumu

    1985-01-01

    Pulmonary arteriography was performed by digital subtraction angiographic (DSA) method in 10 patients with cyanotic heart disease associated with pulmonary stenosis or pulmonary atresia. Ten patients consisted of five patients with tetralogy of Fallot, three with single ventricle and pulmonary stenosis, and two with pseudotruncus arteriosus. Hepato-clavicular position was taken in four patients. Pulmonary artery and its main branches were opacified and recognized clearly, and their diameter could be measured accurately with a small amount of contrast medium. There was a good correlation between the diameter of pulmonary artery measured by DSA and that measured by conventional pulmonary arteriography. DSA is a useful method for evaluating the size and the stenosis of pulmonary artery especially in small cyanotic infants. (author)

  2. Influence of homeopathic treatment with comfrey on bone density around titanium implants: a digital subtraction radiography study in rats.

    Science.gov (United States)

    Sakakura, Celso Eduardo; Neto, Rubens Spin; Bellucci, Marina; Wenzel, Ann; Scaf, Gulnara; Marcantonio, Elcio

    2008-06-01

    The objective of this study was to evaluate the influence of homeopathic treatment with comfrey (Shymphytum officinalis 6CH) on radiographic bone density and area around titanium implants. Forty-eight rats were divided into two groups of 24 animals each: a control group (C) and a test group (SO). Each animal received one titanium micro-implant placed in the tibia. The animals in Group SO were subjected to 10 drops of comfrey 6CH per day mixed into their drinking water until the day of sacrifice. Eight animals of each group were sacrificed at 7, 14 and 28 days post-surgery, respectively. Standardized digital radiographs were obtained on the day of implant installation (baseline images) and on the day of sacrifice (final images). Digital subtraction of the two corresponding images was performed to evaluate changes in bone density and the area related to change around the implant between baseline and final images. Subtraction images demonstrated that a significant difference existed in mean shade of gray at 14 days post-surgery between Group SO (mean 175.3+/-14.4) and Group C (mean 146.2+/-5.2). Regarding the area in pixels corresponding to the bone gain in Group SO, the differences observed between the sacrifice periods and groups were only significant at 7 days sacrifice between Group SO (mean 171.2+/-21.9) and Group C (mean 64.5+/-60.4). Within the limits of this study, comfrey administration promotes an increase in radiographic bone density around titanium implants in the initial period of bone healing.

  3. Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

    National Research Council Canada - National Science Library

    Li, Christina M

    2007-01-01

    Digital breast tomosynthesis (DBT) strives to overcome the obstacles presented in conventional 2D mammography by taking multiple projections over a fixed angle and reconstructing volumetric data isolates overlying anatomy...

  4. Effects of intra-arterial infusion therapy or systemic chemotherapy with docetaxel for VX2 tumor in rabbit hind limb

    International Nuclear Information System (INIS)

    Qian Yuanxin; Wu Xiaomei; He Miao; Liu Tao; Deng Duo

    2010-01-01

    Objective: To discuss the efficacy and safety of intra-arterial infusion therapy with docetaxel. Methods: Animal model of VX2 tumor in rabbit hind limb was set up. Intra-arterial infusion therapy or systemic chemotherapy with docetaxel was performed. Concentrations of docetaxel in VX2 tumor, wall of stomach, liver, kidney and plasma of rabbits with VX2 tumors in hind limbs were determined. Difference of drug concentrations between intra-arterial infusion therapy and systemic chemotherapy was compared using Student t-test. Results: Concentrations of docetaxel in VX2 tumor and wall of stomach of rabbits with intra-arterial infusion therapy were significantly higher than those with systemic chemotherapy (p<0.05). The drug concentration in VX2 tumor of rabbits with intra-arterial infusion was 14 times higher than that with systemic chemotherapy. Concentration of docetaxel in plasma of rabbits with intra-arterial infusion therapy was not significantly lower than that with systemic chemotherapy (P<0.05). Conclusion: Intra-arterial infusion therapy with docetaxel for tumor is effective. However, there is increased risk of toxicity and the dose should adjusted accordingly. (authors)

  5. Diagnostic yield and accuracy of CT angiography, MR angiography, and digital subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage: Prospective, multicentre cohort study

    NARCIS (Netherlands)

    C.J.J. Van Asch (Charlotte J.J.); B.K. Velthuis (Birgitta K.); G.J.E. Rinkel (Gabriël J.E.); A. Algra (Ale); G.A.P. de Kort (G. A P); T.D. Witkamp (Theo); J.C.M. De Ridder (Johanna C.M.); K.M. Van Nieuwenhuizen (Koen M.); F.-E. De Leeuw (Frank-Erik); W.J. Schonewille (Wouter); P.L.M. de Kort (Paul); D.W.J. Dippel (Diederik); T.W.M. Raaymakers (Theodora W.M.); J. Hofmeijer; M.J.H. Wermer (Marieke); H. Kerkhoff (Henk); K. Jellema (Korné); I.M. Bronner (Irene M.); M.J.M. Remmers (Michel ); H.P. Bienfait (Henri); R.J.G.M. Witjes (Ron J.G.M.); J.P. Greving (Jacoba); C.J.M. Klijn (Catharina J.M.); H.F. de Leeuw (Frank); H.B. Boogaarts; E.J. van Dijk (Ewoud); W.J. Schonewille; W.M.J. Pellikaan; C. Puppels-De Waard; P.L.M. De Kort; J.P. Peluso; J. van Tuijl (Jordie); J. Hofmeijer; F.B.M. Joosten (Frank); D.W.J. Dippel (Diederik); L. Khajeh (Ladbon); T.W.M. Raaijmakers; M.J. Wermer; M.A.A. van Walderveen (Marianne); H. Kerkhoff; E. Zock; K. Jellema (Korné); G.J. Lycklama à Nijeholt (Geert); I.M. Bronner; M.J.M. Remmers; R.J.G.M. Witjes; H.P. Bienfait; K.E. Droogh-Greve; R. Donders (Rogier); V.I.H. Kwa; T.H.C.M.L. Schreuder (Tobien H. C. M. L.); C.L. Franke (Cees); J.S. Straver; C. Jansen; S.L.M. Bakker (Stef); C.C. Pleiter (C.); M.C. Visser; C.J.J. Van Asch; B.K. Velthuis (Birgitta); G.J.E. Rinkel (Gabriel); K.M. Van Nieuwenhuizen; C.J.M. Klijn (Catharina J.M.)

    2015-01-01

    textabstractStudy question What are the diagnostic yield and accuracy of early computed tomography (CT) angiography followed by magnetic resonance imaging/angiography (MRI/MRA) and digital subtraction angiography (DSA) in patients with non-traumatic intracerebral haemorrhage? Methods This

  6. Intra-arterial colforsin daropate for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Suzuki, Satoshi; Ito, Osamu; Sayama, Tetsuro; Goto, Katsuya

    2010-01-01

    Cerebral vasospasm (CV) remains a major cause of mortality and morbidity in patients with subarachnoid hemorrhage (SAH). Here, we examined the effectiveness and safety of intra-arterial injection of colforsin daropate hydrochloride (CDH). A consecutive series of 29 patients with angiographically confirmed CV received intra-arterial CDH (IAC) therapy. Angiographic changes in spastic vessels and the cerebral circulation time (CCT) were assessed before and after IAC treatment, together with the change in clinical status. IAC treatment was performed in 53 procedures in 29 patients. Angiographic improvement was observed following all procedures (100%), and clinical improvement was observed following 36 of 42 procedures (86%) in symptomatic cases. CCT improved significantly. At the 3-month follow-up, 19 patients (66%) showed good recovery or moderate disability on the Glasgow Outcome Scale. Major adverse effects were headache and increased heart rate. IAC treatment was effective and safe for the treatment of CV after SAH. (orig.)

  7. A review of the literature for intra-arterial chemotherapy used to treat retinoblastoma.

    Science.gov (United States)

    Wyse, Emily; Handa, James T; Friedman, Alan D; Pearl, Monica S

    2016-08-01

    Retinoblastoma is a malignancy of the retina that usually presents before the age of 5 years. Sporadic retinoblastoma is most often unilateral and with no hereditary influence, whereas familial retinoblastoma presents unilaterally or bilaterally in conjunction with genetic inheritance. Several treatments have been attempted with the goals of saving the child's life, salvaging the eye, and preserving vision. Alternative methods including external beam radiation, systemic chemotherapy and focal therapies have been shown to be effective but carry a risk of enucleation and other complications proportional to the severity of the tumor. Selective intra-arterial chemotherapy for retinoblastoma began in 1988 in Japan and has emerged in the last 7 years in the United States as a feasible, effective and minimally invasive treatment option. We review the retinoblastoma treatment literature focusing on intra-arterial chemotherapy.

  8. A feasibility study of projection-based energy weighting based on a photon-counting detector in contrast-enhanced digital subtraction mammography: a simulation study

    International Nuclear Information System (INIS)

    Choi, Sunghoon; Lee, Seungwan; Choi, Yuna; Kim, Heejoung

    2014-01-01

    Contrast media, such as iodine and gadolinium, are generally used in digital subtraction mammography to enhance the contrast between target and background materials. In digital subtraction mammography, where one image (with contrast medium) is subtracted from another (anatomical background) to facilitate visualization of the tumor structure, tumors can be more easily distinguished after the injection of a contrast medium. In order to have more an effective method to increase the contrast-to-noise ratio (CNR), we applied a projection-based energy-weighting method. The purpose of this study is to demonstrate the feasibility of using the projection-based energy-weighting method in digital subtraction mammography. Unlike some other previous studies, we applied the projection-based energy-weighting method to more practical mammography conditions by using the Monte Carlo method to simulate four different iodine solutions embedded in a breast phantom comprised of 50% adipose and 50% glandular tissues. We also considered an optimal tube voltage and anode/filter combination in digital iodine contrast media mammography in order to maximize the figure-of-merit (FOM). The simulated source energy was from 20 to 45 keV to prevent electronic noise and include the k-edge energy of iodine (33.2 keV). The results showed that the projection-based energy-weighting improved the CNR by factors of 1.05 - 1.86 compared to the conventionally integrated images. Consequently, the CNR of digital subtraction mammography images can be improved by using projection-based energy-weighting with photon-counting detectors.

  9. A feasibility study of projection-based energy weighting based on a photon-counting detector in contrast-enhanced digital subtraction mammography: a simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sunghoon; Lee, Seungwan; Choi, Yuna; Kim, Heejoung [Yonsei University, Wonju (Korea, Republic of)

    2014-06-15

    Contrast media, such as iodine and gadolinium, are generally used in digital subtraction mammography to enhance the contrast between target and background materials. In digital subtraction mammography, where one image (with contrast medium) is subtracted from another (anatomical background) to facilitate visualization of the tumor structure, tumors can be more easily distinguished after the injection of a contrast medium. In order to have more an effective method to increase the contrast-to-noise ratio (CNR), we applied a projection-based energy-weighting method. The purpose of this study is to demonstrate the feasibility of using the projection-based energy-weighting method in digital subtraction mammography. Unlike some other previous studies, we applied the projection-based energy-weighting method to more practical mammography conditions by using the Monte Carlo method to simulate four different iodine solutions embedded in a breast phantom comprised of 50% adipose and 50% glandular tissues. We also considered an optimal tube voltage and anode/filter combination in digital iodine contrast media mammography in order to maximize the figure-of-merit (FOM). The simulated source energy was from 20 to 45 keV to prevent electronic noise and include the k-edge energy of iodine (33.2 keV). The results showed that the projection-based energy-weighting improved the CNR by factors of 1.05 - 1.86 compared to the conventionally integrated images. Consequently, the CNR of digital subtraction mammography images can be improved by using projection-based energy-weighting with photon-counting detectors.

  10. Superselective intra-arterial cisplatin infusion and concomitant radiotherapy for maxillary sinus cancer

    OpenAIRE

    Homma, A; Sakashita, T; Yoshida, D; Onimaru, R; Tsuchiya, K; Suzuki, F; Yasuda, K; Hatakeyama, H; Furusawa, J; Mizumachi, T; Kano, S; Inamura, N; Taki, S; Shirato, H; Fukuda, S

    2013-01-01

    Background: The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS). Methods: Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100-120mgm(-2) per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65-...

  11. Persistent renal enhancement after intra-arterial versus intravenous iodixanol administration

    Energy Technology Data Exchange (ETDEWEB)

    Chou, Shinn-Huey; Wang, Zhen J.; Kuo, Jonathan; Cabarrus, Miguel; Fu Yanjun; Aslam, Rizwan; Yee, Judy; Zimmet, Jeffrey M.; Shunk, Kendrick; Elicker, Brett [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Yeh, Benjamin M., E-mail: Benjamin.Yeh@ucsf.edu [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States)

    2011-11-15

    Purpose: To examine the clinical significance of persistent renal enhancement after iodixanol administration. Methods: We retrospectively studied 166 consecutive patients who underwent non-enhanced abdominopelvic CT within 7 days after receiving intra-arterial (n = 99) or intravenous (n = 67) iodixanol. Renal attenuation was measured for each non-enhanced CT scan. Persistent renal enhancement was defined as CT attenuation >55 Hounsfield units (HU). Contrast-induced nephropathy (CIN) was defined as a rise in serum creatinine >0.5 mg/dL within 5 days after contrast administration. Results: While the intensity and frequency of persistent renal enhancement was higher after intra-arterial (mean CT attenuation of 73.7 HU, seen in 54 of 99 patients, or 55%) than intravenous contrast material administration (51.8 HU, seen in 21 of 67, or 31%, p < 0.005), a multivariate regression model showed that the independent predictors of persistent renal enhancement were a shorter time interval until the subsequent non-enhanced CT (p < 0.001); higher contrast dose (p < 0.001); higher baseline serum creatinine (p < 0.01); and older age (p < 0.05). The route of contrast administration was not a predictor of persistent renal enhancement in this model. Contrast-induced nephropathy was noted in 9 patients who received intra-arterial (9%) versus 3 who received intravenous iodixanol (4%), and was more common in patients with persistent renal enhancement (p < 0.01). Conclusion: Persistent renal enhancement at follow-up non-contrast CT suggests a greater risk for contrast-induced nephropathy, but the increased frequency of striking renal enhancement in patients who received intra-arterial rather than intravenous contrast material also reflects the larger doses of contrast and shorter time to subsequent follow-up CT scanning for such patients.

  12. Persistent renal enhancement after intra-arterial versus intravenous iodixanol administration

    International Nuclear Information System (INIS)

    Chou, Shinn-Huey; Wang, Zhen J.; Kuo, Jonathan; Cabarrus, Miguel; Fu Yanjun; Aslam, Rizwan; Yee, Judy; Zimmet, Jeffrey M.; Shunk, Kendrick; Elicker, Brett; Yeh, Benjamin M.

    2011-01-01

    Purpose: To examine the clinical significance of persistent renal enhancement after iodixanol administration. Methods: We retrospectively studied 166 consecutive patients who underwent non-enhanced abdominopelvic CT within 7 days after receiving intra-arterial (n = 99) or intravenous (n = 67) iodixanol. Renal attenuation was measured for each non-enhanced CT scan. Persistent renal enhancement was defined as CT attenuation >55 Hounsfield units (HU). Contrast-induced nephropathy (CIN) was defined as a rise in serum creatinine >0.5 mg/dL within 5 days after contrast administration. Results: While the intensity and frequency of persistent renal enhancement was higher after intra-arterial (mean CT attenuation of 73.7 HU, seen in 54 of 99 patients, or 55%) than intravenous contrast material administration (51.8 HU, seen in 21 of 67, or 31%, p < 0.005), a multivariate regression model showed that the independent predictors of persistent renal enhancement were a shorter time interval until the subsequent non-enhanced CT (p < 0.001); higher contrast dose (p < 0.001); higher baseline serum creatinine (p < 0.01); and older age (p < 0.05). The route of contrast administration was not a predictor of persistent renal enhancement in this model. Contrast-induced nephropathy was noted in 9 patients who received intra-arterial (9%) versus 3 who received intravenous iodixanol (4%), and was more common in patients with persistent renal enhancement (p < 0.01). Conclusion: Persistent renal enhancement at follow-up non-contrast CT suggests a greater risk for contrast-induced nephropathy, but the increased frequency of striking renal enhancement in patients who received intra-arterial rather than intravenous contrast material also reflects the larger doses of contrast and shorter time to subsequent follow-up CT scanning for such patients.

  13. Intra-arterial intervention chemotherapy for sarcoma and cancerous ulcer via an implanted pump.

    Science.gov (United States)

    Liu, Cheng; Cui, Qiu; Guo, Jun; Li, Dingfeng; Zeng, Yanjun

    2014-04-01

    To observe the efficacy of intra-arterial chemotherapy with subcutaneously implanted pump for soft tissue sarcoma in extremities and cancerous ulcer. 31 patients with ulcerative skin squamous cell carcinoma or sarcoma in extremities who received treatment during the period from July 2003 to November 2011 at our hospital were recruited, including 15 male and 16 female patients, aging between 14 and 83 with average age of 49 years old. 10 patients had tumor in upper extremities and 21 patients in lower extremities. The pathological types of studied cases include 9 cases with skin squamous cell carcinoma, 6 cases with synovial sarcoma, 5 cases with malignant fibrous histiocytoma, 3 cases with liposarcoma, 3 cases with osteosarcoma, 2 cases with malignant melanoma, 2 cases with epidermoid sarcoma, and 1 case with protuberans. The main symptoms of cancerous ulcer were pain, infection and hemorrhage; All the studied patients were administrated with cisplatin and doxorubicin by intra-arterial chemotherapy pump, and the patients with squamous cell carcinoma were additionally applied with bleomycin and patients with malignant melanoma were additionally applied with dacarbazine. The chemotherapy efficiency was observed after at 3 cycles of intra-arterial chemotherapy. The total remission rate of pain (RR) was 87 %, and total remission rate of ulcer cicatrization (RR) was 71 %, with ulcer cicatrizing spontaneously in 9 cases and obvious homeostasis in 5 cases with bleeding ulcers. 19 patients underwent surgery after chemotherapy, in which 16 cases had limb-salvage surgery and 3 cases underwent lower leg amputation after chemotherapy, and 3 patients out of 16 cases had local recurrence (19 %). The subcutaneous intra-arterial targeting chemotherapy could be applied to treat refractory sarcoma and cancerous ulcer in extremities to significantly increase the chemotherapeutic concentration at tumor area so as to effectively constrain the tumor rupture induced main symptoms

  14. Guide to intra-arterial infusion chemotherapy for pancreatic cancers (draft text)

    International Nuclear Information System (INIS)

    2012-01-01

    Pancreatic cancer is one of most malignant solid tumors. Trans-arterial infusion chemotherapy has been used for the inoperable pancreatic cancers. The local drug concentration in intra-arterial infusion chemotherapy is much higher than that in intravenous chemotherapy. Thus, a better therapeutic effect can be surely achieved, the disease-related symptoms can be well improved, the patient's survival time can be markedly prolonged, and the liver metastases can be effectively reduced. This paper aims to suggest a more detailed and standardized therapeutic scheme to perform intra-arterial infusion chemotherapy for inoperable pancreatic cancers, focusing on the relevant concept, contraindications, indications, preoperative preparation, methods of operation, postoperative treatment, the prevention and treatment of complications, etc. The scheme will help domestic interventional physicians to make reasonable decisions in their clinical practice. Of course, the scheme proposed here is not a mandatory standard, and it can not resolve all the problems which might be encountered in employing intra-arterial infusion chemotherapy for patients with inoperable pancreatic cancer. Therefore, the interventional physicians should fully understand the most useful medical evidence of a given patient and sincerely take the patient's own will into consideration before an individualized and reasonable therapeutic plan is able to be worked out. (authors)

  15. Evaluation of the effects of intra-arterial sugammadex and dexmedetomidine: an experimental study

    Directory of Open Access Journals (Sweden)

    Volkan Hancı

    Full Text Available Abstract Background: Intra-arterial injection of medications may cause acute and severe ischemia and result in morbidity and mortality. There is no information in the literature evaluating the arterial endothelial effects of sugammadex and dexmedetomidine. The hypothesis of our study is that sugammadex and dexmedetomidine will cause histological changes in arterial endothelial structure when administered intra-arterially. Methods: Rabbits were randomly divided into 4 groups. Group Control (n = 7; no intervention performed. Group Catheter (n = 7; a cannula inserted in the central artery of the ear, no medication was administered. Group Sugammadex (n = 7; rabbits were given 4 mg/kg sugammadex into the central artery of the ear, and Group Dexmedetomidine (n = 7; rabbits were given 1 µg/kg dexmedetomidine into the central artery of the ear. After 72 h, the ears were amputated and histologically investigated. Results: There was no significant difference found between the control and catheter groups in histological scores. The endothelial damage, elastic membrane and elastic fiber damage, smooth muscle hypertrophy and connective tissue increase scores in the dexmedetomidine and sugammadex groups were significantly higher than both the control and the catheter groups (p < 0.05. There was no significant difference found between the dexmedetomidine and sugammadex groups in histological scores. Conclusion: Administration of sugammadex and dexmedetomidine to rabbits by intra-arterial routes caused histological arterial damage. To understand the histological changes caused by sugammadex and dexmedetomidine more clearly, more experimental research is needed.

  16. Intra-arterial cis-diamminedichloroplatinum infusion treatment for widespread hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Park, Sung Il; Yang, Hee Chul; Lee, Do Yon; Shim, Yong Woon; Kim, Sang Heum; Kim, Myeong Jin; Lee, Jong Tae; Yoo, Hyung Sik

    1997-01-01

    The purpose of this study is to evaluate the therapeutic efficacy of intra-arterial infusion of Cis-diamminedichloroplatinum (C-DDP) for the treatment of hepatocellular carcinomas with widespread involvement. We retrospectively analyzed 22 patients who between July 1994 and June 1996 had undergone intra-arterial c-DDP infusion therapy for the treatment of hepatocellular carcinomas with widespread involvement. The hepatomas involved both lobes in ten, portal venous obstructions in fourteen, arterio-portal shunts in nine, and arterio-venous shunts in two. Proper hepatic artery was selected for infusion of 100 mg/BSA of C-DDP. The same procedure was repeated every 3 to 4 weeks, and the total number of infusions was 65. On the basis of WHO criteria, response was classified as complete remission, partial remission, stable, or progression of the disease. Six-month and one-year survival rates were estimated, and adverse reactions were evaluated. Although the response rate is not high, intra-arterial C-DDP infusion therapy can be used as an alternative treatment for hepatocellular carcinomas with widespread involvement; adverse reactions are tolerable. (author). 16 refs., 3 figs

  17. Risk factors for severe neutropenia following intra-arterial chemotherapy for intra-ocular retinoblastoma.

    Directory of Open Access Journals (Sweden)

    Ira J Dunkel

    Full Text Available PURPOSE: Intra-arterial chemotherapy is a promising strategy for intra-ocular retinoblastoma. Neutropenia is the most commonly encountered systemic toxicity and in this study we aimed to determine the risk factors associated with the development of severe (≥ grade 3 neutropenia. METHODS: Retrospective review of 187 evaluable cycles of melphalan-containing intra-arterial chemotherapy from the first three cycles administered to 106 patients with intra-ocular retinoblastoma from May 2006 to June 2011. Cycles were considered to be evaluable if (1 blood count results were available in the 7 to 14 days post-treatment interval and (2 concurrent intravenous chemotherapy was not administered. Toxicity was assessed via the Common Terminology Criteria for Adverse Events version 4.0. RESULTS: 54 cycles (29% were associated with grade 3 (n = 43 or grade 4 (n = 11 neutropenia. Multivariate stepwise logistic regression revealed that a higher melphalan dose (>0.40 mg/kg was significantly associated with severe neutropenia during all 3 cycles (odds ratio during cycle one 4.11, 95% confidence interval 1.33-12.73, p = 0.01, but the addition of topotecan and/or carboplatin were not. Prior treatment with systemic chemotherapy was not associated with severe neutropenia risk in any analysis. CONCLUSIONS: Intra-arterial melphalan-based chemotherapy can cause severe neutropenia, especially when a dose of greater than 0.40 mg/kg is administered. Further study with a larger sample may be warranted.

  18. Superselective intra-arterial fibrinolysis for acute cerebral ischemic infarct : usefulness of diffusion weighted MR imaging

    International Nuclear Information System (INIS)

    Byun, Woo Mok; Lee, Se Jin; Kim, Yong Sun; Han, Gun Soo; Bae, Won Kyong

    1999-01-01

    To evaluate the efficacy of superselective intra-arterial fibrinolysis for acute cerebral stroke and the usefulness of pre-and postfibrinolysis diffusion-weighted MRI (DWI). In 41 patients with acute ischemic stroke whose treatment involved intra-arterial fibrinolysis, the occlusion site, degree of recanalization, and clinical results were compared. In 12 patients, diffusion weighted MRI was performed before fibrinolysis, and eight of these also underwent diffusion-weighted MRI after fibrinolysis. Using diffusion-weighted MRI, neurological outcomes were compared with signal intensity ratio (SIR, or the average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region). Twenty patients showed complete recanalization, nine partial recanalization, and in twelve there was no recanalization. Fourteen patients (34%) improved neurologically. No relationship existed between occlusion sites, degree of recanalization, and clinical outcome. Among 12 patients who underwent DWI before fibrinolysis, complete recanalization was noted in eight. Neurological improvement was seen in four patients with low SIR( 1.7), neurological outcome was poor despite complete recanalization. Although superselective intra-arterial fibrinolysis for acute cerebral stroke is a good therapeutic method for recanalization, the clinical outcome can be disappointing. We therefore suggest that in cases of acute cerebral ischemic infaret, SIR-as seen on DWI-might be useful for predicting the benefits of recanalization. In such cases, further investigation of the use of DWI prior to fibrinolysis is therefore needed

  19. A quantitative study of bone repair after endodontic therapy on digital subtraction radiography

    International Nuclear Information System (INIS)

    Kim, Jae Duk

    1997-01-01

    This study was performed to prepare the quantitative method of judging the sensitive prognosis of chronic apical periodontitis as early as possible. The subjects were 25 cases with periapical radiolucencies of which were treated with endodontic treatment. Serial radiographs were taken by standardized method longitudinally. The density slice function of digital radiographic system were employed for quantitative and longitudinal assessment of the radiolucent area and the condensing osteitis simultaneously. Obtained results were as follows: 1. The amount of bone repair after endodontic treatment could be detected quantitatively by the density slice function of digital radiographic system. 2. Within the 6-week period after root canal filling, the prognosis could be evaluated by assessment both radiolucent area and condensing osteitis on digital radiographic system. 3. The pattern of bone repair showed peripheral type in most cases from the 6th week after root canal filling. 4. In longitudinal change, bone repair showed two patterns; the succeeding reduction of radiolucent area showing the increase of condensing osteitis in size till 6th week and following by static state or reduction tendency and the reduction following the initial increase of both areas. 5. Cases with pulpitis by trauma showed initial increase of condensing osteitis at 2nd week, marked reduction of radiolucent area and condensing osteitis at 6th week, and approximately normal bone state at 8th week after root canal filling.

  20. A quantitative study of bone repair after endodontic therapy on digital subtraction radiography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Duk [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1997-08-15

    This study was performed to prepare the quantitative method of judging the sensitive prognosis of chronic apical periodontitis as early as possible. The subjects were 25 cases with periapical radiolucencies of which were treated with endodontic treatment. Serial radiographs were taken by standardized method longitudinally. The density slice function of digital radiographic system were employed for quantitative and longitudinal assessment of the radiolucent area and the condensing osteitis simultaneously. Obtained results were as follows: 1. The amount of bone repair after endodontic treatment could be detected quantitatively by the density slice function of digital radiographic system. 2. Within the 6-week period after root canal filling, the prognosis could be evaluated by assessment both radiolucent area and condensing osteitis on digital radiographic system. 3. The pattern of bone repair showed peripheral type in most cases from the 6th week after root canal filling. 4. In longitudinal change, bone repair showed two patterns; the succeeding reduction of radiolucent area showing the increase of condensing osteitis in size till 6th week and following by static state or reduction tendency and the reduction following the initial increase of both areas. 5. Cases with pulpitis by trauma showed initial increase of condensing osteitis at 2nd week, marked reduction of radiolucent area and condensing osteitis at 6th week, and approximately normal bone state at 8th week after root canal filling.

  1. Radiological investigation of renovascular hypertension from IVU to digital subtraction angiography. A critical evaluation

    International Nuclear Information System (INIS)

    Amiel, M.; Froment, A.; Pinet, F.; Huguet, M.

    1986-01-01

    For the last 20 years, the value of radiology in renovascular hypertension (RVH) is well established from diagnostic and therapeutic points of view. However things are changing now due to a better appraisal of the incidence of RVH, new antihypertensive drugs, and new radiological procedures (digital angiography, percutaneous transluminal angioplasty). The approach now takes in account the mode of imaging for a better evaluation of the renal artery stenosis and costs of the proceedings as well. Finally a new strategy has been set up for RVH patients management [fr

  2. Intra-aneurysmal flow patterns: illustrative comparison among digital subtraction angiography, optical flow, and computational fluid dynamics.

    Science.gov (United States)

    Brina, O; Ouared, R; Bonnefous, O; van Nijnatten, F; Bouillot, P; Bijlenga, P; Schaller, K; Lovblad, K-O; Grünhagen, T; Ruijters, D; Pereira, V Mendes

    2014-12-01

    Digital subtraction angiography is the gold standard vascular imaging and it is used for all endovascular treatment of intracranial anerysms. Optical flow imaging has been described as a potential method to evaluate cerebral hemodynamics through DSA. In this study, we aimed to compare the flow patterns measured during angiography, by using an optical flow method, with those measured by using computational fluid dynamics in intracranial aneurysms. A consecutive series of 21 patients harboring unruptured saccular intracranial aneurysms who underwent diagnostic angiography before treatment was considered. High-frame-rate digital subtraction angiography was performed to obtain an intra-aneurysmal velocity field by following the cardiac-modulated contrast wave through the vascular structures by using optical flow principles. Additionally, computational fluid dynamics modeling was performed for every case by using patient-specific inlet-boundary conditions measured with the optical flow method from both DSA and 3D rotational angiography datasets. Three independent observers compared qualitatively both the inflow direction and the apparent recirculation in regular DSA, optical flow images, and computational fluid dynamics flow patterns for each patient; κ statistics were estimated. We included 21 patients. In 14 of these 21, the flow patterns were conclusive and matching between the optical flow images and computational fluid dynamics within the same projection view (κ = .91). However, in only 8 of these 14 patients the optical flow images were conclusive and matching regular DSA images (observer κ = 0.87). In 7 of the 21 patients, the flow patterns in the optical flow images were inconclusive, possibly due to improper projection angles. The DSA-based optical flow technique was considered qualitatively consistent with computational fluid dynamics outcomes in evaluating intra-aneurysmal inflow direction and apparent recirculation. Moreover, the optical flow technique

  3. Subtractive Leadership

    Science.gov (United States)

    Larwin, K. H.; Thomas, Eugene M.; Larwin, David A.

    2015-01-01

    This paper introduces a new term and concept to the leadership discourse: Subtractive Leadership. As an extension of the distributive leadership model, the notion of subtractive leadership refers to a leadership style that detracts from organizational culture and productivity. Subtractive leadership fails to embrace and balance the characteristics…

  4. Combined intravenous and intra-arterial thrombolytic therapy for acute ischemic stroke: a comparative study with simple intra-arterial thrombolytic therapy

    International Nuclear Information System (INIS)

    Xu Haowen; Li Minghua; Guan Sheng; Song Bo; Wang Jianbo; Gu Binxian

    2011-01-01

    Objective: to evaluate the feasibility, efficacy, safety and risk of combined intravenous and local intra-arterial thrombolytic therapy (IV + IA) for ischemic stroke and to compare the results with those obtained by simple intra-arterial thrombolytic therapy (IA). Methods: A total of 46 consecutive patients with ischemic strokes, who were suitable candidates for thrombolytic therapy, were randomly divided into (IV + IA) group (n=24) and IA group (n=22). After the treatment, the arterial recanalization rates, the early clinical improvement, the occurrence of symptomatic intracerebral hemorrhage, the favourable outcome rate and the mortality were evaluated, and the results were compared between the two groups. Results: The average interval between the onset of symptoms and the start of thrombolytic therapy in (IV + IA) group was 255 minutes, which was remarkably lower than that in IA group (310 minutes) with P=0.012. After the thrombolytic therapy, the arterial recanalization rate for (IV + IA) group and IA group was 54.1% and 40.9% respectively (P=0.226). The occurrence of symptomatic intracerebral hemorrhage for (IV + IA) group and IA group was 16.7% and 22.7% respectively (P=0.361). There months after the treatment the favourable outcome rate (modified Rankin Scale, 0 to 2) of (IV + IA) group was 54.2%, which was higher than that of IA group (36.4%), and the mortality in (IV + IA) group and IA group was 8.3% and 9.1% (P=0.927) respectively. No statistically significant difference in recanalization rate and mortality existed between the two groups. Conclusion: This pilot indicates that both (IV + IA) thrombolytic therapy and simple IA thrombolytic therapy are clinically feasible and safe in treating acute ischemic stroke. Compared to simple IA thrombolytic therapy, (IV + IA) thrombolytic therapy is more effective with rather minimal risks. The conclusion of this study needs to be further proved by double-blind and controlled studies with large sample. (authors)

  5. Suppression of high-density artefacts in x-ray CT images using temporal digital subtraction with application to cryotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Baissalov, R.; Sandison, G.A.; Rewcastle, J.C. [Department of Medical Physics, Tom Baker Cancer Center, Calgary, Canada, T2N 4N2 2 Department of Physics and Astronomy, University of Calgary, Calgary T2N 2N4 (Canada); Donnelly, B.J. [Department of Surgery, Tom Baker Cancer Center, Calgary, Canada, T2N 4N2 4 Department of Surgery, Foothills Hospital, Calgary T2N 2T7 (Canada); Saliken, J.C. [Department of Surgery, Tom Baker Cancer Center, Calgary T2N 4N2 (Canada); Department of Diagnostic Imaging, Foothills Hospital, Calgary T2N 2T7 (Canada); McKinnon, J.G. [Department of Surgery, Foothills Hospital, Calgary T2N 2T7 (Canada); Muldrew, K. [Department of Surgery, Faculty of Medicine, University of Calgary, Calgary T2N 2T7 (Canada)

    2000-05-01

    Image guidance in cryotherapy is usually performed using ultrasound. Although not currently in routine clinical use, x-ray CT imaging is an alternative means of guidance that can display the full 3D structure of the iceball, including frozen and unfrozen regions. However, the quality of x-ray CT images is compromised by the presence of high-density streak artefacts. To suppress these artefacts we applied temporal digital subtraction (TDS). This TDS method has the added advantage of improving the grey-scale contrast between frozen and unfrozen tissue in the CT images. Two sets of CT images were taken of a phantom material, cryoprobes and a urethral warmer (UW) before and during the cryoprobe freeze cycle. The high-density artefacts persisted in both image sets. TDS was performed on these two image sets using the corresponding mask image of unfrozen material and the same geometrical configuration of the cryoprobes and the UW. The resultant difference image had a significantly reduced artefact content. Thus TDS can be used to significantly suppress or eliminate high-density CT streak artefacts without reducing the metallic content of the cryoprobes. In vivo study needs to be conducted to establish the utility of this TDS procedure for CT assisted prostate or liver cryotherapy. Applying TDS in x-ray CT guided cryotherapy will facilitate estimation of the number and location of all frozen and unfrozen regions, potentially making cryotherapy safer and less operator dependent. (author)

  6. Suppression of high-density artefacts in x-ray CT images using temporal digital subtraction with application to cryotherapy

    International Nuclear Information System (INIS)

    Baissalov, R.; Sandison, G.A.; Rewcastle, J.C.; Donnelly, B.J.; Saliken, J.C.; McKinnon, J.G.; Muldrew, K.

    2000-01-01

    Image guidance in cryotherapy is usually performed using ultrasound. Although not currently in routine clinical use, x-ray CT imaging is an alternative means of guidance that can display the full 3D structure of the iceball, including frozen and unfrozen regions. However, the quality of x-ray CT images is compromised by the presence of high-density streak artefacts. To suppress these artefacts we applied temporal digital subtraction (TDS). This TDS method has the added advantage of improving the grey-scale contrast between frozen and unfrozen tissue in the CT images. Two sets of CT images were taken of a phantom material, cryoprobes and a urethral warmer (UW) before and during the cryoprobe freeze cycle. The high-density artefacts persisted in both image sets. TDS was performed on these two image sets using the corresponding mask image of unfrozen material and the same geometrical configuration of the cryoprobes and the UW. The resultant difference image had a significantly reduced artefact content. Thus TDS can be used to significantly suppress or eliminate high-density CT streak artefacts without reducing the metallic content of the cryoprobes. In vivo study needs to be conducted to establish the utility of this TDS procedure for CT assisted prostate or liver cryotherapy. Applying TDS in x-ray CT guided cryotherapy will facilitate estimation of the number and location of all frozen and unfrozen regions, potentially making cryotherapy safer and less operator dependent. (author)

  7. Nonlinear Geometric Warping of the Mask Image: A New Method for Reducing Misregistration Artifacts in Digital Subtraction Angiography

    International Nuclear Information System (INIS)

    Hayashi, Nobushige; Sakai, Toyohiko; Kitagawa, Manabu; Inagaki, Rika; Sadato, Norihiro; Ishii, Yasushi; Nishimoto, Yasuhiro; Tanaka, Masato; Fukushima, Tetsuya; Komuro, Hiroyuki; Ogura, Hisakazu; Kobayashi, Hidenori; Kubota, Toshihiko

    1998-01-01

    Purpose: Misregistration artifact is the major cause of image degradation in digital subtraction angiography (DSA). The purpose of this study was to evaluate the efficacy of a newly developed nonlinear geometric warping method to reduce misregistration artifact in DSA. Methods: The processing of the images was carried out on a workstation with a fully automatic computerized program. After making differential images with a lapracian filter, 49 regions of interest (ROIs) were set in the image to be processed. Each ROI of the live image scanned the corresponding ROI of the mask image searching for the best position to match itself. Each pixel of the mask image was shifted individually following the data calculated from the shifts of the ROIs. Five radiologists compared the images produced by the conventional parallel shift technique and those processed with this new method in 16 series of cerebral DSA. Results: In 14 of 16 series (88%), more radiologists judged the images processed with the new method to be better in quality. Small arteries near the skull base and veins of low density were clearly visualized in the images processed by the new method. Conclusion: This newly proposed method could be a simple and practical way to automatically reduce misregistration artifacts in DSA

  8. Variations and Anomalies of the circle of Willis in Korean: Cerebral digital subtraction angiogram studies in 200 case

    International Nuclear Information System (INIS)

    Lee, Ouk; Chung, Gyoo Sik; Kim, So Sun; Huh, Jin Do; Kim, Ho Joon; Joh, Young Duk

    1989-01-01

    In order to evaluate the variations of the circle of Willis in Korean population, digital subtraction angiograms in 200 cases were retrospectively analyzed. There was non-visualization of the anterior communicating artery and the posterior communicating artery in 41 cases and this was the most common type 4 vessel cerebral angiogram (20.5%). Unilateral or bilateral non-visualization of the posterior communicating artery was noted in 40 case (20%). The fetal origin of the posterior cerebral artery from the internal carotid artery was seen in 22 cases (11%). In 20 out of 22 cases, there were non-visualization of either the anterior communicating or posterior communicating artery. Visualization of the anterior communicating artery was noted in 102 cases (51%) and of the posterior communicating artery in 87 cases (43.5%). Hypoplasia of the anterior cerebral artery was noted in 24 cases (12%). Non- visualization of the anterior communicating artery or unilateral posterior communicating artery is noted in 16 cases (8%). Non- visualization of the anterior communicating artery was seen in 14 cases (7%). The most common type in appearance of the basilar artery variation was straight type (Type 1: 51%) and the bifurcation of the basilar artery was most commonly located above the posterior clinoid process of the dorsum sellae (58%) on vertebral angiogram

  9. A comparison between ultrasonography and mammography, computed tomography and digital subtraction angiography for the detection of breast cancers

    Energy Technology Data Exchange (ETDEWEB)

    Tohnosu, Noriyuki; Okuyama, Kazuaki; Koide, Yoshio (Chiba Univ. (Japan). School of Medicine) (and others)

    1993-08-01

    Ultrasound (US) was compared with mammography (MMG), computed tomography (CT), and digital subtraction angiography (DSA) in its effectiveness to detect breast cancer masses and metastatic axillary nodes. Forty-seven breast cancer patients who all underwent MMG, US, CT, and DSA preoperatively in our institution between 1986 and 1990 were studied. US was able to detect tumors in all cases regardless of tumor size, whereas DSA detected T1-size tumors and MMG detected T2-size tumors in 40% and 64.7% of cases, respectively, being specifically inferior to US. It was found that MMG was least likely to detect papillotubular carcinoma, although microcalcification alone without a tumor mass on MMG improved detectability from 46.2% to 76.9%, according to the histological type. CT was found to be most sensitive to axillary node metastases (81.8%), followed by US (72.7%), but DSA was significantly unfavorable (42.9%). Thus, we concluded that US was superior to MMG, CT, and DSA for detecting breast cancer masses, but that CT was more advantageous than US, while DSA was of little value for evaluating axillary nodal status. (author).

  10. Synchrotron-based intra-venous K-edge digital subtraction angiography in a pig model: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Schueltke, Elisabeth [Departments of Surgery, University of Saskatchewan, Saskatoon, SK (Canada); Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK (Canada); Department of Neurological Sciences, Walton Medical Centre, University of Liverpool, Liverpool L97 LJ (United Kingdom)], E-mail: e.schultke@usask.ca; Fiedler, Stefan [European Molecular Biology Laboratory (EMBL), Nottkestrasse 85, 22603 Hamburg (Germany); Nemoz, Christian [European Synchrotron Radiation Facility (ESRF), 6 rue Horowitz, 38043 Grenoble (France); Ogieglo, Lissa [Departments of Surgery, University of Saskatchewan, Saskatoon, SK (Canada); Kelly, Michael E. [Departments of Surgery, University of Saskatchewan, Saskatoon, SK (Canada); Department of Neurosurgery, Section of Cerebrovascular and Endovascular Neurosurgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH (United States); Crawford, Paul [Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herfordshire AL9 7TA (United Kingdom); Esteve, Francois [INSERM U836-ESRF, 6 rue Horowitz, 38043 Grenoble (France); Brochard, Thierry; Renier, Michel; Requardt, Herwig; Le Duc, Geraldine [European Synchrotron Radiation Facility (ESRF), 6 rue Horowitz, 38043 Grenoble (France); Juurlink, Bernhard [Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK (Canada); Meguro, Kotoo [Departments of Surgery, University of Saskatchewan, Saskatoon, SK (Canada)

    2010-03-15

    Background: K-edge digital subtraction angiography (KEDSA) combined with the tunability of synchrotron beam yields an imaging technique that is highly sensitive to low concentrations of contrast agents. Thus, contrast agent can be administered intravenously, obviating the need for insertion of a guided catheter to deliver a bolus of contrast agent close to the target tissue. With the high-resolution detectors used at synchrotron facilities, images can be acquired at high spatial resolution. Thus, the KEDSA appears particularly suited for studies of neurovascular pathology in animal models, where the vascular diameters are significantly smaller than in human patients. Materials and methods: This feasibility study was designed to test the suitability of KEDSA after intravenous injection of iodine-based contrast agent for use in a pig model. Four adult male pigs were used for our experiments. Neurovascular angiographic images were acquired using KEDSA with a solid state Germanium (Ge) detector at the European Synchrotron Radiation Facility (ESRF) in Grenoble, France. Results: After intravenous injection of 0.9 ml/kg iodinated contrast agent (Xenetix), the peak iodine concentrations in the internal carotid and middle cerebral arteries reached 35 mg/ml. KEDSA images in radiography mode allowed the visualization of intracranial arteries of less than 1.5 mm diameter.

  11. Correlation Between Contrast Time-Density Time on Digital Subtraction Angiography and Flow: An in Vitro Study.

    Science.gov (United States)

    Brunozzi, Denise; Shakur, Sophia F; Ismail, Rahim; Linninger, Andreas; Hsu, Chih-Yang; Charbel, Fady T; Alaraj, Ali

    2018-02-01

    Digital subtraction angiography (DSA) provides an excellent anatomic characterization of cerebral vasculature, but hemodynamic assessment is often qualitative and subjective. Various clinical algorithms have been produced to semiquantify flow from the data obtained from DSA, but few have tested them against reliable flow values. An arched flow model was created and injected with contrast material. Seventeen injections were acquired in anterior-posterior and lateral DSA projections, and 4 injections were acquired in oblique projection. Image intensity change over the angiogram cycle of each DSA run was analyzed through a custom MATLAB code. Time-density plots obtained were divided into 3 components (time-density times, TDTs): TDT 10%-100% (time needed for contrast material to change image intensity from 10% to 100%), TDT 100%-10% (time needed for contrast material to change image intensity from 100% to 10%), and TDT 25%-25% (time needed for contrast material to change from 25% image intensity to 25%). Time-density index (TDI) was defined as model cross-sectional area to TDT ratio, and it was measured against different flow rates. TDI 10%-100% , TDI 100%-10% , and TDI 25%-25% all correlated significantly with flow (P flow. TDI on DSA correlates significantly with flow. Although in vitro studies might overlook conditions that occur in patients, this method appears to correlate with the flow and could offer a semiquantitative method to evaluate the cerebral blood flow. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Detection of unruptured familial intracranial aneurysms by intravenous digital subtraction angiography

    International Nuclear Information System (INIS)

    Berg, H.W.M. ter; Regional Hospital Almelo; Overtoom, T.M.D.; Ludwig, J.W.; Bijlsma, J.B.; Tulleken, C.A.F.; Willemse, J.

    1987-01-01

    The authors discuss the detection of intracranial aneurysms (IA) by means of intravenous digital angiography (ivDSA) in (a)symptomatic first degree relatives of families in which more than two or more individuals have IA. ivDSA is an almost noninvasive and low-risk diagnostic procedure. Screening, by means of ivDSA, of two affected families is described. In family I which includes 7 members with proven IA, ivDSA has been carried out in 36 asymptomatic individuals: in one, a 6x15 mm aneurysm was found at the left posterior communicating artery (PCoA). In family II, including one member with a proven IA and another with a subarachnoidal hemorrhage, ivDSA has been carried out in 4 members: one aneurysm with a diameter of 6 mm was found at the left PCoA. Conventional cerebral angiography (CCA) confirmed both IA's. Neurosurgical treatment followed. The advantages and disadvantages of ivDSA vs. CCA as elective screening procedure in such cases are discussed. Screening of asymptomatic first degree relatives of cases with familial IA by means of ivDSA is strongly advocated. (orig.)

  13. Treatment results of selective intra-arterial chemoradiotherapy for oropharyngeal carcinoma

    International Nuclear Information System (INIS)

    Fukahori, Mioko; Chitose, Shun-ichi; Maeda, Akiteru; Umeno, Hirohito; Nakashima, Tadashi

    2010-01-01

    Fourteen patients who had oropharyngeal carcinoma were treated with intra-arterial chemoradiotherapy between December 2002 and December 2008. The patients were classified as 3 stage II, 3 stage III and 8 stage IV cases. According to the subsite of the oropharynx, the patients were classified as 6 lateral wall (LW), 5 anterior wall (AW) and 3 superior wall (SW) cases. Intra-arterial infusion chemotherapy by cisplatin was given weekly with concurrent radiotherapy for approximately four weeks, and the total number of infusions was decided according to intermediate judgments of effectiveness. The total dose of radiation was 60-81.4 Gy (average 65.3 Gy). As a result of this treatment, there were 12 complete response (CR) (85.7%) and 2 partial response (PR) (14.3%) for primary tumor and 4 CR (57.1%), 2 PR (28.6%), and 1 no change (NC) (14.3%) for lymph node. Regarding survival, 7 were alive and cancer-free (50%), 2 were alive with cervical lymph node metastasis (14.3%), 4 died of the primary tumor (28.6%) and 1 died of other disease (7.1%). The local control rates by subsite were 75% in LW, 66.7% in AW and 33.3% in SW. These results indicate in terms of both local control rate and functional preservation, that advanced AW cancer seems to be a good indication for intra-arterial chemoradiotherapy, but the therapy should be determined cautiously with respect to indications for LW and SW oropharyngeal carcinoma. (author)

  14. Follow-up after embolization of ruptured intracranial aneurysms: a prospective comparison of two-dimensional digital subtraction angiography, three-dimensional digital subtraction angiography, and time-of-flight magnetic resonance angiography.

    Science.gov (United States)

    Serafin, Zbigniew; Strześniewski, Piotr; Lasek, Władysław; Beuth, Wojciech

    2012-11-01

    To prospectively compare of the diagnostic value of digital subtraction angiography (DSA) and time-of-flight magnetic resonance angiography (TOF-MRA) in the follow-up of intracranial aneurysms after endovascular treatment. Seventy-two consecutive patients were examined 3 months after the embolization. The index tests included: two-dimensional DSA (2D-DSA), three-dimensional DSA (3D-DSA), and TOF-MRA. The reference test was a retrospective consensus between 2D-DSA images, 3D-DSA images, and source rotational DSA images. The evaluation included: detection of the residual flow, quantification of the flow, and validity of the decision regarding retreatment. Intraobserver agreement and interobserver agreement were determined. The sensitivity and specificity of residual flow detection ranged from 84.6 % (2D-DSA and TOF-MRA) to 92.3 % (3D-DSA) and from 91.3 % (TOF-MRA) to 97.8 % (3D-DSA), respectively. The accuracy of occlusion degree evaluation ranged from 0.78 (2D-DSA) to 0.92 (3D-DSA, Cohen's kappa). The 2D-DSA method presented lower performance in the decision on retreatment than 3D-DSA (P < 0.05, ROC analysis). The intraobserver agreement was very good for all techniques (κ = 0.80-0.97). The interobserver agreement was moderate for TOF-MRA and very good for 2D-DSA and 3D-DSA (κ = 0.72-0.94). Considering the invasiveness of DSA and the minor difference in the diagnostic performance between 3D-DSA and TOF-MRA, the latter method should be the first-line modality for follow-up after aneurysm embolization.

  15. Follow-up after embolization of ruptured intracranial aneurysms: A prospective comparison of two-dimensional digital subtraction angiography, three-dimensional digital subtraction angiography, and time-of-flight magnetic resonance angiography

    International Nuclear Information System (INIS)

    Serafin, Zbigniew; Strzesniewski, Piotr; Lasek, Wladyslaw; Beuth, Wojciech

    2012-01-01

    To prospectively compare of the diagnostic value of digital subtraction angiography (DSA) and time-of-flight magnetic resonance angiography (TOF-MRA) in the follow-up of intracranial aneurysms after endovascular treatment. Seventy-two consecutive patients were examined 3 months after the embolization. The index tests included: two-dimensional DSA (2D-DSA), three-dimensional DSA (3D-DSA), and TOF-MRA. The reference test was a retrospective consensus between 2D-DSA images, 3D-DSA images, and source rotational DSA images. The evaluation included: detection of the residual flow, quantification of the flow, and validity of the decision regarding retreatment. Intraobserver agreement and interobserver agreement were determined. The sensitivity and specificity of residual flow detection ranged from 84.6 % (2D-DSA and TOF-MRA) to 92.3 % (3D-DSA) and from 91.3 % (TOF-MRA) to 97.8 % (3D-DSA), respectively. The accuracy of occlusion degree evaluation ranged from 0.78 (2D-DSA) to 0.92 (3D-DSA, Cohen's kappa). The 2D-DSA method presented lower performance in the decision on retreatment than 3D-DSA (P < 0.05, ROC analysis). The intraobserver agreement was very good for all techniques (κ = 0.80-0.97). The interobserver agreement was moderate for TOF-MRA and very good for 2D-DSA and 3D-DSA (κ = 0.72-0.94). Considering the invasiveness of DSA and the minor difference in the diagnostic performance between 3D-DSA and TOF-MRA, the latter method should be the first-line modality for follow-up after aneurysm embolization. (orig.)

  16. Follow-up after embolization of ruptured intracranial aneurysms: A prospective comparison of two-dimensional digital subtraction angiography, three-dimensional digital subtraction angiography, and time-of-flight magnetic resonance angiography

    Energy Technology Data Exchange (ETDEWEB)

    Serafin, Zbigniew; Strzesniewski, Piotr; Lasek, Wladyslaw [Nicolaus Copernicus University, Collegium Medicum, Department of Radiology and Diagnostic Imaging, Bydgoszcz (Poland); Beuth, Wojciech [Nicolaus Copernicus University, Collegium Medicum, Department of Neurosurgery and Neurotraumatology, Bydgoszcz (Poland)

    2012-11-15

    To prospectively compare of the diagnostic value of digital subtraction angiography (DSA) and time-of-flight magnetic resonance angiography (TOF-MRA) in the follow-up of intracranial aneurysms after endovascular treatment. Seventy-two consecutive patients were examined 3 months after the embolization. The index tests included: two-dimensional DSA (2D-DSA), three-dimensional DSA (3D-DSA), and TOF-MRA. The reference test was a retrospective consensus between 2D-DSA images, 3D-DSA images, and source rotational DSA images. The evaluation included: detection of the residual flow, quantification of the flow, and validity of the decision regarding retreatment. Intraobserver agreement and interobserver agreement were determined. The sensitivity and specificity of residual flow detection ranged from 84.6 % (2D-DSA and TOF-MRA) to 92.3 % (3D-DSA) and from 91.3 % (TOF-MRA) to 97.8 % (3D-DSA), respectively. The accuracy of occlusion degree evaluation ranged from 0.78 (2D-DSA) to 0.92 (3D-DSA, Cohen's kappa). The 2D-DSA method presented lower performance in the decision on retreatment than 3D-DSA (P < 0.05, ROC analysis). The intraobserver agreement was very good for all techniques ({kappa} = 0.80-0.97). The interobserver agreement was moderate for TOF-MRA and very good for 2D-DSA and 3D-DSA ({kappa} = 0.72-0.94). Considering the invasiveness of DSA and the minor difference in the diagnostic performance between 3D-DSA and TOF-MRA, the latter method should be the first-line modality for follow-up after aneurysm embolization. (orig.)

  17. CT findings in ischaemic hepatic failure due to intra-arterial embolisation: A case report

    International Nuclear Information System (INIS)

    Catalano, O.

    1997-01-01

    Liver infarction is relatively uncommon. It may be secondary to several conditions such as sepsis, shock, sickle-cell anaemia, eclampsia, vasculitis, metastatic disease, bacterial endocarditis, rheumatic heart disease, trauma, portal venous occlusion or compression, oral contraception, anaesthesia, hepatic artery thrombosis, therapeutical or inadvertent hepatic artery ligation, intra-arterial chemotherapy or embolisation. A case of hepatic infraction, unusual for iatrogenic pathogenesis, submassive extension with acute hepatic failure, and CT findings of an internally branching pattern due to intravascular gas was observed. (orig./AJ)

  18. Reperfusion demonstrated by apparent diffusion coefficient mapping after local intra-arterial thrombolysis for ischaemic stroke

    International Nuclear Information System (INIS)

    Taleb, M.; Loevblad, K.O.; El-Koussy, M.; Guzman, R.; Oswald, H.; Remonda, L.; Schroth, G.; Bassetti, C.; Arnold, M.

    2001-01-01

    Diffusion-weighted MRI (DWI) is becoming important for diagnosis and investigation of acute cerebral ischaemia. It has been reported that apparent diffusion coefficient (ADC) maps could be an indicator of reperfusion. Our aim was to use echo-planar technology to investigate this phenomenon. We report 19 patients treated by local intra-arterial thrombolysis for middle cerebral artery stroke within 6 h of the onset of symptoms, in whom we performed follow-up DWI. ADC were found to be higher in the patients with angiographically proven reperfusion. (orig.)

  19. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy for gingival carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mukai, Y.; Hata, M.; Koike, I.; Inoue, T. [Yokohama City University Graduate School of Medicine, Department of Radiology, Kanazawa-ku, Yokohama, Kanagawa (Japan); Mitsudo, K.; Koizumi, T.; Oguri, S.; Kioi, M.; Tohnai, I. [Yokohama City University Graduate School of Medicine, Department of Oral and Maxillofacial Surgery, Yokohama, Kanagawa (Japan); Omura, M. [Shonankamakura General Hospital, Department of Radiation Oncology, Kamakura, Kanagawa (Japan)

    2014-02-15

    The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy in the treatment of gingival carcinoma. In all, 34 patients (21 men and 13 women) with squamous cell carcinoma of the gingiva underwent radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy. Treatment consisted of daily external irradiation and concurrent retrograde superselective intra-arterial infusion with cisplatin and docetaxel. A median total dose of 60 Gy in 30 fractions was delivered to tumors. Of the 34 patients, 29 (85 %) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis 1-15 months after treatment. Twenty-six of the 36 patients had survived at a median follow-up time of 36 months (range 12-79 months); 4 died of cancer and 4 died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79 % and the cause-specific survival rates were 85 %. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma. (orig.) [German] Das Ziel dieser Studie war die Ueberpruefung der Effizienz und Toxizitaet einer Strahlenbehandlung des Gingivakarzinoms mit gleichzeitiger retrograder, superselektiver intraarterieller Chemotherapie. Insgesamt 34 Patienten (21 Maenner und 13 Frauen) mit Zahnfleischplattenzellkarzinom erhielten eine Strahlenbehandlung mit gleichzeitiger retrograder, superselektiver intraarterieller Chemotherapie. Die Behandlung umfasste eine taegliche externe Bestrahlung mit gleichzeitiger retrograder, superselektiver intraarterieller Infusion von Cisplatin und

  20. Retinoblastoma Control With Primary Intra-arterial Chemotherapy: Outcomes Before and During the Intravitreal Chemotherapy Era.

    Science.gov (United States)

    Shields, Carol L; Alset, Adel E; Say, Emil Anthony T; Caywood, Emi; Jabbour, Pascal; Shields, Jerry A

    2016-09-01

    To compare outcomes of intra-arterial chemotherapy for retinoblastoma as primary therapy before (Era I) and during (Era II) the intravitreal chemotherapy era. In this retrospective interventional case series at a tertiary referral center, 66 eyes of 66 patients with untreated unilateral retinoblastoma were used. intraarterial chemotherapy into the ophthalmic artery under fluoroscopic guidance was performed using melphalan in every case, with additional topotecan as necessary. Intravitreal chemotherapy using melphalan and/or topotecan was employed as needed for active vitreous seeding. Globe salvage was measured based on the International Classification of Retinoblastoma (ICRB) during two eras. The two eras encompassed 2008 to 2012 (intraarterial chemotherapy alone, Era I) and 2012 to 2015 (intraarterial chemotherapy plus intravitreal chemotherapy, Era II). Over this period, there were 66 patients with unilateral untreated retinoblastoma treated with primary intra-arterial chemotherapy. A comparison of features (Era I vs Era II) revealed no significant difference in mean patient age (24 vs 24 months), ICRB groups, mean largest tumor diameter (19 vs 17 mm), mean largest tumor thickness (10 vs 10 mm), vitreous seed presence (56% vs 59%), subretinal seed presence (67% vs 62%), retinal detachment (70% vs 66%), or vitreous hemorrhage (0% vs 5%). There was no significant difference in mean number of intra-arterial chemotherapy cycles (3 vs 3.1) or intraarterial chemotherapy dosages. Following therapy, there was a significant difference (Era I vs Era II) in the need for enucleation overall (44% vs 15%, P = .012), especially for group E eyes (75% vs 27%, P = .039). Four of the eyes that initiated therapy in Era I later required intravitreal chemotherapy during Era II. The enucleation rate was 0% for groups B and C in both eras and non-significant for group D (23% vs 13%). There were no patients with stroke, seizure, limb ischemia, extraocular tumor extension, secondary

  1. An automatic fuzzy-based multi-temporal brain digital subtraction angiography image fusion algorithm using curvelet transform and content selection strategy.

    Science.gov (United States)

    Momeni, Saba; Pourghassem, Hossein

    2014-08-01

    Recently image fusion has prominent role in medical image processing and is useful to diagnose and treat many diseases. Digital subtraction angiography is one of the most applicable imaging to diagnose brain vascular diseases and radiosurgery of brain. This paper proposes an automatic fuzzy-based multi-temporal fusion algorithm for 2-D digital subtraction angiography images. In this algorithm, for blood vessel map extraction, the valuable frames of brain angiography video are automatically determined to form the digital subtraction angiography images based on a novel definition of vessel dispersion generated by injected contrast material. Our proposed fusion scheme contains different fusion methods for high and low frequency contents based on the coefficient characteristic of wrapping second generation of curvelet transform and a novel content selection strategy. Our proposed content selection strategy is defined based on sample correlation of the curvelet transform coefficients. In our proposed fuzzy-based fusion scheme, the selection of curvelet coefficients are optimized by applying weighted averaging and maximum selection rules for the high frequency coefficients. For low frequency coefficients, the maximum selection rule based on local energy criterion is applied to better visual perception. Our proposed fusion algorithm is evaluated on a perfect brain angiography image dataset consisting of one hundred 2-D internal carotid rotational angiography videos. The obtained results demonstrate the effectiveness and efficiency of our proposed fusion algorithm in comparison with common and basic fusion algorithms.

  2. Extrahepatic Arteries Originating from Hepatic Arteries: Analysis Using CT During Hepatic Arteriography and Visualization on Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ozaki, Kumi, E-mail: ozakik-rad@umin.org [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan); Kobayashi, Satoshi [Kanazawa University Graduate School of Medical Science, Department of Quantum Medicine Technology (Japan); Matsui, Osamu; Minami, Tetsuya; Koda, Wataru; Gabata, Toshifumi [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan)

    2017-06-15

    PurposeTo investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard.Materials and MethodsA total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA.ResultsIn 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively.ConclusionExtrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.

  3. CT Angiography of Peripheral Arterial Disease by 256-Slice Scanner: Accuracy, Advantages and Disadvantages Compared to Digital Subtraction Angiography.

    Science.gov (United States)

    Mishra, Atul; Jain, Narendra; Bhagwat, Anand

    2017-07-01

    Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision. The aim of this retrospective study was to compare the CT angiograms (CTAs) of all cases of PAOD done by 256-slice CT scanner at a tertiary care vascular center and comparing these images with the digital subtraction angiograms (DSAs) of these patients. The retrospective study included 53 patients who underwent both CTA and DSA at our center over a period of 3 years from March 2013 to March 2016. The CTA showed high sensitivity (93%) and specificity (92.7%) for overall assessment of degree of stenosis in a vascular segment in cases of aortic and lower limb occlusive disease. The assessment of lesions of infrapopliteal segment was comparatively inferior (sensitivity 91.6%, accuracy 73.3%, and positive predictive value 78.5%), more so in the presence of significant calcification. The advantages of CTA were its noninvasive nature, ability to image large area of body, almost no adverse effects to the patients, and better assessment of vessel wall disease. However, the CTA assessment of collaterals was inferior with a sensitivity of only 62.7% as compared to DSA. Overall, 256-slice CTA provides fast and accurate imaging of vascular tree which can restrict DSA only in few selected cases as a problem-solving tool where clinico-radiological mismatch is present.

  4. Utility of digital subtraction angiography-based collateral evaluation in medically treated acute symptomatic basilar artery stenosis.

    Science.gov (United States)

    Lee, W-J; Jung, K-H; Ryu, Y J; Kim, J-M; Lee, S-T; Chu, K; Kim, M; Lee, S K; Roh, J-K

    2017-09-01

    Although a stroke from atherosclerosis in the basilar artery (BA) often presents with mild initial stroke severity, it has heterogeneous clinical courses. We investigated the efficacy of digital subtraction angiography (DSA)-based collateral perfusion evaluation in association with long-term outcomes of medically treated symptomatic basilar artery stenosis. From a registry database of all consecutive patients with stroke, we included 98 medically treated patients (due to mild initial stroke severity) [National Institute of Health Stroke Scale (NIHSS) scores ≤ 4; symptomatic basilar artery stenosis, 70-99%] with available initial diagnostic DSA. Basilar collateral scoring was performed via the DSA, using a modified version of the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology grading system in both the superior cerebellar artery and anterior/posterior-inferior cerebellar artery territories (score 0-8). The outcomes were designated as the 90-day modified Rankin Scale (mRS90) score (poor, 3-6). Student's t-test, chi-square test and logistic regression analyses were used to identify factors associated with a poor outcome. The median initial NIHSS score was 2 [interquartile range (IQR), 0-3], median posterior circulation Alberta Stroke Program Early CT Score was 8 (IQR, 7-10), median collateral score was 7 (IQR, 7-8) and 20 (20.4%) had poor mRS90 scores. In multivariate analysis, poorer collateral scores (P = 0.003), higher NIHSS scores (P = 0.005) and lower posterior circulation Alberta Stroke Program Early CT Score (P = 0.017) were independently associated with a poor mRS90 score. The DSA-based collateral scoring of the BA large branches might predict long-term outcome in medically treated symptomatic basilar artery stenosis with mild initial severity. Evaluation of BA collateral perfusion status might be useful to determine appropriate treatment strategies. © 2017 EAN.

  5. Detection of unruptured intracranial aneurysms on noninvasive imaging. Is there still a role for digital subtraction angiography?

    Science.gov (United States)

    Rustemi, Oriela; Alaraj, Ali; Shakur, Sophia F; Orning, Jennifer L; Du, Xinjian; Aletich, Victor A; Amin-Hanjani, Sepideh; Charbel, Fady T

    2015-01-01

    To determine the utility of digital subtraction angiography (DSA) in patients with unruptured intracranial aneurysms (UIA) detected on noninvasive imaging, such as magnetic resonance angiography (MRA) and computed tomography angiography (CTA). The follow-up of patients with untreated UIAs involves serial imaging; however, this diagnosis may be based on false positive (FP) results. We examined the incidence of FPs in our institutional series. DSAs performed at our institution from January 2011 to June 2014 were retrospectively reviewed and patients referred with UIA detected on noninvasive imaging were selected. Clinical presentation as well as aneurysm location, size, and number reported on DSA and noninvasive imaging were assessed. Two hundred and eighty six patients (mean age 56.8 years, female 74.8%) with a total of 355 UIA were included. Thirty-one patients had a symptomatic presentation. Analysis per patient showed the pooled FP rate of noninvasive imaging was 15%. MRA FP was 13% (22/171) and CTA FP was 18% (22/120). FP increased significantly with aneurysm size < 3.5 mm on MRA (P < 0.001) and <4.0 mm on CTA (P = 0.01). Mean aneurysm size among symptomatic patients was significantly larger (P < 0.001) as compared to the incidental group (17.8 vs. 7.7 mm). No location was significantly susceptible to false detection of aneurysms. DSA detection of FP UIA diagnosed on noninvasive imaging is significantly higher for aneurysms <4.0 mm. Accurate diagnosis with DSA may eliminate the need for further follow-up and its associated negative psychological and economic effects. Within the limitations of this retrospective study, we conclude that DSA has a diagnostic role in small aneurysms detected on noninvasive imaging.

  6. MRI evaluation of frequent complications after intra-arterial transplantation of mesenchymal stem cells in rats

    Science.gov (United States)

    Namestnikova, D.; Gubskiy, I.; Gabashvili, A.; Sukhinich, K.; Melnikov, P.; Vishnevskiy, D.; Soloveva, A.; Vitushev, E.; Chekhonin, V.; Gubsky, L.; Yarygin, K.

    2017-08-01

    Intra-arterial transplantation of mesenchymal stem cells (MSCs) is an effective delivery route for treatment of ischemic brain injury. Despite significant therapeutic effects and targeted cells delivery to the brain infraction, serious adverse events such as cerebral embolism have been reported and may restrict potential clinical applications of this method. In current study, we evaluate potential complications of intra-arterial MSCs administration and determine the optimum parameters for cell transplantation. We injected SPIO-labeled human MSCs via internal carotid artery with different infusion parameters and cell dose in intact rats and in rats with the middle cerebral occlusion stroke model. Cerebrovascular complications and labeled cells were visualized in vivo using MRI. We have shown that the incidence of cerebral embolic events depends on such parameters as cell dose, infusion rate and maintenance of blood flow in the internal carotid artery (ICA). Optimal parameters were considered to be 5×105 hMSC in 1 ml of PBS by syringe pump with velocity 100 μ/min and maintenance of blood flow in the ICA. Obtained data should be considered before planning experiments in rats and, potentially, can help in planning clinical trials in stroke patients.

  7. Changes in MR imaging appearance of breast cancer after intra-arterial infusion chemotherapy

    International Nuclear Information System (INIS)

    Kitamura, Kouji; Yoshioka, Hiroyasu; Tanigawa, Noboru; Makino, Shigeru; Hanai, Jyun; Tatsuta, Masayuki; Yoshimura, Hideaki

    2000-01-01

    The purpose of this study was to evaluate whether the characteristic change in breast cancer related to chemotherapeutic response (CR) and the effect of invasion and toxicity in the skin and pectoralis muscle exist on MR imaging after intra-arterial infusion chemotherapy. A total of 11 patients with histologically proven breast cancer underwent MR study before and after chemotherapy. Changes in images and the dynamic curveafter-chemotherapy were evaluated, including time to maximum signal intensity (SI) and the early phase enhance ratio (EPER) in the tumor. In the tumor, changes in the dynamic curve, time to maximum SI, EPER and necrosis did not correlate with CR, but change in SI on T2-weighted images was suggested to do so. Changes in the dynamic curve and images in the pectoralis muscle and in images on the skin were suggested to correlate with CR. In addition, images changed for the worse in many cases of invasion and toxicity in the pectoralis muscle and in some cases of invasion in the skin. In conclusion, tumors had fewer imaging changes correlating with CR after intra-arterial infusion chemotherapy. Changes for the worse in images of the pectoralis muscle and skin may be useful for the evaluation of invasion. (author)

  8. Retinoblastoma frontiers with intravenous, intra-arterial, periocular, and intravitreal chemotherapy

    Science.gov (United States)

    Shields, C L; Fulco, E M; Arias, J D; Alarcon, C; Pellegrini, M; Rishi, P; Kaliki, S; Bianciotto, C G; Shields, J A

    2013-01-01

    In this report, we explore retinoblastoma diagnostic accuracy and review chemotherapy alternatives for retinoblastoma using intravenous, intra-arterial, periocular, and intravitreal routes. A review of 2775 patients referred for management of retinoblastoma, disclosed 78% with confirmed retinoblastoma and 22% with simulating lesions, termed pseudoretinoblastomas. Children ≤2 years old showed leading pseudoretinoblastomas of persistent fetal vasculature, Coats disease, and vitreous haemorrhage, whereas those >5 years showed simulators of Coats, toxocariasis, and familial exudative vitreoretinopathy. The diagnosis of retinoblastoma should be established before planning therapeutic strategy. Chemotherapy strategy depends on tumour laterality and stage of disease. If bilateral retinoblastoma, intravenous chemotherapy (IVC) is important as first-line therapy for control of intraocular disease, prevention of metastasis, and reduction in prevalence of pinealoblastoma and long-term second malignant neoplasms. Bilateral groups D and E retinoblastoma receive additional subtenon's carboplatin boost for improved local control. If unilateral disease is present, then intra-arterial chemotherapy (IAC) is often considered. IAC can be salvage therapy following chemoreduction failure. Unilateral retinoblastoma of groups D and E are managed with enucleation or globe-conserving IVC and/or IAC. Intravitreal chemotherapy is cautiously reserved for recurrent vitreous seeds following other therapies. In conclusion, the strategy for retinoblastoma management with chemotherapy depends on tumour laterality and stage of disease. Bilateral retinoblastoma is most often managed with IVC and unilateral retinoblastoma with IAC, but if advanced stage, combination IVC plus IAC or enucleation. PMID:22995941

  9. Computed tomography after the intra-arterial and intravenous administration of contrast media

    International Nuclear Information System (INIS)

    Young, S.W.

    1981-01-01

    In computed tomography (CT) body scanning, the amount of contrast medium which has accumulated in a tissue is related to the delivery of the contrast agent to the tissue and the contrast medium extraction ratio of the tissue. The two main tissue characteristics responsible for differential contrast medium accumulation are capillary leak and differences in the size of the interstitial space. Given two tissues which leak contrast medium the best CT scanning methodology consists of delivering a rapid bolus of as high a concentration of contrast medium as can be biologically safely delivered. In order to assess the rapid pharmacokinetics, dynamic CT scanning throughout the passage of the bolus is the best technique to employ. Given two tissues, one of which leaks contrast medium and one which does not, optimal technique would utilize a sustained drip infusion, subsequently stopping the infusion, and after the blood pool has declined, obtaining CT scans through the area of interest. The accumulated tissue levels are directly related to the administered concentration, and on this basis, intra-arterial administration is superior to intravenous administration in producing contrast enhancement. The routine intra-arterial administration of contrast medium, although superior, has little practical application in the clinical setting. The contrast enhancement of blood vessels, however, is probably best produced by a sustained bolus infusion, preferably delivered into the vascular structure to be evaluated (i.e., the left foot if the left external iliac vein is to be evaluated). (Auth.)

  10. The role of thromboxane in experimental inadvertent intra-arterial drug injections.

    Science.gov (United States)

    Zachary, L S; Smith, D J; Heggers, J P; Robson, M C; Boertman, J A; Niu, X T; Schileru, R E; Sacks, R J

    1987-03-01

    Inadvertent intra-arterial injection of drugs produces a well-defined clinical syndrome whose pathophysiology remains unclear. This study was designed to determine the role of the inflammatory mediator, thromboxane, in intra-arterial drug injections. The rabbit ear model, as described by Kinmonth and Sheppard, was used. Five of the experimental groups were treated with specific or nonspecific thromboxane blocking agents and two groups served as controls. Immunohistochemical staining of the control ears showed elevated levels of thromboxane within the first 6 hours postinjury. The specific thromboxane blocking agents, methimazole and Aloe vera, showed almost complete blockade of thromboxane production. The percentage of ear survival was significantly greater in the group treated with topical Aloe vera (p less than 0.05) and even greater survival was achieved in the combined Aloe vera/methimazole group (p less than 0.01). On the basis of these results, we have begun treatment of such injuries with specific and nonspecific thromboxane blocking agents.

  11. A comparison of subtracted images from dental subtraction programs

    International Nuclear Information System (INIS)

    Han, Won Jeong

    2002-01-01

    To compare the standard deviation of gray levels on digital subtracted images obtained by different dental subtraction programs. Paired periapical films were taken at the lower premolar and molar areas of the phantoms involving human mandible. The bite registration group used Rinn XCP equipment and bite registration material, based on polyvinyl siloxane, for standardization. The no bite registration group used only Rinn XCP equipment. The periapical film images were digitized at 1200 dpi resolution and 256 gray levels by a flat bed scanner with transparency unit. Dental digital subtraction programs used for this study were Subtractor (Biomedisys Co., Korea) and Emago (Oral Diagnostic Systems, The Netherlands). To measure the similarities between the subtracted images, the standard deviations of the gray levels were obtained using a histogram of subtracted images, which were then analyzed statistically. Subtracted images obtained by using the Emago program without manual selection of corresponding points showed the lowest standard deviation of gray levels (p<0.01). And the standard deviation of gray levels was lower in subtracted images in the group of a bite registration than in the group of no use of bite registration (p<0.01). Digital radiographic subtraction without manual selection of reference points was found to be a convenient and superior method.

  12. A comparison of subtracted images from dental subtraction programs

    Energy Technology Data Exchange (ETDEWEB)

    Han, Won Jeong [School of Dentistry, Dankook University, Cheonan (Korea, Republic of)

    2002-09-15

    To compare the standard deviation of gray levels on digital subtracted images obtained by different dental subtraction programs. Paired periapical films were taken at the lower premolar and molar areas of the phantoms involving human mandible. The bite registration group used Rinn XCP equipment and bite registration material, based on polyvinyl siloxane, for standardization. The no bite registration group used only Rinn XCP equipment. The periapical film images were digitized at 1200 dpi resolution and 256 gray levels by a flat bed scanner with transparency unit. Dental digital subtraction programs used for this study were Subtractor (Biomedisys Co., Korea) and Emago (Oral Diagnostic Systems, The Netherlands). To measure the similarities between the subtracted images, the standard deviations of the gray levels were obtained using a histogram of subtracted images, which were then analyzed statistically. Subtracted images obtained by using the Emago program without manual selection of corresponding points showed the lowest standard deviation of gray levels (p<0.01). And the standard deviation of gray levels was lower in subtracted images in the group of a bite registration than in the group of no use of bite registration (p<0.01). Digital radiographic subtraction without manual selection of reference points was found to be a convenient and superior method.

  13. Comparison of C-arm Computed Tomography and Digital Subtraction Angiography in Patients with Chronic Thromboembolic Pulmonary Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Hinrichs, Jan B., E-mail: hinrichs.jan@mh-hannover.de; Marquardt, Steffen, E-mail: marquardt.steffen@mh-hannover.de; Falck, Christian von, E-mail: falck.christian.von@mh-hannover.de [Hannover Medical School, Department for Diagnostic and Interventional Radiology, German Center for Lung Research (DZL) (Germany); Hoeper, Marius M., E-mail: hoeper.marius@mh-hannover.de; Olsson, Karen M., E-mail: olsson.karen@mh-hannover.de [Hannover Medical School, Clinic for Pneumology, German Center for Lung Research (DZL) (Germany); Wacker, Frank K., E-mail: wacker.frank@mh-hannover.de; Meyer, Bernhard C., E-mail: meyer.bernhard@mh-hannover.de [Hannover Medical School, Department for Diagnostic and Interventional Radiology, German Center for Lung Research (DZL) (Germany)

    2016-01-15

    PurposeTo assess the feasibility and diagnostic performance of contrast-enhanced, C-arm computed tomography (CACT) of the pulmonary arteries compared to digital subtraction angiography (DSA) in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH).MaterialsFifty-two patients with CTEPH underwent ECG-gated DSA and contrast-enhanced CACT. Two readers (R1, R2) independently evaluated pulmonary artery segments and their sub-segmental branching using DSA and CACT for optimal image quality. Afterwards, the diagnostic findings, i.e., intraluminal filling defects, stenosis, and occlusion, were compared. Inter-modality and inter-observer agreement was calculated, and subsequently consensus reading was done and correlated to a reference standard representing the overall consensus of both modalities. Fisher’s exact test and Cohen’s Kappa were applied.ResultsA total of 1352 pulmonary segments were evaluated, of which 1255 (92.8 %) on DSA and 1256 (92.9 %) on CACT were rated to be fully diagnostic. The main causes of the non-diagnostic image quality were motion artifacts on CACT (R1:37, R2:78) and insufficient contrast enhancement on DSA (R1:59, R2:38). Inter-observer agreement was good for DSA (κ = 0.74) and CACT (κ = 0.75), while inter-modality agreement was moderate (R1: κ = 0.46, R2: κ = 0.47). Compared to the reference standard, the inter-modality agreement for CACT was excellent (κ = 0.96), whereas it was inferior for DSA (κ = 0.61) due to the higher number of abnormal consensus findings read as normal on DSA.ConclusionCACT of the pulmonary arteries is feasible and provides additional information to DSA. CACT has the potential to improve the diagnostic work-up of patients with CTEPH and may be particularly useful prior to surgical or interventional treatment.

  14. Carbon dioxide digital subtraction angiography using a new gas management system; Digitale Subtraktionsangiographie mit Kohlendioxid unter Verwendung eines neuen Gasdosiersystems

    Energy Technology Data Exchange (ETDEWEB)

    Schmitz-Rode, T.; Alzen, G.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)

    1997-07-01

    Purpose: The clinical evaluation of digital subtraction angiography with carbon dioxide using a newly developed low-tech CO{sub 2}-dosage- and injection system. Method and patients: The hand-held system (CO{sub 2} angio set) consists of a dosage chamber in connection with a special stopcock to apportion the gas. By optimising injection volume and pressure steady gas flow characteristics are approximated. A safety design prevents unintentional gas injection volume and pressure steady gas flow characteristics are approximated. A safety design prevents unintentional gas injection. CO{sub 2} arteriographies were performed on 185 patients. Main indications were renal insufficiency and a history of adverse reactions to iodinated contrast media. In patients with femoral connula access, catheterless reflux angiography was performed. Results: The injection system provided complete and coherent visualisation of the abdominal aorta, visceral, pelvic, and lower limb arteries via catheter (71 cases) or via femoral cannula using reflux technique (114 cases). Stenoses, occlusions, and collaterals were assessable. Employing the gas reflux over the aortic bifurcation bilateral run-off studies up to the calf trifurcation were performed via unilateral femoral cannula. Use of a dedicated stacking software improved image quality of distal femoral, popliteal and calf arteries. Conclusion: The CO{sub 2} management system allows adequate imaging of the arteries below the diaphragm. Ease and safety of use and low costs are advantageous. (orig.) [Deutsch] Ziel: Die klinische Erprobung der digitalen Subtraktionsangiographie mit Kohlendioxid unter Verwendung eines neuentwickelten, einfachen Gasdosier- und Injektionssystems. Methode und Patienten: Eine Dosierkammer mit einstellbarem Volumen in Verbindung mit einem Spezial-Hahn (CO{sub 2}-Angio-Set) portioniert das Gas. Durch Optimierung von Injektionsvolumen und -druck wurde eine konstante Ausstroemcharakteristik angenaehert. Das System wurde

  15. Local intra-arterial thrombolysis in acute ischemic stroke of the anterior circulation

    International Nuclear Information System (INIS)

    Zhang Yongwei; Liu Jianmin; Hong Bo; Deng Benqiang; Xu Yi; Ding Suju

    2003-01-01

    Objective: To evaluate the safety and efficacy of local intra-arterial thrombolysis (LIT) using urokinase in patients with acute ischemic stroke of the anterior circulation. Methods: Fifty-four patients were treated with LIT using urokinase. The locations of occlusion included 3 of internal carotid artery (ICA), 46 of middle cerebral artery (MCA) and 5 of anterior cerebral artery. Results: Outcome was good in 41 patients (75.9%). Recanalization >50% was obtained in 72.2% of patients and <50% recanalization in 27.8% of patients. Cerebral hemorrhage occurred in 11 patients (20.4%). Four patients died (7.4%). Conclusion: LIT using urokinase can improve the recanalization rate and achieve better functional recovery in patients of acute ischemic stroke

  16. Preoperative localization of endocrine pancreatic tumours by intra-arterial dynamic computed tomography

    International Nuclear Information System (INIS)

    Ahlstroem, H.; Magnusson, A.; Grama, D.; Eriksson, B.; Oeberg, K.; Loerelius, L.E.; Akademiska Sjukhuset, Uppsala; Akademiska Sjukhuset, Uppsala

    1990-01-01

    Eleven patients with biochemically confirmed endocrine pancreatic tumours were examined with intra-arterial (i.a.) dynamic computed tomography (CT) and angiography preoperatively. Seven of the patients suffered from the multiple endocrine neoplasia type 1 (MEN-1) syndrome. All patients were operated upon and surgical palpation and ultrasound were the peroperative localization methods. Of the 33 tumours which were found at histopathologic analysis of the resected specimens in the 11 patients, 7 tumours in 7 patients were correctly localized by both i.a. dynamic CT and angiography. Six patients with MEN-1 syndrome had multiple tumours and this group of patients together had 28 tumours, of which 5 (18%) were localized preoperatively by both CT and angiography. I.a. dynamic CT, with the technique used by us, does not seem to improve the localization of endocrine pancreatic tumours, especially in the rare group of MEN-1 patients, as compared with angiography. (orig.)

  17. Outcome evaluation of intra-arterial infusion of urokinase for acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Hai Bin [First Affiliated Hospital of Nanjing Medical University, Nanjing (China); Suh, Dae Chul; Lim, Soo Mee [Asan Medical Center, College of Medicine, University of Ulsan, Seoul (Korea, Republic of); And Others

    2000-06-01

    To evaluate the results of intra-arterial urokinase thrombolysis in cases of acute ischemic stroke and to define the factors affecting prognosis. Forty-eight patients with angiographically proven occlusion of the intracranial arteries were treated with local intra-arterial infusion of urokinase within six hours of the onset of symptoms. Neurologic status was evaluated on admission and on discharge using the NIH (National Institute of Health) stroke scale score (SSS). When the SSS decreased by at least four points, this was considered indicative of an improved clinical outcome. Complete recanalization was achieved in 17/48 patients (35%), including 8 of 13 (62%) with occlusion of the vertebrobasilar artery (VBA), 9 of 20 (45%) with occlusion of the middle cerebral artery (MCA), and none of 15 with occlusion of the internal carotid artery (ICA). Neurologic status improved in 12 (60%) of patients with MCA occlusion, in five (38%) of those with VBA occlusion and in three (20%) of those with ICA occlusion (p less than 0.005). Patients in whom occluded MCA was completely recanalized showed greater clinical improvement than those with partial or no recanalization (p less than 0.05). The overall mortality rate was 21%, 43% (9/21) in patients in whom CT revealed signs of early infarct, but only 4% (1/27) in those without this sign (p less than 0.05). The mortality rate of patients with parenchymal hematoma (4/5) was higher than that of those with hemorrhagic infarct (3/9) or without hemorrhage (3/34) (p less than 0.005). In patients in whom occluded MCA was completely recanalized, the clinical outcome was better, while patients with VBA occlusion did not benefit from recanalization. The presence on CT scans of signs of early infarct and of parenchymal hematoma after thrombolysis correlated with a high mortality rate. (author)

  18. Combined intra-arterial infusion and systemic chemoradiotherapy for stage IV squamous cell carcinoma of the mandibular gingiva

    International Nuclear Information System (INIS)

    Nakasato, Tatsuhiko; Akahane, Akio; Kikuchi, Koyo; Ehara, Shigeru; Izumisawa, Mitsuru; Shoji, Satoru; Kogi, Shintaro; Mizuki, Harumi; Sugiyama, Yoshiki

    2012-01-01

    The purpose of this study was to show the effectiveness of combining intra-arterial infusion and systemic chemotherapy with concurrent radiotherapy for treatment of stage IV mandibular gingival cancer. A total of 23 patients with mandibular gingival cancer were treated with either docetaxel by intra-arterial infusion followed by systemic chemoradiotherapy with cisplatinum and 5-fluorouracil as a monthly regimen, or with docetaxel and cisplatinum by intra-arterial infusion followed by systemic chemoradiotherapy with 5-fluorouracil as a weekly or biweekly regimen. Tumor responses, locoregional control, overall survival, disease-specific survival, and adverse events were evaluated. Of the 23 patients enrolled in the study, 22 completed the treatment. With regard to clinical stages, 82% were diagnosed as IVA and 18% IVB. Complete and partial response was observed in 82 and 18%, respectively. Five-year overall survival, disease-specific survival, and locoregional control were 51, 70, and 72%, respectively. No statistically significant difference was seen between the monthly regimen and the weekly plus biweekly regimen, although the latter resulted in longer survival and 88% control. Combined intra-arterial infusion and systemic chemoradiotherapy may be an effective treatment for patients with stage IV mandibular gingival cancer. (author)

  19. Impact of Pretreatment Noncontrast CT Alberta Stroke Program Early CT Score on Clinical Outcome After Intra-Arterial Stroke Therapy

    NARCIS (Netherlands)

    Yoo, Albert J.; Zaidat, Osama O.; Chaudhry, Zeshan A.; Berkhemer, Olvert A.; González, R. Gilberto; Goyal, Mayank; Demchuk, Andrew M.; Menon, Bijoy K.; Mualem, Elan; Ueda, Dawn; Buell, Hope; Sit, Siu Po; Bose, Arani

    2014-01-01

    The efficacy of intra-arterial treatment remains uncertain. Because most centers performing IAT use noncontrast CT (NCCT) imaging, it is critical to understand the impact of NCCT findings on treatment outcomes. This study aimed to compare functional independence and safety among patients undergoing

  20. Value of Computed Tomographic Perfusion-Based Patient Selection for Intra-Arterial Acute Ischemic Stroke Treatment

    NARCIS (Netherlands)

    Borst, Jordi; Berkhemer, Olvert A.; Roos, Yvo B. W. E. M.; van Bavel, Ed; van Zwam, Wim H.; van Oostenbrugge, Robert J.; van Walderveen, Marianne A. A.; Lingsma, Hester F.; van der Lugt, Aad; Dippel, Diederik W. J.; Yoo, Albert J.; Marquering, Henk A.; Majoie, Charles B. L. M.; Fransen, Puck S. S.; Beumer, Debbie; van den Berg, Lucie A.; Schonewille, Wouter J.; Vos, Jan Albert; Nederkoorn, Paul J.; Wermer, Marieke J. H.; Staals, Julie; Hofmeijer, Jeannette; van Oostayen, Jacques A.; Lycklama à Nijeholt, Geert J.; Boiten, Jelis; Brouwer, Patrick A.; Emmer, Bart J.; de Bruijn, Sebastiaan F.; van Dijk, Lukas C.; Kappelle, L. Jaap; Lo, Rob H.; van Dijk, Ewoud J.; de Vries, Joost; de Kort, Paul L. M.; van den Berg, Jan S. P.; van Hasselt, Boudewijn A. A. M.; Aerden, Leo A. M.; Dallinga, René J.; Visser, Marieke C.; Bot, Joseph C. J.; Vroomen, Patrick C.; Eshghi, Omid; Schreuder, Tobien H. C. M. L.; Heijboer, Roel J. J.; Keizer, Koos; Tielbeek, Alexander V.; den Hertog, Heleen M.; Gerrits, Dick G.; van den Berg-Vos, Renske M.; Karas, Giorgos B.; Steyerberg, Ewout W.; Flach, H. Zwenneke; Sprengers, Marieke E. S.; Jenniskens, Sjoerd F. M.; Beenen, Ludo F. M.; van den Berg, René; Koudstaal, Peter J.; Brown, Martin M.; Liebig, Thomas; Stijnen, Theo; Andersson, Tommy; Mattle, Heinrich; Wahlgren, Nils; van der Heijden, Esther; Ghannouti, Naziha; Fleitour, Nadine; Hooijenga, Imke; Puppels, Corina; Pellikaan, Wilma; Geerling, Annet; Lindl-Velema, Annemieke; van Vemde, Gina; de Ridder, Ans; Greebe, Paut; de Bont-Stikkelbroeck, José; de Meris, Joke; Janssen, Kirsten; Struijk, Willy; Simons, Tiny; Messchendorp, Gert; van der Minne, Friedus; Bongenaar, Hester; Licher, Silvan; Boodt, Nikki; Ros, Adriaan; Venema, Esmee; Slokkers, Ilse; Ganpat, Raymie-Jayce; Mulder, Maxim; Saiedie, Nawid; Heshmatollah, Alis; Schipperen, Stefanie; Vinken, Stefan; van Boxtel, Tiemen; Koets, Jeroen; Boers, Merel; Santos, Emilie; Jansen, Ivo; Kappelhof, Manon; Lucas, Marit; Geuskens, Ralph; Barros, Renan Sales; Dobbe, Roeland; Csizmadia, Marloes

    2015-01-01

    The utility of computed tomographic perfusion (CTP)-based patient selection for intra-arterial treatment of acute ischemic stroke has not been proven in randomized trials and requires further study in a cohort that was not selected based on CTP. Our objective was to study the relationship between

  1. Subtract it! fun with subtraction

    CERN Document Server

    First, Rachel

    2016-01-01

    Make math fun with Subtract It! Fun photographs, colorful graphics, and simple text are used to teach young readers basic math concepts. From Word Problems to Number Lines this book will help kids develop the math skills they need. A simple activity at the end of the book encourages kids to put subtraction to use! Aligned to Common Core standards and correlated to state standards. Sandcastle is an imprint of Abdo Publishing, a division of ABDO.

  2. A comparison between magnetic resonance angiography at 3 teslas (time-of-flight and contrast-enhanced) and flat-panel digital subtraction angiography in the assessment of embolized brain aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Nakiri, Guilherme S.; Santos, Antonio C.; Abud, Thiago G.; Abud, Daniel G., E-mail: gsnakiri@yahoo.com.b [University of Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Medical School. Div. of Radiology; Aragon, Davi C. [University of Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Medical School. Div. of Statistics; Colli, Benedicto O. [University of Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Medical School. Div. of Neurosurgery

    2011-07-01

    Purpose: to compare the time-of-flight and contrast-enhanced- magnetic resonance angiography techniques in a 3 Tesla magnetic resonance unit with digital subtraction angiography with the latest flat-panel technology and 3D reconstruction in the evaluation of embolized cerebral aneurysms. Introduction: many embolized aneurysms are subject to a recurrence of intra-aneurysmal filling. Traditionally, imaging surveillance of coiled aneurysms has consisted of repeated digital subtraction angiography. However, this method has a small but significant risk of neurological complications, and many authors have advocated the use of noninvasive imaging methods for the surveillance of embolized aneurysms. Methods: forty-three aneurysms in 30 patients were studied consecutively between November 2009 and May 2010. Two interventional neuro radiologists rated the time-of-flight-magnetic resonance angiography, the contrast enhanced-magnetic resonance angiography, and finally the digital subtraction angiography, first independently and then in consensus. The status of aneurysm occlusion was assessed according to the Raymond scale, which indicates the level of recanalization according to degrees: Class 1: excluded aneurysm; Class 2: persistence of a residual neck; Class 3: persistence of a residual aneurysm. The agreement among the analyses was assessed by applying the Kappa statistic. Results: inter-observer agreement was excellent for both methods (K = 0.93; 95 % CI: 0.84-1). Inter-technical agreement was almost perfect between time-of-flight-magnetic resonance angiography and digital subtraction angiography (K = 0.98; 95 % CI: 0.93-1) and between time-of-flight-magnetic resonance angiography and contrast enhanced-magnetic resonance angiography (K = 0.98; 95% CI: 0.93-1). Disagreement occurred in only one case (2.3%), which was classified as Class I by time-of-flight-magnetic resonance angiography and Class II by digital subtraction angiography. The agreement between contrast

  3. A comparison between magnetic resonance angiography at 3 teslas (time-of-flight and contrast-enhanced and flat-panel digital subtraction angiography in the assessment of embolized brain aneurysms

    Directory of Open Access Journals (Sweden)

    Guilherme S. Nakiri

    2011-01-01

    Full Text Available PURPOSE: To compare the time-of-flight and contrast-enhanced- magnetic resonance angiography techniques in a 3 Tesla magnetic resonance unit with digital subtraction angiography with the latest flat-panel technology and 3D reconstruction in the evaluation of embolized cerebral aneurysms. INTRODUCTION: Many embolized aneurysms are subject to a recurrence of intra-aneurismal filling. Traditionally, imaging surveillance of coiled aneurysms has consisted of repeated digital subtraction angiography. However, this method has a small but significant risk of neurological complications, and many authors have advocated the use of noninvasive imaging methods for the surveillance of embolized aneurysms. METHODS: Forty-three aneurysms in 30 patients were studied consecutively between November 2009 and May 2010. Two interventional neuroradiologists rated the time-of-flight-magnetic resonance angiography, the contrast-enhanced-magnetic resonance angiography, and finally the digital subtraction angiography, first independently and then in consensus. The status of aneurysm occlusion was assessed according to the Raymond scale, which indicates the level of recanalization according to degrees: Class 1: excluded aneurysm; Class 2: persistence of a residual neck; Class 3: persistence of a residual aneurysm. The agreement among the analyses was assessed by applying the Kappa statistic. RESULTS: Inter-observer agreement was excellent for both methods (K = 0.93; 95 % CI: 0.84-1. Inter-technical agreement was almost perfect between time-of-flight-magnetic resonance angiography and digital subtraction angiography (K = 0.98; 95 % CI: 0.93-1 and between time-of-flight-magnetic resonance angiography and contrast-enhanced-magnetic resonance angiography (K = 0.98; 95% CI: 0.93-1. Disagreement occurred in only one case (2.3%, which was classified as Class I by time-of-flight-magnetic resonance angiography and Class II by digital subtraction angiography. The agreement between

  4. Superselective intra-arterial cisplatin infusion and concomitant radiotherapy for maxillary sinus cancer.

    Science.gov (United States)

    Homma, A; Sakashita, T; Yoshida, D; Onimaru, R; Tsuchiya, K; Suzuki, F; Yasuda, K; Hatakeyama, H; Furusawa, J; Mizumachi, T; Kano, S; Inamura, N; Taki, S; Shirato, H; Fukuda, S

    2013-12-10

    The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS). Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100-120 mg m(-2) per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65-70 Gy). One patient (1.9%) was diagnosed with T2, 14 (25.9%) with T3, 27 (50%) with T4a, and 12 (22.2%) with T4b disease. Lymph-node involvement was present in 12 patients (22.2%). During the median follow-up period of 6.4 years, the 5-year local progression-free and overall survival rates were 65.8 and 67.9% for all patients, respectively. No patient died as a result of treatment toxicity or experienced a cerebrovascular accident. Osteonecrosis (n=5), brain necrosis (n=1), and ocular/visual problems (n=14) were observed as late adverse reactions. We have shown excellent overall survival and local progression-free rate in SCC-MS patients treated by RADPLAT with acceptable rates of acute and late toxicity. A multi-institutional trial is needed to prove that this strategy is a feasible and effective approach for the treatment of SCC-MS.

  5. Local intra-arterial thrombolysis in the carotid territory: does recanalization depend on the thromboembolus type?

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H.; Wilhelm, K.; Flacke, S.; Schild, H.H. [Department of Radiology/Neuroradiology, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn (Germany); Hartmann, A.; Pohl, C.; Klockgether, T. [Department of Neurology, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn (Germany); Omran, H. [Department of Cardiology, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn (Germany)

    2002-08-01

    Little is known about whether recanalization of carotid territory occlusions by local intra-arterial thrombolysis (LIT) depends on the type of the occluding thromboembolus. We retrospectively analysed the records of 62 patients with thromboembolic occlusions of the intracranial internal carotid artery (ICA) bifurcation or the middle cerebral artery who were undergoing LIT with urokinase within 6 h of symptom onset. We determined the influence of thromboembolus type (according to the TOAST criteria), thromboembolus location, leptomeningeal collaterals, time interval from onset of symptoms to onset of thrombolysis, and patient's age on recanalization. The thromboembolus type was atherosclerotic in six patients, cardioembolic in 29, of other determined etiology in four, and of undetermined etiology in 23 patients. Thirty-three (53%) thromboembolic occlusions were recanalized. The thromboembolus location but not the TOAST stroke type nor other parameters affected recanalization. In the TOAST group of patients with cardioembolic occlusions recanalization occurred significantly less frequently when transoesophageal echocardiography showed cardiac thrombus. The present study underlines the thromboembolus location as being the most important parameter affecting recanalization. The fact that thromboembolic occlusions originating from cardiac thrombi had a lower likelihood of being resolved by thrombolysis indicates the thromboembolus type as another parameter affecting recanalization. (orig.)

  6. Local intra-arterial thrombolysis in the carotid territory: does recanalization depend on the thromboembolus type?

    International Nuclear Information System (INIS)

    Urbach, H.; Wilhelm, K.; Flacke, S.; Schild, H.H.; Hartmann, A.; Pohl, C.; Klockgether, T.; Omran, H.

    2002-01-01

    Little is known about whether recanalization of carotid territory occlusions by local intra-arterial thrombolysis (LIT) depends on the type of the occluding thromboembolus. We retrospectively analysed the records of 62 patients with thromboembolic occlusions of the intracranial internal carotid artery (ICA) bifurcation or the middle cerebral artery who were undergoing LIT with urokinase within 6 h of symptom onset. We determined the influence of thromboembolus type (according to the TOAST criteria), thromboembolus location, leptomeningeal collaterals, time interval from onset of symptoms to onset of thrombolysis, and patient's age on recanalization. The thromboembolus type was atherosclerotic in six patients, cardioembolic in 29, of other determined etiology in four, and of undetermined etiology in 23 patients. Thirty-three (53%) thromboembolic occlusions were recanalized. The thromboembolus location but not the TOAST stroke type nor other parameters affected recanalization. In the TOAST group of patients with cardioembolic occlusions recanalization occurred significantly less frequently when transoesophageal echocardiography showed cardiac thrombus. The present study underlines the thromboembolus location as being the most important parameter affecting recanalization. The fact that thromboembolic occlusions originating from cardiac thrombi had a lower likelihood of being resolved by thrombolysis indicates the thromboembolus type as another parameter affecting recanalization. (orig.)

  7. Facial nerve paralysis after super-selective intra-arterial chemotherapy for oral cancer.

    Science.gov (United States)

    Sugiyama, S; Iwai, T; Oguri, S; Koizumi, T; Mitsudo, K; Tohnai, I

    2017-06-01

    Facial nerve paralysis (FNP) after super-selective intra-arterial chemotherapy (SSIAC) is a relatively rare local side effect of SSIAC to the maxillary artery (MA) or the middle meningeal artery (MMA). The incidence and prognosis of FNP after SSIAC in 381 patients with oral cancer (133 with catheterization of the MA, 248 without) was investigated retrospectively. Only three patients (two male and one female) had FNP, for an incidence of 0.8%. All patients with FNP had undergone catheterization of the MA, and the incidence of FNP in this group was 2.3% (3/133). One of the three patients with FNP had paralysis of the third branch of the trigeminal nerve. FNP occurred a mean of 8.7 days (range 5-11 days) after initial SSIAC, and the mean total dose of cisplatin was 55.8mg (range 42.5-67.2mg) and of docetaxel was 25.4mg (range 17.0-33.6mg). FNP resolved completely a mean of 12.7 months (range 6-19 months) after onset. Because the administration of anticancer agents via the MA or MMA carries a risk of FNP, this information will be useful when obtaining informed consent from patients before treatment. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Efficacy of superselective intra-arterial infusion chemotherapy with concomitant radiotherapy for advanced hypopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Bandoh, Nobuyuki; Takahara, Miki; Moriai, Shigetaka; Katayama, Akihiro; Katada, Akihiro; Hayashi, Tatsuya; Harabuchi, Yasuaki; Nagasawa, Kenichi

    2008-01-01

    Patients with advanced hypopharyngeal carcinoma still have a poor outcome in spite of radical surgery with chemoradiotherapy. We started superselective intra-arterial infusion chemotherapy with concomitant radiotherapy (IA chemoradiation) for advanced hypopharyngeal carcinoma in 2003. The complete response (CR) rate for local and neck lesions was 94.1% and 60%, respectively. After neck dissection the total CR rate was 82.4%. There was no significant difference in survival rates between groups with IA chemoradiation (n=22) and with surgery with preoperative chemoradiotherapy (n=57). However, Kaplan-Meier analysis showed that the cause-specific survival rate in N3 patients and larynx preservation rate was significantly higher in patients treated with IA chemoradiation than in those with surgery with preoperative chemoradiotherapy (p<0.05 and p<0.001). Subjective symptoms are not so severe in patients without the disease after IA chemoradiation. IA chemoradiation is effective for patients with advanced hypopharyngeal carcinoma to maintain quality of life such as voice and swallowing. (author)

  9. Effectiveness of intra-arterial anesthesia for uterine fibroid embolization using dilute lidocaine

    Energy Technology Data Exchange (ETDEWEB)

    Zhan, Songhua; Li, Yi; Wang, Guoliang; Han, Hongjie; Yang, Zhenyan [Tongji Hospital of Tongji University, Department of Radiology, Shanghai (China)

    2005-08-01

    A modified protocol of uterine fibroid embolization (UFE) is proposed for alleviating the postinterventional pain. This randomized and double-blinded clinical trial is to evaluate the effectiveness of intra-arterial infusion of dilute lidocaine for postinterventional pain relief in UFE. Forty-six patients who underwent UFE were randomly grouped equally. In the test group, after the poly(vinyl alcohol) embolization was complete, a dilute lidocaine solution with 40 mg in 6.0 ml, 3.0 ml for each side or 4.0 and 2.0 ml for two sides, was given through the catheter. In the control group, the patients received 6.0 ml of saline solution as a placebo. A simple pain degree classification method for patient self-evaluation was developed. A questionnaire was completed by each patient to record the degree of pain during five periods; these were during the procedure, the first 12 h, the second 12 h, between 24 and 48 h, and between 48 and 72 h. The numbers of patients with the same degree of pain in the five time segments from the two groups were statistically compared. Compared with the control group, the patients in the test group experienced less pain within 48 h after the procedure (p<0.01). The results suggest that this improved UFE protocol is a simple approach to prevent the acute postinterventional pain of UFE. (orig.)

  10. Intra-arterial blood pressure monitoring in the evaluation of the hypertensive athlete.

    Science.gov (United States)

    Palatini, P; Mos, L; Mormino, P; Munari, L; Del Torre, M; Valle, F; Scaldalai, E; Pessina, A C

    1990-04-01

    To compare the blood pressure (BP) changes during a long-distance run with those during bicycle ergometry, nine normotensive and 18 hypertensive joggers were studied by means of ambulatory intra-arterial monitoring. In all subjects the ergometric test caused a progressive increase in systolic and little change in diastolic BP. Exertional BP levels were closely related to pre-exercise baseline values (P less than 0.001). A different BP pattern was observed during track running, as a sharp rise in systolic BP reaching maximum values 2-4 min after the start was recorded. Subsequently, systolic BP progressively declined throughout the run, only to increase again during the final sprint. Diastolic BP fell markedly at the onset of the run and then remained substantially stable throughout. A poor relationship was observed between the BP values at peak exercise and baseline levels (P less than 0.05) as the normotensives showed a significantly higher BP response than the hypertensives. On the contrary, during the ergometric test a parallel increase in BP was recorded in the normotensive and the hypertensive joggers. No correlation was found between the BP response to track running and to bicycle ergometry. These results indicate that the BP response to a standard stress test is not predictive of the BP changes determined by a long-distance run. The BP increase with strenuous effort seems to be reduced in hypertensive individuals, probably because of latent impairment of cardiac performance.

  11. Intra-arterial cisplatin and concurrent radiation for invasive bladder cancer

    International Nuclear Information System (INIS)

    Miyanaga, Naoto; Ohtani, Mikinobu; Noguchi, Ryosuke

    1991-01-01

    Fifteen patients with invasive bladder cancer were treated with selective intra-arterial cisplatin and external beam radiotherapy (30.6 Gy over 3 weeks) prior to a planned cystectomy. Cisplatin, in total 200 mg, was administered via bilateral internal iliac artery infusion during the course of radiotherapy. Seven patients were evaluated for local response. Partial response (PR) was revealed in 4, and minor response (MR) in 3. Ten patients received total cystectomy, and pathological effects by the criteria adipted by Japanese Urological Association and The Japanese Society of Pathology, were as follows: Ef.3 in 1 case, Ef.2 in 6. Ef.1b in 1 and Ef.1a in 2. Down staging was observed in 8 patients from the clinical to the pathological stage. Thirteen patients are alive for 21 months. Two patients have died (1 lung infarction, 1 pancreatic cancer). Though nausea and sciatica-like pain were observed in some cases, there were no severe systemic side effects such as bone marrow suppression and renal toxicity. From these results it is concluded that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated. (author)

  12. TiO2microspheres containing magnetic nanoparticles for intra-arterial hyperthermia.

    Science.gov (United States)

    Kanetaka, Hiroyasu; Liu, Gengci; Li, Zhixia; Miyazaki, Toshiki; Furuya, Maiko; Kudo, Tada-Aki; Kawashita, Masakazu

    2017-11-01

    Magnetic microspheres measuring 15-35 µm in diameter are believed to be useful for intra-arterial hyperthermia. In this study, we attempted to prepare titanium dioxide (TiO 2 ) microspheres containing magnetic nanoparticles (MNPs). MNP-containing TiO 2 microspheres with diameters of approximately 30 µm were successfully obtained by sol-gel reaction of titanium tetraisopropoxide in a water-in-oil emulsion with added cosurfactant of 1-butanol and subsequent heat treatment at 200°C. The microspheres showed ferrimagnetism owing to high content of MNPs in approximately 60 wt % and had a low-crystalline TiO 2 matrix. Furthermore, the agar phantom was heated to above 43°C after approximately 1 min under an alternating magnetic field of 100 kHz and 300 Oe and showed in vitro biocompatibility similar to that of MNP-free TiO 2 microspheres. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2308-2314, 2017. © 2016 Wiley Periodicals, Inc.

  13. Intra-Arterial Prostaglandin E1 Infusion in Patients with Rest Pain: Short-Term Results

    Directory of Open Access Journals (Sweden)

    A. Chatziioannou

    2012-01-01

    Full Text Available Purpose. To present our results after short-term (1 month intra-arterial infusion therapy of PGE1-alprostadil via a port system implanted in the ipsilateral external iliac artery (EIA in patients with severe rest pain. Methods. Ten patients with severe rest pain were included. All patients showed extensive peripheral vascular disease below the knee. The tip of the catheter was introduced via a retrograde puncture in the ipsilateral external iliac artery (EIA. The patients received intraarterial infusion of PGE1, 20 mgr alprostadil daily, via the port catheter for 1 month. Results. Clinical success was evaluated according to subjective grading of pain (group A significant decrease, group B moderate decrease and group C no response. A significant decrease of rest pain was observed in 8 (group A, 80% patients, a moderate decrease in 2 (Group B, 20%, whereas no patients demonstrated any significant response. Both patients of group B had Buergers' disease and continue to smoke during therapy. No peripheral thrombosis or clinical deterioration was noticed. Conclusion. Intraarterial infusion of PGE1 alprostadil on a daily basis, using a port catheter into the ipsilateral EIA, in selected patients with severe rest pain, seems to be very effective, without any serious complications.

  14. Outcome of intra-arterial chemotherapy for retinoblastoma and its influencing factors: a retrospective study.

    Science.gov (United States)

    Chen, Miaojuan; Jiang, Hua; Zhang, Jing; Shen, Gang; Jiang, Yizhou; Li, Haibo; Liu, Zhenyin

    2017-09-01

    Intra-arterial chemotherapy (IAC) has become an essential technique for the treatment of advanced and relapsed intra-ocular retinoblastoma. The outcome of IAC for retinoblastoma is influenced by a variety of medical and non-medical factors. In this study, we aimed to examine the outcome of IAC and determine the factors influencing clinical outcome. A total of 107 eyes of 73 patients with retinoblastoma undergoing IAC between January 2011 and April 2013 were retrospectively reviewed for clinical outcomes. The factors influencing clinical outcomes were determined using univariate and multivariate analyses. After IAC, an overall globe salvage rate of 78.5% was observed during follow-up periods. Specifically, globe salvage was achieved in Group B (100%), Group C (100%), Group D (78.6%), and Group E (62%). Short-term ocular adverse events included eyelid oedema (14%), bulbar conjunctiva congestion (29.9%) and excessive tearing (9.3%). Long-term complications included vitreous haemorrhage (8.4%), subretinal haemorrhage (9.3%), retinal vasculopathy (7.5%) and ophthalmic artery spasm with reperfusion (4.7%). Univariate and multivariate analyses showed that the globe salvage of IAC was significantly associated with tumour staging and previous treatment (p retinoblastoma. Patients with advanced retinoblastoma and previous failed treatment may have a poor outcome after IAC. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  15. Favorable outcome of alternate systemic and intra-arterial chemotherapy for retinoblastoma.

    Science.gov (United States)

    Hahn, Seung Min; Kim, Hyo Sun; Kim, Dong Joon; Lee, Sung Chul; Lyu, Chuhl Joo; Han, Jung Woo

    2016-02-01

    The recent trend of treatment for retinoblastoma is to salvage the eye globes as well as achieving patients' survival. Intra-arterial chemotherapy (IAC) is one of the current standard treatment; however, it cannot exclude the risk of occult micrometastases in the central nervous system in advanced-stage retinoblastoma. Alternate fashion of intravenous chemotherapy (IVC) and IAC strategy was developed to increase the eye salvage rate and to reduce the metastatic risk. Between January 2012 and December 2014, 13 eyes of 12 patients with newly diagnosed retinoblastoma received alternate chemotherapy using IVC and IAC in Yonsei Cancer Center. Eye salvage rate was assessed by the eye preservation time, which was defined as the duration from the diagnosis to the time of enucleation. Total 13 eyes were classified according to the International Classification of Retinoblastoma (ICRB) as group B (n = 1, 7.7%), group C (n = 2, 15.4%), group D (n = 5, 38.5%), or group E (n = 5, 38.5%). IAC was performed, 3 to 5 times (median: 4 times) for each eye, total 54 times. Five to 15 courses (median: 8 courses) of systemic chemotherapy were performed in the patients. During the median follow-up period of 30.4 months, overall eye salvage rate was 63.9 ± 14.7%. All patients survived. The treatment was tolerable without significant complications. These results showed that primary alternate IVC-IAC was tolerable and effective for retinoblastoma.

  16. Intra-arterial cisplatin and concurrent radiation for invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Miyanaga, Naoto; Ohtani, Mikinobu; Noguchi, Ryosuke (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine) (and others)

    1991-10-01

    Fifteen patients with invasive bladder cancer were treated with selective intra-arterial cisplatin and external beam radiotherapy (30.6 Gy over 3 weeks) prior to a planned cystectomy. Cisplatin, in total 200 mg, was administered via bilateral internal iliac artery infusion during the course of radiotherapy. Seven patients were evaluated for local response. Partial response (PR) was revealed in 4, and minor response (MR) in 3. Ten patients received total cystectomy, and pathological effects by the criteria adipted by Japanese Urological Association and The Japanese Society of Pathology, were as follows: Ef.3 in 1 case, Ef.2 in 6. Ef.1b in 1 and Ef.1a in 2. Down staging was observed in 8 patients from the clinical to the pathological stage. Thirteen patients are alive for 21 months. Two patients have died (1 lung infarction, 1 pancreatic cancer). Though nausea and sciatica-like pain were observed in some cases, there were no severe systemic side effects such as bone marrow suppression and renal toxicity. From these results it is concluded that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated. (author).

  17. Reassessing the Role of Intra-Arterial Drug Delivery for Glioblastoma Multiforme Treatment

    Directory of Open Access Journals (Sweden)

    Jason A. Ellis

    2015-01-01

    Full Text Available Effective treatment for glioblastoma (GBM will likely require targeted delivery of several specific pharmacological agents simultaneously. Intra-arterial (IA delivery is one technique for targeting the tumor site with multiple agents. Although IA chemotherapy for glioblastoma (GBM has been attempted since the 1950s, the predicted benefits remain unproven in clinical practice. This review focuses on innovative approaches to IA drug delivery in treating GBM. Guided by novel in vitro and in vivo optical measurements, newer pharmacokinetic models promise to better define the complex relationship between background cerebral blood flow and drug injection parameters. Advanced optical technologies and tracers, unique nanoparticles designs, new cellular targets, and rational drug formulations are continuously modifying the therapeutic landscape for GBM. Personalized treatment approaches are emerging; however, such tailored approaches will largely depend on effective drug delivery techniques and on the ability to simultaneously deliver multidrug regimens. These new paradigms for tumor-selective drug delivery herald dramatic improvements in the effectiveness of IA chemotherapy for GBM. Therefore, within this context of so-called “precision medicine,” the role of IA delivery for GBM is thoroughly reassessed.

  18. Eating and swallowing ability after treatment for head and neck cancers with superselective intra-arterial chemoradiotherapy

    International Nuclear Information System (INIS)

    Akisada, Takeshi; Harada, Tamotsu; Aihara, Teruhito; Uno, Masako; Imai, Shigeki; Hiratsuka, Junichi; Hiraoka, Takashi; Kumakura, Isami

    2008-01-01

    The objective of this study was to evaluate the preservation of eating and swallowing function following the use of superselective intra-arterial chemoradiotherapy for advanced head and neck cancers. Among the 96 Patients receiving concomitant radiation and intra-arterial docetaxel, systemic cisplatin and 5-fluorouracil (FU) chemotherapy, the videofluoroscopic and videoendoscopy findings and results of a questionnaire were evaluated. A Videofluoroscopic examination revealed an improved swallow function in 2 of 13, no change in 4, slightly worse in 5 and worse in 2 patients. Following treatment, the incidence of aspiration increased in four patients. Videoendoscopy revealed a residual of vallecula in few cases. Most of the patients were able to swallow after chemoradiation. The questionnaire results showed that the eating and swallowing functions were well preserved in almost 80% of the patients. The new chemoradiation protocol is thus considered to be equivalent to the other treatment modalities for maintaining the functions of eating and swallowing. (author)

  19. Successful Thrombolysis and Spasmolysis of Acute Leg Ischemia after Accidental Intra-arterial Injection of Dissolved Flunitrazepam Tablets

    International Nuclear Information System (INIS)

    Radeleff, B.; Stampfl, U.; Sommer, C.-M.; Bellemann, N.; Hyhlik-Duerr, A.; Weber, M.-A.; Boeckler, D.; Kauczor, H.-U.

    2011-01-01

    A 37-year-old man with known intravenous drug abuse presented in the surgical ambulatory care unit with acute leg ischemia after accidental intra-arterial injection of dissolved flunitrazepam tablets into the right femoral artery. A combination of anticoagulation, vasodilatation, and local selective and superselective thrombolysis with urokinase was performed to salvage the leg. As a result of the severe ischemia-induced pain, the patient had to be monitored over the complete therapy period on the intensive care unit with permanent administration of intravenous fluid and analgetics. We describe the presenting symptoms and the interventional technique, and we discuss the recent literature regarding the management of accidental intra-arterial injection of dissolved flunitrazepam tablets.

  20. Regional cerebral blod flow studied by xenon-133. Intra-arterial injection studies and inhalation studies using emission tomography

    DEFF Research Database (Denmark)

    Lassen, N A

    1980-01-01

    .) technique is insensitive both to hyperemia and ischemia yielding essentially only a mean flow value. A new rapidly moving single photon tomograph following D. Kuhl's principle is presented applicable to Xe-133. Preliminary clinical data show that this technique is able to detect ischemic areas both with Xe......A survey of the Xenon-133 techniques for measurement of regional cerebral blood flow, rCBF, in man is presented. The intra-arterial Xe-133 injection method is very sensitive for detecting even small hyperemic areas, but cannot "see" smaller ischemic areas. The Xe-133 inhalation (or i.v. inj......-133 intra-arterial injection and with Xe-133 inhalation. The practical and economic advantages of Xe-133 or Xe-127 tomography over positron tomography for rCBF are discussed....

  1. Comparison of classification methods for voxel-based prediction of acute ischemic stroke outcome following intra-arterial intervention

    Science.gov (United States)

    Winder, Anthony J.; Siemonsen, Susanne; Flottmann, Fabian; Fiehler, Jens; Forkert, Nils D.

    2017-03-01

    Voxel-based tissue outcome prediction in acute ischemic stroke patients is highly relevant for both clinical routine and research. Previous research has shown that features extracted from baseline multi-parametric MRI datasets have a high predictive value and can be used for the training of classifiers, which can generate tissue outcome predictions for both intravenous and conservative treatments. However, with the recent advent and popularization of intra-arterial thrombectomy treatment, novel research specifically addressing the utility of predictive classi- fiers for thrombectomy intervention is necessary for a holistic understanding of current stroke treatment options. The aim of this work was to develop three clinically viable tissue outcome prediction models using approximate nearest-neighbor, generalized linear model, and random decision forest approaches and to evaluate the accuracy of predicting tissue outcome after intra-arterial treatment. Therefore, the three machine learning models were trained, evaluated, and compared using datasets of 42 acute ischemic stroke patients treated with intra-arterial thrombectomy. Classifier training utilized eight voxel-based features extracted from baseline MRI datasets and five global features. Evaluation of classifier-based predictions was performed via comparison to the known tissue outcome, which was determined in follow-up imaging, using the Dice coefficient and leave-on-patient-out cross validation. The random decision forest prediction model led to the best tissue outcome predictions with a mean Dice coefficient of 0.37. The approximate nearest-neighbor and generalized linear model performed equally suboptimally with average Dice coefficients of 0.28 and 0.27 respectively, suggesting that both non-linearity and machine learning are desirable properties of a classifier well-suited to the intra-arterial tissue outcome prediction problem.

  2. Changes in distribution of hepatic blood flow induced by intra-arterial infusion of angiotensin II in human hepatic cancer

    International Nuclear Information System (INIS)

    Sasaki, Y.; Imaoka, S.; Hasegawa, Y.

    1985-01-01

    Changes in the distribution of the hepatic blood flow induced by intra-arterial infusion of angiotensin II (AT-II) were studied in human hepatic cancers using extremely short-lived radioisotope (RI) (krypton 81 m [/sup 81m/Kr]; half-life, 13 seconds). After the start of continuous infusion of AT-II, the radioactivity of the tumor showed about a two-fold increase, whereas that of the nontumor region decreased to about one half as much as the level before the infusion. Consequently, the mean ratio of the arterial blood flow in the tumor region to that in the nontumor region (T/N ratio) increased to 3.30 (P less than 0.001). The T/N ratio showed a peak before the peripheral blood pressure reached the maximum, and thereafter tended to decrease. Intra-arterial infusion of AT-II raised the T/N ratio more obviously than did intravenous infusion of the drug, with less rise in the peripheral blood pressure. It is believed that intra-arterial infusion chemotherapy with local use of AT-II enables better accessibility of chemotherapeutic drugs to tumors

  3. Intra-arterial and intra-venous chemotherapy combined with radiation in the treatment of brain tumours

    International Nuclear Information System (INIS)

    Watne, K.

    1992-01-01

    The present investigations were undertaken to study the effect of combining different modalities of chemotherapy with radiation in post-operative treatment of brain tumours. The conclusions and clinical implication of the investigations are as follows: The combination of combined intra-arterial chemotherapy followed by radiation leads to an increased median survival with more long term survivors in patients with anaplastic astrocytomas and in patients older than 40 years with astrocytomas. In patients with glioblastoma multiforme, this modality of treatment do not improve median survival, but an increased number of long-term survivors may be seen. Patients younger than 40 years with astrocytomas do not benefit from this modality of treatment. A parallelism exists between sensitivity to chemotherapy and response to radiotherapy. Patients who will benefit from the treatment may be selected early, normally two months after treatment start. Combining intra-arterial chemotherapy and radiation does not lead to an increased incidence of adverse CNS reactions. Specific transient abnormalities in the brain may occur during the first year after treatment and may be misinterpreted as tumour recurrence. EEG may be valuable in predicting adverse CNS reactions following treatment. Nuclear brain scan may be of valuable in selecting the patients who are in danger of developing adverse CNS reactions. Intra-arterial chemotherapy does have an effect in patients with brain tumours who have recurrent tumour after radiation. The most important prognostic factors are age, corticosteroid dependency at treatment start, performance status, histology and frontal lobe location. 103 refs., 2 tabs

  4. Quantitative analysis of errors in alveolar crest level caused by discrepant projection geometry in digital subtraction radiography: an in vivo study.

    Science.gov (United States)

    Huh, Kyung-Hoe; Lee, Sam-Sun; Jeon, In-Seong; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul

    2005-12-01

    This study compared the difference between 3 intraoral radiographic techniques on digital subtraction radiography (DSR) in vivo that are commonly used in a clinical setting. We evaluated and statistically analyzed the errors in the DSR image in 6 regions with 3 radiographic techniques: paralleling technique with a bite block attached to XCP, paralleling technique using XCP, and bisecting-angle technique. The amount of error using the bisecting-angle technique was too large for DSR, compared to that of the paralleling technique with a bite block attached to XCP. In the mandibular anterior region, the paralleling technique using XCP was not different from paralleling technique with a bite block attached to XCP. The lowest degree of error was present in the anterior region whereas the highest was present in the molar region. Bisecting-angle technique should be avoided, and paralleling technique using XCP can be used in the mandibular anterior region for DSR.

  5. Tests of variable-band multilayers designed for investigating optimal signal-to-noise vs artifact signal ratios in Dual-Energy Digital Subtraction Angiography (DDSA) imaging systems

    International Nuclear Information System (INIS)

    Boyers, D.; Ho, A.; Li, Q.; Piestrup, M.; Rice, M.; Tatchyn, R.

    1993-08-01

    In recent work, various design techniques were applied to investigate the feasibility of controlling the bandwidth and bandshape profiles of tungsten/boron-carbon (W/B 4 C) and tungsten/silicon (W/Si) multilayers for optimizing their performance in synchrotron radiation based angiographical imaging systems at 33 keV. Varied parameters included alternative spacing geometries, material thickness ratios, and numbers of layer pairs. Planar optics with nominal design reflectivities of 30%--94% and bandwidths ranging from 0.6%--10% were designed at the Stanford Radiation Laboratory, fabricated by the Ovonic Synthetic Materials Company, and characterized on Beam Line 4-3 at the Stanford Synchrotron Radiation Laboratory, in this paper we report selected results of these tests and review the possible use of the multilayers for determining optimal signal to noise vs. artifact signal ratios in practical Dual-Energy Digital Subtraction Angiography systems

  6. [Intra-arterial regional chemotherapy and intensive loco-regional radiotherapy in the treatment of locally advanced cancer of the breast].

    Science.gov (United States)

    Nicolato, A

    1990-09-01

    A multimodal treatment combining intra-arterial chemotherapy and intensive loco-regional radiotherapy was administered to 55 patients with locally advanced breast cancer. Adjuvant polychemotherapy followed, and eventually endocrino-therapy. Combined intra-arterial chemotherapy and intensive radiotherapy gave excellent results in both primary and lymph node lesions, with 90.9% and 92.2% complete/partial response rates. Three-year and 5-year actuarial survival rates were 69% and 59%, respectively. Patients showing better local responses to combined intra-arterial chemotherapy and intensive radiotherapy had longer survival and less frequent local recurrences. Combined intra-arterial chemotherapy and intensive loco-regional radiotherapy seems to be an effective modality for the treatment of locally advanced breast cancer.

  7. Hydraulic and hemodynamic performance of a minimally invasive intra-arterial right ventricular assist device.

    Science.gov (United States)

    Hsu, Po-Lin; Graefe, Roland; Boehning, Fiete; Wu, Chen; Parker, Jack; Autschbach, Rüdiger; Schmitz-Rode, Thomas; Steinseifer, Ulrich

    2014-09-01

    Right ventricular assistance is still in the early phase of development compared to left ventricular assist device (LVAD) technology. In order to provide flexible pulmonary support and potentially reduce the known complications, we propose a minimally invasive right ventricular assist device (MIRVAD), located in the pulmonary artery (PA) and operating in series with the right ventricle (RV). The MIRVAD is an intra-arterial rotary blood pump containing a single axial impeller, which is not enclosed by a rigid housing but stent-fixed within the vessel. The impeller geometry has been designed with the assistance of analytical methods and computational fluid dynamics (CFD). The hydraulic performance of the impeller was evaluated experimentally with a customized test setup using blood synthetic medium (HES). The blade-tip clearance (BTC) was varied between 0.25-4.25 mm to evaluate the effect of different PA sizes on impeller performance. Furthermore, the Langrangian particle-tracking method was used to estimate the level of hemolysis and generate numerical blood damage indexes.The impeller design generated 25.6 mmHg for flow rates of 5 lpm at a speed of 6,000 rpm at the baseline condition, capable of providing sufficient support for the RV. The BTC presented a significant effect on the static pressure generation and the efficiency, but the operational range is suitable for most vessel sizes. The numerical results demonstrated a low risk of blood damage at the design point (mean Lagrangian damage index 2.6*10(-7)). The preliminary results have encouraged further impeller optimization and development of the MIRVAD.

  8. Intra-Arterial Chemotherapy with Doxorubicin and Cisplatin Is Effective for Advanced Hepatocellular Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Ming-Chun Ma

    2014-01-01

    Full Text Available Advanced hepatocellular carcinoma (HCC remains a fatal disease even in the era of targeted therapies. Intra-arterial chemotherapy (IACT can provide therapeutic benefits for patients with locally advanced HCC who are not eligible for local therapies or are refractory to targeted therapies. The aim of this retrospective study was to analyze the effect of IACT with cisplatin and doxorubicin on advanced HCC. Methods. Patients with advanced HCC who were not eligible for local therapies or were refractory to sorafenib received doxorubicin (50 mg/m2 and cisplatin (50 mg/m2 infusions into the liver via the transhepatic artery. Between January 2005 and December 2011, a total of 50 patients with advanced HCC received this treatment regimen. The overall response rate (ORR was 22% in all treated patients. In patients who received at least 2 cycles of IACT, the ORR was 36.7%, and the disease control rate was 70%. Survival rate differed significantly between patients who received only one cycle of IACT (group I and those who received several cycles (group II. The median progression-free survival was 1.3 months and 5.8 months in groups I and II, respectively (P<0.0001. The median overall survival was 8.3 months for all patients and was 3.1 months and 12.0 months in groups I and II, respectively (P<0.0001. The most common toxicity was alopecia. Four patients developed grade 3 or 4 leukopenia. Worsening of liver function, nausea, and vomiting were uncommon side effects. This study demonstrated clinical efficacy and tolerable side effects of repeated IACT with doxorubicin and cisplatin in advanced HCC. Our regimen can be an alternative choice for patients with adequate liver function who do not want to receive continuous infusion of IACT.

  9. Feeding Arteries of Primary Tongue Cancers on Intra-arterial Infusion Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kamitani, Takeshi, E-mail: kamitani@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Kawanami, Satoshi, E-mail: kawanami-01@mac.com [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences (Japan); Asayama, Yoshiki, E-mail: asayama@radiol.med.kyushu-u.ac.jp; Matsuo, Yoshio, E-mail: yymatsuo@radiol.med.kyushu-u.ac.jp; Yonezawa, Masato, E-mail: ymasato@radiol.med.kyushu-u.ac.jp; Yamasaki, Yuzo, E-mail: yyama@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences (Japan); Yamanouchi, Torahiko, E-mail: tora0228@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Yabuuchi, Hidetake, E-mail: h-yabu@med.kyushu-u.ac.jp [Kyushu University, Department of Health Sciences, Graduate School of Medical Sciences (Japan); Nakamura, Katsumasa, E-mail: nakam@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan); Nakashima, Torahiko, E-mail: nakatora@qent.med.kyushu-u.ac.jp [Kyushu University, Department of Otorhinolaryngology, Graduate School of Medical Sciences (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.jp [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences (Japan)

    2016-02-15

    PurposeTo evaluate the frequency and the predictive factor of each feeding artery on intra-arterial infusion chemotherapy (IAIC) in primary tongue cancer.Materials and MethodsWe retrospectively evaluated 20 patients who received IAIC for primary tongue cancer. The main and accompanying feeding arteries were identified on super-selective angiography of the branches of the external carotid artery. Tumor diameter, and extension to the contralateral side, tongue extrinsic muscles (TEMs), and lateral mesopharyngeal wall were determined based on magnetic resonance imaging or computed tomography findings.ResultsThe main feeding artery was the ipsilateral lingual artery (LA) in 15 of the 20 examined tumors and the contralateral LA in the other 5. Ten cancers had only one feeding artery, and multiple feeding arteries were detected in the remaining 10. Tumors >4 cm (n = 9), those with extension to the contralateral side (n = 13), and those with extension to TEMs (n = 15) were supplied by significantly larger numbers of feeding arteries compared to tumors without these features (P = 0.01, 0.049, and 0.02, respectively). The frequency of feeding from the contralateral LA was 64 % (9/14) and 17 % (1/6) in tumors with and without extension to the contralateral side, respectively. Feeding from a facial artery (FA) was not detected in tumors ≤4 cm, while 5 of the 9 (56 %) tumors >4 cm were supplied by a FA (P = 0.01).ConclusionA careful search for feeding arteries is required, especially in large tumors with extension to the contralateral side or to TEMs.

  10. Collateral status and tissue outcome after intra-arterial therapy for patients with acute ischemic stroke.

    Science.gov (United States)

    Boers, Anna Mm; Jansen, Ivo Gh; Berkhemer, Olvert A; Yoo, Albert J; Lingsma, Hester F; Slump, Cornelis H; Roos, Yvo Bwem; van Oostenbrugge, Robert J; Dippel, Diederik Wj; van der Lugt, Aad; van Zwam, Wim H; Marquering, Henk A; Majoie, Charles Blm

    2017-11-01

    Intra-arterial therapy (IAT) for ischemic stroke aims to save brain tissue. Collaterals are thought to contribute to prolonged penumbra sustenance. In this study, we investigate the effect of collateral status on brain tissue salvage with IAT. In 500 patients randomized between IAT and standard care, collateral status was graded from 0 (absent) to 3 (good). Final infarct volumes (FIV) were calculated on post-treatment CT. FIVs were compared between treatment groups per collateral grade. Multivariable linear regression with interaction terms was performed to study whether collaterals modified IAT effect on FIV. Four-hundred-forty-nine patients were included in the analysis. Median FIV for the IAT group was significantly lower with 54.5 mL (95% IQR: 21.8-145.0) than for the controls with 81.8 mL (95% IQR: 40.0-154.0) ( p = 0.020). Treatment effect differed across collateral grades, although there was no significant interaction (unadjusted p = 0.054; adjusted p = 0.105). For grade 3, IAT resulted in a FIV reduction of 30.1 mL ( p = 0.024). For grade 2 and 1, this difference was, respectively, 28.4 mL ( p = 0.028) and 28.4 mL ( p = 0.29). For grade 0, this was 88.6 mL ( p = 0.28) in favour of controls. IAT saves substantially more brain tissue as compared to standard care. We observed a trend of increasing effect of IAT with higher collateral grades.

  11. Prevalence and rupture rate of cerebral aneurysms discovered during intra-arterial chemotherapy of brain tumors.

    Science.gov (United States)

    Bourekas, E C; Newton, H B; Figg, G M; Slone, H W

    2006-02-01

    During the administration of intra-arterial (IA) chemotherapy for the treatment of brain tumors (BTs), angiography may demonstrate asymptomatic, incidental cerebral aneurysms. The prevalence and complication rate of incidental aneurysms in patients undergoing IA chemotherapy remains unknown. It remains unclear whether the presence of an aneurysm represents an increased risk or a contraindication to this form of treatment. We performed a chart and angiography review of BT patients receiving IA chemotherapy over the previous 16 months. Seventy-eight patients were identified with primary (39) and metastatic (39) BTs. The cohort consisted of 40 men and 38 women, with a mean age of 47.8 years (range, 22-80 years). During initial angiography, 8 patients (10.3%) were identified with incidental cerebral aneurysms. The aneurysms were saccular and varied in size from 2-4 mm (mean, 3 mm). Seven of the 8 patients continued IA chemotherapy after detection of the aneurysm, for a total of 35 IA procedures. Of these 7 patients, 5 expired from nonaneurysmal complications (mean survival, 5.4 months; range, 2-10 months); 4 from the primary tumor, and one from an infected craniotomy site. Two patients continue to survive; one remains in treatment, and the other has completed 12 months of IA therapy. There were no aneurysmal complications during or after IA treatment in any of the BT patients. Incidental aneurysms may be more common in patients with BTs than the general population. In our patient population, there was no indication that an incidental aneurysm was reason to preclude or delay the use of IA chemotherapy.

  12. Combined, sequential intravenous and intra-arterial chemotherapy (bridge chemotherapy for young infants with retinoblastoma.

    Directory of Open Access Journals (Sweden)

    Y Pierre Gobin

    Full Text Available BACKGROUND: Intra-arterial (i.a. chemotherapy has more risks of procedural complications in neonates and young infants. For these reasons, we have developed a strategy of bridge intravenous single agent chemotherapy to postpone i.a. chemotherapy in these children PROCEDURE: Neonates and young infants with retinoblastoma who required chemotherapy were treated with systemic carboplatin chemotherapy (18.7 mg/kg i.v. every 3-4 weeks until they reached the age of 3 months and a weight of 6 Kg. If necessary, i.a. chemotherapy was subsequently performed at 4 weeks intervals. Efficacy was judged by tumor regression on ophthalmological examination. Retinal toxicity was judged by electroretinography. RESULTS: Eleven children (19 eyes were treated. All patients are alive and no patient has developed metastatic disease or second malignancies (mean follow-up 27 months, range 9-46 months. Intravenous carboplatin (median 2 cycles, range 1-5 combined with cryotherapy and laser was given to all children. This was effective for five eyes, which did not require i.a. chemotherapy. I.a. chemotherapy was administered to 14 eyes (median 3.5 cycles per eye, range 1 to 6. No radiation therapy was required. The Kaplan Meier estimate of ocular radiation-free survival was 94.7% at one year (95% confidence interval 68.1-99.2%. One eye was enucleated due to tumor progression. ERG showed no deterioration of retinal function. CONCLUSION: Bridge i.v.-i.a. chemotherapy was feasible and safe, and is a promising strategy to treat retinoblastoma in neonates and young infants.

  13. Application of neutron capture autoradiography to Boron Delivery seeking techniques for selective accumulation of boron compounds to tumor with intra-arterial administration of boron entrapped water-in-oil-in-water emulsion

    Science.gov (United States)

    Mikado, S.; Yanagie, H.; Yasuda, N.; Higashi, S.; Ikushima, I.; Mizumachi, R.; Murata, Y.; Morishita, Y.; Nishimura, R.; Shinohara, A.; Ogura, K.; Sugiyama, H.; Iikura, H.; Ando, H.; Ishimoto, M.; Takamoto, S.; Eriguchi, M.; Takahashi, H.; Kimura, M.

    2009-06-01

    It is necessary to accumulate the 10B atoms selectively to the tumor cells for effective Boron Neutron Capture Therapy (BNCT). In order to achieve an accurate measurement of 10B accumulations in the biological samples, we employed a technique of neutron capture autoradiography (NCAR) of sliced samples of tumor tissues using CR-39 plastic track detectors. The CR-39 track detectors attached with the biological samples were exposed to thermal neutrons in the thermal column of the JRR3 of Japan Atomic Energy Agency (JAEA). We obtained quantitative NCAR images of the samples for VX-2 tumor in rabbit liver after injection of 10BSH entrapped water-in-oil-in-water (WOW) emulsion by intra-arterial injection via proper hepatic artery. The 10B accumulations and distributions in VX-2 tumor and normal liver of rabbit were investigated by means of alpha-track density measurements. In this study, we showed the selective accumulation of 10B atoms in the VX-2 tumor by intra-arterial injection of 10B entrapped WOW emulsion until 3 days after injection by using digitized NCAR images (i.e. alpha-track mapping).

  14. Application of neutron capture autoradiography to Boron Delivery seeking techniques for selective accumulation of boron compounds to tumor with intra-arterial administration of boron entrapped water-in-oil-in-water emulsion

    International Nuclear Information System (INIS)

    Mikado, S.; Yanagie, H.; Yasuda, N.; Higashi, S.; Ikushima, I.; Mizumachi, R.; Murata, Y.; Morishita, Y.; Nishimura, R.; Shinohara, A.; Ogura, K.; Sugiyama, H.; Iikura, H.; Ando, H.; Ishimoto, M.; Takamoto, S.; Eriguchi, M.; Takahashi, H.; Kimura, M.

    2009-01-01

    It is necessary to accumulate the 10 B atoms selectively to the tumor cells for effective Boron Neutron Capture Therapy (BNCT). In order to achieve an accurate measurement of 10 B accumulations in the biological samples, we employed a technique of neutron capture autoradiography (NCAR) of sliced samples of tumor tissues using CR-39 plastic track detectors. The CR-39 track detectors attached with the biological samples were exposed to thermal neutrons in the thermal column of the JRR3 of Japan Atomic Energy Agency (JAEA). We obtained quantitative NCAR images of the samples for VX-2 tumor in rabbit liver after injection of 10 BSH entrapped water-in-oil-in-water (WOW) emulsion by intra-arterial injection via proper hepatic artery. The 10 B accumulations and distributions in VX-2 tumor and normal liver of rabbit were investigated by means of alpha-track density measurements. In this study, we showed the selective accumulation of 10 B atoms in the VX-2 tumor by intra-arterial injection of 10 B entrapped WOW emulsion until 3 days after injection by using digitized NCAR images (i.e. alpha-track mapping).

  15. Application of neutron capture autoradiography to Boron Delivery seeking techniques for selective accumulation of boron compounds to tumor with intra-arterial administration of boron entrapped water-in-oil-in-water emulsion

    Energy Technology Data Exchange (ETDEWEB)

    Mikado, S. [Physical Science Laboratories, College of Industrial Technology, Nihon University, Chiba (Japan)], E-mail: mikado@cit.nihon-u.ac.jp; Yanagie, H. [Department of Nuclear Engineering and Management, University of Tokyo, Tokyo (Japan); Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Yasuda, N. [Fundamental Technology Center, National Institute of Radiological Sciences, Chiba (Japan); Higashi, S.; Ikushima, I. [Miyakonojyo Metropolitan Hospital, Miyazaki (Japan); Mizumachi, R.; Murata, Y. [Department of Pharmacology, Kumamoto Institute Branch, Mitsubishi Chemical Safety Institute Ltd., Kumamoto (Japan); Morishita, Y. [Department of Human and Molecular Pathology, University of Tokyo, Tokyo (Japan); Nishimura, R. [Faculty of Agriculture, Laboratory of Veterinary Surgery, University of Tokyo (Japan); Shinohara, A. [Department of Humanities, The Graduate School of Seisen University, Tokyo (Japan); Ogura, K. [Physical Science Laboratories, College of Industrial Technology, Nihon University, Chiba (Japan); Sugiyama, H. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Iikura, H.; Ando, H. [Japan Atomic Energy Agency, Ibaraki (Japan); Ishimoto, M. [Department of Nuclear Professional School, University of Tokyo (Japan); Takamoto, S. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo (Japan); Eriguchi, M. [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Department of Microbiology, Syowa University School of Pharmaceutical Sciences, Tokyo (Japan); Takahashi, H. [Department of Nuclear Engineering and Management, University of Tokyo, Tokyo (Japan); Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Kimura, M. [Department of Physics, Toho University, Chiba (Japan)

    2009-06-21

    It is necessary to accumulate the {sup 10}B atoms selectively to the tumor cells for effective Boron Neutron Capture Therapy (BNCT). In order to achieve an accurate measurement of {sup 10}B accumulations in the biological samples, we employed a technique of neutron capture autoradiography (NCAR) of sliced samples of tumor tissues using CR-39 plastic track detectors. The CR-39 track detectors attached with the biological samples were exposed to thermal neutrons in the thermal column of the JRR3 of Japan Atomic Energy Agency (JAEA). We obtained quantitative NCAR images of the samples for VX-2 tumor in rabbit liver after injection of {sup 10}BSH entrapped water-in-oil-in-water (WOW) emulsion by intra-arterial injection via proper hepatic artery. The {sup 10}B accumulations and distributions in VX-2 tumor and normal liver of rabbit were investigated by means of alpha-track density measurements. In this study, we showed the selective accumulation of {sup 10}B atoms in the VX-2 tumor by intra-arterial injection of {sup 10}B entrapped WOW emulsion until 3 days after injection by using digitized NCAR images (i.e. alpha-track mapping)

  16. Clinically useful dilution factors for iodine and gadolinium contrast material: an animal model of pediatric digital subtraction angiography using state-of-the-art flat-panel detectors.

    Science.gov (United States)

    Racadio, John M; Kashinkunti, Soumya R; Nachabe, Rami A; Racadio, Judy M; Johnson, Neil D; Kukreja, Kamlesh U; Patel, Manish N; Privitera, Mary Beth; Hales, Jasmine E; Abruzzo, Todd A

    2013-11-01

    Iodinated and gadolinium contrast agents pose some risk for certain pediatric patients, including allergic-like reactions, contrast-induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF). Digital flat-panel detectors enhance image quality during angiography and might allow use of more dilute contrast material to decrease risk of complications that might be dose-dependent, such as CIN and NSF. To assess the maximum dilution factors for iodine- and gadolinium-based contrast agents suitable for vascular imaging with fluoroscopy and digital subtraction angiography (DSA) on digital flat-panel detectors in an animal model. We performed selective catheterization of the abdominal aorta, renal artery and common carotid artery on a rabbit. In each vessel we performed fluoroscopy and DSA during contrast material injection using iodinated and gadolinium contrast material at 100%, 80%, 50%, 33% and 20% dilutions. An image quality score (0 to 3) was assigned by each of eight evaluators. Intracorrelation coefficient, paired t-test, one-way repeated analysis of variance, Spearman correlation and receiver operating characteristic curve analysis were applied to the data. Overall the image quality scores correlated linearly with dilution levels. For iodinated contrast material, the optimum cut-off level for DSA when a score of at least 2 is acceptable is above 33%; it is above 50% when a score of 3 is necessary. For gadolinium contrast material, the optimum cut-off for DSA images is above 50% when a score of at least 2 is acceptable and above 80% when a score of 3 is necessary. Knowledge of the relationship between image quality and contrast material dilution might allow a decrease in overall contrast load while maintaining appropriate image quality when using digital flat-panel detectors.

  17. Intra-arterial thrombolysis vs. standard treatment or intravenous thrombolysis in adults with acute ischemic stroke: a systematic review and meta-analysis.

    Science.gov (United States)

    Nam, Julian; Jing, He; O'Reilly, Daria

    2015-01-01

    Recent evidence has suggested that intra-arterial thrombolysis may provide benefit beyond intravenous thrombolysis in ischemic stroke patients. Previous meta-analyses have only compared intra-arterial thrombolysis with standard treatment without thrombolysis. The objective was to review the benefits and harms of intra-arterial thrombolysis in ischemic stroke patients. We undertook a meta-analysis of randomized controlled trials comparing the efficacy and safety of intra-arterial thrombolysis with either standard treatment or intravenous thrombolysis following acute ischemic stroke. Primary outcomes included poor functional outcomes (modified Rankin Scale 3-6), mortality, and symptomatic intracranial hemorrhage. Study quality was assessed, and outcomes were stratified by comparison treatment received. Four trials (n = 351) comparing intra-arterial thrombolysis with standard treatment were identified. Intra-arterial thrombolysis reduced the risk of poor functional outcomes (modified Rankin Scale 3-6) [relative risk (RR) = 0·80; 95% confidence interval = 0·67-0·95; P = 0·01]. Mortality was not increased (RR = 0·82; 95% confidence interval = 0·56-1·21; P = 0·32); however, risk of symptomatic intracranial hemorrhage was nearly four times more likely (RR = 3·90; 95% confidence interval = 1·41-10·76; P = 0·006). Two trials (n = 81) comparing intra-arterial thrombolysis with intravenous thrombolysis were identified. Intra-arterial thrombolysis was not found to reduce poor functional outcomes (modified Rankin Scale 3-6) (RR = 0·68; 95% confidence interval = 0·46-1·00; P = 0·05). Mortality was not increased (RR = 1·12; 95% confidence interval = 0·47-2·68; P = 0·79); neither was symptomatic intracranial hemorrhage (RR = 1·13; 95% confidence interval = 0·32-3·99; P = 0·85). Differences in time from symptom onset-to-treatment and type of thrombolytic administered were found

  18. Computational fluid dynamics study of intra-arterial chemotherapy for oral cancer.

    Science.gov (United States)

    Kitajima, Hiroaki; Oshima, Marie; Iwai, Toshinori; Ohhara, Yoshihito; Yajima, Yasuharu; Mitsudo, Kenji; Tohnai, Iwai

    2017-05-15

    Intra-arterial chemotherapy (IAC) for oral cancer can deliver a higher concentration of anticancer agent into a tumor-feeding artery than intravenous systemic chemotherapy. However, distribution of anticancer agent into several branches of the external carotid artery (ECA) in IAC has not demonstrated sufficient treatment efficacy. To improve the effectiveness of IAC, the flow distribution of anticancer agent into the branches of the ECA in several IAC methods was investigated using computational fluid dynamics (CFD). Patient-specific three-dimensional vessel models were created from CT images of 2 patients with tongue cancer. Catheter models were combined with the vessel models. Thirty-two models were generated with varying vertical and horizontal positions of the catheter tip. With the use of a zero-dimensional resistance model of the peripheral vessel network, conventional IAC and superselective IAC were simulated in 30 and 2 models, respectively. The flow distribution of anticancer agent into the branches of the ECA was investigated in 32 models. Additionally, the blood streamline was traced from the inlet of the common carotid artery toward each outlet to examine the flow of anticancer agent in all models, and the wall shear stress of the vessel was calculated for some models. The CFD simulations could be conducted within a reasonable computational time. In several models, the anticancer agent flowed into the target artery only when the catheter tip was located below the bifurcation of the ECA and each target artery. Furthermore, the anticancer agent tended to flow into the target artery when the catheter tip was shifted toward the target artery. In all ECA branches that had flow of anticancer agent, the blood streamlines to the target arteries contacted the catheter tip. Anticancer agent flowed into only the target artery in patients' models for superselective IAC. However, high wall shear stress was observed at the target artery in one patient's model. This

  19. Intra-Arterial Chemotherapy (Ophthalmic Artery Chemosurgery for Group D Retinoblastoma.

    Directory of Open Access Journals (Sweden)

    David H Abramson

    Full Text Available To report globe salvage rates, patient survival and adverse events of ophthalmic artery chemosurgery (OAC for International Classification of Retinoblastoma (ICRB group D retinoblastoma (naive and after prior failures.Single institution retrospective review of all Group D eyes treated with OAC from 5/2006-12/2012. Patients were treated according to our previously-published techniques. Primary outcome was globe retention without need for external beam radiotherapy (EBRT. Demographics, prior treatments, OAC agents used, and adverse events were also recorded.112 group D eyes (103 patients that underwent OAC were included (average follow-up was 34 months, range: 2-110 months. 47 eyes were treatment-naïve, 58 eyes received prior treatments elsewhere, and 7 young infants (7 eyes underwent our published "bridge therapy" (single agent intravenous carboplatin until old enough to undergo OAC. Median number of OAC sessions/eye was 3 (range 1-9. 110/112 eyes received intra-arterial melphalan, but only 31 eyes received melphalan alone. 43 eyes received carboplatin, and 78 eyes received topotecan (never as a single agent. 80/112 eyes received >1 drug over their treatment course, and 39 eyes received all three agents. 24 eyes (16 pretreated, 7 treatment-naïve, 1 bridge failed treatment and required enucleation during the study period. Enucleation and EBRT were avoided in 88/112 eyes (78.6%; including 40/47 [85.1%] treatment-naïve eyes, 42/58 [72.4%] previously-treated eyes, and 6/7 eyes [85.7%] among bridge patients. By Kaplan-Meier survival analysis, globe salvage rate was 74% at 110 months among all patients, and 85% at 110 months in the treatment-naïve subgroup. Transient grade 3/4 neutropenia was more common in patients receiving OAC bilaterally. No child died of metastatic disease.OAC is effective for curing group D retinoblastoma, achieving rates of globe salvage many times higher than systemic chemotherapy (10-47%, even in eyes that previously

  20. Impact of pretreatment noncontrast CT Alberta Stroke Program Early CT Score on clinical outcome after intra-arterial stroke therapy.

    Science.gov (United States)

    Yoo, Albert J; Zaidat, Osama O; Chaudhry, Zeshan A; Berkhemer, Olvert A; González, R Gilberto; Goyal, Mayank; Demchuk, Andrew M; Menon, Bijoy K; Mualem, Elan; Ueda, Dawn; Buell, Hope; Sit, Siu Po; Bose, Arani

    2014-03-01

    The efficacy of intra-arterial treatment remains uncertain. Because most centers performing IAT use noncontrast CT (NCCT) imaging, it is critical to understand the impact of NCCT findings on treatment outcomes. This study aimed to compare functional independence and safety among patients undergoing intra-arterial treatment stratified by the extent of ischemic change on pretreatment NCCT. The study cohort was derived from multicenter trials of the Penumbra System. Inclusion criteria were anterior circulation proximal occlusion, evaluable pretreatment NCCT, and known time to reperfusion. Ischemic change was quantified using the Alberta Stroke Program Early CT Score (ASPECTS) and stratified into 3 prespecified groups for comparison: 0 to 4 (most ischemic change) versus 5 to 7 versus 8 to 10 (least ischemic change). A total of 249 patients were analyzed: 40 with ASPECTS 0 to 4, 83 with ASPECTS 5 to 7, and 126 with ASPECTS 8 to 10. For ASPECTS 0 to 4, 5 to 7, and 8 to 10, respectively, good outcome (modified Rankin Scale score, 0-2) rates were 5%, 38.6%, and 46% (P<0.0001), and mortality rates were 55%, 28.9%, and 19% (P=0.0001). The only significant pairwise differences were between ASPECTS 0 to 4 and other groups. Symptomatic hemorrhage was more common with lower ASPECTS (P=0.02). Shorter time to reperfusion was significantly associated with better outcomes among patients with ASPECTS 8 to 10 (P=0.01). A similar relationship was seen for ASPECTS 5 to 7 but was not statistically significant. No such relationship was seen for ASPECTS 0 to 4. NCCT seems useful for excluding patients with the greatest burden of ischemic damage from futile intra-arterial treatment, which is unlikely to result in patient functional independence and increases the risk of hemorrhage.

  1. Histopathological studies of radiation-combined intra-arterial chemotherapy on squamous cell carcinoma of the mandible

    International Nuclear Information System (INIS)

    Yonemochi, Takemi

    1996-01-01

    The 2nd Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Hospital, Iwate Medical University has performed radiation-combined intra-arterial chemotherapy as a preoperative treatment and subsequent mandibulectomy. During a 20 year-period from 1975 to 1994, clinical and histopathological examination of the above therapy was made for its effect and usefulness by using 15 primary cases of mandibular gingival squamous cell carcinoma, which were all identifiable. Roentgenological examination by bone resorptive pattern (invasive type, erosive type) and by bone resorptive depth (degree 0-III) revealed that early infiltration case and advanced case were predominant in the erosive type and the invasive type respectively. Histopathologically, the therapeutical effect of the radiation-combined intra-arterial chemotherapy on the tumor cells was examined using osteoclast, fibrous connective tissue, osteoblast, new bone, site of neoosteogenesis, and post-treatment site of residual tumor ceils as findings in the healing process. The histological therapeutic effect was good on well-differentiated type cases, and the histological effect on osteo-infiltrated region was as good as, or better than on soft tissue region. The cases with good histological therapeutic effect scarcely showed osteoclast, but showed remarkable hyperplasia of fibrous connective tissue, appearance of osteoblast and repair mechanism via neoosteogenesis. Invasive type tumor was persistent in the depth of the mandible, while erosive type tumor showed a tendency to be persistent in superficial layer. The results suggested that the application of the present radiation-combined intra-arterial chemotherapy to mandibular gingival squamous cell carcinoma is very useful leading to the improvement in radical curability of the tumor in its primary focus and the preservation of mandibular continuity in surgery. (author)

  2. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  3. Contexts for Column Addition and Subtraction

    Science.gov (United States)

    Lopez Fernandez, Jorge M.; Velazquez Estrella, Aileen

    2011-01-01

    In this article, the authors discuss their approach to column addition and subtraction algorithms. Adapting an original idea of Paul Cobb and Erna Yackel's from "A Contextual Investigation of Three-Digit Addition and Subtraction" related to packing and unpacking candy in a candy factory, the authors provided an analogous context by…

  4. Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer: Analysis of therapeutic results in 112 cases

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Nakashima, Hideyuki; Oguri, Senri; Kioi, Mitomu; Hirota, Makoto; Koike, Izumi; Hata, Masaharu; Tohnai, Iwai

    2014-01-01

    Purpose: To evaluate the therapeutic results and rate of organ preservation in patients with stage III or IV oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Materials and methods: One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. Treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60 mg/m 2 , cisplatin, total 150 mg/m 2 ) and daily concurrent radiotherapy (total of 60 Gy) for 6 weeks. Results: The median follow-up for all patients was 46.2 months (range, 10–76 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1% of patients. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure in 0.9% of patients. Conclusion: Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer provided good overall survival and local control

  5. Four-dimensional CT angiography (4D-CTA) in the evaluation of juvenile nasopharyngeal angiofibromas: comparison with digital subtraction angiography (DSA) and surgical findings.

    Science.gov (United States)

    Xiao, Zebin; Zheng, Yingyan; Li, Jian; Chen, Dehua; Liu, Fang; Cao, Dairong

    2017-12-01

    To explore the value of four-dimensional CT angiography (4D-CTA) in the preoperative evaluation of juvenile nasopharyngeal angiofibromas (JNAs) using 320-row volume CT. 4D-CTA and DSA data of 18 patients with histopathologically proven JNAs were retrospectively reviewed. The location, extent, feeding vessels and stage of JNAs were assessed by two radiologists independently and blindly. The agreements between both reviewers and between 4D-CTA and surgical findings for assessing the above indicators were analysed, respectively. The radiation dose and the number of feeding arteries between 4D-CTA and digital subtraction angiography (DSA) were also compared. 4D-CTA showed high diagnostic consistency with surgical pathology for JNAs with consistent rates of 96.2 and 100% in both reviewers, respectively. The effective dose of 4D-CTA was significantly less than that of DSA (p 0.05). 4D-CTA can provide a reliable preoperative diagnosis and assessment of JNAs, which is useful for determining the surgical strategy and management of this condition.

  6. Dual-energy CT head bone and hard plaque removal for quantification of calcified carotid stenosis: utility and comparison with digital subtraction angiography

    International Nuclear Information System (INIS)

    Uotani, Kensuke; Watanabe, Yoshiyuki; Higashi, Masahiro; Nakazawa, Tetsuro; Kono, Atsushi K.; Hori, Yoshiro; Fukuda, Tetsuya; Kanzaki, Suzu; Yamada, Naoaki; Naito, Hiroaki; Itoh, Toshihide; Sugimura, Kazuro

    2009-01-01

    We evaluated quantification of calcified carotid stenosis by dual-energy (DE) CTA and dual-energy head bone and hard plaque removal (DE hard plaque removal) and compared the results to those of digital subtraction angiography (DSA). Eighteen vessels (13 patients) with densely calcified carotid stenosis were examined by dual-source CT in the dual-energy mode (tube voltages 140 kV and 80 kV). Head bone and hard plaques were removed from the dual-energy images by using commercial software. Carotid stenosis was quantified according to NASCET criteria on MIP images and DSA images at the same plane. Correlation between DE CTA and DSA was determined by cross tabulation. Accuracies for stenosis detection and grading were calculated. Stenosis could be evaluated in all vessels by DE CTA after applying DE hard plaque removal. In contrast, conventional CTA failed to show stenosis in 13 out of 18 vessels due to overlapping hard plaque. Good correlation between DE plaque removal images and DSA images was observed (r 2 =0.9504) for stenosis grading. Sensitivity and specificity to detect hemodynamically relevant (>70%) stenosis was 100% and 92%, respectively. Dual-energy head bone and hard plaque removal is a promising tool for the evaluation of densely calcified carotid stenosis. (orig.)

  7. Detection and characterization of intracranial aneurysms with 16-channel multidetector row CT angiography: a prospective comparison of volume-rendered images and digital subtraction angiography.

    Science.gov (United States)

    Yoon, D Y; Lim, K J; Choi, C S; Cho, B M; Oh, S M; Chang, S K

    2007-01-01

    The aim of our study was to compare multidetector row CT angiography (MDCTA) with digital subtraction angiography (DSA) in the detection and characterization of intracranial aneurysms. In our blinded prospective study, 85 patients with suspected intracranial aneurysm (47 women, 38 men; age range, 19-83 years) underwent both 16-channel MDCTA and DSA. The MDCT angiograms were interpreted for the presence, location, size, ratio of the neck to the dome (N/D ratio), and lobularity of the aneurysms and relationship of the aneurysm with the adjacent arterial branches, by using volume-rendering techniques. MDCTA and DSA images (reference standard) were interpreted by 2 independent readers, and the results were compared. A total of 93 aneurysms were detected at DSA in 71 patients, whereas no aneurysms were detected in 14 patients. Compared with DSA, the overall sensitivity, specificity, and accuracy of MDCTA on a per-aneurysm basis were 92.5%, 93.3%, and 92.6%, respectively, for both independent readers. For aneurysms of <3 mm, however, MDCTA had a sensitivity of 74.1% for reader 1 and 77.8% for reader 2. There was excellent agreement between readers in the detection of aneurysms (kappa = 0.822). In addition, MDCTA was also accurate in determining N/D ratio of aneurysms, aneurysm lobularity, and adjacent arterial branches. MDCTA is accurate in the detection and characterization of intracranial aneurysms and can be used as a reliable alternative imaging technique to DSA in selected cases.

  8. The value of magnetic resonance imaging for the detection of the bleeding source in non-traumatic intracerebral haemorrhages: a comparison with conventional digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lummel, Nina; Lutz, Juergen; Brueckmann, Hartmut; Linn, Jennifer [University of Munich, Department of Neuroradiology, Munich (Germany)

    2012-07-15

    Conventional digital subtraction angiography (DSA) is currently regarded as the gold standard in detecting underlying vascular pathologies in patients with intracerebral haemorrhages (ICH). However, the use of magnetic resonance imaging (MRI) in the diagnostic workup of ICHs has considerably increased in recent years. Our aim was to evaluate the diagnostic accuracy and yield of MRI for the detection of the underlying aetiology in ICH patients. Sixty-seven consecutive patients with an acute ICH who underwent MRI (including magnetic resonance angiography (MRA) and DSA during their diagnostic workup) were included in the study. Magnetic resonance images were retrospectively analysed by two independent neuroradiologists to determine the localisation and cause of the ICH. DSA was used as a reference standard. In seven patients (10.4%), a DSA-positive vascular aetiology was present (one aneurysm, four arteriovenous malformations, one dural arteriovenous fistula and one vasculitis). All of these cases were correctly diagnosed by both readers on MRI. In addition, MRI revealed the following probable bleeding causes in 39 of the 60 DSA-negative patients: cerebral amyloid angiopathy (17), cavernoma (9), arterial hypertension (8), haemorrhagic transformation of an ischaemic infarction (3) and malignant brain tumour with secondary ICH (2). Performing MRI with MRA proved to be an accurate diagnostic tool in detecting vascular malformations in patients with ICH. In addition, MRI provided valuable information regarding DSA-negative ICH causes, and thus had a high diagnostic yield in ICH patients. (orig.)

  9. Conventional digital subtraction x-ray angiography versus magnetic resonance angiography in the evaluation of carotid disease: patient satisfaction and preferences

    Energy Technology Data Exchange (ETDEWEB)

    U-King-Im, J.M. E-mail: jhg21@cam.ac.uk; Trivedi, R.; Cross, J.; Higgins, N.; Graves, M.; Kirkpatrick, P.; Antoun, N.; Gillard, J.H

    2004-04-01

    AIM: To compare conventional digital subtraction x-ray angiography (DSA) and contrast-enhanced magnetic resonance angiography (MRA) of the carotid arteries in terms of patient satisfaction and preferences. METHODS: One hundred and sixty-seven patients with symptomatic carotid artery disease, who underwent both DSA and MRA, were prospectively recruited in this study. Patients' perceptions of each method were assessed by the use of a questionnaire after each procedure. Main outcome measures were anxiety, pain, satisfaction rate and patient preferences. RESULTS: DSA generated more anxiety and pain during the procedure, but the severity of these ill-effects was mild. Satisfaction rates for each method were similar. More patients were, however, willing to have a repeat MRA compared with DSA (67 versus 41%). The majority of patients (62%) preferred MRA over DSA (31%). The shorter MRA imaging time was found to be a significant factor in patients' acceptance of the technique. The main reasons cited by patients for their dislike of a particular procedure was noise and claustrophobia for MRA and invasiveness, pain and post-procedural bed rest for DSA. CONCLUSIONS: MRA is the method that is preferred by the majority of patients, although the actual disutility of DSA may be small. Assuming equal diagnostic accuracy, our data supports replacement of DSA by MRA for routine carotid imaging.

  10. Superselective intra-arterial chemoradiotherapy for advanced head and neck cancers. Evaluation of preservation of organ function

    International Nuclear Information System (INIS)

    Akisada, Takeshi; Harada, Tamotsu; Imai, Shigeki; Gyoten, Masayuki; Hiraoka, Takashi

    2008-01-01

    The objective of this study was to evaluate preservation of organ function in the treatment of superselective intra-arterial chemoradiotherapy for advanced head and neck cancers. Among 96 patients receiving concomitant radiation and intra-arterial docetaxel, systemic cisplatin and 5-fluorouracil (FU) chemotherapy, we identified laryngeal preservation rate, studied tracheostomy cases and gastrostomy cases, and evaluated videofluoroscopic examination and videoendoscopy. Laryngeal preservation rate of hypopharyngeal cancer is very high at 96.2%, and that of laryngeal cancer is high at 71.4%. Videofluoroscopic examination revealed improved swallowing function in 2 of 12, no change in 3, slightly worse in 5, and worse in 2 patients. Following treatment, the incidence of aspiration increased to 4 patients. Videoendoscopy revealed residual vallecula in a few cases. Only 7 patients (7.3%) required a tracheostomy and 4 patients (4.2%) required a gastrostomy. Most of the patients are able to swallow after chemoradiation. Our new chemoradiation protocol is as good as other treatment modalities for maintaining organ preservation and function. (author)

  11. Sex-based differences in the effect of intra-arterial treatment of stroke: analysis of the PROACT-2 study.

    Science.gov (United States)

    Hill, Michael D; Kent, David M; Hinchey, Judith; Rowley, Howard; Buchan, Alastair M; Wechsler, Lawrence R; Higashida, Randall T; Fischbein, Nancy J; Dillon, William P; Gent, Michael; Firszt, Carolyn M; Schulz, Gregory A; Furlan, Anthony J

    2006-09-01

    Sex influences outcome after intravenous thrombolysis. In a combined analysis of the tissue plasminogen activator clinical trials, a sex-by-treatment interaction was observed. We sought to confirm that observation in an independent data set. Data were from the Pro-Urokinase for Acute Cerebral Thromboembolism-2 (PROACT-2) trial. Baseline factors were compared by sex. The primary outcome was an assessment of a sex-by-treatment interaction term within a logistic regression model, using a modified Rankin Scale score intra-arterial stroke thrombolysis, in both women and men, prourokinase resulted in better outcomes than control. A sex by prourokinase treatment interaction was observed, with women showing a larger treatment effect (20% absolute benefit) compared with men (10% absolute benefit). The reason for this interaction is that thrombolytic treatment nullifies the worse outcome for untreated women compared with men. The reasons for effect modification do not include improved recanalization at 2 hours among women. Women with middle cerebral artery ischemic stroke benefit more from intra-arterial therapy. Further study of how sex affects stroke outcome is needed.

  12. Clinical experience of intra-arterial therapy in patients with acute ischemic stroke from a single institute

    International Nuclear Information System (INIS)

    Park, So Young; Lee, Han Bin; Kim, Jong Guk; Oh, Seung Hun; Kim, Jin Kwon; Kim, Sang Heum; Kim, Ok Joon; Kim, Nam Keun

    2016-01-01

    To compare the efficacy and safety between intra-arterial therapy (IAT) and intra-venous and intra-arterial combined therapy (IVIACT) in patients with acute ischemic stroke in the anterior circulation territory. Forty-one patients treated with IAT using Solitaire were retrospectively reviewed. Nineteen patients were treated with IAT, twenty-two patients were treated with IVIACT, and ten patients of the forty-one patients were managed with multimodal treatment like stent, balloon angioplasty etc. We investigated the rate of recanalization and hemorrhage, NIH stroke scale and 3-month modified Rankin Scale. The overall recanalization rate was 93% and symptomatic ICH occurred in 10% of the patients. There was no difference in hemorrhage, recanalization rate, and early improvement between IAT and IVIACT. Good outcome was more frequently observed in 59% of the patients with IVIACT than 36% of the patients treated with IAT without any significant difference. The patients managed with multimodal treatment did not show any significant hemorrhage outcome. IAT using Solitaire is a useful treatment method without high risk in patients with acute ischemic stroke in the anterior circulation territory. Also, IVIACT and multimodal treatment might be considered as reasonable therapeutic options in these patients

  13. Imatinib mesylate induces responses in patients with liver metastases from gastrointestinal stromal tumor failing intra-arterial hepatic chemotherapy

    Directory of Open Access Journals (Sweden)

    Fiorentini Giammaria

    2006-01-01

    Full Text Available Background: Imatinib mesylate represents a real major paradigm shift in cancer therapy, targeting the specific molecular abnormalities, crucial in the etiology of tumor. Intra-arterial hepatic chemotherapy (IAHC followed by embolization, has been considered an interesting palliative option for patients with liver metastases from gastrointestinal stromal tumor (GIST, due to the typically hypervascular pattern of the tumor. Aims: We report our experience with IAHC followed by Imatinib mesylate, in order to show the superiority of the specific molecular approach in liver metastases from GIST. Materials and Methods: Three patients (pts with pretreated massive liver metastases from GIST, received IAHC with Epirubicin 50 mg/mq, every 3 weeks for 6 cycles. At the evidence of progression, they received Imatinib mesylate. Results: We observed progressive diseases in all cases. In 1998, one patient underwent Thalidomide at 150 mg orally, every day for 4 months, with evidence of stable disease and clinical improvement. In 2001, two patients received Imatinib mesylate at 400 mg orally, every day, with evidence of partial response lasting 18+ months and 16 months. One of them had grade 3 neutropenia, with suspension of therapy for 3 weeks. Conclusion: No patient treated with IAHC, reported objective responses, but two of them obtained partial response after the assumption of Imatinib mesylate and one showed temporary stabilization with thalidomide. Imatinib mesylate represents a new opportunity in GIST therapy, targeting the specific molecular alteration. It seems to be superior to conventional intra arterial hepatic chemotherapy.

  14. Quality assessment of clinical research on liver cancer treated by intra-arterial infusion of Chinese medicine.

    Science.gov (United States)

    Zhai, Xiao-Feng; Qiao, Cui-Xia; Liu, Qun; Chen, Zhe; Ling, Chang-Quan

    2014-11-01

    To assess the methodological quality of clinical research on Chinese medicine (CM) applied by intra-arterial infusion in treating primary liver cancer (PLC). Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and three Chinese databases, including Chinese BioMedical Database (CBM), China National Knowledge Infrastructure (CNKI) and China Academic Journal (VIP) were searched. Chinese articles were also searched manually in 16 journals. Two reviewers independently selected studies, the quality of literatures were assessed according to the Cochrane Collaboration method of quality assessment. A total of 14 articles met the inclusion criteria for this review. Only three of these articles described the randomization method used. None of the studies was blinded. All of the articles didn't report the calculation of the sample size. Only six studies mentioned adverse reactions. All of the studies were of grade C according to the Cochrane Collaboration method. Six studies reported results of survival, and only two of these reported better efficacy in the treatment groups. The quality of studies concerned intra-arterial infusion of CM in treating with PLC was poor and the exact effect of these medicines still need evaluation. Well designed RCTs with large sample sizes, adequate follow-up data and reliable methods of assessment are needed to better appraise the real effect of CMs in the treatment of PLC patients.

  15. Beneficial effects of intra-arterial and intravenous prostaglandin E1 in intestinal ischaemia-reperfusion injury.

    Science.gov (United States)

    San Norberto García, Enrique María; Taylor, James Henry; Cenizo, Noelia; Vaquero, Carlos

    2014-04-01

    Ischaemia-reperfusion (I/R) injury is encountered in conditions that diminish intestinal blood flow. There is no clinically feasible technique available for mucosal preservation. One hundred Wistar rats were subjected to intestinal ischaemia for 15 and 60 min (I15', I60'), followed by 1 and 7 days of reperfusion (R1d, R7d). Rats were subjected to ischaemia by clamping the superior mesenteric artery. Prostaglandin E1 (PGE1) (2.500 ng/kg intra-arterial bolus or 20 ng/kg intravenous infusion) was administered immediately prior to the commencement of the experimental period. Animals were divided into 20 groups: sham (laparotomy alone), sacrificed at 1 or 7 days; saline administration, 15 or 60 min of ischaemia, 1 or 7 days of reperfusion; prostaglandin E1 administration, 15 or 60 min of ischaemia, 1 or 7 days of reperfusion, each one for intra-arterial or intravenous administration. Ileal segments were excised and assessed for histopathological score, polymorphonuclear (PMN) leucocytes encountered and myeloperoxidase (MPO) activity measurement. I/R caused deterioration of histological characteristics. Prophylactic administration of PGE1 resulted in a significant decrease in the histological score compared with the respective saline group (analysis of variance, P prostaglandin E1 prevents I/R injury by diminishing histological damage parameters, inhibiting PMN leucocyte infiltration and attenuating MPO activity.

  16. Comparison of Intra-arterial and Subcutaneous Testicular Hyaluronidase Injection Treatments and the Vascular Complications of Hyaluronic Acid Filler.

    Science.gov (United States)

    Wang, Muyao; Li, Wei; Zhang, Yan; Tian, Weidong; Wang, Hang

    2017-02-01

    Hyaluronidase is a key preventative treatment against vascular complications of hyaluronic acid (HA) filler injection, but the degradation profile of HA to hyaluronidase is limited, and the comparison between intra-arterial and subcutaneous injections of hyaluronidase has not been studied. To evaluate HA degradation to hyaluronidase and compare different treatments between intra-arterial and subcutaneous testicular hyaluronidase injections. The authors observed HA degradation to hyaluronidase in vitro via microscopic examination and particle analysis. Rabbit ears were used for the in vivo study. There were 2 control groups receiving ligation or HA-induced embolism in the arteries, respectively, and 2 intervention groups receiving hyaluronidase treatments in different regions. The laser Doppler blood perfusion monitoring measurements were made at defined time points, and biopsies were taken on Day 2. Nearly, all of the HAs degraded in vitro at the 1-hour time point. Subcutaneous hyaluronidase treatment showed better recovery of blood perfusion. Histology showed severe inflammation in the embolism group and mild inflammation in the intervention groups. A complete enzymatic degradation of HA filler to hyaluronidase needs a certain time, and subcutaneous hyaluronidase treatment may be the better option.

  17. Clinical experience of intra-arterial therapy in patients with acute ischemic stroke from a single institute

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    Park, So Young [Dept. Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul (Korea, Republic of); Lee, Han Bin; Kim, Jong Guk; Oh, Seung Hun; Kim, Jin Kwon; Kim, Sang Heum; Kim, Ok Joon [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of); Kim, Nam Keun [Institute for Clinical Research, School of Medicine, CHA University, Seongnam (Korea, Republic of)

    2016-11-15

    To compare the efficacy and safety between intra-arterial therapy (IAT) and intra-venous and intra-arterial combined therapy (IVIACT) in patients with acute ischemic stroke in the anterior circulation territory. Forty-one patients treated with IAT using Solitaire were retrospectively reviewed. Nineteen patients were treated with IAT, twenty-two patients were treated with IVIACT, and ten patients of the forty-one patients were managed with multimodal treatment like stent, balloon angioplasty etc. We investigated the rate of recanalization and hemorrhage, NIH stroke scale and 3-month modified Rankin Scale. The overall recanalization rate was 93% and symptomatic ICH occurred in 10% of the patients. There was no difference in hemorrhage, recanalization rate, and early improvement between IAT and IVIACT. Good outcome was more frequently observed in 59% of the patients with IVIACT than 36% of the patients treated with IAT without any significant difference. The patients managed with multimodal treatment did not show any significant hemorrhage outcome. IAT using Solitaire is a useful treatment method without high risk in patients with acute ischemic stroke in the anterior circulation territory. Also, IVIACT and multimodal treatment might be considered as reasonable therapeutic options in these patients.

  18. The clinical effect of combination therapy for oral cancer with S-1, superselective intra-arterial chemotherapy, and radiation therapy

    International Nuclear Information System (INIS)

    Yamamoto, Chika; Yoshikawa, Hiromasa; Fukumoto, Shunsuke; Higuchi, Takashi; Yoshida, Masanori; Yasumori, Koutarou; Horinouchi, Yasufumi; Uehara, Satoru

    2011-01-01

    Combination therapy with S-1, superselective intra-arterial infusion of carboplatin (CBDCA) and radiation therapy has been used to treat patients with oral cancer since 2005. In this study, the histopathological effects and toxicities following concurrent chemoradiotherapy were examined. The subjects consisted of 15 patients (10 men and 5 women) who were treated with S-1 (60-80 mg/day, 4 weeks), superselective intra-arterial infusion of CBDCA (300 mg/body) and radiation therapy (total dose 30-36 Gy) in our department from 2005 to 2009. Nine patients, showed T2 disease, 3 showed T3 disease, and another 3 showed T4 diseases. The primary cancer sites were the tongue (6 cases), buccal mucosa (4 cases), mandible gingival (3 cases), maxillary gingival (1 case), and the floor of the mouth (1 case). The histopathological effects were evaluated according to Oboshi-Shimosato classification. Grade IV was shown in 10 cases (66.7%), grade III in 1 case (6.7%), II bin 3 cases (20.0%), and II a in 1 case (6.7%). All patients completed the treatment. The pathological response of the resected tumor was grade IIb or higher in 14 cases (93.3%). While good histological effects were noted, there was one patient for whom viable tumor cells remained in the central part of the tumor. The present study indicates that further investigation is needed to determine the best dosing and dosing schedule. (author)

  19. Intra-arterial infusion of MTX for the treatment of cesarean scar pregnancy: a comparative study between different doses

    International Nuclear Information System (INIS)

    Gu Weijin; Wang Haiyun; Wan Jun; Zhang Lei; Wang Ying; Wang Wei; Ji Fang; Ji Lihua

    2010-01-01

    Objective: To investigate the effective dose of methotrexate (MTX) via intra-arterial infusion for the treatment of cesarean scar pregnancy. Methods: Thirty-six cases of incisional scar pregnancy at the gestational age of 5-9 weeks received bilateral uterine arterial infusion of MTX. According to the dose of MTX used, the patients were randomly and equally divided into four groups with MTX dose of 60, 100, 150 and 200 mg respectively. After the perfusion was completed the embolization of both uterine arteries with Gelfoam was carried out until the uterine arteries were no longer visualized on DSA. Uterine curettage was conducted within 1-7 days after the treatment. Results: In one week after the procedure, the difference in the decreasing rate of serum β-HCG and progesterone between group 60 mg and group 200 mg was of statistical significance (P 0.05). The hospitalization days of group 60 mg was the longest, while that of group 200 mg was the shortest. Conclusion: The recommended dose of MTX used via intra-arterial infusion in treating cesarean scar pregnancy is 200 mg. The interventional procedure can kill the embryo tissue and quickly lower the serum β-HCG and progesterone levels,it can also shorten the patient's hospitalization time. (authors)

  20. Intra-arterial drug and light delivery for photodynamic therapy using Visudyne®: implication for atherosclerotic plaque treatment

    Directory of Open Access Journals (Sweden)

    Manish Jain

    2016-09-01

    Full Text Available Photodynamic therapy (PDT, which is based on the activation of photosensitizers with light, can be used to reduce plaque burden. We hypothesized that intra-arterial photosensitizer administration and photo-activation will lead to high and rapid accumulation within the plaque with reduced systemic adverse effects. Thus this intra-arterial PDT would be expected to have less side effects and due to the short time involved would be compatible with percutaneous coronary interventions. Aim: We characterized the dose-dependent uptake and efficacy of intra-arterial PDT using Liposomal Verteporfin (Visudyne®, efficient for cancer-PDT but not tested before for PDT of atherosclerosis. Methods and Results: Visudyne® (100, 200 and 500 ng/ml was perfused for 5-30 minutes in atherosclerotic aorta isolated from ApoE-/- mice. The fluorescence Intensity (FI after 15 minutes of Visudyne® perfusion increased with doses of 100 (FI-5.5 ± 1.8, 200 (FI-31.9 ± 1.9 or 500 ng/ml (FI-42.9 ± 1.2. Visudyne® (500 ng/ml uptake also increased with the administration time from 5 minutes (FI-9.8 ± 2.5 to 10 minutes (FI-23.3 ± 3.0 and 15 minutes (FI-42.9 ± 3.4 before reaching saturation at 30 minutes (FI-39.3 ± 2.4 contact. Intra-arterial PDT (Fluence: 100 and 200 J/cm2, irradiance-334 mW/cm2 applied immediately after Visudyne® perfusion (500 ng/ml for 15 minutes using a cylindrical light diffuser coupled to a diode laser (690 nm, led to an increase of ROS (Dihydroethidium (FI-6.9 ± 1.8, 25.3 ± 5.5, 43.4 ± 13.9 and apoptotic cells (TUNEL (2.5 ± 1.6 %, 41.3 ± 15.3 %, 58.9 ± 6 %, mainly plaque macrophages (immunostaining (0.3 ± 0.2 %, 37.6 ± 6.4 %, 45.3 ± 5.4 % at light doses of 0, 100 or 200 J/cm2 respectively. Limited apoptosis was observed in the medial wall (0.5 ± 0.2 %, 8.5 ± 4.7 %, 15.3 ± 12.7 %. Finally, Visudyne®-PDT was found to be associated with reduced vessel functionality (Myogram. Conclusion: We demonstrated that sufficient accumulation of

  1. Intra-Arterial Drug and Light Delivery for Photodynamic Therapy Using Visudyne®: Implication for Atherosclerotic Plaque Treatment.

    Science.gov (United States)

    Jain, Manish; Zellweger, Matthieu; Frobert, Aurélien; Valentin, Jérémy; van den Bergh, Hubert; Wagnières, Georges; Cook, Stéphane; Giraud, Marie-Noelle

    2016-01-01

    Photodynamic therapy (PDT), which is based on the activation of photosensitizers with light, can be used to reduce plaque burden. We hypothesized that intra-arterial photosensitizer administration and photo-activation will lead to high and rapid accumulation within the plaque with reduced systemic adverse effects. Thus, this "intra-arterial" PDT would be expected to have less side effects and due to the short time involved would be compatible with percutaneous coronary interventions. We characterized the dose-dependent uptake and efficacy of intra-arterial PDT using Liposomal Verteporfin (Visudyne®), efficient for cancer-PDT but not tested before for PDT of atherosclerosis. Visudyne® (100, 200, and 500 ng/ml) was perfused for 5-30 min in atherosclerotic aorta isolated from ApoE(-/-) mice. The fluorescence Intensity (FI) after 15 min of Visudyne® perfusion increased with doses of 100 (FI-5.5 ± 1.8), 200 (FI-31.9 ± 1.9) or 500 ng/ml (FI-42.9 ± 1.2). Visudyne® (500 ng/ml) uptake also increased with the administration time from 5 min (FI-9.8 ± 2.5) to 10 min (FI-23.3 ± 3.0) and 15 min (FI-42.9 ± 3.4) before reaching saturation at 30 min (FI-39.3 ± 2.4) contact. Intra-arterial PDT (Fluence: 100 and 200 J/cm(2), irradiance-334 mW/cm(2)) was applied immediately after Visudyne® perfusion (500 ng/ml for 15 min) using a cylindrical light diffuser coupled to a diode laser (690 nm). PDT led to an increase of ROS (Dihydroethidium; FI-6.9 ± 1.8, 25.3 ± 5.5, 43.4 ± 13.9) and apoptotic cells (TUNEL; 2.5 ± 1.6, 41.3 ± 15.3, 58.9 ± 6%), mainly plaque macrophages (immunostaining; 0.3 ± 0.2, 37.6 ± 6.4, 45.3 ± 5.4%) respectively without laser irradiation, or at 100 and 200 J/cm(2). Limited apoptosis was observed in the medial wall (0.5 ± 0.2, 8.5 ± 4.7, 15.3 ± 12.7%). Finally, Visudyne®-PDT was found to be associated with reduced vessel functionality (Myogram). We demonstrated that sufficient accumulation of Visudyne® within plaque could be achieved in short

  2. TU-CD-207-03: Time Evolution of Texture Parameters of Subtracted Images Obtained by Contrast-Enhanced Digital Mammography (CEDM)

    Energy Technology Data Exchange (ETDEWEB)

    Mateos, M-J; Brandan, M-E [Instituto de Fisica, Universidad Nacional Autonom de Mexico, Mexico, Distrito Federal (Mexico); Gastelum, A; Marquez, J [Centro de Ciencias Aplicadas y Desarrollo Tecnologico Universidad Nacional Autonoma de Mexico, Mexico, Distrito Federal (Mexico)

    2015-06-15

    Purpose: To evaluate the time evolution of texture parameters, based on the gray level co-occurrence matrix (GLCM), in subtracted images of 17 patients (10 malignant and 7 benign) subjected to contrast-enhanced digital mammography (CEDM). The goal is to determine the sensitivity of texture to iodine uptake at the lesion, and its correlation (or lack of) with mean-pixel-value (MPV). Methods: Acquisition of clinical images followed a single-energy CEDM protocol using Rh/Rh/48 kV plus external 0.5 cm Al from a Senographe DS unit. Prior to the iodine-based contrast medium (CM) administration a mask image was acquired; four CM images were obtained 1, 2, 3, and 5 minutes after CM injection. Temporal series were obtained by logarithmic subtraction of registered CM minus mask images.Regions of interest (ROI) for the lesion were drawn by a radiologist and the texture was analyzed. GLCM was evaluated at a 3 pixel distance, 0° angle, and 64 gray-levels. Pixels identified as registration errors were excluded from the computation. 17 texture parameters were chosen, classified according to similarity into 7 groups, and analyzed. Results: In all cases the texture parameters within a group have similar dynamic behavior. Two texture groups (associated to cluster and sum mean) show a strong correlation with MPV; their average correlation coefficient (ACC) is r{sup 2}=0.90. Other two groups (contrast, homogeneity) remain constant with time, that is, a low-sensitivity to CM uptake. Three groups (regularity, lacunarity and diagonal moment) are sensitive to CM uptake but less correlated with MPV; their ACC is r{sup 2}=0.78. Conclusion: This analysis has shown that, at least groups associated to regularity, lacunarity and diagonal moment offer dynamical information additional to the mean pixel value due to the presence of CM at the lesion. The next step will be the analysis in terms of the lesion pathology. Authors thank PAPIIT-IN105813 for support. Consejo Nacional de Ciencia Y

  3. Quantitative Real-Time Fluoroscopy Analysis on Measurement of the Hepatic Arterial Flow During Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma: Comparison with Quantitative Digital Subtraction Angiography Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yi-Yang; Lee, Rheun-Chuan, E-mail: rclee@vghtpe.gov.tw; Guo, Wan-Yuo, E-mail: wyguo@vghtpe.gov.tw; Chu, Wei-Fa [Taipei Veterans General Hospital, Department of Radiology (China); Wu, Frank Chun-Hsien [Siemens Healthcare Ltd. (China); Gehrisch, Sonja [Siemens Healthcare GmbH (Germany)

    2016-11-15

    PurposeTo quantify the arterial flow change during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) using digital subtraction angiography, quantitative color-coding analysis (d-QCA), and real-time subtraction fluoroscopy QCA (f-QCA).Materials and MethodsThis prospective study enrolled 20 consecutive patients with HCC who had undergone TACE via a subsegmental approach between February 2014 and April 2015. The TACE endpoint was a sluggish antegrade tumor-feeding arterial flow. d-QCA and f-QCA were used for determining the relative maximal density time (rT{sub max}) of the selected arteries. The rT{sub max} of the selected arteries was analyzed in d-QCA and f-QCA before and after TACE, and its correlation in both analyses was evaluated.ResultsThe pre- and post-TACE rT{sub max} of the embolized segmental artery in d-QCA and f-QCA were 1.59 ± 0.81 and 2.97 ± 1.80 s (P < 0.001) and 1.44 ± 0.52 and 2.28 ± 1.02 s (P < 0.01), respectively. The rT{sub max} of the proximal hepatic artery did not significantly change during TACE in d-QCA and f-QCA. The Spearman correlation coefficients of the pre- and post-TACE rT{sub max} of the embolized segmental artery between d-QCA and f-QCA were 0.46 (P < 0.05) and 0.80 (P < 0.001). Radiation doses in one series of d-QCA and f-QCA were 140.7 ± 51.5 milligray (mGy) and 2.5 ± 0.7 mGy, respectively.Conclusionsf-QCA can quantify arterial flow changes with a higher temporal resolution and lower radiation dose. Flow quantification of the embolized segmental artery using f-QCA and d-QCA is highly correlated.

  4. Assessment of the left ventricular systolic and diastolic function by the left ventricular density curve derived from intravenous digital subtraction angiography in children

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    Horigome, Hitoshi; Satoh, Hideo; Isobe, Takeshi; Takita, Hitoshi (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine)

    1991-05-01

    To evaluate the left ventricular (LV) systolic and diastolic function, fifty-four children with various heart diseases underwent intravenous digital subtraction angiography (IV-DSA). Global left ventricular density curve was obtained through densitometry of the DSA images. The curve was smoothed by a third-degree Fourier transformation and systolic and diastolic indexes were obtained. In the control group, consisting of Kawasaki disease without coronary lesion and mild pulmonary stenosis, the peak ejection rate (PER) and the peak filling rate in early diastole (PFR-E) correlated positively with the heart rate (HR) in a quadratic curve manner (PER: r= 0.93 p<0.01, PFR-E: r= 0.94 p<0.01). Time from end-diastolic to PER (T-PER) and time from end-systolic to PFR (T-PFR) were correlated negatively with HR (T-PER: r=-0.86 p<0.01, T-PFR: r=-0.91 p<0.01). However, T-PER/RR and T-PFR/RR values were rather constant (20.9+-3.2%, 17.0+-2.6%, respectively). We also found significant correlations of PER and PFR-E with left ventricular ejection fraction (LVEF). Patients with corrected tetralogy of Fallot and with cardiomyopaties showed not only abnormal systolic indexes but some depressed diastolic indexes. LV density curve also disclosed isolated diastolic dysfunction in a group of aortic stenosis and in two patients with coronary lesions. A correlation of LVEF derived from the density curve and conventional area-length method was high (r= 0.91 p<0.001). To evaluate the reproducibility, we were able to obtain the digital data twice with over one month interval on 24 patients. The intraobserver correlation was satisfactory. We applied the remasking method, resulting in improving the quality of digital images under spontaneous breathing. Our results indicated that IV-DSA was a less-invasive and clinically reliable method for assessment of LV function in children. (author).

  5. Assessment of the left ventricular systolic and diastolic function by the left ventricular density curve derived from intravenous digital subtraction angiography in children

    International Nuclear Information System (INIS)

    Horigome, Hitoshi; Satoh, Hideo; Isobe, Takeshi; Takita, Hitoshi

    1991-01-01

    To evaluate the left ventricular (LV) systolic and diastolic function, fifty-four children with various heart diseases underwent intravenous digital subtraction angiography (IV-DSA). Global left ventricular density curve was obtained through densitometry of the DSA images. The curve was smoothed by a third-degree Fourier transformation and systolic and diastolic indexes were obtained. In the control group, consisting of Kawasaki disease without coronary lesion and mild pulmonary stenosis, the peak ejection rate (PER) and the peak filling rate in early diastole (PFR-E) correlated positively with the heart rate (HR) in a quadratic curve manner [PER: r= 0.93 p<0.01, PFR-E: r= 0.94 p<0.01]. Time from end-diastolic to PER (T-PER) and time from end-systolic to PFR (T-PFR) were correlated negatively with HR [T-PER: r=-0.86 p<0.01, T-PFR: r=-0.91 p<0.01]. However, T-PER/RR and T-PFR/RR values were rather constant (20.9±3.2%, 17.0±2.6%, respectively). We also found significant correlations of PER and PFR-E with left ventricular ejection fraction (LVEF). Patients with corrected tetralogy of Fallot and with cardiomyopaties showed not only abnormal systolic indexes but some depressed diastolic indexes. LV density curve also disclosed isolated diastolic dysfunction in a group of aortic stenosis and in two patients with coronary lesions. A correlation of LVEF derived from the density curve and conventional area-length method was high [r= 0.91 p<0.001]. To evaluate the reproducibility, we were able to obtain the digital data twice with over one month interval on 24 patients. The intraobserver correlation was satisfactory. We applied the remasking method, resulting in improving the quality of digital images under spontaneous breathing. Our results indicated that IV-DSA was a less-invasive and clinically reliable method for assessment of LV function in children. (author)

  6. Successful Treatment of Two Cases of Squamous Cell Carcinoma on the Ear with Intra-Arterial Administration of Peplomycin through a Superficial Temporal Artery

    Directory of Open Access Journals (Sweden)

    Takahiro Haga

    2014-09-01

    Full Text Available Cutaneous squamous cell carcinoma (SCC is the second most common non-melanoma skin cancer and tends to develop in sun-exposed cosmetic areas, including the ear. In this report, we describe two cases of SCC on the ear successfully treated with intra-arterial administration of peplomycin through a superficial temporal artery. In addition to this selective chemotherapy, we administered oral tegafur, which achieved complete remission of the tumor. These findings suggest that intra-arterial administration of peplomycin with tegafur is one of the optimal therapies for the treatment of SCC developing on the ear.

  7. Pilot clinical study of boron neutron capture therapy for recurrent hepatic cancer involving the intra-arterial injection of a (10)BSH-containing WOW emulsion.

    Science.gov (United States)

    Yanagie, Hironobu; Higashi, Syushi; Seguchi, Koji; Ikushima, Ichiro; Fujihara, Mituteru; Nonaka, Yasumasa; Oyama, Kazuyuki; Maruyama, Syoji; Hatae, Ryo; Suzuki, Minoru; Masunaga, Shin-ichiro; Kinashi, Tomoko; Sakurai, Yoshinori; Tanaka, Hiroki; Kondo, Natsuko; Narabayashi, Masaru; Kajiyama, Tetsuya; Maruhashi, Akira; Ono, Koji; Nakajima, Jun; Ono, Minoru; Takahashi, Hiroyuki; Eriguchi, Masazumi

    2014-06-01

    A 63-year-old man with multiple HCC in his left liver lobe was enrolled as the first patient in a pilot study of boron neutron capture therapy (BNCT) involving the selective intra-arterial infusion of a (10)BSH-containing water-in-oil-in-water emulsion ((10)BSH-WOW). The size of the tumorous region remained stable during the 3 months after the BNCT. No adverse effects of the BNCT were observed. The present results show that (10)BSH-WOW can be used as novel intra-arterial boron carriers during BNCT for HCC. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Experimental study on intra-arterial infusion of basic fibroblast growth factor in the ischemic limbs of rabbit model

    International Nuclear Information System (INIS)

    Zhang Jing; Yang Wenduo

    2005-01-01

    Objective: To evaluate the effect of intra-arterial infusion of basic fibroblast growth factor (bFGF) on improving neovascularization, vascular perfusion and the function of partially ischemic limbs of rabbits. Methods: Twenty-seven New Zealand male rabbits were selected. Partial ischemia model was induced by surgical ligation of the primary branches of right femoral artery in each animal, and the left hind limb of each animal was served as a nonischemic control. Then, 27 rabbits were randomly assigned to three groups: intra-arterial (IA) infusion of bFGF (n=9), intravenous (IV) infusion of bFGF and IA infusion of saline (n=9). Infusion was separately performed immediately after vascular ligation, 8th and 15th days post-surgery with 10 μg (4 ml) of bFGF per-time (or the same volume of saline). The differences between three groups and between ischemic and nonischemic limbs of the same group were compared and evaluated by the following indexes: (1) vessel section count (VSC), vessel section surface area (VSS) and vessel section perimeter (VSP) in the field of ischemic muscle tissues taken at 22nd day postoperatively; (2) capillary refilling time of ischemic limbs; and (3) functional and trophic changes of ischemic limbs. Statistical differences were evaluated by one-way ANOVA and T test. Results: VSC, VSS and VSP of the IA-bFGF group were significantly increased than those of the IV-bFGF and IA-saline groups (P<0.01). At 22nd day postoperatively, the capillary refilling time, new hair growth, the appearance and function of all ischemic limbs in IA-bFGF group were approximately normal. However, in IA-saline group, the ischemic changes, capillary refilling time and the function of ischemic limbs were not improved significantly. All the indexes of IV-bFGF group showed no difference statistically from those of IA-saline group. Conclusions: This experimental study identifies that intra-arterial infusion of bFGF may significantly promote neovascularization and vascular

  9. Percutaneous implantation of intra-arterial port system for regional drug infusion: results and complications in 110 cases

    International Nuclear Information System (INIS)

    Won, Je Hwan; Lee, Jong Hyuk; Ko, Kyung Hee; Won, Jong Yoon; Park, Sung Il; Lee, Do Yun; Kang, Byung Chul

    2000-01-01

    To investigate the feasibility and complications of a percutaneously implantable port system for regional drug infusion. For intra-arterial drug infusion, a 5.8 or 5-F pediatric venous port system was implanted in 110 patients with hepatocellular carcinoma (n=79), liver metastasis (n=16), gallbladder cancer (n=4), stomach cancer (n=3), pancreatic cancer (n=3), Burger's diseases mellitus (n=2), or lymphoma (n=1). All intra-arterial port implantations were performed percutaneously in an angiographic ward through the common femoral artery (n=98), left subclavian artery (n=10), or left superficial femoral artery (n=2). Complications were evaluated during the follow-up period, which ranged from 21 to 530 (mean, 163) days. The technical success rate for percutaneous implantation of the system was 97.3% (107 of 110 patients). The tips of the port catheter were located in the common hepatic artery (n=34), proper hepatic artery (n=49), right hepatic artery quick resulthepatic artery (n=1), descending aorta at T9 level (n=10), left popliteal artery (n=2), right external iliac artery (n=1), left external iliac artery (n=1), or left deep femoral artery (n=1). Complications were encountered in 24 patients (22.4%), namely chamber site infection (n=7), catheter dislodgement (n=7), catheter occlusion (n=3), migration of coil (n=2), disconnection between chamber and catheter (n=1), kinking of catheter (n=1), arterial occlusion (n=1), necrosis of overlying skin (n=1), and leakage around port chamber (n=1). Outcomes of complications included removal of port systems or cessation of therapy in 12 cases (11.2%), correction of catheter location using a guide wire in five (4.7%), thrombolysis with urokinase in three (2.8%), and straightening using a snare in one (0.9%). In three patients, the port system was used without reintervention. Percutaneous implantation of an intra-arterial port system showed a high technical success rate and a low rate of serious complications. The method may be

  10. Gadolinium-DTPA-enhanced and digitally subtracted magnetic resonance imaging of estrogen-induced pituitary lesions in rats: correlation with pituitary anatomy.

    Science.gov (United States)

    van Nesselrooij, J H; Szeverenyi, N M; Tillapaugh-Fay, G M; Hendriksen, F G

    1990-01-01

    Pituitary hypertrophy and tumors were induced in male Sprague Dawley rats using estradiol-17 beta. This tumor model generates a variety of pituitary lesions which are relevant to human pituitary disease. In order to characterize these lesions, gadolinium DTPA was injected intravenously into the tail vein of estrogen treated and control rats. High resolution T1-weighted MR images, pre- and postenhancement, were obtained at 8 different time points spanning 300 days following the subcutaneous implantation of the estrogen pellets. Images with 2-mm slice thickness were made with a 2 Telsa small-bore MR imaging system. Both normal and tumorous pituitaries were found to enhance with contrast agent, but contrast uptake was not uniform. Gd-DTPA distribution was sensitive to the different types of lesions generated in the course of this study. Digital subtraction of congruent images, pre- and postcontrast, provided difference images reflecting contrast concentration and allowed identification of subtle enhancement effects. Hypertrophic pituitaries displayed uptake of contrast, but the distribution of contrast agent was nonuniform and appeared mottled. A bright rim enhancement was often seen anterior to the pituitary gland, most likely arising from the oculomotor nerves and arachnoid. Histological slices in the same anatomical plane as the MR images were obtained on the animals allowing identification of individual lesions. Cystic areas within tumors were found to give strong contrast enhancement in less than five min postinjection. Solid and hemorrhagic areas of the pituitary tumor were hypo- to isointense relative to surrounding brain and did not take up contrast agent. Significant perfusion in these areas apparently does not occur.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Time-of-flight MR angiography at 3 T versus digital subtraction angiography in the imaging follow-up of 51 intracranial aneurysms treated with coils

    Energy Technology Data Exchange (ETDEWEB)

    Ferre, Jean-Christophe [Department of Neuroradiology, Hopital Pontchaillou, University Hospital Rennes, 2 rue Henri Le Guilloux, 35000 Rennes (France)], E-mail: jean-christophe.ferre@chu-rennes.fr; Carsin-Nicol, Beatrice [Department of Neuroradiology, Hopital Pontchaillou, University Hospital Rennes, 2 rue Henri Le Guilloux, 35000 Rennes (France); Morandi, Xavier [Department of Neurosurgery, Hopital Pontchaillou, University Hospital Rennes, 2 rue Henri Le Guilloux, 35000 Rennes (France); Carsin, Michel [Department of Neuroradiology, Hopital Pontchaillou, University Hospital Rennes, 2 rue Henri Le Guilloux, 35000 Rennes (France); Kersaint-Gilly, Axel de [Department of Neuroradiology, Hopital Laennec, University Hospital Nantes, Boulevard Jacques Monod, 44800 Saint-Herblain (France); Gauvrit, Jean-Yves [Department of Neuroradiology, Hopital Pontchaillou, University Hospital Rennes, 2 rue Henri Le Guilloux, 35000 Rennes (France); Desal, Hubert-Armand [Department of Neuroradiology, Hopital Laennec, University Hospital Nantes, Boulevard Jacques Monod, 44800 Saint-Herblain (France)

    2009-12-15

    Objective: To compare 3D time-of-flight MR angiography (TOF-MRA) at 3 Tesla (3 T) with digital subtraction angiography (DSA) for the evaluation of intracranial aneurysm occlusion after endovascular coiling. Methods: In a prospective study, 51 consecutive patients (25 females, 26 males; median age, 51 years) with 51 saccular aneurysms treated with endovascular coiling underwent simultaneous DSA and 3 T TOF-MRA at follow-up. DSA and TOF-MRA images were analyzed independently by two senior neuroradiologists. Findings were assigned to 1 of 3 categories in the Raymond classification: complete obliteration, residual neck or residual aneurysm. Agreement between observers and techniques was evaluated using {kappa} statistics. Results: DSA images were not interpretable for one patient. Interobserver agreement was determined as excellent for DSA ({kappa} = 0.86) and TOF-MRA ({kappa} = 0.80). After reaching a consensus, DSA follow-up showed 26 (51%) complete obliterations, 20 (39%) residual necks and 4 (8%) residual aneurysms. TOF-MRA showed 23 (45%) complete obliterations, 22 (43%) residual necks and 6 (12%) residual aneurysms. Comparison between TOF-MRA and DSA showed excellent agreement between the techniques ({kappa} = 0.86). In the four cases that were misclassified, TOF-MRA findings were assigned to a higher class than for DSA. Conclusion: TOF-MRA at 3 T is at least as efficient as DSA for the evaluation of intracranial aneurysm occlusion after endovascular treatment with detachable coils. We suggest that TOF-MRA at 3 T might be used as the primary method for imaging follow-up of coiled intracranial aneurysms.

  12. Quantitative perfusion computed tomography measurements of cerebral hemodynamics: Correlation with digital subtraction angiography identified primary and secondary cerebral collaterals in internal carotid artery occlusive disease

    International Nuclear Information System (INIS)

    Cheng Xiaoqing; Tian Jianming; Zuo Changjing; Liu Jia; Zhang Qi; Lu Guangming

    2012-01-01

    Background: The aim of the present study was to assess hemodynamic variations in symptomatic unilateral internal carotid artery occlusion (ICAO) patients with primary collateral flow via circle of Willis or secondary collateral flow via ophthalmic artery and/or leptomeningeal collaterals. Methods: Thirty-eight patients with a symptomatic unilateral ICAO were enrolled in the study. Based on digital subtraction angiography (DSA) findings, patients were classified into 2 groups: primary collateral (n = 14) and secondary collateral (n = 24) groups. Collateral flow hemodynamics were investigated with perfusion computed tomography (PCT) by measuring the cerebral blood flow (CBF), cerebral blood volume (CBV) and time to peak (TTP) in the hemispheres ipsilateral and contralateral to ICAO. Based on the measurements, the ipsilateral to contralateral ratio for each parameter was calculated and compared. Results: Irrespective of the collateral patterns, ipsilateral CBF was not significantly different from that of the contralateral hemisphere (P = 0.285); ipsilateral CBV and TTP was significantly increased compared with those of the contralateral hemisphere (P = 0.000 and P = 0.000 for CBV and TTP, respectively). Furthermore, patients with secondary collaterals had significantly larger ipsilateral-to-contralateral ratios for both CBV (rCBV, P = 0.0197) and TTP (rTTP, P = 0.000) than those of patients with only primary collaterals. These two groups showed no difference in ipsilateral-to-contralateral ratio for CBF (rCBF, P = 0.312). Conclusion: Patients with symptomatic unilateral ICAO in our study were in an autoregulatory vasodilatation status. Moreover, secondary collaterals in ICAO patients were correlated with ipsilateral CBV and delayed TTP that suggested severe hemodynamic impairment, presumably increasing the risk of ischemic events.

  13. Influence of the catheter-top-position upon the distribution pattern of continuous intra-arterially infused chemotherapeutic agent

    International Nuclear Information System (INIS)

    Ichinohe, Hyobu

    1980-01-01

    The whole body scanning showed the distribution pattern of infused drug in continuous intra-arterially infused chemotherapy by using a gamma camera and infused RI (sup(99m)Tc-MAA) from catheter. I measured the whole body scanning counts without shield (A) and with lead shield (B) on ROI and natural back ground counts (BG). Then I calculated the distribution ratio on ROI as following. [(A-B)/(A-BG)] x 100(%). It was easy to find a certain relation between the catheter-top-position and the distribution ratio. As a result of investigating data, there were about 4 catheter-top-positions in aorta. Case by case, we putted the catheter-top in better position and prevented technical side effects and measured roughly total dose on ROI. (author)

  14. Intra-arterial papaverine and leg vascular resistance during in situ bypass surgery with high or low epidural anaesthesia

    DEFF Research Database (Denmark)

    Rørdam, Peter; Jensen, Leif Panduro; Schroeder, T V

    1993-01-01

    In situ saphenous vein arterial bypass flow was studied in 16 patients with respect to level of epidural anaesthesia. Arterial pressure and electromagnetic flow were used to evaluate arterial tone by intra-arterial (i.a.) papaverine. Eight patients had a low epidural block (... patients were operated during high epidural anaesthesia (> Th. 10). Flow increased and arterial pressure decreased after i.a. papaverine in all patients. When compared with patients operated during high epidural anaesthesia, flow increase and decrease in vascular resistance took place in patients operated...... during low epidural anaesthesia (P i.a. papaverine was not significantly different in patients operated in low epidural and general anaesthesia (n = 8). In eight patients with insulin-dependent diabetes mellitus who had low epidural anaesthesia, the increase...

  15. Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies

    Energy Technology Data Exchange (ETDEWEB)

    Kwok, Chun Shing, E-mail: shingkwok@doctors.org.uk [Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent (United Kingdom); Rashid, Muhammad [St. Helens & Knowsley Teaching Hospital (NHS) Trust, Whiston Hospital, Prescot (United Kingdom); Fraser, Doug [Manchester Heart Centre, Manchester Royal Infirmary (United Kingdom); Nolan, James [University Hospital of North Midlands, Stoke-on-Trent (United Kingdom); Mamas, Mamas [Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent (United Kingdom); Farr Institute, Institute of Population Health, University of Manchester, Manchester (United Kingdom)

    2015-12-15

    Objectives: The aim of this study is to review the available literature on the efficacy and safety of agents used for prevention of RAS. Background: Different vasodilator agents have been used to prevent radial artery spasm (RAS) in patients undergoing transradial cardiac catheterization. Methods: We included studies that evaluated any intra-arterial drug administered in the setting cardiac catheterization that was undertaken through the transradial access site (TRA). We also compared studies for secondary outcomes of major bleeding, procedure time, and procedure failure rate in setting of RAS prevention, patent hemostasis and radial artery occlusion. Results: 22 clinical studies met the inclusion criteria. For placebo, RAS rate was 12% (4 studies, 638 participants), which was similar to 2.5 mg of verapamil 12% (3 studies, 768 participants) but greater than 5 mg of verapamil (4%, 2 studies, 497 participants). For nicorandil, there was a much higher RAS rate compared to placebo (16%, 3 studies, 447 participants). The lowest rates of RAS was found for nitroglycerin at both 100 μg (4%) and 200 μg (2%) doses, isosorbide mononitrate (4%) and nicardipine (3%). We found no information regarding the procedure failure rates, patent hemostasis, and radial artery occlusion in these studies. Conclusions: In this largest and up-to-date review on intra-arterial vasodilators use to reduce RAS, we have found that the verapamil at a dose of 5 mg or verapamil in combination with nitroglycerine are the best combinations to reduce RAS. - Highlights: • Radial artery spasm (RAS) causes procedural failure in transradial catheterization. • RAS may complicate 10–15% procedures undertaken through the radial approach. • We reviewed the efficacy of vasodilators that have been used to minimize RAS. • The pooled RAS rate was lowest with 5 mg of verapamil (4%) compared to placebo (12%). • The best combination of drugs to minimize RAS is nitroglycerine and verapamil.

  16. Intra-arterial transplantation of human umbilical cord blood mononuclear cells in neonatal hypoxic-ischemic rats.

    Science.gov (United States)

    Greggio, Samuel; de Paula, Simone; Azevedo, Pâmella Nunes; Venturin, Gianina Teribele; Dacosta, Jaderson Costa

    2014-02-06

    Based on preclinical findings, cellular therapy has become a promising therapeutic approach for neonatal hypoxia-ischemia (HI). However, before translation into the clinical setting, new and effective routes of cell delivery must be determined. Intra-arterial (IA) delivery is an attractive route of cellular administration but has never been used in neonatal HI rats. In this study, we investigated the feasibility of IA transplantation of human umbilical cord blood (HUCB) mononuclear cells for the treatment of long-term behavior dysfunction and brain lesion after neonatal HI. Seven-day-old rats were subjected to a HI model and the animals received HUCB mononuclear cells into the left common carotid artery 24 h after HI insult. At 9 weeks post-HI, intra-arterially transplanted HUCB mononuclear cells significantly improved learning and long-term spatial memory impairments when evaluated by the Morris water maze paradigm. There was no effect of neonatal HI insult or IA procedure on body weight and on motor coordination and balance when evaluated by the accelerating rotarod test. Cellular transplantation by the IA route did not restore neonatal HI-induced brain damage according to stereological volume assessment. Furthermore, HUCB mononuclear cells were tracked in the injured brain and peripheral organs of HI transplanted-rats by nested polymerase chain reaction analysis at different time points. Our findings contribute to the translational knowledge of cell based-therapy in neonatal HI and demonstrate for the first time that IA transplantation into rat pups is a feasible route for cellular delivery and prevents long-term cognitive deficits induced by experimental neonatal HI. © 2013.

  17. Neoadjuvant intra-arterial chemotherapy combined with radiotherapy and surgery in patients with advanced maxillary sinus cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Tae; Kim, Yong Kan; Lee, Ju Hye; Kim, Dong Hyun; Park, Dahl; Cho, Kyu Sup; Kim, Dong Won [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Nam, Ji Ho; Roh, Hwan Jung [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2013-09-15

    The optimal treatment of advanced maxillary sinus cancer has been challenging for several decades. Intra-arterial chemotherapy (IAC) for head and neck cancer has been controversial. We have analyzed the long-term outcome of neoadjuvant IAC followed by radiation therapy (RT) and surgery. Twenty-seven patients with advanced maxillary sinus cancer were treated between 1989 and 2002. Five-fluorouracil (5-FU, 500 mg/m2) was infused intra-arterially, and followed by RT (total 50.4 Gy/28 fractions). A planned surgery was performed 3 to 4 weeks after completion of IAC and RT. At a median follow-up of 77 months (range, 12 to 169 months), the 5-year rates of overall survival in all patients were 63%. The 5-year rates of overall survival of stage T3/T4 patients were 70.0% and 58.8%, respectively. Seven of fourteen patients with disease recurrence had a local recurrence alone. The 5-year actuarial local control rates in patients with stage T3/T4, and in all patients were 20.0%, 32.3%, and 27.4%, respectively. Overall response rate after the completion of IAC and RT was 70.3%. During the follow-up, seven patients (25.9%) showed mild to moderate late complications. The tumor extent (i.e., the involvement of either orbit and/or base of skull) appeared to be related with local recurrence. Neoadjuvant IAC with 5-FU followed by RT and surgery may be effective to improve local tumor control in the patients with advanced maxillary sinus cancer. However, local failure was still the major cause of death. Further investigations are required to determine the optimal treatment schedule, radiotherapy techniques and chemotherapy regimens.

  18. Intra-arterial AICA-riboside administration induces NO-dependent vasodilation in vivo in human skeletal muscle.

    Science.gov (United States)

    Bosselaar, Marlies; Boon, Hanneke; van Loon, Luc J C; van den Broek, Petra H H; Smits, Paul; Tack, Cees J

    2009-09-01

    In animal models, administration of the adenosine analog AICA-riboside has shown beneficial effects on ischemia-reperfusion injury and glucose homeostasis. The vascular and/or metabolic effects of AICA-riboside administration in humans remain to be established. AICA-riboside was infused intra-arterially in four different dosages up to 8 mg x min(-1) x dl(-1) in 24 healthy subjects. Forearm blood flow (FBF) and glucose uptake and plasma glucose, free fatty acid, and AICA-riboside concentrations were assessed. We also combined AICA-riboside infusion (2 mg x min(-1) x dl(-1)) with the intra-arterial administration of the adenosine receptor antagonist caffeine (90 microg x min(-1) x dl(-1); n = 6) and with the endothelial NO synthase inhibitor l-NMMA (0.4 mg x min(-1) x dl(-1); n = 6). Additional in vitro experiments were performed to explain our in vivo effects of AICA-riboside in humans. AICA-riboside increased FBF dose dependently from 2.0 +/- 0.2 to 13.2 +/- 1.9 ml x min(-1) x dl(-1) maximally (P AICA-riboside concentrations, forearm glucose uptake did not change. In vitro experiments showed rapid uptake of AICA-riboside by the equilibrative nucleoside transporter in erythrocytes and subsequent phosphorylation to AICA-ribotide. We conclude that AICA-riboside induces a potent vasodilator response in humans that is mediated by NO. Despite high local plasma concentrations, AICA-riboside does not increase skeletal muscle glucose uptake.

  19. Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment: a subgroup analysis of a randomised phase 3 trial (MR CLEAN)

    NARCIS (Netherlands)

    Yoo, Albert J.; Berkhemer, Olvert A.; Fransen, Puck S. S.; van den Berg, Lucie A.; Beumer, Debbie; Lingsma, Hester F.; Schonewille, Wouter J.; Sprengers, Marieke E. S.; van den Berg, René; van Walderveen, Marianne A. A.; Beenen, Ludo F. M.; Wermer, Marieke J. H.; Nijeholt, Geert J. Lycklama À; Boiten, Jelis; Jenniskens, Sjoerd F. M.; Bot, Joseph C. J.; Boers, Anna M. M.; Marquering, Henk A.; Roos, Yvo B. W. E. M.; van Oostenbrugge, Robert J.; Dippel, Diederik W. J.; van der Lugt, Aad; van Zwam, Wim H.; Majoie, Charles B. L. M.

    2016-01-01

    Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the

  20. Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment: a subgroup analysis of a randomised phase 3 trial (MR CLEAN)

    NARCIS (Netherlands)

    Yoo, A.J.; Berkhemer, O.A.; Fransen, P.S.; Berg, L.A. van den; Beumer, D.; Lingsma, H.F.; Schonewille, W.J.; Sprengers, M.E.; Berg, R. van den; Walderveen, M.A. van; Beenen, L.F.; Wermer, M.J.; Nijeholt, G.J.; Boiten, J.; Jenniskens, S.F.M.; Bot, J.C.; Boers, A.M.; Marquering, H.A.; Roos, Y.B.; Oostenbrugge, R.J. van; Dippel, D.W.; Lugt, A. van der; Zwam, W.H. van; Majoie, C.B.; et al.,

    2016-01-01

    BACKGROUND: Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis

  1. ECG-triggered non-contrast-enhanced MR angiography (TRANCE) versus digital subtraction angiography (DSA) in patients with peripheral arterial occlusive disease of the lower extremities

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Sutter, Reto [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); Froehlich, Johannes M.; Roos, Justus E.; Sautter, Thomas; Schoch, Erik; Giger, Barbara; Weymarn, Constantin von; Binkert, Christoph A. [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Wyss, Michael [University and ETH Zurich, Institute for Biomedical Engineering, Zurich (Switzerland); Graf, Nicole [University Hospital of Zurich, Clinical Trials Center, Center for Clinical Research, Zurich (Switzerland); Jenelten, Regula [Cantonal Hospital Winterthur, Department of Angiology, Winterthur (Switzerland); Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria)

    2011-09-15

    To prospectively determine the diagnostic value of electrocardiography-triggered non-contrast-enhanced magnetic resonance angiography (TRANCE) of the lower extremities including the feet versus DSA. All 43 patients with symptomatic peripheral arterial occlusive disease (PAOD) underwent TRANCE before DSA. Quality of MRA vessel depiction was rated by two independent radiologists on a 3-point scale. Arterial segments were graded for stenoses using a 4-point scale (grade 1: no stenosis; grade 2: moderate stenosis; grade 3: severe stenosis; grade 4: occlusion). Findings were compared with those of DSA. In the 731 vessel segments analysed, intra-arterial DSA revealed 283 stenoses: 33.6% moderate, 16.6% severe and 49.8% occlusions. TRANCE yielded a mean sensitivity, specificity, positive and negative predictive value and diagnostic accuracy to detect severe stenoses or occlusions of 95.6%, 97.4%, 87.2%, 99.2%, 97.1% for the thigh segments and 95.2%, 87.5%, 83.2%, 96.6%, 90.5% for the calf segments. Excellent overall image quality was observed for TRANCE in 91.4% versus 95.7% (DSA) for the thigh and in 60.7% versus 91.0% for the calves, while diagnostic quality of the pedal arteries was rated as insufficient. TRANCE achieves high diagnostic accuracy in the thigh and calf regions, whereas the pedal arteries showed limited quality. (orig.)

  2. Targeted Intra-arterial Transplantation of Stem Cells to the Injured CNS is More Effective than Intravenous Administration - Engraftment is Dependent on Cell Type and Adhesion Molecule Expression

    DEFF Research Database (Denmark)

    Lundberg, Johan; Södersten, Erik; Sundström, Erik

    2011-01-01

    with inflammation, such as traumatic brain injury, there is a transient up-regulation of ICAM-1 and VCAM-1 which might provide enviromental cues for migration of stem cells from blood to parenchyma. The aim of this study was to i) analyze the effect of intra-arterial administration on cellular engraftment, ii...

  3. Intra-arterial infusion of Solcoseryl: a clinical trial of a method of treatment for pre-gangrene of the lower limb.

    Science.gov (United States)

    Charlesworth, D; Harris, P L; Palmer, M K

    1975-05-01

    A randomized double blind trial of the drug Solcoseryl given by intra-arterial infusion was carried out on 57 patients with pre-gangrene of the lower limb. A sequential analysis was carried out and the trial stopped when the results showed a statistically significant result in favour of the active drug.

  4. Treatment of recurrent glioblastoma with intra-arterial BCNU [1, 3-bis (2-chloroethyl-1-nitrosourea] Tratamento do glioblastoma recorrente com BCNU [1, 3-bis (2-chloroethyl-1-nitrosourea] intra arterial

    Directory of Open Access Journals (Sweden)

    Eberval Gadelha Figueiredo

    2010-10-01

    Full Text Available Contemporary therapies for patients with glioblastomas remain marginally efficient, and recurrence following surgery, radiation therapy and adjuvant chemotherapy is practically universal. The major obstacles to the successful use of chemotherapy for CNS tumors are the drug delivery to the tumor site and the infusion of chemotherapeutic agents directly into the arterial supply of a tumor. The latter could provide a pharmacokinetic advantage by enhancing drug delivery to the tumor. Sixteen patients with recurrent unilateral glioblastomas treated with intra-arterial BCNU were evaluated retrospectively. During the infusion, eleven patients referred pain in the ipsilateral eye, five patients were nauseated, three reported headache, one patient presented mental confusion, while two presented focal signs. There were two deaths during the course of therapy. Four patients achieved temporary clinical improvement, seven showed disease stability, and three presented clinical deterioration. The median total survival time was 87.9 weeks. Unilateral vision loss and focal signs were observed as delayed complications of this treatment. This study has confirmed previous reports indicating that arterial chemotherapy is clearly not curative, and presents serious toxicity. Only through a randomized prospective study performed in a large series of patients can the questions concerning survival period increment be answered properlyOs tratamentos atuais para pacientes com glioblastoma permanecem pouco eficientes e a recorrência, acompanhando cirurgia, radioterapia e quimioterapia, é a regra geral. O maior obstáculo para o sucesso da quimioterapia para os tumores do SNC é a disponibilização da droga no sitio do tumor sendo que a infusão do agente quimioterápico diretamente na trama arterial da lesão pode proporcionar vantagens por maior liberação da substância diretamente no tumor. Estudamos retrospectivamente dezesseis pacientes com glioblastomas

  5. TU-H-CAMPUS-IeP1-04: Combined Organ Dose for Digital Subtraction Angiography and Computed Tomography Using Monte Carlo Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Sakabe, D; Ohno, T; Araki, F; Hashida, M; Funama, Y [Kumamota University, Kumamoto, Kumamoto (Japan)

    2016-06-15

    Purpose: The purpose of this study was to evaluate the combined organ dose of digital subtraction angiography (DSA) and computed tomography (CT) using a Monte Carlo (MC) simulation on the abdominal intervention. Methods: The organ doses for DSA and CT were obtained with MC simulation and actual measurements using fluorescent-glass dosimeters at 7 abdominal portions in an Alderson-Rando phantom. DSA was performed from three directions: posterior anterior (PA), right anterior oblique (RAO), and left anterior oblique (LAO). The organ dose with MC simulation was compared with actual radiation dose measurements. Calculations for the MC simulation were carried out with the GMctdospp (IMPS, Germany) software based on the EGSnrc MC code. Finally, the combined organ dose for DSA and CT was calculated from the MC simulation using the X-ray conditions of a patient with a diagnosis of hepatocellular carcinoma. Results: For DSA from the PA direction, the organ doses for the actual measurements and MC simulation were 2.2 and 2.4 mGy/100 mAs at the liver, respectively, and 3.0 and 3.1 mGy/100 mAs at the spinal cord, while for CT, the organ doses were 15.2 and 15.1 mGy/100 mAs at the liver, and 14.6 and 13.5 mGy/100 mAs at the spinal cord. The maximum difference in organ dose between the actual measurements and the MC simulation was 11.0% of the spleen at PA, 8.2% of the spinal cord at RAO, and 6.1% of left kidney at LAO with DSA and 9.3% of the stomach with CT. The combined organ dose (4 DSAs and 6 CT scans) with the use of actual patient conditions was found to be 197.4 mGy for the liver and 205.1 mGy for the spinal cord. Conclusion: Our method makes it possible to accurately assess the organ dose to patients for abdominal intervention with combined DSA and CT.

  6. Evaluation of Anterior Ethmoidal Artery by 320-Slice CT Angiography with Comparison to Three-Dimensional Spin Digital Subtraction Angiography: Initial Experiences

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Juan; Sun, Gang; Yu, Bling Bing; Li, Min; Li, Guo Ying; Peng, Zhao Hui; Zhang, Xu Ping [Dept. of Medical Imaging, Jinan Military General Hospital, Jinan (China); Lu, Yang [Dept. of Radiology, University of Illinois College of Medicine, Illinois (United States)

    2012-11-15

    To explore the usefulness of 320-slice CT angiography (CTA) for evaluating the course of the anterior ethmoidal artery (AEA) and its relationship with adjacent structures by using three-dimensional (3D) spin digital subtraction angiography (DSA) as standard reference. From December 2008 to December 2010, 32 patients with cerebrovascular disease, who underwent both cranial 3D spin DSA and 320-slice CTA within a 30 day period from each other, were retrospectively reviewed. AEA course in ethmoid was analyzed in DSA and CTA. In addition, adjacent bony landmarks (bony notch in medial orbital wall, anterior ethmoidal canal, and anterior ethmoidal sulcus) were evaluated with CTA using the MPR technique oriented along the axial, coronal and oblique coronal planes in all patients. The dose length product (DLP) for CTA and the dose-area product (DAP) for 3D spin DSA were recorded. Effective dose (ED) was calculated. The entire course of the AEA was seen in all 32 cases (100%) with 3D spine DSA and in 29 of 32 cases (90.1%) with 320-slice CTA, with no significant difference (p = 0.24). In three cases where AEA was not visualized on 320-slice CTA, two were due to the dominant posterior ethmoidal artery, while the remaining case was due to diminutive AEA. On MPR images of 320-slice CT, a bony notch in the orbital medial walls was detected in all cases (100%, 64 of 64); anterior ethmoidal canal was seen in 28 of 64 cases (43.8%), and the anterior ethmoidal sulcus was seen in 63 of 64 cases (98.4%). The mean effective dose in CTA was 0.6 {+-} 0.25 mSv, which was significantly lower than for 3D spin DSA (1.3 {+-} 0.01 mSv) (p < 0.001). 320-slice CTA has a similar detection rate for AEA to that of 3D spin DSA; however, it is noninvasive, and may be preferentially used for the evaluation of AEA and its adjacent bony variations and pathologic changes in preoperative patients with paranasal sinus diseases.

  7. Impact of femoral artery puncture using digital subtraction angiography and road mapping on vascular and bleeding complications after transfemoral transcatheter aortic valve implantation.

    Science.gov (United States)

    El-Mawardy, Mohamed; Schwarz, Bettina; Landt, Martin; Sulimov, Dmitriy; Kebernik, Julia; Allali, Abdelhakim; Becker, Bjoern; Toelg, Ralph; Richardt, Gert; Abdel-Wahab, Mohamed

    2017-01-20

    The use of large-diameter sheaths carries the risk of significant vascular and bleeding complications after transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to assess the impact of a modified femoral artery puncture technique using digital subtraction angiography (DSA) and road mapping during transfemoral TAVI on periprocedural vascular and bleeding events. This is a retrospective analysis of transfemoral TAVI patients included in a prospective institutional database. The modified femoral artery puncture technique using DSA-derived road mapping guidance was introduced in October 2012. Before the introduction of this technique, vascular puncture was acquired based on an integration of angiographic data, the bony iliofemoral landmarks and a radiopaque object. Consecutive patients who underwent TAVI with the road mapping technique (RM group, n=160) were compared with consecutive patients who underwent TAVI without road mapping (control group, n=160) prior to its introduction. A standardised strategy of periprocedural anticoagulation was adopted in both groups as well as the use of a single suture-based closure device. All endpoints were defined according to the VARC-2 criteria for event definition. The mean age in the RM group was 80±7.7 years compared to 81±5.9 years in the control group (p=0.19), and females were equally distributed between both groups (63.1% vs. 58.1%, p=0.36). The baseline logistic EuroSCORE was 20.7±14.4% vs. 24.9±15.2% in the RM and control group, respectively (p=0.01). Notably, sheath size was significantly larger in the RM compared to the control group due to the more frequent use of the 20 Fr sheath (23.8% vs. 1.8%, proad map group but did not reach statistical significance (8.1% vs. 13.8%, p=0.1). Other forms of vascular and bleeding complications as well as all-cause mortality were comparable in both groups. A modified femoral artery puncture technique using DSA and road mapping was associated

  8. Carbon dioxide (CO{sub 2}) digital subtraction angiography. Evaluation of a new delivery system; Angiografia con anidride carbonica. Nuovo sistema di iniezione

    Energy Technology Data Exchange (ETDEWEB)

    Nicolini, A.; Lovaria, A.; Meregaglia, D. [Ospedale Maggiore IRCCS Policlinico, Milan (Italy). Dipt. di Scienze Radiologiche; Palatresi, S. [Ospedale Maggiore IRCCS Policlinico, Milan (Italy). Ist. di Clinica Medica Generale e Terapia Medica

    2000-02-01

    Purpose of this work is to evaluate the usefulness of a new carbon dioxide (CO{sub 2}) intravascular injection system in digital subtraction angiography. March 1998 to May 1999, 39 patients were submitted to digital subtraction angiography with CO{sub 2} injection by a new delivery system, CO{sub 2}-Angio set, OptiMed, Ettingen, Germany. The patients were 29 men and 10 women, whose age ranged 32 to 76 (mean: 47), 18 of them with absolute or relative contraindications to iodinated contrast media and 6 with poor diagnostic findings at previous conventional angiography. CO{sub 2} was used for comparison with iodinated contrast agents in 4 patients. It was studied the following vascular districts: renal arteries in 9 patients, portal vein in 18, lower limb arteries in 7, upper limb veins in 4. In 1 patient CO{sub 2} angiography was carried out for the diagnosis and interventional treatment, by transcatheter embolization, of a postbioptic arteriovenous renal fistula. During the procedure, arterial blood pressure, EKG status and oxygen saturation were monitored, and subjective sensations recorded in all patients. CO{sub 2} angiography provided adequate visualization of vascular districts and of abnormal findings in 32 cased (82%), while its results were considered insufficient for correct and complete assessment in 7 cases (18%). CO{sub 2}-Angio set delivery system has proved to be a simple and safe tool, particularly suitable for use in patients at risk for allergic reactions to iodinated contrast agents and in those with renal function impairment. Also, the system can help carry out some interventional procedures such as arteriovenous fistula embolization and trans jugular portosystemic shunting. [Italian] Scopo di questo articolo e' verificare la validita' e l'efficacia di un nuovo sistema di iniezione angiografico per anidride carbonica. Da marzo 1998 a maggio 1999 sono stati sottoposti ad angiografia con anidride carbonica mediante sistema non

  9. EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds.

    Science.gov (United States)

    Giammarile, Francesco; Bodei, Lisa; Chiesa, Carlo; Flux, Glenn; Forrer, Flavio; Kraeber-Bodere, Françoise; Brans, Boudewijn; Lambert, Bieke; Konijnenberg, Mark; Borson-Chazot, Françoise; Tennvall, Jan; Luster, Markus

    2011-07-01

    Primary liver cancers (i.e. hepatocellular carcinoma or cholangiocarcinoma) are worldwide some of the most frequent cancers, with rapidly fatal liver failure in a large majority of patients. Curative therapy consists of surgery (i.e. resection or liver transplantation), but only 10-20% of patients are candidates for this. In other patients, a variety of palliative treatments can be given, such as chemoembolization, radiofrequency ablation or recently introduced tyrosine kinase inhibitors, e.g. sorafenib. Colorectal cancer is the second most lethal cancer in Europe and liver metastases are prevalent either at diagnosis or in follow-up. These patients are usually treated by a sequence of surgery, chemotherapy and antibody therapy [Okuda et al. (Cancer 56:918-928, 1985); Schafer and Sorrell (Lancet 353:1253-1257, 1999); Leong et al. (Arnold, London, 1999)]. Radioembolization is an innovative therapeutic approach defined as the injection of micron-sized embolic particles loaded with a radioisotope by use of percutaneous intra-arterial techniques. Advantages of the use of these intra-arterial radioactive compounds are the ability to deliver high doses of radiation to small target volumes, the relatively low toxicity profile, the possibility to treat the whole liver including microscopic disease and the feasibility of combination with other therapy modalities. Disadvantages are mainly due to radioprotection constraints mainly for (131)I-labelled agents, logistics and the possibility of inadvertent delivery or shunting [Novell et al. (Br J Surg 78:901-906, 1991)]. The Therapy, Oncology and Dosimetry Committees have worked together in order to revise the European Association of Nuclear Medicine (EANM) guidelines on the use of the radiopharmaceutical (131)I-Lipiodol (Lipiocis®, IBA, Brussels, Belgium) and include the newer medical devices with (90)Y-microspheres. (90)Y is either bound to resin (SIR-Spheres®, Sirtex Medical, Lane Cove, Australia) or embedded in a glass

  10. Change apparent diffusion coefficient immediately after recanalization through intra-arterial revascularization therapy in acute ischemic stroke

    International Nuclear Information System (INIS)

    Roh, Ji Eun; Yeom, Joeng A; Kim, Young Soo; Yoon, Chang Hyo; Park, Min Gyu; Park, Kyung Pil; Baik, Seung Kug

    2016-01-01

    Intra-arterial revascularization therapy (IART) for acute ischemic stroke has become increasingly popular recently. However, early change in apparent diffusion coefficient (ADC) values after full recanalization in human stroke has not received much attention. The aim of this study was to evaluate ADC changes immediately after interventional full-recanalization in patients with acute ischemic stroke. ADC values of 25 lesions from 18 acute ischemic stroke patients were recorded with both pre- and post-recanalization ADC maps. Measurement was done by placing region of interests over the representative images of the lesion. For analysis, lesions were divided into territorial infarction (TI) and watershed infarction (WI). Mean ADC values of the overall 25 lesions before IART were 415.12 × 10-6 mm 2 /sec, and increased to 619.08 × 10-6 mm 2 /sec after the IART. Average relative ADC (rADC) value for 22 TI increased from 0.59 to 0.92 (p < 0.000), whereas, average rADC value for 3 WI did not change significantly. There was a conspicuous increase of ADC values immediately after full-recanalization in TI lesions. On the other hand, WI lesions did not show significant change in ADC values after recanalization

  11. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Lee, Jin Young; Shin, Hwa Seon; Choi, Hye Young; Chung, Sung Hoon; You, Jin Jong; Choi, Dae Seob; Son, Seung Nam; Ryu, Jae Wook

    2012-01-01

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed

  12. Successful Intra-Arterial Chemotherapy for Extramammary Paget’s Disease of the Axilla in a Patient with Parkinson’s Disease

    International Nuclear Information System (INIS)

    Damascelli, Bruno; Ticha, Vladimira

    2011-01-01

    Extramammary Paget’s disease (EMPD) is a rare intraepithelial neoplasm occurring less frequently in men and even more rarely in the axilla. A 59-year-old man with severe Parkinson’s disease presented with axillary EMPD. The neurological comorbidity made treatment of the EMPD problematical and prompted us to propose locoregional intra-arterial chemotherapy in single short sessions. Two innovative chemotherapeutic macrocomplexes were used: doxorubicin incorporated in large liposomes and the taxane paclitaxel incorporated in albumin nanoparticles. A therapeutic response was seen right from the first treatment and was macroscopically close to complete after four cycles. Five months after the end of treatment the patient had minimal visible disease and had enjoyed a distinct improvement in quality of life, with no noteworthy complications related to the intra-arterial chemotherapy with percutaneous transfemoral catheterization.

  13. Image-Based Analysis of Tumor Localization After Intra-Arterial Delivery of Technetium-99m-Labeled SPIO Using SPECT/CT and MRI

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    In Joon Lee MD, PhD

    2017-01-01

    Full Text Available The aim of this study is to evaluate the localization of 99mTc-labeled dextran-coated superparamagnetic iron oxide (SPIO nanoparticles to the liver tumor using image-based analysis. We delivered 99mTc-SPIO intravenously or intra-arterially (IA with/without Lipiodol to compare the tumor localization by gamma scintigraphy, single-photon emission computed tomography (SPECT, and magnetic resonance imaging (MRI in a rabbit liver tumor. The gamma and SPECT image-based analysis shows that the uptake ratio of the tumor to the normal liver parenchyma is highest after delivery of 99mTc-SPIO with Lipiodol IA and that well correlates with the trend of the signal decrease in the liver MRIs. Intra-arterial delivery of SPIO with Lipiodol might be a good drug delivery system targeting the hepatic tumors, as confirmed by image-based analysis.

  14. Treatment of mechanically-induced vasospasm of the carotid artery in a primate using intra-arterial verapamil: a technical case report

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    Meyers Philip

    2004-07-01

    Full Text Available Abstract Background Despite improvements in the safety and efficacy of endovascular procedures, considerable morbidity may still be attributed to vasospasm. Vasospasm has proven amenable to pharmacological intervention such as nitrates, intravenous calcium channel blockers (CCBs, and intra-arterial papaverine, particularly in small vessels. However, few studies have focused on medium to large vessel spasm. Here we report the use of an intra-arterial CCB, verapamil, to treat flow-limiting mechanically-induced spasm of the common carotid artery (CCA in a primate. We believe this to be the first such report of its kind. Case presentation As part of a study assessing the placement feasibility and safety of a catheter capable of delivering intra-arterial cerebroprotective therapy, a female 16 kg baboon prophylaxed with intravenous nitroglycerin underwent transfemoral CCA catheterization with a metallic 6-Fr catheter without signs of acute spasm. The protocol dictated that the catheter remain in the CCA for 12 hours. Upon completion of the protocol, arteriography revealed a marked decrease in CCA size (mean cross-sectional area reduction = 31.6 ± 1.9% localized along the catheter length. Intra-arterial verapamil (2 mg/2cc was injected and arteriography was performed 10 minutes later. Image analysis at 6 points along the CCA revealed a 21.0 ± 1.7% mean increase in vessel diameter along the length of the catheter corresponding to a 46.7 ± 4.0% mean increase in cross-sectional area. Mean systemic blood pressure did not deviate more than 10 mm Hg during the procedure. Conclusions Intraluminal CCBs like verapamil may constitute an effective endovascular treatment for mechanically-induced vasospasm in medium to large-sized vessels such as the CCA.

  15. Biodistribution of 10B in a rat liver tumor model following intra-arterial administration of sodium borocaptate (BSH)/degradable starch microspheres (DSM) emulsion

    International Nuclear Information System (INIS)

    Suzuki, Minoru; Nagata, Kenji; Masunaga, Shinichiro; Kinashi, Yuko; Sakurai, Yoshinori; Maruhashi, Akira; Ono, Koji

    2004-01-01

    We reported that intra-arterial administration of borocaptate sodium (BSH)/lipiodol emulsion provided selectively high 10 B concentrations (approximately 200 ppm 6 h after administration) in experimental liver tumors. In the present study, we investigated the pharmacokinetics of BSH following intra-arterial administration of BSH with other embolizing agent, degradable starch microspheres (DSM). The 10 B concentration in the tumor at 1 h after administration of BSH with DSM was 231 ppm. At 6 h, the 10 B concentration in the tumor in BSH with DSM group was 81.5 ppm. The 10 B concentration in the liver at 1 h after administration of BSH with DSM was 184 ppm. At 6 h, the 10 B concentration in the liver in BSH with DSM group was 78 ppm. The tumor/liver 10 B concentration ratios (T/L ratio) in the 'BSH+DSM' group were significantly smaller than those in the 'BSH+lipiodol' group at 1 h (1.4 vs. 3.6) and 6 h (1.1 vs. 14.9). BSH/DSM-boron neutron capture therapy (BNCT) was not suitable for treatment of multiple liver tumors due to the low T/L 10 B concentration ratio. However, the high 10 B accumulation in the liver tumors following intra-arterial administration of BSH/DSM emulsion suggests that BSH/DSM-BNCT has the potential for application to malignant tumors in other sites

  16. Pilot clinical study of boron neutron capture therapy for recurrent hepatic cancer involving the intra-arterial injection of a 10BSH-containing WOW emulsion

    International Nuclear Information System (INIS)

    Yanagie, Hironobu; Higashi, Syushi; Seguchi, Koji; Ikushima, Ichiro; Fujihara, Mituteru; Nonaka, Yasumasa; Oyama, Kazuyuki; Maruyama, Syoji; Hatae, Ryo; Suzuki, Minoru; Masunaga, Shin-ichiro; Kinashi, Tomoko; Sakurai, Yoshinori; Tanaka, Hiroki; Kondo, Natsuko; Narabayashi, Masaru; Kajiyama, Tetsuya; Maruhashi, Akira; Ono, Koji; Nakajima, Jun

    2014-01-01

    A 63-year-old man with multiple HCC in his left liver lobe was enrolled as the first patient in a pilot study of boron neutron capture therapy (BNCT) involving the selective intra-arterial infusion of a 10 BSH-containing water-in-oil-in-water emulsion ( 10 BSH-WOW). The size of the tumorous region remained stable during the 3 months after the BNCT. No adverse effects of the BNCT were observed. The present results show that 10 BSH-WOW can be used as novel intra-arterial boron carriers during BNCT for HCC. - Highlights: • We started the pilot clinical study of BNCT to recurrence hepatic cancer. • The tumor size was remained stable during 3 months after BNCT(SD). • No adverse effect as a result of BNCT was observed during follow-up period. • 10 B-containing WOW emulsion can be applied as a novel intra-arterial boron carrier for BNCT for HCC

  17. Effect of preoperative oral S-1 combined with regional intra-arterial chemotherapy on malignant molecule expression in locally advanced unresectable gastric cancer tissue

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    Lei Liu

    2016-11-01

    Full Text Available Objective: To study the effect of preoperative oral S-1 combined with regional intra-arterial chemotherapy on malignant molecule expression in locally advanced unresectable gastric cancer tissue. Methods: A total of 144 patients with locally advanced gastric cancer receiving surgical resection after neoadjuvant chemotherapy in our hospital between May 2012 and August 2015 were selected and randomly divided into experimental group who received preoperative oral S-1 combined with regional intra-arterial chemotherapy and control group who received preoperative intravenous systemic chemotherapy. The levels of serum tumor markers were determined after chemotherapy, and the expression levels of tumor suppressor genes and cell cycle-related molecules in tumor tissue were determined after surgical resection. Results: After neoadjuvant chemotherapy, the serum G-17, TK-1, CEA, CA19-9, CA12-5, CA72-4 and CK, CK-MB, ALT, AST levels of experimental group were significantly lower than those of control group; after surgical resection, the p16, p27, PTEN and TXNIP mRNA levels in tumor tissue of experimental group were significantly higher than those of control group while CyclinB2, CyclinD1, CyclinE, CDK1 and CDK2 mRNA levels were significantly lower than those of control group. Conclusions: Preoperative oral S-1 combined with regional intra-arterial chemotherapy can more effectively kill gastric cancer cells, reduce tumor load, inhibit cell cycle and promote cell apoptosis.

  18. The Fate and Distribution of Autologous Bone Marrow Mesenchymal Stem Cells with Intra-Arterial Infusion in Osteonecrosis of the Femoral Head in Dogs

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    Hongting Jin

    2016-01-01

    Full Text Available This study aimed to investigate if autologous bone marrow mesenchymal stem cells (MSCs could treat osteonecrosis of the femoral head (ONFH and what the fate and distribution of the cells are in dogs. Twelve Beagle dogs were randomly divided into two groups: MSCs group and SHAM operated group. After three weeks, dogs in MSCs group and SHAM operated group were intra-arterially injected with autologous MSCs and 0.9% normal saline, respectively. Eight weeks after treatment, the necrotic volume of the femoral heads was significantly reduced in MSCs group. Moreover, the trabecular bone volume was increased and the empty lacunae rate was decreased in MSCs group. In addition, the BrdU-positive MSCs were unevenly distributed in femoral heads and various vital organs. But no obvious abnormalities were observed. Furthermore, most of BrdU-positive MSCs in necrotic region expressed osteocalcin in MSCs group and a few expressed peroxisome proliferator-activated receptor-γ (PPAR-γ. Taken together, these data indicated that intra-arterially infused MSCs could migrate into the necrotic field of femoral heads and differentiate into osteoblasts, thus improving the necrosis of femoral heads. It suggests that intra-arterial infusion of autologous MSCs might be a feasible and relatively safe method for the treatment of femoral head necrosis.

  19. Therapeutic effect of intra-arterial chemotherapy with DDP and 5-FU via bilateral uterine arteries for advanced uterine cervical cancer

    International Nuclear Information System (INIS)

    Zhou Kang; Li Xiaoguang; Jin Zhengyu; Yang Ning; Liu Wei; Pan Jie; Zhang Xiaobo; Shi Haifeng; Sun Hao; Wang Zhiwei

    2010-01-01

    Objective: To evaluate the therapeutic effect of intra-arterial chemotherapy with Ddp and 5-Fu via bilateral uterine arteries for advanced uterine cervical cancer. Methods: During the period of Jan. 2006-Jan. 2009, initial intra-arterial chemotherapy by using a combination of Ddp and 5-Fu via bilateral uterine arteries was performed in 72 patients (mean age 42.9 years) with advanced uterine cervical caner. Of 72 patients, stage I b2 cervical cancer was confirmed in 28, stage II a in 12 and stage II b in 32. Pathologically, cervical squamous cell carcinoma was seen in 56 and cervical adenocarcinoma in 16 patients. Ultrasonography and physical examination were conducted both before and after intra-arterial chemotherapy. The therapeutic results,complications,the surgical resection rate and the pathologic findings were observed and statistically analyzed. Results: Fifty-four patients received one treatment course and 18 patients received two treatment courses. The over all response rate was 77.8%. The response rates of patients with I b2, II a and II b cervical cancer were 92.9%, 83.3% and 62.5% respectively, the difference between three groups was statistically significant (P < 0.05). And the response rates of patients with squamous cell carcinoma and adenocarcinoma were 85.7% and 50.0% respectively, the difference between the two was statistically significant (P < 0.05). The most common side-effects included gastrointestinal symptoms and bone marrow suppression. Thirty-four patients received radical hysterectomy,among them, 22 (78.6%) had stage I b2, 8 (66.7%) had stage II a and 4 (12.5%) had stage II b cervical cancer (P < 0.05). Pathologic exam found no vaginal invasion and ovarian metastasis in all 34 patients. The occurrence of metastasis to lymph nodes and para uterine infiltration were 17.6% and 11.8% respectively. Conclusion: Intra-arterial chemotherapy with a combination of DDP and 5-Fu via bilateral uterine arteries can safely and effectively reduce the

  20. Relationship between clinical factors and the incidence of toxicity after intra-arterial chemoradiation for head and neck cancer

    International Nuclear Information System (INIS)

    Broek, Guido B. van den; Balm, Alfons J.M.; Brekel, Michiel W.M. van den; Hauptmann, Michael; Schornagel, Jan H.; Rasch, Coen R.N.

    2006-01-01

    Background and purpose: Concomitant chemoradiation is more and more used for advanced head and neck cancer. It improves local control and survival compared to radiotherapy alone, but goes along with serious toxicity. This study was set up to determine the relationship between patient-, tumour- and treatment-related factors and acute/late toxicity after concomitant chemoradiation. Patients and methods: One hundred and twenty-five consecutive patients with newly diagnosed inoperable stage III and IV head and neck cancer were enrolled for intra-arterial chemoradiation. There were 28 women (22%) and 97 men (78%) and the mean age was 55 years (range 30-80). One hundred and nine patients had stage IV disease (87%), 16 patients (13%) had stage III disease. Statistical analyses were performed to identify an association between factors and acute/late toxicity. Results: There were eight treatment-related deaths (6%). Severe acute toxicity (grade 3-4), mainly mucositis and dysphagia as categorized by the RTOG toxicity criteria, was recorded in 51% of the patients. Leucopenia (grade 3-4) occurred in 39% and aspiration pneumonia in 20% of patients. Tracheotomy was necessary in 15 (12%) patients. Neurological complications during treatment occurred in 3 (2%) patients. Severe late toxicity occurred in 34% of the patients. The most important of these were pneumonia (14%), osteoradionecrosis (9%) and swallowing problems with permanent percutaneous gastrostomy (20%). Statistical analysis did show a significant association between site and severe acute mucositis (p = 0.007), site and osteoradionecrosis (p = 0.014) and age and xerostomia (p = 0.004). Conclusions: Chemoradiation is frequently associated with serious toxicity. Oral cavity tumours and older age are related to acute mucositis/osteoradionecrosis and xerostomia, respectively

  1. Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment

    International Nuclear Information System (INIS)

    Sogabe, Shu; Satomi, Junichiro; Tada, Yoshiteru; Kanematsu, Yasuhisa; Kuwayama, Kazuyuki; Yagi, Kenji; Yoshioka, Shotaro; Mizobuchi, Yoshifumi; Mure, Hideo; Yamaguchi, Izumi; Kitazato, Keiko T.; Nagahiro, Shinji; Abe, Takashi; Harada, Masafumi; Yamamoto, Nobuaki; Kaji, Ryuji

    2017-01-01

    Arterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment. Our study included 13 patients with acute ICA occlusion who had undergone angiographic and ASL studies within 48 h of onset. We retrospectively identified the high IAS on ASL images and angiograms and recorded the occluded segment and the number of high IAS-positive slices on ASL images. The ICA segments were classified as cervical (C1), petrous (C2), cavernous (C3), and supraclinoid (C4). Of seven patients with intracranial ICA occlusion, five demonstrated high IASs at C1-C2, suggesting that high IASs could identify stagnant flow proximal to the occluded segment. Among six patients with extracranial ICA occlusion, five presented with high IASs at C3-C4, suggesting that signals could identify the collateral flow via the ophthalmic artery. None had high IASs at C1-C2. The mean number of high IAS-positive slices was significantly higher in patients with intra- than extracranial ICA occlusion. High IASs on ASL images can identify slow stagnant and collateral flow through the ophthalmic artery in patients with acute ICA occlusion and help to predict the occlusion site. (orig.)

  2. Randomized comparison of intra-arterial and intravenous thrombolysis in a canine model of acute basilar artery thrombosis

    International Nuclear Information System (INIS)

    Qureshi, A.I.; Yahia, A.M.; Boulos, A.S.; Hanel, R.A.; Suri, M.F.K.; Hopkins, L.N.; Alberico, R.A.

    2004-01-01

    We compared the rates of recanalization cerebral infarct and hemorrhage between intra-arterial (IA) reteplase and intravenous (IV) alteplase thrombolysis in a canine model of basilar artery thrombosis. Thrombosis was induced by injecting a clot in the basilar artery of 13 anesthetized dogs via superselective catheterization. The animals were randomized in a blinded fashion, 2 h after clot injection and verification of arterial occlusion, to receive IV alteplase 0.9 mg/kg over 60 min and IA placebo, or IA reteplase 0.09 units/kg over 20 min, equivalent to one-half the alteplase dose, and IV placebo. Recanalization was studied for 6 h after treatment with serial angiography; the images were later graded in a blinded fashion. Blinded interpretation of postmortem MRI was performed to assess the presence of brain infarcts and/or hemorrhage. At 3 h after initiation of treatment, partial or complete recanalization was observed in one of six dogs in the IV alteplase group and in five of seven in the IA reteplase group (P = 0.08). At 6 h, no significant difference in partial or complete recanalization was observed between the groups (two of six vs. five of seven; P = 0.20). Postmortem MRI revealed infarcts in four of six animals treated with IV alteplase and three of seven treated with IA reteplase (P = 0.4). Intracerebral hemorrhage was more common in the IV alteplase group (four of six vs. none of seven; P = 0.02). This study thus suggests that IA thrombolysis affords a recanalization rate similar to that of IV thrombolysis, but with a lower rate of intracerebral hemorrhage. (orig.)

  3. Intra-arterial chemotherapy for retinoblastoma: Two-year results from tertiary eye-care center in India

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    Pukhraj Rishi

    2017-01-01

    Full Text Available Aim: The aim of this study is to describe treatment outcomes and complications of selective intra-arterial chemotherapy (IAC for intraocular retinoblastoma (RB. Materials and Methods: A retrospective, interventional series of 10 eyes with RB which underwent IAC using melphalan (5 mg/7.5 mg and topotecan (1 mg, or melphalan (5 mg/7.5 mg alone. Treatment outcomes were evaluated in terms of tumor control, vitreous seeds (VS and subretinal seeds (SRS control, and globe salvage rates. Results: Ten eyes of 10 patients underwent 38 IAC sessions (mean = 3.8; median = 4; range = 3–5 sessions. Following IAC, complete regression of main tumor was seen in 9 eyes (90% and partial regression in 1 (10%. All four eyes with SRS showed complete regression (100%. Of 5 eyes with VS, 3 eyes (60% showed complete regression, 1 eye (20% showed relapse, while 1 eye (20% showed no response. Globe salvage was achieved in 8 of 10 eyes (80%. Complications included transient ophthalmic artery narrowing (n = 2, branched retinal vein occlusion (n = 1, forehead skin pigmentation (n = 1, and vitreous hemorrhage (n = 2. There was no case of stroke, hemiplegia, metastasis, or death. Transient hematological changes included relative pancytopenia (n = 4, relative leukopenia (n = 5, and relative thrombocytopenia (n = 4. Mean follow-up was 26 months (median = 28, range = 13–36 from the initiation of first IAC. Conclusions: IAC is an effective therapy for globe preservation in eyes with intraocular RB, in the setting of a developing country like India. Larger studies with longer follow-up are required to validate these results.

  4. Influential factors of clinical outcome of local intra-arterial thrombolysis using urokinase in patients with hyperacute ischemic stroke

    International Nuclear Information System (INIS)

    Song, Jae Min; Yoon, Woong; Kim, Jae Kyu; Seo, Jeong Jin; Heo, Sook Hee; Park, Jin Gyoon; Jeong, Yoon Yeon; Kang, Heoung Keun

    2002-01-01

    To evaluate the clinical outcome and other relevant factors in cases where local intra-arterial thrombolysis (LIT) is used for the treatment of hyperacute ischemic stroke. Forty-eight hyperacute ischemic stroke patients were treated by LIT, using urokinase, within six hours of ictus, and for evaluation of their neurological status, the national institutes of health stroke scale (NIHSS) score was used. Angiography recanalization was classified according to Mori recanalization grades. Three months after LIT, the outcome was assessed by clinical examination using the modified rankin scale (good outcome: RS=0-3; poor outcome: RS=4-6). In all patients, the findings of pre- and post- LIT CT, and angiography, as well as neurological status and hemorrhagic complications, were also analysed. Thirty-three patients had occlusions of the middle cerebral artery (MCA), and 15, of the internal carotid artery (ICA). The NIHSS score averaged 16.9 at the onset of therapy and 13.5 at 24 hours later. Successful recanalization (Mori grade 3,4) was achieved in 28 (58.3%) of 48 patients, but in 20 (41.7%) the attempt failed. Twenty-two (45.8%) of the 48 patients had a good outcome, but in (54.2%) the outcome was poor. Thirteen (40.6%) of 32 patients with MCA occlusions and 13 (81.2%) of 16 with ICA occlusions had a poor outcome. Eight patients (16.7%) died. Overall, hemorrhages occured in 20 (41.7%) of 48 patients, with symptomatic hemorrhage in ten. Five (50%) of these ten died. LIT using urokinase for hyperacute ischemic stroke is feasible; patients with MCA occlusions had better outcomes than those with ICA occlusions. Hemorrhagic complications of LIT were frequent, and in cases of symptomatic hemorrhage a fatal outcome may be expected

  5. A bladder preservation regimen using intra-arterial chemotherapy and radiotherapy for invasive bladder cancer. A prospective study

    International Nuclear Information System (INIS)

    Miyanaga, Naoto; Akaza, Hideyuki; Okumura, Toshiyuki

    2000-01-01

    A prospective study was performed to investigate combined treatment with intra-arterial chemotherapy and radiation therapy for bladder preservation in locally invasive bladder cancer. Patients with invasive bladder cancer, stage T2-3N0M0, were included in the study. lntra-arterial chemotherapy was performed with three injections of methotrexate and cisplatin at 3-week intervals. Simultaneously, the patients underwent X-ray irradiation (40 Gy) of the small pelvic space. Where a post-treatment transurethral resection (TUR) biopsy showed no residual tumor, the tumor site was irradiated by a 30 Gy proton beam and the bladder was preserved. Where tumors remained, radical cystectomy was performed. Between 1990 and 1996, 42 patients were treated according to this protocol. Post-treatment TUR biopsy and urine cytology showed no residual tumors in 39 of 42 cases (93%). The bladder was preserved in accordance with the study protocol in 36 cases. A median follow-up of 38 months showed 3-year non-recurrence in 72% of bladder-preserved patients and the rate of bladder preservation was 84%. The nine recurrences included eight cases of superficial bladder recurrence. One cancer death occurred among the bladder-preservation patients, giving 3-year survival and cause-specific survival rates of 84% and 100%, respectively. Although bladder function decreased slightly in compliance, bladder capacity was retained in almost all cases. This regimen is useful for bladder preservation in T2-3 locally invasive bladder cancer. Information from more cases and the results of more long-term observations are needed, as is an evaluation of appropriate subject selection and factors associated with quality of life issues, particularly regarding bladder function. (author)

  6. Factors associated with rapid neurological improvement 24 h following intra-arterial thrombolytic treatment for acute ischemic stroke.

    Science.gov (United States)

    Christoforidis, Gregorgy; Mohammad, Yousef M; Khadir, Mohammed; Yang, Ming; Slivka, Andrew P

    2013-01-01

    Significant 24 h improvement is the strongest indicator of functional recovery following thrombolytic treatment for acute ischemic stroke. This study sought to analyze factors contributing to rapid neurological improvement (RNI) following intra-arterial thrombolytic treatment (IATT). Angiograms and clinical information derived from consecutive patients receiving treatment initiated within 6 h of stroke onset were retrospectively reviewed. RNI was defined as at least 50% 24 h improvement on the National Institutes of Health Stroke Scale score. Logistic regression analysis identified factors associated with RNI. Variables tested included: age, gender, serum glucose, platelet count, pial collateral formation, presenting National Institutes of Health Stroke Scale score, time to treatment, extent of reperfusion, site and location of occlusion, treatment agent and systolic blood pressure. Greater than 50% reperfusion of the involved territory, time to treatment within 270 min and good pial collateral formation (large penumbra zone) significantly predicted RNI. RNI occurred in 31% of the 112 patients studied. RNI occurred in 21/26 (80.8%) patients exhibiting all three favorable variables whereas patients with only one favorable variable had a 6.5% chance of RNI. 94% of patients displaying RNI had a modified Rankin Scale score of 2 or less at 3 months compared with 28.6% without RNI. RNI following IATT for stroke is more likely when at least two of the following are present: good reperfusion, good pial collateral formation and treatment within 4.5 h of symptom onset, and is strongly predictive of 3 month outcomes. Important to clinical management, IATT may need to be reconsidered in patients with poor pial collateral formation if time to treatment exceeds 4.5 h.

  7. Comparison of arterial blood gas with continuous intra-arterial and transcutaneous PO2 sensors in adult critically ill patients.

    Science.gov (United States)

    Green, G E; Hassell, K T; Mahutte, C K

    1987-05-01

    We compared the partial pressure of oxygen directly via a continuous intra-arterial probe (PiaO2) and indirectly using a transcutaneous device (PtcO2) with simultaneously obtained arterial blood PaO2. The PiaO2 values were measured using a bipolar oxygen sensor placed through an 18-ga arterial catheter. The PtcO2 values were measured using a transcutaneous O2-CO2 sensor placed on the abdomen. Seven critically ill, hemodynamically stable, ventilator-dependent adult patients were studied. Measurements were obtained at varying concentrations (0.25 to 1.0) of inspired oxygen after a 10-min stabilization. A total of 78 simultaneous values were obtained; by linear regression: PiaO2 = 0.91 PaO2 + 1.39 (r = .98, standard errors of the estimate [SEE] = 18.6); PtcO2 = 0.39 PaO2 + 36.2 (r = .89, SEE = 14.1). To assess these instruments as trend monitors, we compared the changes in simultaneous PaO2, PiaO2, and PtcO2 values; by linear regression: delta PiaO2 = 0.90 delta PaO2 + 3.88 (r = .96, SEE = 27.7); delta PtcO2 = 0.43 delta PaO2 + 5.6 (r = .94, SEE = 15.2). We conclude that, although these instruments correlate highly with the PaO2, the SEE was substantial and therefore may limit their clinical reliability in adults. Any acute or clinically significant change in PiaO2 or PtcO2 should be confirmed with a blood gas PaO2.

  8. Pilot study of intra-arterial cisplatin and intravenous vinblastine and dacarbazine in patients with melanoma in-transit metastases.

    Science.gov (United States)

    Eton, O; East, M; Legha, S S; Bedikian, A; Buzaid, A C; Papadopoulos, N; Hodges, C; Gianan, M; Carrasco, C H; Benjamin, R S

    1999-10-01

    For melanoma, in-transit metastases (ITMs) are a harbinger of systemic disease in over 70% of patients and thus warrant a systemic approach to management. In this study, previously untreated patients with ITMs (n=15) received a systemic regimen of 'CVD' in 21 day cycles (median, three cycles) as follows: dacarbazine 800 mg/m2 intravenously (i.v.) on day 1, vinblastine 1.6 mg/m2 i.v. on days 1-5, and cisplatin (CDDP) 100 mg/m2 by 24 h intra-arterial (i.a.) infusion in 1l of heparinized saline via the iliac or subclavian artery on day 3. There were three clinical complete responses (CRs) in patients with a modest burden of ITMs (< 3 cm in size) and seven partial responses (PRs), yielding a 67% response rate (95% confidence interval, 38-88%). One of the clinical CRs had microscopic residual disease at surgery (a pathological PR). The times to progression (TTP) for the CRs were 5, 21 and 38+ months; the median TTP for the PRs was 4.5 months (range, 2-10 months). Overall median survival was 31 months. Systemic toxicities were similar to those induced by i.v. CVD. However, patients noted more pronounced paraesthesia in the infused extremity. Also, two patients experienced severe CDDP-induced burns, one patient developed brachial plexopathy, and one patient had a haemorrhage in an occult brain metastasis. The high clinical activity of this regimen will have to be confirmed in more patients before a first-pass i.a. advantage can be claimed. Furthermore, the dose, schedule and technique of i.a. CDDP delivery must be further refined before it can be routinely incorporated in regimens as an alternative to isolated regional hyperthermic perfusion, which is technically more difficult and is not readily available in community-based hospitals.

  9. Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment

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    Sogabe, Shu; Satomi, Junichiro; Tada, Yoshiteru; Kanematsu, Yasuhisa; Kuwayama, Kazuyuki; Yagi, Kenji; Yoshioka, Shotaro; Mizobuchi, Yoshifumi; Mure, Hideo; Yamaguchi, Izumi; Kitazato, Keiko T.; Nagahiro, Shinji [Tokushima University Graduate School, Department of Neurosurgery, Tokushima (Japan); Abe, Takashi; Harada, Masafumi [Tokushima University Graduate School, Department of Radiology, Tokushima (Japan); Yamamoto, Nobuaki; Kaji, Ryuji [Tokushima University Graduate School, Department of Clinical Neurosciences, Institute of Biomedical Biosciences, Tokushima (Japan)

    2017-06-15

    Arterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment. Our study included 13 patients with acute ICA occlusion who had undergone angiographic and ASL studies within 48 h of onset. We retrospectively identified the high IAS on ASL images and angiograms and recorded the occluded segment and the number of high IAS-positive slices on ASL images. The ICA segments were classified as cervical (C1), petrous (C2), cavernous (C3), and supraclinoid (C4). Of seven patients with intracranial ICA occlusion, five demonstrated high IASs at C1-C2, suggesting that high IASs could identify stagnant flow proximal to the occluded segment. Among six patients with extracranial ICA occlusion, five presented with high IASs at C3-C4, suggesting that signals could identify the collateral flow via the ophthalmic artery. None had high IASs at C1-C2. The mean number of high IAS-positive slices was significantly higher in patients with intra- than extracranial ICA occlusion. High IASs on ASL images can identify slow stagnant and collateral flow through the ophthalmic artery in patients with acute ICA occlusion and help to predict the occlusion site. (orig.)

  10. Intra-Arterial Delivery of AAV Vectors to the Mouse Brain After Mannitol Mediated Blood Brain Barrier Disruption

    Science.gov (United States)

    Santillan, Alejandro; Sondhi, Dolan; Dyke, Jonathan P.; Crystal, Ronald G.; Gobin, Y. Pierre; Ballon, Douglas J.

    2014-01-01

    The delivery of therapeutics to neural tissue is greatly hindered by the blood brain barrier (BBB). Direct local delivery via diffusive release from degradable implants or direct intra-cerebral injection can bypass the BBB and obtain high concentrations of the therapeutic in the targeted tissue, however the total volume of tissue that can be treated using these techniques is limited. One treatment modality that can potentially access large volumes of neural tissue in a single treatment is intra-arterial (IA) injection after osmotic blood brain barrier disruption. In this technique, the therapeutic of interest is injected directly into the arteries that feed the target tissue after the blood brain barrier has been disrupted by exposure to a hyperosmolar mannitol solution, permitting the transluminal transport of the therapy. In this work we used contrast enhanced magnetic resonance imaging (MRI) studies of IA injections in mice to establish parameters that allow for extensive and reproducible BBB disruption. We found that the volume but not the flow rate of the mannitol injection has a significant effect on the degree of disruption. To determine whether the degree of disruption we observed with this method was sufficient for delivery of nanoscale therapeutics, we performed IA injections of an adeno-associated viral vector containing the CLN2 gene (AAVrh.10CLN2), which is mutated in the lysosomal storage disorder Late Infantile Neuronal Ceroid Lipofuscinosis (LINCL). We demonstrated that IA injection of AAVrh.10CLN2 after BBB disruption can achieve widespread transgene production in the mouse brain after a single administration. Further, we showed that there exists a minimum threshold of BBB disruption necessary to permit the AAV.rh10 vector to pass into the brain parenchyma from the vascular system. These results suggest that IA administration may be used to obtain widespread delivery of nanoscale therapeutics throughout the murine brain after a single

  11. Influential factors of clinical outcome of local intra-arterial thrombolysis using urokinase in patients with hyperacute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jae Min; Yoon, Woong; Kim, Jae Kyu; Seo, Jeong Jin; Heo, Sook Hee; Park, Jin Gyoon; Jeong, Yoon Yeon; Kang, Heoung Keun [Chonam University Hospital, Kwangju (Korea, Republic of)

    2002-10-01

    To evaluate the clinical outcome and other relevant factors in cases where local intra-arterial thrombolysis (LIT) is used for the treatment of hyperacute ischemic stroke. Forty-eight hyperacute ischemic stroke patients were treated by LIT, using urokinase, within six hours of ictus, and for evaluation of their neurological status, the national institutes of health stroke scale (NIHSS) score was used. Angiography recanalization was classified according to Mori recanalization grades. Three months after LIT, the outcome was assessed by clinical examination using the modified rankin scale (good outcome: RS=0-3; poor outcome: RS=4-6). In all patients, the findings of pre- and post- LIT CT, and angiography, as well as neurological status and hemorrhagic complications, were also analysed. Thirty-three patients had occlusions of the middle cerebral artery (MCA), and 15, of the internal carotid artery (ICA). The NIHSS score averaged 16.9 at the onset of therapy and 13.5 at 24 hours later. Successful recanalization (Mori grade 3,4) was achieved in 28 (58.3%) of 48 patients, but in 20 (41.7%) the attempt failed. Twenty-two (45.8%) of the 48 patients had a good outcome, but in (54.2%) the outcome was poor. Thirteen (40.6%) of 32 patients with MCA occlusions and 13 (81.2%) of 16 with ICA occlusions had a poor outcome. Eight patients (16.7%) died. Overall, hemorrhages occured in 20 (41.7%) of 48 patients, with symptomatic hemorrhage in ten. Five (50%) of these ten died. LIT using urokinase for hyperacute ischemic stroke is feasible; patients with MCA occlusions had better outcomes than those with ICA occlusions. Hemorrhagic complications of LIT were frequent, and in cases of symptomatic hemorrhage a fatal outcome may be expected.

  12. Accuracy of a Cone-Beam CT Virtual Parenchymal Perfusion Algorithm for Liver Cancer Targeting during Intra-arterial Therapy.

    Science.gov (United States)

    Derbel, Haytham; Kobeiter, Hicham; Pizaine, Guillaume; Ridouani, Fourat; Luciani, Alain; Radaelli, Alessandro; Van der Sterren, William; Chiaradia, Mélanie; Tacher, Vania

    2018-02-01

    To evaluate accuracy of virtual parenchymal perfusion (VPP) algorithm developed for targeting liver cancer during intra-arterial therapy (IAT) using cone-beam CT guidance. VPP was retrospectively applied to 15 patients who underwent IAT for liver cancer. Virtual territory (VT) was estimated after positioning a virtual injection point on nonselective dual-phase (DP) cone-beam CT images acquired during hepatic arteriography at the same position chosen for selective treatment. Targeted territory (TT) was used as the gold standard and was defined by parenchymal phase enhancement of selective DP cone-beam CT performed before treatment start. Qualitative evaluation of anatomic conformity between VT and TT was performed using a 3-rank scale (poor, acceptable, excellent) by 3 double-blinded readers. VT and TT were also quantitatively compared using spatial overlap-based (Dice similarity coefficient [DSC], sensitivity, and positive predictive value), distance-based (mean surface distance [MSD]), and volume-based (absolute volume error and correlation between pairwise volumes) metrics. Interreader agreement was evaluated for the 2 evaluation methods. Eighteen DP cone-beam CT scans were performed. Qualitative evaluation showed excellent overlap between VT and TT in 88.9%-94.4%, depending on the readers. DSC was 0.78 ± 0.1, sensitivity was 80%, positive predictive value was 83%, and MSD was 5.1 mm ± 2.4. Absolute volume error was 15%, and R 2 Pearson correlation factor was 0.99. Interreader agreement was good for both qualitative and quantitative evaluations. VPP algorithm is accurate and reliable in identification of liver arterial territories during IAT using cone-beam CT guidance. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  13. Radionuclide identification using subtractive clustering method

    Energy Technology Data Exchange (ETDEWEB)

    Farias, Marcos Santana, E-mail: msantana@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Instrumentacao e Confiabilidade Humana; Nedjah, Nadia, E-mail: nadia@eng.uerj.br [Departamento de Engenharia Eletronica e Telecomunicacoes. Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil); Mourelle, Luiza de Macedo, E-mail: ldmm@eng.uerj.br [Departamento de Engenharia de Sistemas e Computacao. Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil)

    2011-07-01

    Radionuclide identification is crucial to planning protective measures in emergency situations. This paper presents the application of a method for a classification system of radioactive elements with a fast and efficient response. To achieve this goal is proposed the application of subtractive clustering algorithm. The proposed application can be implemented in reconfigurable hardware, a flexible medium to implement digital hardware circuits. (author)

  14. Radionuclide identification using subtractive clustering method

    International Nuclear Information System (INIS)

    Farias, Marcos Santana; Mourelle, Luiza de Macedo

    2011-01-01

    Radionuclide identification is crucial to planning protective measures in emergency situations. This paper presents the application of a method for a classification system of radioactive elements with a fast and efficient response. To achieve this goal is proposed the application of subtractive clustering algorithm. The proposed application can be implemented in reconfigurable hardware, a flexible medium to implement digital hardware circuits. (author)

  15. Temporal evolution of vasospasm and clinical outcome after intra-arterial vasodilator therapy in patients with aneurysmal subarachnoid hemorrhage.

    Directory of Open Access Journals (Sweden)

    Laleh Daftari Besheli

    Full Text Available Intra-arterial (IA vasodilator therapy is one of the recommended treatments to minimize the impact of aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm refractory to standard management. However, its usefulness and efficacy is not well established. We evaluated the effect IA vasodilator therapy on middle cerebral artery blood flow and on discharge outcome. We reviewed records for 115 adults admitted to Neurointensive Care Unit to test whether there was a difference in clinical outcome (discharge mRS in those who received IA infusions. In a subset of 19 patients (33 vessels treated using IA therapy, we tested whether therapy was effective in reversing the trends in blood flow. All measures of MCA blood flow increased from day -2 to -1 before infusion (maximum Peak Systolic Velocity (PSV 232.2±9.4 to 262.4±12.5 cm/s [p = 0.02]; average PSV 202.1±8.5 to 229.9±10.9 [p = 0.02]; highest Mean Flow Velocity (MFV 154.3±8.3 to 172.9±10.5 [p = 0.10]; average MFV 125.5±6.3 to 147.8±9.5 cm/s, [p = 0.02] but not post-infusion (maximum PSV 261.2±14.6 cm/s [p = .89]; average PSV 223.4±11.4 [p = 0.56]; highest MFV 182.9±12.4 cm/s [p = 0.38]; average MFV 153.0±10.2 cm/s [p = 0.54]. After IA therapy, flow velocities were consistently reduced (day X infusion interaction p<0.01 for all measures. However, discharge mRS was higher in IA infusion group, even after adjusting for sex, age, and admission grades. Thus, while IA vasodilator therapy was effective in reversing the vasospasm-mediated deterioration in blood flow, clinical outcomes in the treated group were worse than the untreated group. There is need for a prospective randomized controlled trial to avoid potential confounding effect of selection bias.

  16. Added Value of Bone Subtraction in Dual-energy Digital Radiography in the Detection of Pneumothorax: Impact of Reader Expertise and Medical Specialty.

    Science.gov (United States)

    Urbaneja, Ayla; Dodin, Gauthier; Hossu, Gabriela; Bakour, Omar; Kechidi, Rachid; Gondim Teixeira, Pedro; Blum, Alain

    2018-01-01

    This study aimed to determine the value of dual-energy thoracic radiography in the diagnosis of pneumothorax considering the reader's experience. Forty patients with a suspected pneumothorax, imaged with dual-energy chest radiographs, were divided into two groups: those with pneumothorax as the final diagnosis (n = 19) and those without (n = 21). The images were analyzed by 36 readers (5 interns, 16 residents, 15 senior physicians) for the presence or absence of pneumothorax during three readout sessions at 2-week intervals: standard images alone (session 1), dual-energy images with bone subtraction alone (session 2), and a combination of the two (session 3). The number of correct responses increased 13.3% between sessions 1 and 2 (P expertise. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  17. High incidence of nephropathy in neurosurgical patients after intra-arterial administration of low-osmolar and iso-osmolar contrast media.

    Science.gov (United States)

    Serafin, Zbigniew; Karolkiewicz, Maciej; Gruszka, Marzena; Strózecki, Pawel; Lasek, Wladyslaw; Odrowaz-Sypniewska, Grazyna; Manitius, Jacek; Beuth, Wojciech

    2011-05-01

    Percutaneous endovascular examinations and interventions require significant amounts of iodinated contrast media (CM) and have been reported to be complicated by an increased incidence of post-contrast nephropathy. To evaluate renal function, the incidence of post-contrast nephropathy, and risk factors after interventional procedures in neurosurgical patients after intra-arterial administration of a low-osmolar contrast medium (LOCM) versus an iso-osmolar contrast medium (IOCM). This single-center, prospective, randomized, double-blinded study included 92 patients in its final analysis (mean age 49.6 ± 12.6 years, 29.3% men, mean eGFR 97.8 ± 26.3 mL/min/1.73 m(2)). LOCM was used in 48 patients (52.2%) and IOCM in 44 patients (47.8%). The patients were given an average of 151.2 ± 52.1 mL of contrast medium intra-arterially. Serum creatinine (SCr), urinary N-acetyl-β-glucosaminidase (NAG) excretion, and creatinine clearance (CCr) were measured at baseline, and on days 1 and 3 after the procedure. Baseline risk factors, renal functional parameters, and average CM doses were not statistically different between the two groups. SCr, NAG, and CCr values did not differ significantly between the LOCM and IOCM groups on days 1 and 3 after CM administration. Nephropathy developed in 21 cases (22.8%): 13 (27.1%) after LOCM use and 8 (18.2%) after IOCM; (P = NS). The only significant risk factors of CIN were the diabetes (P = 0.0466) and atherosclerosis (P = 0.0498). We found a high incidence of nephropathy in neurosurgical patients after intra-arterial CM administration. The renal function values and incidence of nephropathy following LOCM administration were not statistically different from those following IOCM administration.

  18. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  19. Treatment of hepatocellular carcinoma (HCC) with intra-arterial Yttrium-90 microspheres for down-staging patients to transplantation

    International Nuclear Information System (INIS)

    De Man, K.; Defreyne, L.; Delanghe, E.; Smeets, P.; Verhelst, X.; Geerts, A.; Van Vlierberghe, H.; Rogiers, X.; Troisi, R.; Lambert, B.

    2015-01-01

    Full text of publication follows. Introduction and aim: in our hospital, patients are referred for intra-arterial treatment with Yttrium-90 microspheres if they present with an HCC confined to the liver, but are ineligible for curative treatment options such as liver transplantation, partial hepatectomy or radio-frequent ablation. Additional eligibility criteria for radio-embolisation consist of Child-P ugh score

  20. Targeting brain tumors by intra-arterial delivery of cell-penetrating peptides: a novel approach for primary and metastatic brain malignancy.

    Science.gov (United States)

    Joshi, Shailendra; Cooke, Johann R N; Ellis, Jason A; Emala, Charles W; Bruce, Jeffrey N

    2017-12-01

    Computational modeling shows that intra-arterial delivery is most efficient when the delivered drugs rapidly and avidly bind to the target site. The cell-penetrating peptide trans-activator of transcription (TAT) is a candidate carrier molecule that could mediate such specificity for brain tumor chemotherapeutics. To test this hypothesis we first performed in vitro studies testing the uptake of TAT by one primary and three potentially metastatic brain cancer cell lines (9L, 4T-1, LLC, SKOV-3). Then we performed in vivo studies in a rat model where TAT was delivered either intra-arterially (IA) or intravenously (IV) to 9L brain tumors. We observed robust uptake of TAT by all tumor cell lines in vitro. Flow cytometry and confocal microscopy revealed a rapid uptake of fluorescein-labeled TAT within 5 min of exposure to the cancer cells. IA injections done under transient cerebral hypoperfusion (TCH) generated a four-fold greater tumor TAT concentration compared to conventional IV injections. We conclude that it is feasible to selectively target brain tumors with TAT-linked chemotherapy by the IA-TCH method.

  1. Intra-Arterial Treatment in Patients with Acute Massive Gastrointestinal Bleeding after Endoscopic Failure: Comparisons between Positive versus Negative Contrast Extravasation Groups

    International Nuclear Information System (INIS)

    Chang, Wei Chou; Liu, Chang Hsien; Hsu, Hsian He; Huang, Guo Shu; Hsieh, Tasi Yuan; Tsai, Shin Hung; Hsieh, Chung Bao; Yu, Chin Yung; Tung, Ho Jui

    2011-01-01

    To determine whether treatment outcome is associated with visualization of contrast extravasation in patients with acute massive gastrointestinal bleeding after endoscopic failure. From January 2007 to December 2009, patients that experienced a first attack of acute gastrointestinal bleeding after failure of initial endoscopy were referred to our interventional department for intra-arterial treatment. We enrolled 79 patients and divided them into two groups: positive and negative extravasation. For positive extravasation, patients were treated by coil embolization; and in negative extravasation, patients were treated with intra-arterial vasopressin infusion. The two groups were compared for clinical parameters, hemodynamics, laboratory findings, endoscopic characteristics, and mortality rates. Forty-eight patients had detectable contrast extravasation (positive extravasation), while 31 patients did not (negative extravasation). Fifty-six patients survived from this bleeding episode (overall clinical success rate, 71%). An elevation of hemoglobin level was observed in the both two groups; significantly greater in the positive extravasation group compared to the negative extravasation group. Although these patients were all at high risk of dying, the 90-day mortality rate was significantly lower in the positive extravasation than in the negative extravasation (20% versus 42%, p < 0.05). A multivariate analysis suggested that successful hemo stasis (odds ratio [OR] = 28.66) is the most important predictor affecting the mortality in the two groups of patients. Visualization of contrast extravasation on angiography usually can target the bleeding artery directly, resulting in a higher success rate to control of hemorrhage.

  2. Intra-arterial cisplatin and concurrent radiation in the treatment of invasive bladder cancer in the elderly: 10 years of experience

    International Nuclear Information System (INIS)

    Eapen, L.; Stewart, D.; Grimard, L.; Crook, J.; Aref, I.; Huan, S.; Futter, N.; Rasuli, P.; Peterson, R.

    1998-01-01

    Analysis of the results obtained in elderly (75 years and older) included a phase II trial combining intra-arterial cisplatin and concurrent radiation into invasive bladder cancer. Thirty-five patients (28 males and 7 females) were accrued from 1985 to 1996. There were 1 Ta, 4 T2, 11 T3A, 12 T3B, 3 T4A, and 4 T4B patients. Nine had unilateral hydronephrosis and two bilateral hydronephrosis. There were 28 trans-urethral resections which were incomplete in 23 patients. Intra-arterial cisplatin was given as 2-4 hours infusion (60-90 mg/m 2 ) split through both internal iliac arteries on day 1, 14, 21, and 42. Irradiation to the pelvis was started on day 14 and consisted of 40 Gy/20 fractions followed by a boost of 20 Gy/10 fractions to the tumor with margins of 2 cm. Thirty (86%) completed fully the protocol. One patient died from sepsis secondary to the treatment. The tumor response was evaluable in 29 patients and complete response was observed for 27> of them. Five of these 27 patients had an isolated bladder relapse which was salvaged by by cystectomy in two patients. There were 11 deaths from bladder cancer (31% of the patients): 9 from deaths metastases, one from local failure, and one from treatment. This combined modality yields excellent results with high complete response rate and good tolerance. This approach may therefore be particularly appropriate for the elderly. (author)

  3. Superselective intra-arterial chemoradiotherapy for laryngeal cancer. Is it reasonable to treat glottic cancer in a similar way to supraglottic cancer?

    International Nuclear Information System (INIS)

    Yoshizaki, Tomokazu; Murono, Shigeyuki; Wakisaka, Naohiro; Kondo, Satoru; Furukawa, Mitsuru

    2006-01-01

    The standard treatment for advanced laryngeal cancer has been shifting from total laryngectomy to various organ preservation therapies such as subtotal laryngectomy and chemoradiotherapy. Robbins showed remarkable results with RADPLAT, the superselective intra-arterial infusion of supradose cisplatin (150 mg/m 2 ), against advanced head and neck cancer. However, the volume of laryngeal cancer is smaller than those of the other sites of head and neck cancers, and so a swaller less dose of cisplatin could save advanced laryngeal cancer patients. It may be reasonable to treat these subtypes of laryngeal cancer with a different modality. Thirty-five patients with laryngeal cancer were treated with tri-weekly intra-arterial infusion of cisplatin (100 mg/body). A 200 times molar excessive amount of sodium thiosulfate was intravenously infused to reduce the toxicity of cisplatin. Ten of 16 patients with glottic cancer and 10 of 19 patients with supraglottic cancer were followed for more than 2 years. Larynx preservation rate of glottic and supraglottic cancer was 80% and 70%, and progression-free survival rate was 80% and 50%, respectively. Grade III and IV toxic events were less frequent than with RADPLAT or systemic administration of a similar dose of cisplatin. Glottic and supraglottic cancers show different clinical behaviors. Our protocol with less cisplatin than RADPLAT is especially effective for glottic cancer. (author)

  4. The relationship between interventionists' experience and clinical and radiological outcome in intra-arterial treatment for acute ischemic stroke. A MR CLEAN pretrial survey.

    Science.gov (United States)

    Beumer, Debbie; van Boxtel, Tiemen H; Schipperen, Stefanie; van Zwam, Wim H; Lycklama À Nijeholt, Geert J; Brouwer, Patrick A; Jenniskens, Sjoerd F M; Schonewille, Wouter J; Vos, Jan Albert; van der Lugt, Aad; Roos, Yvo B; Majoie, Charles B; van Oostenbrugge, Robert J; Dippel, Diederik W J

    2017-06-15

    Intra-arterial treatment in acute ischemic stroke is safe and effective as recently shown in several randomized clinical trials. The level of experience of the interventionist performing the IAT procedure has not been studied. The present study investigates effects of interventionists' experience on technical aspects of the procedure and clinical outcome of the patient. In this study of 313 patients with a proximal intracranial arterial anterior circulation occlusion, treated in the Netherlands from 2002 until participation in the Multicenter Randomized Clinical trial of Endovascular treatment for acute ischemic stroke (MR CLEAN), data were collected retrospectively. The association of the senior interventionists' experience with duration of the procedure, adverse events, recanalization, neurological outcome, and functional outcome at discharge was analyzed. Multiple regression models adjusted for age, sex, stroke severity, carotid terminus occlusion, use of a retrievable stent and onset to door time were used. No association between interventionists' experience and recanalization, neurological outcome, or functional outcome was observed in a strict selection of patients. This strict selection include a start of intra-arterial treatment within 6h, no coagulation disturbances, systolic blood pressureexperience and either serious neurologic adverse events or poor outcomes was observed in this study of treatments by interventionists with experience of experience with procedure times, results and patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Two cases of upper gingival cancer with a new superselective intra-arterial chemotherapy method from superficial temporal artery. Combined with arterial redistribution and preoperative embolization

    International Nuclear Information System (INIS)

    Tange, Kazuhisa; Fukuta, Kohta; Higa, Teruo

    2007-01-01

    We have begun to apply arterial redistribution and preoperative embolization in superselective intra-arterial chemotherapy from the superficial temporal artery. This study examines two typical cases of upper gingival cancer. Case 1 was a male, age 61, with T4N0M0 upper gingival cancer. Drug dosage began with 50-100 mg/m 2 /day of 5-fluorouracil (FU), while 15 mg/m 2 /hour of Docetaxel was also given once a week for three weeks. At the same time, radiation therapy with a total of 30 Gy (2 Gy at a time) was given. Immediately before the operation, embolization in the internal maxillary artery was performed in order to limit bleeding. Case 2 was a female, age 73, with T3N0M0 upper gingival cancer. This patient was also given 5-FU and Docetaxel for four weeks respectively with a total of 40 Gy radiation therapy. No operation was performed. Both cases gained complete response (CR) with a sole side effect of grade 3 mucositis. Superselective intra-arterial chemotherapy with arterial redistribution in the oral area is highly effective due to local, concentrated dosage of anticancer drug and reduced side effects. It is a promising method to replace surgical operation especially in cases of upper gingival cancer, whose tumor is often limited to the internal maxillary artery alone. (author)

  6. Entropy-Based Dark Frame Subtraction

    OpenAIRE

    Goesele, Michael; Heidrich, Wolfgang; Seidel, Hans-Peter

    2001-01-01

    Noise due to dark current is a serious limitation for taking long exposure time images with a CCD digital camera. Current solutions have serious drawbacks: interpolation of pixels with high dark current leads to smoothing effects or other artifacts -- especially if a large number of pixels are corrupted. Due to the exponential temperature dependence of the dark current, dark frame subtraction works best for temperature controlled high end CCD imaging systems. On the ...

  7. Case-Control Study of Intra-arterial Verapamil for Intraprostatic Anastomoses to Extraprostatic Arteries in Prostatic Artery Embolization for Benign Prostatic Hypertrophy.

    Science.gov (United States)

    Yu, Simon Chun Ho; Cho, Carmen; Hung, Esther; Wang, Defeng; Chiu, Peter; Yee, Chi Hang; Ng, Anthony

    2017-08-01

    It is hypothesized that intra-arterial administration of verapamil is a safe and effective way to reverse the flow in intraprostatic anastomoses to extraprostatic arteries without compromising treatment outcomes in prostatic artery embolization (PAE) for benign prostatic hypertrophy (BPH). A prospective study of 62 prostate sides in 31 consecutive patients (median age, 66 y; range, 60-71 y) with symptomatic BPH was undertaken. Median prostate volume was 72.4 mL (range, 48.8-85.8 mL), median International Prostate Symptom Score was 21 (range, 15-23), and median urine peak flow rate was 4 mL/s (range, 2-6 mL/s). The arterial anastomoses were classified as types I-III according to vascular morphology. Treatment safety was assessed in terms of adverse events and complications, and treatment effectiveness was assessed in terms of success rate of angiographic flow reversal. The PAE procedure was successfully completed in all 31 patients (100%). Adverse events in both groups were transient and mild and did not necessitate prolonged hospitalization. There was no clinical evidence of any significant nontarget ischemic complication in either group. Intraprostatic anastomosis was diagnosed in 19 of 31 patients (61.3%) and 22 of 62 prostate sides (35.5%). Success rates of verapamil treatment were 88.9% overall (20 of 22) and 100% (19 of 19) in type II and III anastomoses. There was no difference between the treatment group and the control group in clinical, urologic, and imaging outcomes of PAE. Intra-arterial verapamil treatment was probably safe and effective in causing flow reversal in type II and III intraprostatic anastomoses and in preventing ischemic complications in PAE for BPH without compromising PAE outcomes. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  8. Impact of intra-arterial administration of boron compounds on dose-volume histograms in boron neutron capture therapy for recurrent head-and-neck tumors

    International Nuclear Information System (INIS)

    Suzuki, Minoru; Sakurai, Yoshinori; Nagata, Kenji; Kinashi, Yuko; Masunaga, Shinichiro; Ono, Koji; Maruhashi, Akira; Kato, Ituro; Fuwa, Nobukazu; Hiratsuka, Junichi; Imahori, Yoshio

    2006-01-01

    Purpose: To analyze the dose-volume histogram (DVH) of head-and-neck tumors treated with boron neutron capture therapy (BNCT) and to determine the advantage of the intra-arterial (IA) route over the intravenous (IV) route as a drug delivery system for BNCT. Methods and Materials: Fifteen BNCTs for 12 patients with recurrent head-and-neck tumors were included in the present study. Eight irradiations were done after IV administration of boronophenylalanine and seven after IA administration. The maximal, mean, and minimal doses given to the gross tumor volume were assessed using a BNCT planning system. Results: The results are reported as median values with the interquartile range. In the IA group, the maximal, mean, and minimal dose given to the gross tumor volume was 68.7 Gy-Eq (range, 38.8-79.9), 45.0 Gy-Eq (range, 25.1-51.0), and 13.8 Gy-Eq (range, 4.8-25.3), respectively. In the IV group, the maximal, mean, and minimal dose given to the gross tumor volume was 24.2 Gy-Eq (range, 21.5-29.9), 16.4 Gy-Eq (range, 14.5-20.2), and 7.8 Gy-Eq (range, 6.8-9.5), respectively. Within 1-3 months after BNCT, the responses were assessed. Of the 6 patients in the IV group, 2 had a partial response, 3 no change, and 1 had progressive disease. Of 4 patients in the IA group, 1 achieved a complete response and 3 a partial response. Conclusion: Intra-arterial administration of boronophenylalanine is a promising drug delivery system for head-and-neck BNCT

  9. Technical innovation: Multidimensional computerized software enabled subtraction computed tomographic angiography.

    Science.gov (United States)

    Bhatia, Mona; Rosset, Antoine; Platon, Alexandra; Didier, Dominique; Becker, Christoph D; Poletti, Pierre-Alexandre

    2010-01-01

    Computed tomographic angiography (CTA) is a frequent noninvasive alternative to digital subtraction angiography. We previously reported the development of a new subtraction software to overcome limitations of adjacent bone and calcification in CT angiographic subtraction. Our aim was to further develop and improve this fast and automated computerized software, universally available for free use and compatible with most CT scanners, thus enabling better delineation of vascular structures, artifact reduction, and shorter reading times with potential clinical benefits. This computer-based free software will be available as an open source in the next release of OsiriX at the Web site http://www.osirix-viewer.com.

  10. [111In-DTPA]octreotide tumor uptake in GEPNET liver metastases after intra-arterial administration: An overview of preclinical and clinical observations and implications for tumor radiation dose after peptide radionuclide therapy

    NARCIS (Netherlands)

    S.E. Pool (Stefan); B.L. Kam (Boen); G.A. Koning (Gerben); M. Konijnenberg (Mark); T.L.M. ten Hagen (Timo); W.A.P. Breeman (Woulter); E.P. Krenning (Eric); M. de Jong (Marcel); C.H.J. van Eijck (Casper)

    2014-01-01

    textabstractAims: With the aim to improve peptide receptor radionuclide therapy effects in patients with gastroenteropancreatic neuroendocrine tumor (GEPNET) liver metastases we explored the effect of intra-arterial (IA) administration of [111In-DTPA]octreotide (111In-DTPAOC) on tumor uptake in an

  11. Superselective intra-arterial infusion via the superficial temporal artery and occipital artery for gingival carcinoma of the mandible. Simultaneous catheter placement to the maxillary artery and facial artery

    International Nuclear Information System (INIS)

    Iwai, Toshinori; Mitsudo, Kenji; Fukui, Takafumi

    2009-01-01

    Superselective intra-arterial infusion via the superficial temporal artery (STA) has become useful for oral cancer. Approaching via the occipital artery (OA) enables superselective intra-arterial infusion when catheter placement via the STA is impossible. Therefore, simultaneous catheter placement via the STA and OA is possible. We report a surgical method of simultaneous catheter placement via the STA and OA to achieve retrograde superselective intra-arterial infusion for gingival carcinoma of the mandible. Preoperatively, three-dimensional computed tomography angiography was performed to identify the route of the external carotid artery and branches such as the STA, OA, maxillary artery, and facial artery (FA). Thirteen patients with mandibular gingival cancer underwent catheter placement via the STA and OA under local anesthesia. Catheter placement via the STA and OA was superselectively successful in all the patients. The mean operating time was 150.8 min. Catheter placed to the FA via the OA was dislocated during the treatment in one patient, and so the catheter was replaced. This method is useful to enable superselective intra-arterial chemotherapy to the whole gingival carcinoma of the mandible from the start of treatment compared with approaching via the STA. (author)

  12. [Plasma platinum concentration and anti-tumor effects after intra-arterial infusion of lipiodol-CDDP suspension evaluation with VX 2 rabbit liver cancer model and 7.0 Tesla MRI system].

    Science.gov (United States)

    Sonoda, Akinaga; Nitta, Norihisa; Ohta, Shinichi; Itoh, Ryuta; Takahashi, Masashi; Murata, Kiyoshi; Morikawa, Shigehiro; Inubushi, Toshiro; Miyagawa, Yoshihiro; Takamori, Michie; Oonaka, Yasuo

    2006-07-01

    To evaluate the usefulness of combination chemotherapy with cisplatin powder, which was newly designed for intra-arterial infusion (IA CALL) and lipiodol, for the VX 2 liver cancer model of the rabbit, sequential change of the plasma platinum concentration within the first 24 hours, as well as the tissue platinum concentration at 24 hours was measured after intra-arterial infusion of IA CALL. The infused materials were either IA CALL alone (C) or the combination of lipiodol+IA CALL (CL). In addition,the reduction rate of the VX 2 tumor was calculated among four therapeutic groups (C, CL, lipiodol alone (L), and saline alone (S)) after one week of intra-arterial infusion on the basis of 7.0 Tesla MR images. Total plasma platinum concentrations within the first 24 hours were kept low in group CL. No increase in the tissue platinum concentration in group CL was observed. On the other hand, the tumor reduction rate tended to be higher in group CL (group CL>group L=group C>group S). These results suggested that the intra-arterial infusion of IA CALL with lipiodol is more effective than that of IA CALL alone.

  13. Randomised Phase I/II trial assessing the safety and efficacy of radiolabelled anti-carcinoembryonic antigen I131 KAb201 antibodies given intra-arterially or intravenously in patients with unresectable pancreatic adenocarcinoma

    International Nuclear Information System (INIS)

    Sultana, Asma; Garvey, Conall; Sutton, Robert; Neoptolemos, John P; Ghaneh, Paula; Shore, Susannah; Raraty, Michael GT; Vinjamuri, Sobhan; Evans, Jonathan E; Smith, Catrin Tudur; Lane, Steven; Chauhan, Seema; Bosonnet, Lorraine

    2009-01-01

    Advanced pancreatic cancer has a poor prognosis, and the current standard of care (gemcitabine based chemotherapy) provides a small survival advantage. However the drawback is the accompanying systemic toxicity, which targeted treatments may overcome. This study aimed to evaluate the safety and tolerability of KAb201, an anti-carcinoembryonic antigen monoclonal antibody, labelled with I 131 in pancreatic cancer (ISRCTN 16857581). Patients with histological/cytological proven inoperable adenocarcinoma of the head of pancreas were randomised to receive KAb 201 via either the intra-arterial or intravenous delivery route. The dose limiting toxicities within each group were determined. Patients were assessed for safety and efficacy and followed up until death. Between February 2003 and July 2005, 25 patients were enrolled. Nineteen patients were randomised, 9 to the intravenous and 10 to the intra-arterial arms. In the intra-arterial arm, dose limiting toxicity was seen in 2/6 (33%) patients at 50 mCi whereas in the intravenous arm, dose limiting toxicity was noted in 1/6 patients at 50 mCi, but did not occur at 75 mCi (0/3). The overall response rate was 6% (1/18). Median overall survival was 5.2 months (95% confidence interval = 3.3 to 9 months), with no significant difference between the intravenous and intra-arterial arms (log rank test p = 0.79). One patient was still alive at the time of this analysis. Dose limiting toxicity for KAb201 with I 131 by the intra-arterial route was 50 mCi, while dose limiting toxicity was not reached in the intravenous arm

  14. Randomised Phase I/II trial assessing the safety and efficacy of radiolabelled anti-carcinoembryonic antigen I131 KAb201 antibodies given intra-arterially or intravenously in patients with unresectable pancreatic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Bosonnet Lorraine

    2009-02-01

    Full Text Available Abstract Background Advanced pancreatic cancer has a poor prognosis, and the current standard of care (gemcitabine based chemotherapy provides a small survival advantage. However the drawback is the accompanying systemic toxicity, which targeted treatments may overcome. This study aimed to evaluate the safety and tolerability of KAb201, an anti-carcinoembryonic antigen monoclonal antibody, labelled with I131 in pancreatic cancer (ISRCTN 16857581. Methods Patients with histological/cytological proven inoperable adenocarcinoma of the head of pancreas were randomised to receive KAb 201 via either the intra-arterial or intravenous delivery route. The dose limiting toxicities within each group were determined. Patients were assessed for safety and efficacy and followed up until death. Results Between February 2003 and July 2005, 25 patients were enrolled. Nineteen patients were randomised, 9 to the intravenous and 10 to the intra-arterial arms. In the intra-arterial arm, dose limiting toxicity was seen in 2/6 (33% patients at 50 mCi whereas in the intravenous arm, dose limiting toxicity was noted in 1/6 patients at 50 mCi, but did not occur at 75 mCi (0/3. The overall response rate was 6% (1/18. Median overall survival was 5.2 months (95% confidence interval = 3.3 to 9 months, with no significant difference between the intravenous and intra-arterial arms (log rank test p = 0.79. One patient was still alive at the time of this analysis. Conclusion Dose limiting toxicity for KAb201 with I131 by the intra-arterial route was 50 mCi, while dose limiting toxicity was not reached in the intravenous arm.

  15. Dual isotope technique for in vivo quantitative assessment of intra-arterial(IA) drug delivery to hepatic metastases

    International Nuclear Information System (INIS)

    Line, B.R.; Harper, G.; Armstrong, M.; Ruckdeschel, J.

    1984-01-01

    Qualitative Tc-99m macro-aggregated albumin (MAA) scans can evaluate both IA catheter placement and regional hepatic perfusion. The authors report a new, dual isotope technique for the quantitative assessment of IA drug delivery to hepatic metastases (mets). Four patients (pts) with colon cancer metastatic to liver were treated for two week cycles with continuous IA 5-fluoro-2'-deoxyuridine (FUDR) infusion via an implantable pump (INFUSAID) at a dose of 0.1 to 0.3 mg/kg/d. At four week intervals each patient had quantitative hepatic imaging studies with Tc-99m SC to estimate met volume followed immediately by Tc-99m MAA through the pump to map drug distribution. MAA was distinguished from SC by computer subtraction and a distribution index (DI) expressed as the ratio of MAA in tumor vs normal tissues was determined. The lesion volume and DI were used to calculate the amount of FUDR delivered to tumor during treatment. Marked variability was found in the DI and chemotherapy delivered to tumor tissue between and within different pts. Pretreatment DIs were estimated to be 54%, 20%, 15%, and 1%. One pt demonstrated a drop in relative blood flow from a pretreatment DI of 54% to 49% at 4 weeks, and 37% at 8 weeks. The pt with the least DI (1.1%-5.0%) had the largest tumor burden (900 gm) and the smallest FUDR tumor delivery (0.2-1.1 ng/gm/min). The pt with the smallest tumor burden (80 gm) had the greatest FUDR delivery (14.8-22.1 ng/gm/min). This imaging technique provides quantitative estimates of tumor size and relative perfusion which can evaluate drug delivery to tumor and refine the assessment of both antitumor drug activity and toxicity of IA hepatic chemotherapy

  16. Computed tomography hepatic arteriography has a hepatic falciform artery detection rate that is much higher than that of digital subtraction angiography and 99mTc-MAA SPECT/CT: Implications for planning 90Y radioembolization?

    International Nuclear Information System (INIS)

    Burgmans, M.C.; Too, C.W.; Kao, Y.H.; Goh, A.S.W.; Chow, P.K.H.; Tan, B.S.; Tay, K.H.; Lo, R.H.G.

    2012-01-01

    Purpose: To compare the hepatic falciform artery (HFA) detection rates of digital subtraction angiography (DSA), computed tomography hepatic arteriography (CTHA) and 99mTc-macroaggregated albumin (99mTc-MAA) single photon emission computed tomography with integrated CT (SPECT/CT) and to correlate HFA patency with complication rates of yttrium-90 (90Y) radioembolization. Material and methods: From August 2008 to November 2010, 79 patients (range 23–83 years, mean 62.3 years; 67 male) underwent pre-treatment DSA, CTHA and 99mTc-MAA scintigraphy (planar/SPECT/CT) to assess suitability for radioembolization with 90Y resin microspheres. Thirty-seven patients were excluded from the study, because CTHA was performed with a catheter position that did not result in opacification of the liver parenchyma adjacent to the falciform ligament. DSA, CTHA and 99mTc-MAA SPECT/CT images and medical records were retrospectively reviewed. Results: A patent HFA was detected in 22 of 42 patients (52.3%). The HFA detection rates of DSA, CTHA and 99mTc-MAA SPECT/CT were 11.9%, 52.3% and 13.3%, respectively (p < 0.0001). An origin from the segment 4 artery was seen in 51.7% of HFAs. Prophylactic HFA coil-embolization prior to 90Y microspheres infusion was performed in 2 patients. Of the patients who underwent radioembolization with a patent HFA, none developed supra-umbilical radiation dermatitis. One patient experienced epigastric pain attributed to post-embolization syndrome and was managed conservatively. Conclusion: The HFA detection rate of CTHA is superior to that of DSA and 99mTc-MAA SPECT/CT. Complications related to non-target radiation of the HFA vascular territory rarely occur, even in patients undergoing radioembolization with a patent HFA.

  17. Computed tomography hepatic arteriography has a hepatic falciform artery detection rate that is much higher than that of digital subtraction angiography and 99mTc-MAA SPECT/CT: Implications for planning 90Y radioembolization?

    Energy Technology Data Exchange (ETDEWEB)

    Burgmans, M.C., E-mail: mburgmans@hotmail.com [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Too, C.W., E-mail: too.chow.wei@singhealth.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Kao, Y.H., E-mail: yung.h.kao@gmail.com [Department of Nuclear Medicine and PET, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Goh, A.S.W., E-mail: anthony.goh.s.w@sgh.com.sg [Department of Nuclear Medicine and PET, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Chow, P.K.H., E-mail: gsupc@singnet.com.sg [Department of General Surgery, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore 169857 (Singapore); Department of Surgical Oncology, National Cancer Center Singapore, 11 Hospital Drive, Singapore 169610 (Singapore); Tan, B.S., E-mail: tan.bien.soo@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Tay, K.H., E-mail: tay.kiang.hiong@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Lo, R.H.G., E-mail: richard.lo.h.g@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore)

    2012-12-15

    Purpose: To compare the hepatic falciform artery (HFA) detection rates of digital subtraction angiography (DSA), computed tomography hepatic arteriography (CTHA) and 99mTc-macroaggregated albumin (99mTc-MAA) single photon emission computed tomography with integrated CT (SPECT/CT) and to correlate HFA patency with complication rates of yttrium-90 (90Y) radioembolization. Material and methods: From August 2008 to November 2010, 79 patients (range 23–83 years, mean 62.3 years; 67 male) underwent pre-treatment DSA, CTHA and 99mTc-MAA scintigraphy (planar/SPECT/CT) to assess suitability for radioembolization with 90Y resin microspheres. Thirty-seven patients were excluded from the study, because CTHA was performed with a catheter position that did not result in opacification of the liver parenchyma adjacent to the falciform ligament. DSA, CTHA and 99mTc-MAA SPECT/CT images and medical records were retrospectively reviewed. Results: A patent HFA was detected in 22 of 42 patients (52.3%). The HFA detection rates of DSA, CTHA and 99mTc-MAA SPECT/CT were 11.9%, 52.3% and 13.3%, respectively (p < 0.0001). An origin from the segment 4 artery was seen in 51.7% of HFAs. Prophylactic HFA coil-embolization prior to 90Y microspheres infusion was performed in 2 patients. Of the patients who underwent radioembolization with a patent HFA, none developed supra-umbilical radiation dermatitis. One patient experienced epigastric pain attributed to post-embolization syndrome and was managed conservatively. Conclusion: The HFA detection rate of CTHA is superior to that of DSA and 99mTc-MAA SPECT/CT. Complications related to non-target radiation of the HFA vascular territory rarely occur, even in patients undergoing radioembolization with a patent HFA.

  18. Potentiating intra-arterial sonothrombolysis for acute ischemic stroke by the addition of the ultrasound contrast agents (Optison™ & SonoVue(®)).

    Science.gov (United States)

    Soltani, Azita; Singhal, Ruchi; Obtera, Melissa; Roy, Ronald A; Clark, Wayne M; Hansmann, Douglas R

    2011-01-01

    Transcranial ultrasound in combination with intravenously administered ultrasound contrast agents (UCA) in the presence or absence of recombinant tissue plasminogen activator (rt-PA) has been widely evaluated as a new modality for treatment of ischemic stroke. Despite the successful demonstration of accelerated clot lysis there are inherent limitations associated with this modality such as inconsistency in temporal window thickness and/or potential serious cardiopulmonary reactions to intravenous administration of UCA that prevent broad application to ischemic stroke populations. As a complementary modality, we evaluated potential lysis enhancement by intra-arterial ultrasound with concurrent intra-clot delivery of UCA and rt-PA. To this end, clots were formed with average pore diameter similar to clinically retracted clots by adjusting the thrombin concentration. Physical characteristic and retention of UCA after delivery through the catheter as a function of clinically relevant flow rates of 6, 12, 18 ml/h were determined using a microscopic method. The ability of the UCA employed in this study, Optison and SonoVue, to penetrate into the clot was verified using ultrasound B-mode imaging. Clot lysis as a function of rt-PA concentration, 0.009 through 0.5 mg/ml, in the presence and absence of UCA diluted to 1:10, 1:100, and 1:200 v/v at two Peak rarefaction acoustic pressures of 1.3 and 2.1 MPa were evaluated using a weighing method. The study results suggest the addition of only 0.02 ml of 1:100 diluted UCA to rt-PA of 0.009, 0.05, 0.3, and 0.5 mg/ml can enhance the lysis rate by 3.9, 2.6, 1.9 and 1.8 fold in the presence of peak rarefaction acoustic pressure of 1.3 MPa and by 5.1, 3.4, 2.6, 3.1 in the presence of peak rarefaction acoustic pressure of 2.1 MPa, respectively. In addition, Optison and SonoVue demonstrated comparable effectiveness in enhancing the clot lysis rate. Addition of UCA to intra-arterial sonothrombolysis could be considered as a viable

  19. Digital subtraction angiography for lower extremity phlebography

    International Nuclear Information System (INIS)

    Yokoyama, Kunihiko; Nakashima, Noriko; Takata, Yasunori; Hashimoto, Shozo.

    1989-01-01

    DSA was applied to the lower extremity phlebography on 21 cases (36 legs). The patient lay in the supine position and a tourniquet was placed around the ankle. Forty ml of contrast medium, diluted to 25% of the original concentration with normal saline, was injected into the dorsal vein of the foot. The anterior tibial vein, posterior tibial vein, peroneal vein and muscular vein of the calf were identified in 24(63.2%), 36(94.7%), 37(97.4%) and 7 legs (18.4%), respectively. The poor opacification of the anterior tibial vein was attributed partly to the compression effect of the tourniquet. The abnormal findings were deep vein thrombosis (5 legs), reflux from the deep to the superficial vein (14 legs) and irregularity of the vein wall (16 legs). The superficial varicose veins were not demonstrated in DSA phlebography. The examination was comfortable because the patient position was supine and the dilute contrast medium caused no burning sensation. We believe that DSA phelobography is a safe and useful method for diagnosing the deep venous system disorders. (author)

  20. Digital subtraction angiography for lower extremity phlebography

    Energy Technology Data Exchange (ETDEWEB)

    Yokoyama, Kunihiko; Nakashima, Noriko; Takata, Yasunori; Hashimoto, Shozo.

    1989-04-01

    DSA was applied to the lower extremity phlebography on 21 cases (36 legs). The patient lay in the supine position and a tourniquet was placed around the ankle. Forty ml of contrast medium, diluted to 25% of the original concentration with normal saline, was injected into the dorsal vein of the foot. The anterior tibial vein, posterior tibial vein, peroneal vein and muscular vein of the calf were identified in 24(63.2%), 36(94.7%), 37(97.4%) and 7 legs (18.4%), respectively. The poor opacification of the anterior tibial vein was attributed partly to the compression effect of the tourniquet. The abnormal findings were deep vein thrombosis (5 legs), reflux from the deep to the superficial vein (14 legs) and irregularity of the vein wall (16 legs). The superficial varicose veins were not demonstrated in DSA phlebography. The examination was comfortable because the patient position was supine and the dilute contrast medium caused no burning sensation. We believe that DSA phelobography is a safe and useful method for diagnosing the deep venous system disorders. (author).

  1. Methylene blue intra-arterial staining of resected colorectal cancer specimens improves accuracy of nodal staging: A randomized controlled trial.

    Science.gov (United States)

    Reima, H; Saar, H; Innos, K; Soplepmann, J

    2016-11-01

    Metastatic involvement of regional lymph nodes is a major prognostic factor of colorectal cancer, which influences also its treatment strategy. International consensus foresees retrieval of ≥12 lymph nodes from colorectal specimens. The aim of the study was to assess the effect of intra-arterial staining of colorectal specimens with methylene blue on lymph node harvest. A total of 266 radically operated colorectal cancer patients were randomized into the methylene blue staining and non-staining groups. In the staining group, methylene blue solution was injected into the colorectal specimen's artery after its removal. The specimens were analysed for lymph node count, diameter and metastatic involvement. The median number of lymph nodes was higher in the staining group, 27 (95% CI 23-31%), compared with the control group, 16 (95% CI 14-19, p Methylene blue staining improves significantly staging accuracy through finding more small-diameter lymph nodes. It enables to detect ≥12 lymph nodes in the majority of cases. We recommend routine use of this technique in all colorectal resections with curative intent. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  2. Early survival prediction after intra-arterial therapies: a 3D quantitative MRI assessment of tumour response after TACE or radioembolization of colorectal cancer metastases to the liver

    Energy Technology Data Exchange (ETDEWEB)

    Chapiro, Julius; Savic, Lynn Jeanette [The Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Baltimore, MD (United States); Charite Universitaetsmedizin, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Duran, Rafael; Schernthaner, Ruediger; Wang, Zhijun; Geschwind, Jean-Francois [The Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Baltimore, MD (United States); Lin, MingDe [The Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Baltimore, MD (United States); U/S Imaging and Interventions (UII), Philips Research North America, Briarcliff Manor, NY (United States); Lesage, David [Philips Research, Medisys, Suresnes (France)

    2015-07-15

    This study evaluated the predictive role of 1D, 2D and 3D quantitative, enhancement-based MRI regarding overall survival (OS) in patients with colorectal liver metastases (CLM) following intra-arterial therapies (IAT). This retrospective analysis included 29 patients who underwent transarterial chemoembolization (TACE) or radioembolization and received MRI within 6 weeks after therapy. Tumour response was assessed using 1D and 2D criteria (such as European Association for the Study of the Liver guidelines [EASL] and modified Response Evaluation Criteria in Solid Tumors [mRECIST]). In addition, a segmentation-based 3D quantification of overall (volumetric [v] RECIST) and enhancing lesion volume (quantitative [q] EASL) was performed on portal venous phase MRI. Accordingly, patients were classified as responders (R) and non-responders (NR). Survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios (HR). Only enhancement-based criteria identified patients as responders. EASL and mRECIST did not predict patient survival (P = 0.27 and P = 0.44, respectively). Using uni- and multivariate analysis, qEASL was identified as the sole predictor of patient survival (9.9 months for R, 6.9 months for NR; P = 0.038; HR 0.4). The ability of qEASL to predict survival early after IAT provides evidence for potential advantages of 3D quantitative tumour analysis. (orig.)

  3. Early survival prediction after intra-arterial therapies: a 3D quantitative MRI assessment of tumour response after TACE or radioembolization of colorectal cancer metastases to the liver

    International Nuclear Information System (INIS)

    Chapiro, Julius; Savic, Lynn Jeanette; Duran, Rafael; Schernthaner, Ruediger; Wang, Zhijun; Geschwind, Jean-Francois; Lin, MingDe; Lesage, David

    2015-01-01

    This study evaluated the predictive role of 1D, 2D and 3D quantitative, enhancement-based MRI regarding overall survival (OS) in patients with colorectal liver metastases (CLM) following intra-arterial therapies (IAT). This retrospective analysis included 29 patients who underwent transarterial chemoembolization (TACE) or radioembolization and received MRI within 6 weeks after therapy. Tumour response was assessed using 1D and 2D criteria (such as European Association for the Study of the Liver guidelines [EASL] and modified Response Evaluation Criteria in Solid Tumors [mRECIST]). In addition, a segmentation-based 3D quantification of overall (volumetric [v] RECIST) and enhancing lesion volume (quantitative [q] EASL) was performed on portal venous phase MRI. Accordingly, patients were classified as responders (R) and non-responders (NR). Survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios (HR). Only enhancement-based criteria identified patients as responders. EASL and mRECIST did not predict patient survival (P = 0.27 and P = 0.44, respectively). Using uni- and multivariate analysis, qEASL was identified as the sole predictor of patient survival (9.9 months for R, 6.9 months for NR; P = 0.038; HR 0.4). The ability of qEASL to predict survival early after IAT provides evidence for potential advantages of 3D quantitative tumour analysis. (orig.)

  4. Effects of intra-arterial chemotherapy with a new lipophilic anticancer agent, estradiol-chlorambucil (KM2210), dissolved in lipiodol on experimental liver tumor in rats

    Energy Technology Data Exchange (ETDEWEB)

    Egawa, H.; Maki, A.; Mori, K.; Yamamoto, Y.; Mitsuhashi, S.; Bannai, K.; Asano, K.; Ozawa, K. (Kyoto Univ. (Japan))

    1990-06-01

    Anticancer effects and biodistribution of a new lipophilic anticancer agent, estradiol-chlorambucil (KM2210), dissolved in lipiodol (LPD) were investigated as an intra-arterial chemotherapy (IAC) on Walker 256 carcinosarcoma grown in the liver of 136 Wistar rats. All rats treated with KM2210 (10 mg)-LPD survived for 90 days after administration, whereas none of the rats with LPD alone were alive for more than 19 days. Histological examination revealed that there was no viable tumor cell in the encapsulated necrotic tumor at 21 days after administration. There was no significant liver dysfunction or leukopenia due to KM2210. The biodistribution study using (14C, 3H)KM2210-LPD solution showed that KM2210 accumulated selectively in tumor and that the tumor-to-normal-liver and tumor-to-blood ratios were 10 and 1,000, respectively, at 21 days after administration. These results suggest that KM2210 has potential clinical application in the treatment of human liver cancer.

  5. Carotid stenosis measurement on colour Doppler ultrasound: Agreement of ECST, NASCET and CCA methods applied to ultrasound with intra-arterial angiographic stenosis measurement

    Energy Technology Data Exchange (ETDEWEB)

    Wardlaw, Joanna M. [Division of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh EH4 2XU (United Kingdom)]. E-mail: jmw@skull.dcn.ed.ac.uk; Lewis, Steff [Division of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh EH4 2XU (United Kingdom)

    2005-11-01

    Purpose: Carotid stenosis is usually determined on Doppler ultrasound from velocity readings. We wondered if angiography-style stenosis measurements applied to ultrasound images improved accuracy over velocity readings alone, and if so, which measure correlated best with angiography. Materials and methods: We studied prospectively patients undergoing colour Doppler ultrasound (CDU) for TIA or minor stroke. Those with 50%+ symptomatic internal carotid artery (ICA) stenosis had intra-arterial angiography (IAA). We measured peak systolic ICA velocity, and from the ultrasound image, the minimal residual lumen, the original lumen (ECST), ICA diameter distal (NASCET) and CCA diameter proximal (CCA method) to the stenosis. The IAAs were measured by ECST, NASCET and CCA methods also, blind to CDU. Results: Amongst 164 patients (328 arteries), on CDU the ECST, NASCET and CCA stenosis measures were similarly related to each other (ECST = 0.54 NASCET + 46) as on IAA (ECST = 0.6 NASCET + 40). Agreement between CDU- and IAA-measured stenosis was similar for ECST (r = 0.51), and CCA (r = 0.48) methods, and slightly worse for NASCET (r = 0.41). Adding IAA-style stenosis to the peak systolic ICA velocity did not improve agreement with IAA over peak systolic velocity alone. Conclusion: Angiography-style stenosis measures have similar inter-relationships when applied to CDU, but do not improve accuracy of ultrasound over peak systolic ICA velocity alone.

  6. Intra-arterial administration of carboplatin plus lower dosage radiation of {sup 60}CO as induction treatment in advanced oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Okutomi, Tadashi; Kato, Yukihiro; Ichihara, Hideki; Kusunoki, Yukihiro; Hatakeyama, Daijiro; Yokoyama, Kyoko; Tatematsu, Norichika [Gifu Univ. (Japan). School of Medicine; Liu, Jianhua

    2000-11-01

    Conventional pre-operative chemoradiotherapy often causes severe side effects, which may result in interruption of the treatment and delay of decided operation. Carboplatin (CBDCA) is one of the effective chemotherapeutants for head and neck cancer. We treated 23 patients with advanced oral cancers by a combination of intra-arterial administration of Carboplatin and {sup 60}CO radiotherapy. The dosage of Carboplatin was between 20 mg and 35 mg per square meter of body surface. The dosage of external {sup 60}CO irradiation was 2 Gy per day and 30 to 60 Gy in total. We evaluated clinical response, toxicity and survival of this therapy of all the patients. Histologic response was also evaluated in some of them. All cancers responded to the regional chemoradiotherapy and demonstrated remission. Two (8%) completed response rate (CR) and 16 (69%) partial response rate (PR) were achieved. The accumulated five-year overall survival rate by Kaplan-Meier method was 73.9%. Fourteen patients (60.8%) showed no evidence of disease (NED) within five years after the therapy. All patients had stomatitis, but most of them were not so severe. The major hematological toxicity was leukopenia, but it was from mild to moderate and reversible. Our study showed that this therapy provided low toxicity, high clinical and histological response rate. (author)

  7. Revisiting intra-arterial drug delivery for treating brain diseases or is it "déjà-vu, all over again"?

    Directory of Open Access Journals (Sweden)

    Shailendra Joshi

    2014-01-01

    Full Text Available For over six decades intra-arterial (IA drugs have been sporadically used for the treatment of lethal brain diseases. In recent years considerable advance has been made in the IA treatment of retinoblastomas, liver and locally invasive breast cancers, but relatively little progress has been made in the treatment of brain cancers. High resting blood flow and the presence of the blood-brain barrier (BBB, makes IA delivery to the brain tissue far more challenging, compared to other organs. The lack of advance in the field is also partly due to the inability to understand the complex pharmacokinetics of IA drugs as it is difficult to track drug concentrations in sub-second time frame by conventional chemical methods. The advances in optical imaging now provide unprecedented insights into the pharmacokinetics of IA drug and optical tracer delivery. Novel delivery methods, improved IA drug formulations, and optical pharmacokinetics, present us with untested paradigms in pharmacology that could lead to new therapeutic interventions for brain cancers and stroke. The object of this review is to bring into focus the current practice, problems, and the potential of IA drug delivery for treating brain diseases. A concerted effort is needed at basic sciences (pharmacology and drug imaging, and translational (drug delivery techniques and protocol development levels by the interventional neuroradiology community to advance the field.

  8. Carotid stenosis measurement on colour Doppler ultrasound: Agreement of ECST, NASCET and CCA methods applied to ultrasound with intra-arterial angiographic stenosis measurement

    International Nuclear Information System (INIS)

    Wardlaw, Joanna M.; Lewis, Steff

    2005-01-01

    Purpose: Carotid stenosis is usually determined on Doppler ultrasound from velocity readings. We wondered if angiography-style stenosis measurements applied to ultrasound images improved accuracy over velocity readings alone, and if so, which measure correlated best with angiography. Materials and methods: We studied prospectively patients undergoing colour Doppler ultrasound (CDU) for TIA or minor stroke. Those with 50%+ symptomatic internal carotid artery (ICA) stenosis had intra-arterial angiography (IAA). We measured peak systolic ICA velocity, and from the ultrasound image, the minimal residual lumen, the original lumen (ECST), ICA diameter distal (NASCET) and CCA diameter proximal (CCA method) to the stenosis. The IAAs were measured by ECST, NASCET and CCA methods also, blind to CDU. Results: Amongst 164 patients (328 arteries), on CDU the ECST, NASCET and CCA stenosis measures were similarly related to each other (ECST = 0.54 NASCET + 46) as on IAA (ECST = 0.6 NASCET + 40). Agreement between CDU- and IAA-measured stenosis was similar for ECST (r = 0.51), and CCA (r = 0.48) methods, and slightly worse for NASCET (r = 0.41). Adding IAA-style stenosis to the peak systolic ICA velocity did not improve agreement with IAA over peak systolic velocity alone. Conclusion: Angiography-style stenosis measures have similar inter-relationships when applied to CDU, but do not improve accuracy of ultrasound over peak systolic ICA velocity alone

  9. Anesthetic strategy during endovascular therapy: General anesthesia or conscious sedation? (GOLIATH - General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial.

    Science.gov (United States)

    Simonsen, Claus Z; Sørensen, Leif H; Juul, Niels; Johnsen, Søren P; Yoo, Albert J; Andersen, Grethe; Rasmussen, Mads

    2016-12-01

    Endovascular therapy after acute ischemic stroke due to large vessel occlusion is now standard of care. There is equipoise as to what kind of anesthesia patients should receive during the procedure. Observational studies suggest that general anesthesia is associated with worse outcomes compared to conscious sedation. However, the findings may have been biased. Randomized clinical trials are needed to determine whether the choice of anesthesia may influence outcome. The objective of GOLIATH (General or Local Anestesia in Intra Arterial Therapy) is to examine whether the choice of anesthetic regime during endovascular therapy for acute ischemic stroke influence patient outcome. Our hypothesis is that that conscious sedation is associated with less infarct growth and better functional outcome. GOLIATH is an investigator-initiated, single-center, randomized study. Patients with acute ischemic stroke, scheduled for endovascular therapy, are randomized to receive either general anesthesia or conscious sedation. The primary outcome measure is infarct growth after 48-72 h (determined by serial diffusion-weighted magnetic resonance imaging). Secondary outcomes include 90-day modified Rankin Scale score, time parameters, blood pressure variables, use of vasopressors, procedural and anesthetic complications, success of revascularization, radiation dose, and amount of contrast media. Choice of anesthesia may influence outcome in acute ischemic stroke patients undergoing endovascular therapy. The results from this study may guide future decisions regarding the optimal anesthetic regime for endovascular therapy. In addition, this study may provide preliminary data for a multicenter randomized trial. © 2016 World Stroke Organization.

  10. Curative and organ-preserving treatment with intra-arterial carboplatin induction followed by surgery and/or radiotherapy for advanced head and neck cancer: single-center five-year results

    Directory of Open Access Journals (Sweden)

    Tinelli Carmine

    2007-04-01

    Full Text Available Abstract Background This study evaluated the feasibility, toxicity, response rate and survival of neoadjuvant superselective intra-arterial infusion of high dose carboplatin in advanced head and neck cancer. Methods Forty-six patients with primary head and neck squamous cell carcinoma received 3 cycles of intra-arterial carboplatin (300 to 350 mg/m2 per cycle every 2 weeks, followed by radiotherapy or surgery plus radiotherapy. Results No complications or severe toxicity occurred. Sixteen patients (35% were complete responders, 20 (43% partial responders while 10 (22% did not respond to treatment. After completion of the multimodality treatment, 38/46 patients (83% were complete responders. After a 5-year follow-up period, 18/46 patients (39% are alive and disease-free, 3 (6,5% have died of a second primary tumor and 25 (54,5% have died of the disease. Conclusion Intra-arterial carboplatin induction chemotherapy is a safe, well-tolerated technique that discriminates between responders and non-responders and so may have prognostic significance in planning further integrated treatments aimed to organ preservation for advanced head and neck carcinomas.

  11. The Use of Procedural Knowledge in Simple Addition and Subtraction Problems

    Science.gov (United States)

    Fayol, Michel; Thevenot, Catherine

    2012-01-01

    In a first experiment, adults were asked to solve one-digit additions, subtractions and multiplications. When the sign appeared 150 ms before the operands, addition and subtraction were solved faster than when the sign and the operands appeared simultaneously on screen. This priming effect was not observed for multiplication problems. A second…

  12. Background subtraction theory and practice

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    Elgammal, Ahmed

    2014-01-01

    Background subtraction is a widely used concept for detection of moving objects in videos. In the last two decades there has been a lot of development in designing algorithms for background subtraction, as well as wide use of these algorithms in various important applications, such as visual surveillance, sports video analysis, motion capture, etc. Various statistical approaches have been proposed to model scene backgrounds. The concept of background subtraction also has been extended to detect objects from videos captured from moving cameras. This book reviews the concept and practice of back

  13. Tc99m-HMPAO Neuro--SPECT Assessment of Ischemic Penumbra in Acute Brain Infarct: Control of Intra-arterial Thrombolysis Treatment

    International Nuclear Information System (INIS)

    Mena, Francisco; Mena, Ismael; Ducci, Hector; Soto, Francisco; Pedraza, Luis; Contreras, Andrea; Miranda, Marcelo; Basaez, Esteban; Fruns, Manuel

    2004-01-01

    Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis, an approved therapy, if performed in the first 3 to 6 hours of evolution. Thrombolysis has many benefits, but it also has associated risks, mainly development of intracranial hemorrhage. The selection of which patient should receive this type of treatment had been an important research topic over the last decade. As a consequence neuroimaging of brain infarct has significantly improved during the last few years. A variety of diagnostic studies are now available in the evaluation of brain infarct and in particular of potentially reversible brain ischemia, including magnetic resonance imaging (MRI) diffusion-perfusion, perfusion computed tomography (CT) and functional neuroimaging techniques includes positron emission tomography (PET) and single-photon emission tomography (SPECT). The aim of this study is to present our experience with a group of patients that presented with acute brain ischemia and had a NeuroSPECT evaluation before and after intra-arterial thrombolysis and/or possible stent placement, in the treatment of acute brain infarct. Methods: 16 patients were treated acutely for a significant ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan performed to rule out hemorrhage or established infarct. 3) IV injection of 1100MBq Tc 99m HMPAO (Ceretec tm ) 4) Conventional cerebral angiography and intra-arterial thrombolysis with tPA and /or angioplasty/stent if necessary. 5) NeuroSPECT assessment of ischemic penumbra (Pre-therapy results). 6) 14 of 16 patients received a NeuroSPECT (Post-therapy results) control at 24 hours. NeuroSPECT image acquisition was performed immediately following arterial thrombolysis with a dual Head Camera, Siemens ECAM, SHR collimators and conventional protocol. Image processing was performed using the Neurogam, Segami Corp. Software as previously reported in Alasbimn Journal 2

  14. Superselective intra-arterial infusion of high-dose cisplatin combined with radiation therapy for head and neck carcinoma. Experience of Yamagata University Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Hamamoto, Yasushi; Niino, Keiji; Ishiyama, Hiromichi; Koike, Shuji; Hosoya, Takaaki; Aoyagi, Masaru [Yamagata Univ. (Japan). School of Medicine

    2003-03-01

    Local effectiveness and complication of superselective intra-arterial infusion of high-dose cisdiamminedichloroplatinum (CDDP) (SIC) combined with radiation therapy (RT) were investigated. Between 1998 and 2000, 18 head and neck carcinomas including 10 maxillary carcinomas (T3; 1, T4; 9), 3 oral cavity carcinomas (T2; 1, T4; 2), and 5 oropharyngeal carcinomas (T2; 2, T4; 3) were treated with SIC and RT with or without surgery. CDDP of 100-150 mg/body was administered weekly in principle for 2-9 weeks (mean: 4.9) with the simultaneous administration of sodium thiosulfate. Radiation doses ranged from 40 Gy to 70 Gy (mean: 56.8 Gy). Complete response was obtained in 7 of 10 maxillary carcinomas, 2 of 3 oral-cavity carcinomas, and 2 of 5 oropharyngeal carcinomas, respectively. When surgical intervention was performed if necessary, 2-year local control rates for maxillary carcinoma, and other carcinoma including oral-cavity carcinoma and oropharyngeal carcinoma were 80% and 63% respectively. Two-year local control rates for T4 maxillary carcinoma, and other T4 carcinoma including oral-cavity carcinoma and oropharyngeal carcinoma were 78% and 40% respectively. Two-year overall survival rates for all cases, maxillary carcinoma, and oral-cavity/oropharyngeal carcinoma were 88%, 90% and 86% respectively. All local recurrences occurred within 6 months from the initiation of treatment. The systemic toxicity of weekly SIC was comparatively mild; however, a total CDDP dose of 1,000 mg or more and/or RT of 70 Gy induced complications of local soft tissue such as mucosal ulcer and fistula. SIC combined with RT is useful to improve the local control/survival rates and to avoid the aggressive surgery for locally advanced head and neck carcinoma. A high total dose of CDDP and/or RT of a comparatively high dose may be risk factors for local soft tissue complications. (author)

  15. X-ray angiography perfusion imaging with an intra-arterial injection: comparative study with 15O-gas/water positron emission tomography.

    Science.gov (United States)

    Asai, Katsunori; Nakamura, Hajime; Watabe, Tadashi; Nishida, Takeo; Sakaguchi, Manabu; Hatazawa, Jun; Yoshimine, Toshiki; Kishima, Haruhiko

    2017-12-04

    X-ray angiography perfusion (XAP) is a perfusion imaging technique based on conventional DSA. In this study, we aimed to validate parameters derived from XAP by comparing them with 15 O-gas/water positron emission tomography (PET), using data from patients with chronic ischemic cerebrovascular disease. 18 consecutive patients were included. XAP was performed with intra-arterial infusion of contrast media, and a time-density curve was constructed for each cerebral hemisphere. From the curves, the relative values of mean transit time (rMTT) and wash-in rate (rWiR) were obtained by dividing the values of the right hemisphere by those of the left hemisphere. These were then compared with the relative values of cerebral blood flow (rCBF) and rMTT calculated from the PET data. XAP rWiR correlated strongly with PET rCBF (r=0.86, P<0.0001). rMTT measurements from the two modalities were also strongly correlated (r=0.85, P<0.0001). Bland-Altman analysis revealed a bias of 0.14±0.18 (95% limits of agreement -0.22 to 0.51) for PET rCBF versus XAP rWiR, and 0.016±0.093 (95% limits of agreement -0.17 to 0.20) for rMTT between the two modalities. The relative values obtained from XAP were validated across a population of patients with chronic ischemic cerebrovascular disease. © 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.

  16. Focal Low and Global High Permeability Predict the Possibility, Risk, and Location of Hemorrhagic Transformation following Intra-Arterial Thrombolysis Therapy in Acute Stroke.

    Science.gov (United States)

    Li, Y; Xia, Y; Chen, H; Liu, N; Jackson, A; Wintermark, M; Zhang, Y; Hu, J; Wu, B; Zhang, W; Tu, J; Su, Z; Zhu, G

    2017-09-01

    The contrast volume transfer coefficient ( K trans ), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation. We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment. K trans maps were obtained with first-pass perfusion CT data. The K trans values at the region level, obtained with the Alberta Stroke Program Early CT Score system, were compared to determine the differences between the hemorrhagic transformation and nonhemorrhagic transformation regions. The K trans values of the whole ischemic region based on baseline perfusion CT were obtained as a variable to hemorrhagic transformation possibility at the global level. Forty-eight (45.3%) patients had hemorrhagic transformation, and 21 (19.8%) had symptomatic intracranial hemorrhage. At the region level, there were 82 ROIs with hemorrhagic transformation and parenchymal hemorrhage with a mean K trans , 0.5 ± 0.5/min, which was significantly lower than that in the nonhemorrhagic transformation regions ( P hemorrhage (1.3 ± 0.9) and those without symptomatic intracranial hemorrhage (0.8 ± 0.4). Only a high K trans value at the global level could predict the occurrence of symptomatic intracranial hemorrhage ( P hemorrhagic transformation or symptomatic intracranial hemorrhage at the patient level, whereas focal low K trans values can predict the spatial distributions of hemorrhagic transformation at the region level. © 2017 by American Journal of Neuroradiology.

  17. Selective boron delivery by intra-arterial injection of BSH-WOW emulsion in hepatic cancer model for neutron capture therapy.

    Science.gov (United States)

    Yanagie, Hironobu; Dewi, Novriana; Higashi, Syushi; Ikushima, Ichiro; Seguchi, Koji; Mizumachi, Ryoji; Murata, Yuji; Morishita, Yasuyuki; Shinohara, Atsuko; Mikado, Shoji; Yasuda, Nakahiro; Fujihara, Mitsuteru; Sakurai, Yuriko; Mouri, Kikue; Yanagawa, Masashi; Iizuka, Tomoya; Suzuki, Minoru; Sakurai, Yoshinori; Masunaga, Shin-Ichiro; Tanaka, Hiroki; Matsukawa, Takehisa; Yokoyama, Kazuhito; Fujino, Takashi; Ogura, Koichi; Nonaka, Yasumasa; Sugiyama, Hirotaka; Kajiyama, Tetsuya; Yui, Sho; Nishimura, Ryohei; Ono, Koji; Takamoto, Sinichi; Nakajima, Jun; Ono, Minoru; Eriguchi, Masazumi; Hasumi, Kenichiro; Takahashi, Hiroyuki

    2017-06-01

    Boron neutron-capture therapy (BNCT) has been used to inhibit the growth of various types of cancers. In this study, we developed a 10 BSH-entrapped water-in-oil-in-water (WOW) emulsion, evaluated it as a selective boron carrier for the possible application of BNCT in hepatocellular carcinoma treatment. We prepared the 10 BSH-entrapped WOW emulsion using double emulsification technique and then evaluated the delivery efficacy by performing biodistribution experiment on VX-2 rabbit hepatic tumour model with comparison to iodized poppy-seed oil mix conventional emulsion. Neutron irradiation was carried out at Kyoto University Research Reactor with an average thermal neutron fluence of 5 × 10 12  n cm -2 . Morphological and pathological analyses were performed on Day 14 after neutron irradiation. Biodistribution results have revealed that 10 B atoms delivery with WOW emulsion was superior compared with those using iodized poppy-seed oil conventional emulsion. There was no dissemination in abdomen or lung metastasis observed after neutron irradiation in the groups treated with 10 BSH-entrapped WOW emulsion, whereas many tumour nodules were recognized in the liver, abdominal cavity, peritoneum and bilateral lobes of the lung in the non-injected group. Tumour growth suppression and cancer-cell-killing effect was observed from the morphological and pathological analyses of the 10 BSH-entrapped WOW emulsion-injected group, indicating its feasibility to be applied as a novel intra-arterial boron carrier for BNCT. Advances in knowledge: The results of the current study have shown that entrapped 10 BSH has the potential to increase the range of therapies available for hepatocellular carcinoma which is considered to be one of the most difficult tumours to cure.

  18. Study of the stability of packaging and storage conditions of human mesenchymal stem cell for intra-arterial clinical application in patient with critical limb ischemia.

    Science.gov (United States)

    Gálvez-Martín, Patricia; Hmadcha, Abdelkrim; Soria, Bernat; Calpena-Campmany, Ana C; Clares-Naveros, Beatriz

    2014-04-01

    Critical limb ischemia (CLI) is associated with significant morbidity and mortality. In this study, we developed and characterized an intra-arterial cell suspension containing human mesenchymal stem cells (hMSCs) for the treatment of CLI. Equally, the stability of cells was studied in order to evaluate the optimal conditions of storage that guarantee the viability from cell processing to the administration phase. Effects of various factors, including excipients, storage temperature and time were evaluated to analyze the survival of hMSCs in the finished medicinal product. The viability of hMSCs in different packaging media was studied for 60 h at 4 °C. The best medium to maintain hMSCs viability was then selected to test storage conditions (4, 8, 25 and 37 °C; 60 h). The results showed that at 4 °C the viability was maintained above 80% for 48 h, at 8 °C decreased slightly, whereas at room temperature and 37 °C decreased drastically. Its biocompatibility was assessed by cell morphology and cell viability assays. During stability study, the stored cells did not show any change in their phenotypic or genotypic characteristics and physicochemical properties remained constant, the ability to differentiate into adipocytes and osteocytes and sterility requirements were also unaltered. Finally, our paper proposes a packing media composed of albumin 20%, glucose 5% and Ringer's lactate at a concentration of 1×10(6) cells/mL, which must be stored at 4 °C as the most suitable to maintain cell viability (>80%) and without altering their characteristics for more than 48 h. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. The Fate of High-Density Lesions on the Non-contrast CT Obtained Immediately After Intra-arterial Thrombolysis in Ischemic Stroke Patients

    International Nuclear Information System (INIS)

    Jang, Yu Mi; Lee, Deok Hee; Kim, Ho Sung; Ryu, Chang Woo; Lee, Jeong Hyun; Choi, Choong Gon; Kim, Sang Joon; Suh, Dae Chul

    2006-01-01

    Hyperdense lesions can frequently be observed on the CT obtained immediately after intra-arterial (IA) thrombolysis, and it is sometimes difficult to differentiate contrast extravasation from the hemorrhagic lesions. The purposes of this study are to classify the hyperdense lesions according to their morphologic features and to track the outcome of those lesions. Among the 94 patients who suffered with anterior circulation ischemic stroke and who were treated with IA thrombolysis, 31 patients revealed hyperdense lesions on the CT obtained immediately after the procedure. The lesions were categorized into four types according to their volume, shape, location and density: cortical high density (HD), soft HD, metallic HD and diffuse HD. The follow-up images were obtained 3 5 days later in order to visualize the morphologic changes and hemorrhagic transformation of the lesions. Among the 31 patients with HD lesions, 18 (58%) showed hemorrhagic transformation of their lesion, and six of them were significant. All the cortical HD lesions (n = 4) revealed spontaneous resolution. Seven of the soft HD lesions (n = 13) showed spontaneous resolution, while the rest of the group showed hemorrhagic transformation. Among them the hemorrhage was significant in only two patients (2/6) who did not achieve successful recanalization. All the metallic HD lesions (n = 10) resulted in hemorrhagic transformation; among them, three cases (30%) with a maximum CT value more than 150 HU (Hounsfield unit) subsequently showed significant hemorrhagic transformation on the follow-up CT. There were four diffuse HD lesions, and two of them showed hemorrhagic transformation. The parenchymal hyperdense lesions observed on the CT obtained immediately after IA thrombolysis in ischemic stroke patients exhibited varying features and they were not always hemorrhagic. Most of the soft HD lesions were benign, and although all of the metallic HD lesions were hemorrhagic, some of them were ultimately found

  20. Intra-Arterial Chemotherapy as Primary Therapy for Retinoblastoma in Infants Less than 3 Months of Age: A Series of 10 Case-Studies.

    Directory of Open Access Journals (Sweden)

    Miaojuan Chen

    Full Text Available Retinoblastoma is the most common primary malignant intra-ocular tumor in children. Although intra-arterial chemotherapy (IAC by selectively infusing chemotherapy through the ophthalmic artery has become an essential technique in the treatment of advanced intra-ocular retinoblastoma in children, the outcome of IAC as primary therapy for infants less than 3 months of age remains unknown. In this retrospective study, we reviewed the outcome of IAC as primary therapy for retinoblastoma in infants less than 3 months of age.We retrospectively reviewed ten retinoblastoma patients attending our center from January 2009 to September 2015 and beginning primary IAC before the age of 3 months. The patient characteristics, overall outcomes and therapy-related complications were assessed.The mean patient age at the first IAC treatment was 10.4 weeks (range 4.9-12.9 weeks. These eyes were classified according to the International Classification of Retinoblastoma (ICRB as group A (n = 0, B (n = 2, C (n = 0, D (n = 9, or E (n = 2. A total of 28 catheterizations were performed, and the procedure was stopped in one patient because of internal carotid artery spasm. Each eye received a mean of 2.6 cycles of IAC (range 2-4 cycles. After IAC with a mean follow-up of 28.3 months (range 9-65 months, tumor regression was observed in 12 of 13 eyes. One eye was enucleated due to tumor progression. All patients are alive and no patient has developed metastatic disease or other malignancies.Our experience suggests IAC as primary therapy is a feasible and promising treatment for retinoblastoma in infants less than 3 months of age.

  1. Developing a Model to Support Students in Solving Subtraction

    Directory of Open Access Journals (Sweden)

    Nila Mareta Murdiyani

    2013-01-01

    Full Text Available Subtraction has two meanings and each meaning leads to the different strategies. The meaning of “taking away something” suggests a direct subtraction, while the meaning of “determining the difference between two numbers” is more likely to be modeled as indirect addition. Many prior researches found that the second meaning and second strategy rarely appeared in the mathematical textbooks and teacher explanations, including in Indonesia. Therefore, this study was conducted to contribute to the development of a local instruction theory for subtraction by designing instructional activities that can facilitate first grade of primary school students to develop a model in solving two digit numbers subtraction. Consequently, design research was chosen as an appropriate approach for achieving the research aim and Realistic Mathematics Education (RME was used as a guide to design the lesson. This study involved 6 students in the pilot experiment, 31 students in the teaching experiment, and a first grade teacher of SDN 179 Palembang. The  result of this study shows that the beads string could bridge students from the contextual problems (taking ginger candies and making grains bracelets to the use of the empty number line. It also shows that the empty number line could promote students to  use different strategies (direct subtraction, indirect addition, and indirect subtraction in solving subtraction problems. Based on these findings, it is recommended to apply RME in the teaching learning process to make it more meaningful for students. Keywords: Subtraction, Design Research, Realistic Mathematics Education, The Beads String, The Empty Number Line DOI: http://dx.doi.org/10.22342/jme.4.1.567.95-112

  2. Comparison between digital subtraction angiography and magnetic resonance angiography in investigation of nonlacunar ischemic stroke in young patients: preliminary results Comparação entre arteriografia digital e angioressonância na investigação de acidente vascular cerebral isquêmico não-lacunar em pacientes jovens: resultados preliminares

    Directory of Open Access Journals (Sweden)

    Adriana Bastos Conforto

    2006-06-01

    Full Text Available PURPOSE: We preliminarily investigated the relevance of performing digital subtraction angiography (DSA in addition to magnetic resonance angiography (MRA in definition of ischemic stroke etiology in young patients. METHOD: DSAs and MRAs from 17 young patients with nonlacunar ischemic stroke were blindly analyzed and their impact on stroke management was evaluated. RESULTS: Etiologies were the same considering results of either DSA or MRA in 12/17 cases. In 15/17 patients no changes would have been made in treatment, regardless of the modality of angiography considered. CONCLUSION: These preliminary results suggest that DSA may be redundant in two thirds of ischemic strokes in young patients. Further larger prospective studies are necessary to determine indications of DSA in this age group.PROPÓSITO DO ESTUDO: Investigar de forma preliminar a relevância da realização de angiografia digital (AD adicionalmente a angioressonância (AR na definição de etiologias de acidente vascular cerebral isquêmico (AVCI em pacientes jovens. MÉTODO: ADs e ARs de 17 pacientes jovens com AVCIs não-lacunares foram analisadas. Avaliamos o impacto destes exames no manejo clínico dos casos. RESULTADOS: Em 12/17 casos, as etiologias dos AVCIs de acordo com os resultados de AD ou de AR foram idênticas. Em 15/17 pacientes, nenhuma mudança de conduta terapêutica seria realizada, independentemente da modalidade de exame considerada. CONCLUSÃO: Estes resultados preliminares sugerem que os resultados da AD podem ser redundantes em relação à AR em até dois terços dos pacientes jovens com AVCI. Estudos prospectivos maiores são necessários para otimizar o estabelecimento de indicações de AD nesta faixa etária.

  3. Potentiating intra-arterial sonothrombolysis for acute ischemic stroke by the addition of the ultrasound contrast agents (Optison™ & SonoVue®)

    Science.gov (United States)

    Singhal, Ruchi; Obtera, Melissa; Roy, Ronald A.; Clark, Wayne M.; Hansmann, Douglas R.

    2010-01-01

    Transcranial ultrasound in combination with intravenously administered ultrasound contrast agents (UCA) in the presence or absence of recombinant tissue plasminogen activator (rt-PA) has been widely evaluated as a new modality for treatment of ischemic stroke. Despite the successful demonstration of accelerated clot lysis there are inherent limitations associated with this modality such as inconsistency in temporal window thickness and/or potential serious cardiopulmonary reactions to intravenous administration of UCA that prevent broad application to ischemic stroke populations. As a complementary modality, we evaluated potential lysis enhancement by intraarterial ultrasound with concurrent intra-clot delivery of UCA and rt-PA. To this end, clots were formed with average pore diameter similar to clinically retracted clots by adjusting the thrombin concentration. Physical characteristic and retention of UCA after delivery through the catheter as a function of clinically relevant flow rates of 6, 12, 18 ml/h were determined using a microscopic method. The ability of the UCA employed in this study, Optison and SonoVue, to penetrate into the clot was verified using ultrasound B-mode imaging. Clot lysis as a function of rt-PA concentration, 0.009 through 0.5 mg/ml, in the presence and absence of UCA diluted to 1:10, 1:100, and 1:200 v/v at two Peak rarefaction acoustic pressures of 1.3 and 2.1 MPa were evaluated using a weighing method. The study results suggest the addition of only 0.02 ml of 1:100 diluted UCA to rt-PA of 0.009, 0.05, 0.3, and 0.5 mg/ml can enhance the lysis rate by 3.9, 2.6, 1.9 and 1.8 fold in the presence of peak rarefaction acoustic pressure of 1.3 MPa and by 5.1, 3.4, 2.6, 3.1 in the presence of peak rarefaction acoustic pressure of 2.1 MPa, respectively. In addition, Optison and SonoVue demonstrated comparable effectiveness in enhancing the clot lysis rate. Addition of UCA to intra-arterial sonothrombolysis could be considered as a viable

  4. Type I interferon receptor in peripheral blood mononuclear cells may predict response to intra-arterial 5-fluorouracil + interferon therapy for advanced hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Korenaga K

    2011-04-01

    Full Text Available Yasuyuki Tomiyama1, Naoko Yoshioka1, Yoshiaki Yanai2,3, Tomoya Kawase1, Sohji Nishina1, Yuichi Hara1, Koji Yoshida1, Keiko Korenaga1, Masaaki Korenaga1, Keisuke Hino11Department of Hepatology and Pancreatology, Kawasaki Medical University, Kurashiki, Japan; 2Institute of Fujisaki, Hayashibara Biochemical Lab Inc, Okayama, Japan; 3Pharmaceutical Marketing Division, Otsuka Pharmaceutical Co Ltd, Tokyo, JapanBackground: Type 1 interferon alpha receptor 2 (IFNAR2 in the liver has been reported to be a predictive factor for the response to intra-arterial 5-fluorouracil (5-FU + systemic interferon (IFN-alpha combination therapy in patients with advanced hepatocellular carcinoma. We tested whether IFNAR2 expression in peripheral blood mononuclear cells could predict the response to 5-FU + IFN.Methods: Predictive factors for survival and response to therapy were determined in 30 patients with advanced hepatocellular carcinoma who underwent treatment with 5-FU + IFN. IFNAR2 expression in peripheral blood mononuclear cells was measured in 11 of the 30 patients.Results: With a mean number of 4.2 courses of combination therapy, one patient (3% showed a complete response, eight (27% showed partial responses, 13 (43% had stable disease, and eight (27% showed progressive disease. The median survival time of responders (complete response/partial response was 12.7 months and that of nonresponders (stable disease/progressive disease was 7.5 months. The one-year and two-year cumulative survival rates of responders and nonresponders were 87/69% and 40/11%, respectively (P = 0.019. Multivariate analysis identified response to therapy (P = 0.037 as the sole independent determinant of survival. The expression level of IFNAR2 in peripheral blood mononuclear cells was significantly (P = 0.012 higher in responders (6.5 ± 2.4 than in nonresponders (2.4 ± 0.6, even though no clinical factors were identified as being associated with the response to the combination

  5. FDG-PET for prediction of tumour aggressiveness and response to intra-arterial chemotherapy and radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Kitagawa, Yoshimasa; Sano, Kazuo; Nakamura, Mikiko; Ogasawara, Toshiyuki; Nishizawa, Sadahiko; Sadato, Norihiro; Yonekura, Yoshiharu

    2003-01-01

    The aim of this study was to evaluate the possible usefulness of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for predicting tumour aggressiveness and response to intra-arterial chemotherapy (THP-ADM + 5-FU + carboplatin) and radiotherapy in head and neck carcinomas. Twenty patients with squamous cell carcinoma (SCC) of the head and neck were included in the study. All patients completed the treatment regimen, and each patient underwent two FDG-PET studies, one prior to and one at 4 weeks after the chemoradiotherapy. For the quantitative evaluation of regional FDG uptake in the tumour, standardised uptake values (SUVs) with an uptake period of 50 min were used. The pre-treatment SUV (pre-SUV) and post-treatment SUV (post-SUV) were compared with immunohistologically evaluated tumour proliferative potential (MIB-1 and PCNA), tumour cellularity and other parameters including histological grade, tumour size and stage, clinical response and histological evaluation after therapy. All neoplastic lesions showed high SUVs (mean, 9.75 mg/ml) prior to the treatment, which decreased significantly after the therapy (3.41 mg/ml, P 7 mg/ml) showed residual tumour cells after treatment in 4 out of 15 patients, whereas patients whose lesions showed a low pre-SUV (<7 mg/ml, five patients) were successfully treated. Four out of six tumours with a post-SUV higher than 4 mg/ml had viable tumour cells, whereas all tumours (14/14) with a post-SUV lower than 4 mg/ml showed no viable tumour cells. Computational multivariate analysis using multiple regression revealed four factors (MIB-1 labelling index, cellularity, the number of MIB-1 labelled tumour cells and tumour size grade) contributing to pre-SUV and pre-post SUV (difference between pre-treatment SUV and post-treatment SUV in each patient) with statistical significance. FDG uptake in the tumour might reflect tumour aggressiveness, which is closely related to the proliferative activity and cellularity. Pre

  6. Intra-arterial embolization with pingyangmycin-lipiodol emulsion for the treatment of hepatic cavernous hemangioma: an analysis of factors affecting therapeutic results

    International Nuclear Information System (INIS)

    Zeng Qingle; Chen Yong; Zhao Jianbo; Zhang Kewei; Li Yanhao

    2009-01-01

    Objective: To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization (PLE-IASE) in treating symptomatic cavernous hemangioma of liver (SCHL). Methods: PLE-IASE was performed in 89 patients with SCHL (32 males and 57 females). Before treatment the mean diameter of the hemangioma was (8.3±3.8) cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabach-Merrit syndrome. Before PLE-IASE, the arteriographic classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion (PLE) was injected through the feeding artery. The dosage of pingyangmycin (PYM) was (9.8 ± 4.4) mg and the dosage of lipiodol (LP) was (5.9 ± 2.9) ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results: Of all 89 cases of SCHL, hypervascular type was seen in 51, hypovascular type in 26 and arteriovenous shunt (AVS) type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear

  7. Correlation of Noninvasive Blood Pressure and Invasive Intra-arterial Blood Pressure in Patients Treated with Vasoactive Medications in a Neurocritical Care Unit.

    Science.gov (United States)

    Saherwala, Ali A; Stutzman, Sonja E; Osman, Mohamed; Kalia, Junaid; Figueroa, Stephen A; Olson, DaiWai M; Aiyagari, Venkatesh

    2018-03-22

    The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simultaneously measured NBP and IAP recordings in these patients. Prospective observational study of patients (N = 70) admitted to a neurocritical care unit receiving continuous vasopressor or antihypertensive infusions. Paired NBP/IAP observations along with covariate and demographic data were abstracted via chart audit. Analysis was performed using SAS v9.4. A total of 2177 paired NBP/IAP observations from 70 subjects (49% male, 63% white, mean age 59 years) receiving vasopressors (n = 21) or antihypertensive agents (n = 49) were collected. Paired t test analysis showed significant differences between NBP versus IAP readings: ([systolic blood pressure (SBP): mean = 136 vs. 140 mmHg; p blood pressure (DBP): mean = 70 vs. 68 mmHg, p blood pressure (MAP): mean = 86 vs. 90 mmHg, p blood pressures. Pearson correlation coefficients show strong positive correlations for paired MAP (r = 0.82), SBP (r = 0.84), and DBP (r = 0.73) recordings. An absolute NBP-IAP SBP difference of > 20 mmHg was seen in ~ 20% of observations of nicardipine, ~ 25% of observations of norepinephrine, and ~ 35% of observations of phenylephrine. For MAP, the corresponding numbers were ~ 10, 15, and 25% for nicardipine, norepinephrine, and phenylephrine, respectively. Despite overall strong positive correlations between paired NBP and IAP readings of MAP and SBP, clinically relevant differences in blood pressure are frequent. When treating with vasoactive infusions targeted to a specific BP goal, it is important to keep in mind that NBP and IAP values are not interchangeable.

  8. Comparison of maximum intensity projection and digitally reconstructed radiographic projection for carotid artery stenosis measurement

    International Nuclear Information System (INIS)

    Hyde, Derek E.; Habets, Damiaan F.; Fox, Allan J.; Gulka, Irene; Kalapos, Paul; Lee, Don H.; Pelz, David M.; Holdsworth, David W.

    2007-01-01

    Digital subtraction angiography is being supplanted by three-dimensional imaging techniques in many clinical applications, leading to extensive use of maximum intensity projection (MIP) images to depict volumetric vascular data. The MIP algorithm produces intensity profiles that are different than conventional angiograms, and can also increase the vessel-to-tissue contrast-to-noise ratio. We evaluated the effect of the MIP algorithm in a clinical application where quantitative vessel measurement is important: internal carotid artery stenosis grading. Three-dimensional computed rotational angiography (CRA) was performed on 26 consecutive symptomatic patients to verify an internal carotid artery stenosis originally found using duplex ultrasound. These volumes of data were visualized using two different postprocessing projection techniques: MIP and digitally reconstructed radiographic (DRR) projection. A DRR is a radiographic image simulating a conventional digitally subtracted angiogram, but it is derived computationally from the same CRA dataset as the MIP. By visualizing a single volume with two different projection techniques, the postprocessing effect of the MIP algorithm is isolated. Vessel measurements were made, according to the NASCET guidelines, and percentage stenosis grades were calculated. The paired t-test was used to determine if the measurement difference between the two techniques was statistically significant. The CRA technique provided an isotropic voxel spacing of 0.38 mm. The MIPs and DRRs had a mean signal-difference-to-noise-ratio of 30:1 and 26:1, respectively. Vessel measurements from MIPs were, on average, 0.17 mm larger than those from DRRs (P<0.0001). The NASCET-type stenosis grades tended to be underestimated on average by 2.4% with the MIP algorithm, although this was not statistically significant (P=0.09). The mean interobserver variability (standard deviation) of both the MIP and DRR images was 0.35 mm. It was concluded that the MIP

  9. Feasibility evaluation of neutron capture therapy for hepatocellular carcinoma using selective enhancement of boron accumulation in tumour with intra-arterial administration of boron-entrapped water-in-oil-in-water emulsion.

    Science.gov (United States)

    Yanagie, Hironobu; Kumada, Hiroaki; Nakamura, Takemi; Higashi, Syushi; Ikushima, Ichiro; Morishita, Yasuyuki; Shinohara, Atsuko; Fijihara, Mitsuteru; Suzuki, Minoru; Sakurai, Yoshinori; Sugiyama, Hirotaka; Kajiyama, Tetsuya; Nishimura, Ryohei; Ono, Koji; Nakajima, Jun; Ono, Minoru; Eriguchi, Masazumi; Takahashi, Hiroyuki

    2011-12-01

    Hepatocellular carcinoma (HCC) is one of the most difficult to cure with surgery, chemotherapy, or other combinational therapies. In the treatment of HCC, only 30% patients can be operated due to complication of liver cirrhosis or multiple intrahepatic tumours. Tumour cell destruction in boron neutron-capture therapy (BNCT) is due to the nuclear reaction between (10)B atoms and thermal neutrons, so it is necessary to accumulate a sufficient quantity of (10)B atoms in tumour cells for effective tumour cell destruction by BNCT. Water-in-oil-in-water (WOW) emulsion has been used as the carrier of anti-cancer agents on intra-arterial injections in clinical. In this study, we prepared (10)BSH entrapped WOW emulsion by double emulsifying technique using iodized poppy-seed oil (IPSO), (10)BSH and surfactant, for selective intra-arterial infusion to HCC, and performed simulations of the irradiation in order to calculate the dose delivered to the patients. WOW emulsion was administrated with intra-arterial injections via proper hepatic artery on VX-2 rabbit hepatic tumour models. We simulated the irradiation of epithermal neutron and calculated the dose delivered to the tissues with JAEA computational dosimetry system (JCDS) at JRR4 reactor of Japan Atomic Research Institute, using the CT scans of a HCC patient. The (10)B concentrations in VX-2 tumour obtained by delivery with WOW emulsion were superior to those by conventional IPSO mix emulsion. According to the rabbit model, the boron concentrations (ppm) in tumour, normal liver tissue, and blood are 61.7, 4.3, and 0.1, respectively. The results of the simulations show that normal liver biologically weighted dose is restricted to 4.9 Gy-Eq (CBE; liver tumour: 2.5, normal liver: 0.94); the maximum, minimum, and mean tumour weighted dose are 43.1, 7.3, and 21.8 Gy-Eq, respectively, in 40 min irradiation. In this study, we show that (10)B entrapped WOW emulsion could be applied to novel intra-arterial boron delivery carrier

  10. Behavior Subtraction applied to radar

    NARCIS (Netherlands)

    Rossum, W.L. van; Caro Cuenca, M.

    2014-01-01

    An algorithm developed for optical images has been applied to radar data. The algorithm, Behavior Subtraction, is based on capturing the dynamics of a scene and detecting anomalous behavior. The radar application is the detection of small surface targets at sea. The sea surface yields the expected

  11. Color Addition and Subtraction Apps

    Science.gov (United States)

    Ruiz, Frances; Ruiz, Michael J.

    2015-01-01

    Color addition and subtraction apps in HTML5 have been developed for students as an online hands-on experience so that they can more easily master principles introduced through traditional classroom demonstrations. The evolution of the additive RGB color model is traced through the early IBM color adapters so that students can proceed step by step…

  12. Alterações histopatológicas associadas à braquiterapia intra-arterial com o samário-153

    Directory of Open Access Journals (Sweden)

    Précoma Dalton Bertolim

    2004-01-01

    Full Text Available A lesão da parede arterial provocada por balão de angioplastia ou implante de próteses endovasculares em modelos experimentais e humanos pode provocar a reestenose do vaso, principalmente por migração e proliferação de células musculares lisas e síntese de matriz extracelular. Vários estudos demonstraram que a braquiterapia intra-arterial atua nestes fatores e, conseqüentemente, no tratamento da reestenose coronariana. Este estudo tem por objetivo avaliar as alterações vasculares morfológicas e morfométricas induzidas pela braquiterapia com samário-153 (153Sm, utilizando uma dose considerada ideal e outra elevada em coelhos hipercolesterolêmicos. Foram analisados 43 coelhos hipercolesterolêmicos e um total de 86 artérias ilíacas submetidas à lesão por balão de angioplastia, divididos em três grupos, sendo irradiados com as doses de 15Gy (n = 14 e 60Gy (n = 36 e controle (n = 36. Foram realizadas análise morfométrica (área neo-intimal, área da camada média, área do vaso e análise histológica qualitativa para avaliação tecidual. O colesterol médio foi de 1.362 ± 497mg/dl nos três grupos. O achado mais relevante foi uma significativa inibição da hiperplasia neo-intimal no grupo irradiado com a dose de 15Gy, maior do que o controle e com a dose de 60Gy. Na dose de 60 Gy, além de ineficaz para inibir a proliferação neo-intimal, teve características tissulares e estruturais sugestivas de radiolesão, como presença de células xantomatosas, tecidos hialino e amorfo, proliferação vascular. Estas células, bem como o aumento das dimensões morfométricas do vaso, foram proporcionais aos graus de lesão nas lâminas elásticas interna e externa, sendo observados principalmente com a dose de 60Gy. Os segmentos médios das artérias ilíacas, representando o local de maior contato com o balão, tiveram maiores alterações morfométricas e celulares em relação aos segmentos referenciais (proximal e distal nos

  13. Segurança do transplante autólogo, intra-arterial, de células mononucleares da medula óssea na fase aguda do acidente vascular cerebral isquêmico Intra-arterial autologous bone marrow mononuclear cell transplantation for acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Furtado de Mendonça

    2006-01-01

    Full Text Available O acidente vascular cerebral (AVC é a terceira causa de óbito e a principal causa de incapacidade em indivíduos adultos. Embora a mortalidade do AVC esteja diminuindo em alguns países, a morbidade tem aumentado em razão do envelhecimento da população e do aumento da sobrevida dos pacientes¹. O tratamento com ativador do plasminogênio tissular recombinante (rt-PA é eficaz quando instituído em até 3 horas após o início dos sintomas², porém seu uso está limitado a cerca de 5% dos pacientes na fase aguda do AVC isquêmico. Além disso, nenhum agente para neuroproteção teve sua eficácia comprovada em estudos clínicos em humanos. Portanto, outras estratégias terapêuticas precisam ser desenvolvidas. Em modelos animais, o uso de células-tronco correlacionou-se com melhora funcional após o AVC³. Publicações recentes têm demonstrado a segurança do tratamento com células mononucleares da medula óssea (CMMO injetadas via intracoronária em pacientes portadores de cardiopatia isquêmica aguda ou crônica4,5. Baseado nesses dados iniciais, há crescente interesse no estudo do transplante com CMMO na fase aguda do AVC. Relatamos o primeiro caso de transplante autólogo de CMMO via intra-arterial na fase aguda do AVC isquêmico.Stroke is the third cause of death and the leading cause of disability in adult subjects. Although stroke mortality has been declining in some countries, stroke morbidity has been increasing due to the aging of population and patients improved survival.¹ Treatment with recombinant tissue plasminogen activator (rtPA is successful provided it is administered within 3 hours of symptoms onset,² but its use is limited to about 5% of the patients with acute ischemic stroke. Furthermore, no neuroprotective agent has yet been proven effective in human clinical trials. The development of other therapeutic strategies is, therefore, warranted. The use of stem cells in animal models has led to functional improvement

  14. Feasibility evaluation of neutron capture therapy for hepatocellular carcinoma using selective enhancement of boron accumulation in tumour with intra-arterial administration of boron-entrapped water-in-oil-in-water emulsion

    International Nuclear Information System (INIS)

    Yanagie, Hironobu; Kumada, Hiroaki; Nakamura, Takemi; Higashi, Syushi; Ikushima, Ichiro; Morishita, Yasuyuki; Shinohara, Atsuko; Fijihara, Mitsuteru; Suzuki, Minoru; Sakurai, Yoshinori; Sugiyama, Hirotaka; Kajiyama, Tetsuya; Nishimura, Ryohei; Ono, Koji; Nakajima, Jun; Ono, Minoru; Eriguchi, Masazumi; Takahashi, Hiroyuki

    2011-01-01

    Introduction: Hepatocellular carcinoma (HCC) is one of the most difficult to cure with surgery, chemotherapy, or other combinational therapies. In the treatment of HCC, only 30% patients can be operated due to complication of liver cirrhosis or multiple intrahepatic tumours. Tumour cell destruction in boron neutron-capture therapy (BNCT) is due to the nuclear reaction between 10 B atoms and thermal neutrons, so it is necessary to accumulate a sufficient quantity of 10 B atoms in tumour cells for effective tumour cell destruction by BNCT. Water-in-oil-in-water (WOW) emulsion has been used as the carrier of anti-cancer agents on intra-arterial injections in clinical. In this study, we prepared 10 BSH entrapped WOW emulsion by double emulsifying technique using iodized poppy-seed oil (IPSO), 10 BSH and surfactant, for selective intra-arterial infusion to HCC, and performed simulations of the irradiation in order to calculate the dose delivered to the patients. Materials and methods: WOW emulsion was administrated with intra-arterial injections via proper hepatic artery on VX-2 rabbit hepatic tumour models. We simulated the irradiation of epithermal neutron and calculated the dose delivered to the tissues with JAEA computational dosimetry system (JCDS) at JRR4 reactor of Japan Atomic Research Institute, using the CT scans of a HCC patient. Results and discussions: The 10 B concentrations in VX-2 tumour obtained by delivery with WOW emulsion were superior to those by conventional IPSO mix emulsion. According to the rabbit model, the boron concentrations (ppm) in tumour, normal liver tissue, and blood are 61.7, 4.3, and 0.1, respectively. The results of the simulations show that normal liver biologically weighted dose is restricted to 4.9 Gy-Eq (CBE; liver tumour: 2.5, normal liver: 0.94); the maximum, minimum, and mean tumour weighted dose are 43.1, 7.3, and 21.8 Gy-Eq, respectively, in 40 min irradiation. In this study, we show that 10 B entrapped WOW emulsion could be

  15. Feasibility evaluation of neutron capture therapy for hepatocellular carcinoma using selective enhancement of boron accumulation in tumour with intra-arterial administration of boron-entrapped water-in-oil-in-water emulsion

    Energy Technology Data Exchange (ETDEWEB)

    Yanagie, Hironobu, E-mail: yanagie@n.t.u-tokyo.ac.jp [Dept of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan)] [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Kumada, Hiroaki [Proton Medical Research Center, University of Tsukuba, Ibaraki (Japan); Nakamura, Takemi [Japan Atomic Energy Research Institute, Ibaraki (Japan); Higashi, Syushi [Dept of Surgery, Ebihara Memorial Hospital, Miyazaki (Japan)] [Kyushu Industrial Sources Foundation, Miyazaki (Japan); Ikushima, Ichiro [Dept of Radiology, Miyakonojyo Metropolitan Hospital, Miyazaki (Japan); Morishita, Yasuyuki [Dept of Human and Molecular Pathology, Graduate School of Medicine, University of Tokyo, Tokyo (Japan); Shinohara, Atsuko [Dept of Humanities, Graduate School of Seisen University, Tokyo (Japan); Fijihara, Mitsuteru [SPG Techno Ltd. Co., Miyazaki (Japan); Suzuki, Minoru; Sakurai, Yoshinori [Research Reactor Institute, Kyoto University, Osaka (Japan); Sugiyama, Hirotaka [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan); Kajiyama, Tetsuya [Kyushu Industrial Sources Foundation, Miyazaki (Japan); Nishimura, Ryohei [Dept of Veternary Surgery, University of Tokyo Veternary Hospital, Tokyo (Japan); Ono, Koji [Research Reactor Institute, Kyoto University, Osaka (Japan); Nakajima, Jun; Ono, Minoru [Dept of Cardiothracic Surgery, University of Tokyo Hospital, Tokyo (Japan); Eriguchi, Masazumi [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)] [Department of Surgery, Shin-Yamanote Hospital, Saitama (Japan); Takahashi, Hiroyuki [Dept of Nuclear Engineering and Management, Graduate School of Engineering, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan)] [Cooperative Unit of Medicine and Engineering, University of Tokyo Hospital, Tokyo (Japan)

    2011-12-15

    Introduction: Hepatocellular carcinoma (HCC) is one of the most difficult to cure with surgery, chemotherapy, or other combinational therapies. In the treatment of HCC, only 30% patients can be operated due to complication of liver cirrhosis or multiple intrahepatic tumours. Tumour cell destruction in boron neutron-capture therapy (BNCT) is due to the nuclear reaction between {sup 10}B atoms and thermal neutrons, so it is necessary to accumulate a sufficient quantity of {sup 10}B atoms in tumour cells for effective tumour cell destruction by BNCT. Water-in-oil-in-water (WOW) emulsion has been used as the carrier of anti-cancer agents on intra-arterial injections in clinical. In this study, we prepared {sup 10}BSH entrapped WOW emulsion by double emulsifying technique using iodized poppy-seed oil (IPSO), {sup 10}BSH and surfactant, for selective intra-arterial infusion to HCC, and performed simulations of the irradiation in order to calculate the dose delivered to the patients. Materials and methods: WOW emulsion was administrated with intra-arterial injections via proper hepatic artery on VX-2 rabbit hepatic tumour models. We simulated the irradiation of epithermal neutron and calculated the dose delivered to the tissues with JAEA computational dosimetry system (JCDS) at JRR4 reactor of Japan Atomic Research Institute, using the CT scans of a HCC patient. Results and discussions: The {sup 10}B concentrations in VX-2 tumour obtained by delivery with WOW emulsion were superior to those by conventional IPSO mix emulsion. According to the rabbit model, the boron concentrations (ppm) in tumour, normal liver tissue, and blood are 61.7, 4.3, and 0.1, respectively. The results of the simulations show that normal liver biologically weighted dose is restricted to 4.9 Gy-Eq (CBE; liver tumour: 2.5, normal liver: 0.94); the maximum, minimum, and mean tumour weighted dose are 43.1, 7.3, and 21.8 Gy-Eq, respectively, in 40 min irradiation. In this study, we show that {sup 10}B

  16. A New Algorithm for the Subtraction Games

    OpenAIRE

    He, Guanglei; Qin, Zhihui

    2012-01-01

    Subtraction games is a class of combinatorial games. It was solved since the Sprague-Grundy Theory was put forward. This paper described a new algorithm for subtraction games. The new algorithm can find win or lost positions in subtraction games. In addition, it is much simpler than Sprague-Grundy Theory in one pile of the games.

  17. Efeitos cardiovasculares e renais da injeção intra-arterial de contraste radiológico iônico em cães com restrição hídrica Efectos cardiovasculares y renales de la inyección intra-arterial de contraste radiológico iónico en perros con restricción hídrica Cardiovascular and renal effects of intra-arterial injection of ionic radiological contrast in dogs under fluid restriction

    Directory of Open Access Journals (Sweden)

    Marisa Aparecida Lima Verderese

    2005-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O objetivo desta pesquisa foi estudar os efeitos agudos do contraste radiológico em situações de restrição de volume, avaliando-se os efeitos renais e cardiovasculares após a injeção intra-arterial de contraste radiológico de alta osmolaridade. MÉTODO: Participaram do estudo 16 cães anestesiados com tiopental sódico (15 mg.kg-1 e fentanil (15 µg.kg-1 em bolus, seguido de infusão contínua nas doses de 40 µg.kg-1.min-1 (tiopental sódico e 0,1 µg.kg-1.min-1 (fentanil. Foi feita hidratação com solução de glicose a 5% (0,03 mL.kg-1.min-1 e a ventilação pulmonar foi controlada mecanicamente com ar comprimido. Foram verificados os seguintes atributos: freqüência cardíaca (FC; pressão arterial média (PAM; pressão da veia cava inferior (PVI; débito cardíaco (DC; hematócrito (Ht; fluxo plasmático efetivo renal (FPER; fluxo sangüíneo renal (FSR; ritmo de filtração glomerular (RFG; fração de filtração; resistência vascular renal (RVR; volume urinário (VU; osmolaridade plasmática e urinária; depuração osmolar, depuração de água livre e depuração de sódio e de potássio; sódio e potássio plasmáticos; excreção urinária e fracionária de sódio e potássio e temperatura retal. Estes atributos foram avaliados em quatro momentos: 30 (M1, 60 (M2, 90 (M3 e 120 (M4 minutos após o início da infusão de para-aminohipurato de sódio e creatinina (início da experiência. No momento 2, no grupo G1 foi feita injeção intra-arterial de solução fisiológica a 0,9% (1,24 mL.kg-1, e no grupo G2 foi injetado contraste radiológico (1,24 mL.kg-1 pela mesma via. RESULTADOS: O grupo G1 apresentou aumento da FC, do FPER, do FSR, da osmolaridade plasmática, da depuração de sódio e da excreção urinária de sódio; apresentou ainda diminuição da osmolaridade urinária, do potássio plasmático, da depuração de potássio e da temperatura retal. No grupo G2 ocorreu aumento da FC, da

  18. Dual-energy subtraction radiography of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Asaga, Taro; Masuzawa, Chihiro; Kawahara, Satoru; Motohashi, Hisahiko; Okamoto, Takashi; Tamura, Nobuo

    1988-06-01

    Dual-energy projection radiography was applied to breast examination. To perform the dual-energy subtraction radiography using a digital radiography unit, high and low-energy exposures were made at an appropriate time interval under differing X-ray exposure conditions. Dual-energy subtraction radiography was performed in 41 cancer patients in whom the tumor shadow was equivocal or the border of cancer infiltration was not clearly demonstrated by compression mammography, and 15 patients with benign diseases such as fibrocystic disease, cyst and fibroadenoma. In 21 cases out of the 41 cancer patients, the dual-energy subtraction radiography clearly visualized the malignant tumor shadows and the border of cancer infiltration and the daughter nodules by removing the shadows of normal mammary gland. On the other hand, beign diseases such as fibrocystic disease and cyst could be diagnosed as such, because the tumor shadow and the irregularly concentrated image of mammary gland disappeared by the dual-energy subtraction. These results suggest that this new technique will be useful in examination of breast masses.

  19. Temporal subtraction technique for detection of subtle anomalies on temporally sequential bone-subtracted chest radiographs by energy subtraction

    International Nuclear Information System (INIS)

    Sanada, Shigeru; Kobayashi, Takeshi; Yoshida, Megumi; Takashima, Tsutomu; Matsui, Takeshi

    2000-01-01

    We developed a temporal subtraction technique for the detection of subtle anomalies on temporally sequential bone-subtracted chest radiographs (soft tissue images) by energy subtraction. To recognize the temporal changes in a current soft tissue image in comparison with those in a previous soft tissue image, we attempted to enhance the changes by a difference image processing technique. The lung markings were enhanced by the first derivative filter. The image registration for the lung markings on both images by the sequential similarity detection algorithm (SSDA) method was then employed. The soft tissue image provided by the energy subtraction technique was excellent in its detection of subtle abnormalities in the lung, and this method was able to detect subtle abnormalities such as infiltrates and nodules missed in screening. It was suggested that this temporal subtraction technique improves accuracy when radiologists diagnose soft tissue chest images by x-ray energy subtraction. (author)

  20. Use of Intra-arterial Thrombolytic Therapy for Acute Treatment of Frostbite in 62 Patients with Review of Thrombolytic Therapy in Frostbite.

    Science.gov (United States)

    Gonzaga, Teresa; Jenabzadeh, Kamrun; Anderson, Christopher P; Mohr, William J; Endorf, Frederick W; Ahrenholz, David H

    2016-01-01

    Amputations are common after severe frostbite injuries, often mediated by postinjury arterial thrombosis. Since 1994, the authors have performed angiography to identify perfusion deficits in severely frostbitten digits and treated these lesions with intraarterial infusion of thrombolytic agents, usually combined with papaverine to reduce vasospasm. A retrospective review was performed of patients admitted to the regional burn center with frostbite injury from 1994 to 2007. Patients with severe frostbite, without contraindications to thrombolytic therapy, underwent diagnostic angiography of the affected extremities. Limbs with perfusion defects received intraarterial thrombolytic therapy according to protocol and the response was documented. Delayed amputation was performed for mummified digits. Angiogram results and amputation rates were tabulated. In this 14-year review, 114 patients were admitted for frostbite injuries. There was a male predominance (84%) and the mean age was 40.4 years. Of this group, 69 patients with severe frostbite underwent angiography; 66 were treated with intraarterial thrombolytic therapy. Four treated were excluded due to incomplete data. In the remaining 62 patients, angiography identified 472 digits with frostbite injury and impaired arterial perfusion. At the termination of thrombolytic infusion, a completion angiogram was performed. Partial or complete amputations were performed on only four of 198 digits (2.0%) with distal vascular blush, and in 71 of 75 digits (94.7%) with no improvement. Amputations occurred in 73 of 199 digits (36.7%) with partially restored flow. Overall complete digit salvage rate was 68.6%. Angiography after severe frostbite is a sensitive method to detect impaired arterial blood flow and permits catheter-directed treatment with thrombolytic agents. Improved perfusion after such treatment decreases late amputations following frostbite injury.

  1. 99mTc-RBC subtraction scintigraphy

    International Nuclear Information System (INIS)

    Inagaki, Syoichi; Tonami, Syuichi; Yasui, Masakazu; Kuranishi, Makoto; Sugishita, Kouki; Nakamura, Mamoru

    1994-01-01

    Sequential abdominal scintigrams with 99m Tc-labelled red blood cells (RBC) were subtracted for observing a site of gastrointestinal bleeding and calculating the bleeding rate. This method is technically very easy and can detect the site of bleeding with the minimum rate, as low as 0.2 ml/min., in a phantom experiment. In 23 cases with final diagnosis of gastrointestinal bleeding, conventional non-subtraction scintigraphy detected only 30% (7/23), but subtraction scintigraphy detected 61% (14/23). It was concluded that subtraction scintigraphy had higher sensitivity than conventional scintigraphy for early diagnosing bleeding. A combination of non-subtraction and subtraction scintigraphy is recommended to detect a site of gastrointestinal bleeding in a clinical setting. (author)

  2. New Noise Subtraction Methods in Lattice QCD

    OpenAIRE

    Baral, Suman; Wilcox, Walter; Morgan, Ronald B.

    2016-01-01

    Noise subtraction techniques can help reduce the statistical uncertainty in the extraction of hard to detect signals. We describe new noise subtraction methods in Lattice QCD which apply to disconnected diagram evaluations. Some of the noise suppression techniques include polynomial quark matrix methods, eigenspectrum deflation methods, and combination methods. Our most promising technique combines polynomial and Hermitian deflation subtraction methods. The overall goal is to improve the effi...

  3. Statistically tuned Gaussian background subtraction technique for ...

    Indian Academy of Sciences (India)

    Keywords. Tuning factor; background segmentation; unmanned aerial vehicle; aerial surveillance; thresholding. Abstract. Background subtraction is one of the efficient techniques to segment the targets from non-informative background of a video. The traditional background subtraction technique suits for videos with static ...

  4. Addition and Subtraction, and Algorithms in General

    Science.gov (United States)

    Fielker, David

    2007-01-01

    The juxtaposition of articles by Ian Thompson and Ian Sugarman in "MT202" on addition and subtraction respectively engendered some bemused thoughts in this author, who for some years has been sheltered from controversy by retirement. In this article, Fielker shares some thoughts on addition and subtraction raised by Thompson and Sugarman in their…

  5. Subtraction radiography of interradicular bone lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kullendorf, B.; Groendahl, K.; Rohlin, M.; Nilsson, M. (Lund Univ., Malmoe (Sweden))

    1992-10-01

    Subtraction and conventional radiography were evaluated for their diagnostic potential to assess interradicular bone lesions in the mandibular premolar region. Both conventional radiographs and subtraction images were interpreted by 10 observers. The receiver-operating characteristic technique was used to compare the two techniques. The diagnostic validity was higher for the subtraction technique, both for lesions confined to cancellous bone and for lesions including the cortical bone, than for the conventional technique. For bone defects confined to cancellous bone the diagnostic accuracy was lower than those reported from periapical bone lesion irrespective of whether subtraction or conventional radiography was used. It is concluded that subtraction radiography improves the detectability of bone lesions, shallow ones in particular. Lesions in the interradicular bone are more difficult to detect than those in the periapical bone. 26 refs., 3 figs., 2 tabs.

  6. Subtraction radiography of interradicular bone lesions

    International Nuclear Information System (INIS)

    Kullendorf, B.; Groendahl, K.; Rohlin, M.; Nilsson, M.

    1992-01-01

    Subtraction and conventional radiography were evaluated for their diagnostic potential to assess interradicular bone lesions in the mandibular premolar region. Both conventional radiographs and subtraction images were interpreted by 10 observers. The receiver-operating characteristic technique was used to compare the two techniques. The diagnostic validity was higher for the subtraction technique, both for lesions confined to cancellous bone and for lesions including the cortical bone, than for the conventional technique. For bone defects confined to cancellous bone the diagnostic accuracy was lower than those reported from periapical bone lesion irrespective of whether subtraction or conventional radiography was used. It is concluded that subtraction radiography improves the detectability of bone lesions, shallow ones in particular. Lesions in the interradicular bone are more difficult to detect than those in the periapical bone. 26 refs., 3 figs., 2 tabs

  7. Compressive Sensing for Background Subtraction

    Science.gov (United States)

    2009-12-20

    i) reconstructing an image using only a single optical pho- todiode (infrared, hyperspectral, etc.) along with a digital micromirror device (DMD...NSF CCF-0431150, ONR N00014-07-1-0936,AFOSR FA9550-07-1-0301,AROW911NF-07-1-0502,AROMURI W311NF-07-1-0185, and the Texas Instruments Leadership

  8. Optimization of background subtraction for image enhancement

    Science.gov (United States)

    Venetsky, Larry; Boczar, Ross; Lee-Own, Robert

    2013-05-01

    Analysis of foreground objects in scenery via image processing often involves a background subtraction process. This process aims to improve blob (connected component) content in the image. Quality blob content is often needed for defining regions of interest for object recognition and tracking. Three techniques are examined which optimize the background to be subtracted - genetic algorithm, an analytic solution based on convex optimization, and a related application of the CVX solver toolbox. These techniques are applied to a set of images and the results are compared. Additionally, a possible implementation architecture that uses multiple optimization techniques with subsequent arbitration to produce the best background subtraction is considered.

  9. Subarachnoid hemorrhage: role of subtraction CT angiography in etiological diagnosis and pretreatment planning.

    Science.gov (United States)

    Li, K; Wei, X; Lv, F; Li, Q; Xie, P

    2014-12-01

    Subarachnoid hemorrhage (SAH) is a deleterious cerebrovascular disorder that requires prompt etiological diagnosis. We wished to evaluate the diagnostic performance of the latest generation 3D subtraction CT angiography (CTA) in etiological diagnosis and pretreatment planning of patients with suspected SAH. A total of 88 patients were included in our study and underwent both 3D subtraction CTA and digital subtraction angiography (DSA) examinations. The 3D subtraction CTA images were reviewed by two independent readers who were blinded to the results of DSA. Sensitivity, specificity, positive and negative predictive values of 3D subtraction CTA were calculated on a per-patient basis. The possibility for surgical treatment was also evaluated based on information provided by CTA alone. According to DSA results, 72 patients were diagnosed with ruptured intracranial aneurysms, 5 patients with arteriovenous malformations, and no lesion was detected in 11 patients. Sensitivity, specificity, positive predictive value and negative predictive values of CTA for etiological evaluation of SAH were all 100%. Correct pretreatment decision was made in 67 of 70 patients based on the CTA measurements alone. THE results of our study indicate that 3D subtraction CTA is an accurate, fast and non-invasive imaging modality that is equal to DSA in etiological evaluation and pretreatment planning of patients with suspected SAH. It may replace DSA as the first step imaging method in patients with suspected SAH, while DSA should still be reserved for case of uncertainty.

  10. Distinct representations of subtraction and multiplication in the neural systems for numerosity and language

    Science.gov (United States)

    Prado, Jérôme; Mutreja, Rachna; Zhang, Hongchuan; Mehta, Rucha; Desroches, Amy S.; Minas, Jennifer E.; Booth, James R.

    2010-01-01

    It has been proposed that recent cultural inventions such as symbolic arithmetic recycle evolutionary older neural mechanisms. A central assumption of this hypothesis is that the degree to which a pre-existing mechanism is recycled depends upon the degree of similarity between its initial function and the novel task. To test this assumption, we investigated whether the brain region involved in magnitude comparison in the intraparietal sulcus (IPS), localized by a numerosity comparison task, is recruited to a greater degree by arithmetic problems that involve number comparison (single-digit subtractions) than by problems that involve retrieving facts from memory (single-digit multiplications). Our results confirmed that subtractions are associated with greater activity in the IPS than multiplications, whereas multiplications elicit greater activity than subtractions in regions involved in verbal processing including the middle temporal gyrus and inferior frontal gyrus that were localized by a phonological processing task. Pattern analyses further indicated that the neural mechanisms more active for subtraction than multiplication in the IPS overlap with those involved in numerosity comparison, and that the strength of this overlap predicts inter-individual performance in the subtraction task. These findings provide novel evidence that elementary arithmetic relies on the co-option of evolutionary older neural circuits. PMID:21246667

  11. Recanalization rate and clinical outcome of intravenous tissue plasminogen activator at 0.6 mg/kg and intra-arterial urokinase in acute ischemic stroke with large vessel occlusion

    International Nuclear Information System (INIS)

    Nakashima, Kazuya; Ohnishi, Hideyuki; Taomoto, Katsushi

    2008-01-01

    We evaluated the recanalization rate and clinical outcome of intravenous tissue plasminogen activator (t-PA) and intra-arterial urokinase (PTA) in acute ischemic stroke with large vessel occlusion. The recanalization of the occlusion site and the ischemic change were evaluated with pre-and post-treated MRI and MR angiography (MRA). Total recanalization rates after the intravenous (IV) t-PA and the PTA therapy were 35.6 and 21.9%, respectively. These rates were 50.0 and 16.7% in the distal middle cerebral artery (MCA), 52.6 and 25.0% in the proximal MCA, 6.3 and 5.3% in the internal carotid artery (ICA), 25.0 and 26.3% in the basilar artery (BA), respectively. The rates of the symptomatic intracerebral hemorrhage after IV t-PA and PTA were 0 and 5.2%, respectively. The proportion of modified Rankin Scale (mRS) of 0 to 1 at 3 months after treatments were 17.4% in IV t-PA and 12.5% in PTA. Our results indicated better recanalization rate and outcome of MCA with t-PA than that of PTA. However, the recanalization rate of ICA and BA were very poor in both t-PA and PTA as yet. It is necessary to investigate newly strategies and/or modality for ICA and BA occlusion. (author)

  12. Long-term follow up of patients with good outcome after intra-arterial thrombolysis for major arterial occlusion in the carotid territory. Clinical and magnetic resonance imaging evaluation

    International Nuclear Information System (INIS)

    Sorimachi, Takatoshi; Morita, Kenichi; Ito, Yasushi; Fujii, Yukihiko

    2010-01-01

    Long-term clinical symptoms, including extrapyramidal signs, and magnetic resonance (MR) imaging studies were retrospectively analyzed in 21 patients with good outcome (modified Rankin scale scores 0-2) after successful recanalization of occluded major arteries by intra-arterial thrombolysis with mechanical disruption. Changes in high intensity areas (HIAs) and cerebral atrophy in the ischemic hemisphere were evaluated on follow-up fluid-attenuated inversion recovery MR images. Extrapyramidal signs, short-stepped gait and/or masked face, were observed in 12 of 21 patients during the follow-up period (11 to 68 months, mean 42 months). Enlargement of HIA was demonstrated in 10 of 18 patients undergoing follow-up MR imaging. Cerebral atrophy in the ischemic hemisphere was