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Sample records for koronarangiographie mittels mehrzeilendetektorspiral-ct-klinische

  1. Mediastinal fibrosis with pulmonary artery obstruction; diagnosis and investigation with helical CT imaging including 3-dimensional reconstructions; Pulomonalarterienstenose bei aggresiver Mediastinalfibrose; Diagnostik und 3D-Darstellung mittels helikaler CT-Untersuchung

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    Kolbe, M. [Inst. fuer Diagnostische Radiologie, Kantonsspital Basel (Switzerland); Helwig, A. [Inst. fuer Diagnostische Radiologie, Kantonsspital Basel (Switzerland); Habicht, J.M. [Klinik fuer Herz-Torax-Chirurgie, Universitaetskliniken Basel (Switzerland); Steinbruch, W. [Inst. fuer Diagnostische Radiologie, Kantonsspital Basel (Switzerland)

    1997-07-01

    An aggressive mediastinal fibrosis was found in a 42-year-old female, suffering from dysphagia, stabbing pain in the chest, and an unclear weight loss. In this case, the rare combination of esophageal involvement, bronchial narrowing, and pulmonary artery obstruction could easily be demonstrated with a barium study and a helical CT examination including three-dimensional reconstructions. (orig.) [Deutsch] Wir stellen den Fall einer 42jaehrigen Patientin vor, welche zur Abklaerung einer zunehmenden Dysphagie, stechender Thoraxschmerzen und eines Gewichtsverlustes hospitalisiert wurde. Mittels klinischer und radiologischer Abklaerung konnte eine aggressive Mediastinalfibrose diagnostiziert werden. Die seltene Kombination einer Oesophaguseinengung mit Pulmonalarterienstenosen sowie einer Bronchuskompression konnte nichtinvasiv mittels Oesophagogramm und helikaler CT-Untersuchung zuverlaessig und schnell dargestellt werden. (orig.)

  2. Clinically relevant incidental cardiovascular findings in CT examinations; Klinisch relevante kardiovaskulaere Zufallsbefunde bei CT-Untersuchungen

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    Voigt, P.; Fahnert, J.; Kahn, T.; Surov, A. [Universitaetsklinikum Leipzig, Klinik fuer Diagnostische und Interventionelle Radiologie, Leipzig (Germany); Schramm, D.; Bach, A.G. [Universitaetsklinikum Halle (Saale), Klinik fuer Radiologie, Halle (Germany)

    2017-04-15

    Incidental cardiovascular findings are a frequent phenomenon in computed tomography (CT) examinations. As the result of a dedicated PubMed search this article gives a systemic overview of the current literature on the most important incidental cardiovascular findings, their prevalence and clinical relevance. The majority of incidental cardiovascular findings are of only low clinical relevance; however, highly relevant incidental findings, such as aortic aneurysms, thromboses and thromboembolic events can also occasionally be found, especially in oncology patients. The scans from every CT examination should also be investigated for incidental findings as they can be of decisive importance for the further clinical management of patients, depending on their clinical relevance. (orig.) [German] Inzidentelle kardiovaskulaere Befunde sind ein haeufiges Phaenomen bei CT-Untersuchungen. Mit dieser Arbeit soll nach gezielter PubMed-Recherche ein systematischer Literaturueberblick ueber die wichtigsten kardiovaskulaeren Zufallsbefunde sowie deren Haeufigkeit und klinische Relevanz gegeben werden. Die Mehrzahl der inzidentellen kardiovaskulaeren Befunde sind klinisch nur von untergeordneter Bedeutung, allerdings werden immer wieder auch hochgradig relevante Zufallsbefunde wie beispielsweise Aortenaneurysmata oder - gerade bei onkologischen Patienten - Thrombosen und thrombembolische Ereignisse detektiert. Jede CT-Untersuchung sollte gezielt nach inzidentellen Befunden durchsucht werden, da diese je nach klinischer Relevanz von entscheidender Bedeutung fuer das weitere klinische Management des Patienten sein koennen. (orig.)

  3. Functional CT imaging: load-dependent visualization of the subchondral mineralization by means of CT osteoabsorptionmetry (CT-OAM); Funktionelle Computertomographie: Beanspruchungsabhaengige Darstellung der subchondralen Mineralisierung mittels CT gestuetzter Osteoabsorptiometrie (CTOAM)

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    Linsenmaier, U.; Schlichtenhorst, K.; Pfeifer, K.J.; Reiser, M. [Inst. fuer Klinische Radiologie, Innenstadt, Ludwig-Maximilians-Univ. Muenchen (Germany); Kersting, S.; Putz, R.; Mueller-Gerbl, M. [Anatomische Anstalt, Ludwig-Maximilians-Univ. Muenchen (Germany)

    2003-05-01

    Purpose: Functional computed tomography for visualization and quantification of subchondral bone mineralization using CT osteoabsorptiometry (CT-OAM). Materials and Methods: Tarsometatarsal (TMT) and metatarsophalangeal (MTP) joints of 46 human hallux valgus (HV) specimens were examined (sagittal 1/1/1 mm) on a single slice CT scanner SCT (Somatom Plus 4, Siemens AG). Subchondral bone pixels were segmented and assigned to 10 density value groups (triangle 100 HU, range 200 - 1200 HU) the pixels using volume rendering technique (VRT). The data analysis considered the severity of HV as determined by the radiographically measured HV-angle (a.p. projection). Results: CT-OAM could generate reproducible densitograms of the distribution pattern of the subchondral bone density for all four joint surfaces (TMT and MTP joints). The bone density localization enables the assignment to different groups, showing a characteristic HV-angle-dependent distribution of the maximum bone mineralization of the load-dependent densitogram (p < 0.001). Conclusion: CT-OAM is a functional CT technique for visualizing and quantifying the distribution of the subchondral bone density, enabling a noninvasive load-dependent assessment of the joint surfaces. Load-dependent densitograms of hallux valgus specimens show a characteristic correlation with an increase of the HV-angle. (orig.) [German] Ziel: Darstellung und Quantifizierung der subchondralen Mineralisierung in Abhaengigkeit von unterschiedlichen Beanspruchungssituationen mittels funktioneller Computertomographie als CT-Osteoabsorptiometrie (CT-OAM). Methode: An 46 humanen Praeparaten mit Hallux valgus (HV) wurden exemplarisch die TMT I (Tarsometatarsal)- und MTP I (Metatarsophalangeal)-Gelenke des ersten Strahles (sagittal 1/1/1 mm) an einem Singleslice Spiral-CT (SCT, Somatom Plus 4, Siemens AG) untersucht. Der subchondrale Knochen wurde segmentiert, den Pixel wurde mittels Volume Rendering Technik (VRT) 10 Graustufenbereiche (D100 HU

  4. Präoperative Vorhersge der Rezidivrate des klinisch lokalisierten Prostatakarzinoms nach einer radikalen Prostatektomie

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    Graefen M

    1999-01-01

    Full Text Available Die radikale Prostatektomie scheint die zur Zeit effektivste Therapie des klinisch lokalisierten Prostatakarzinoms zu sein. Dennoch liegt die Rezidivrate bei bis zu 40 % der operierten Patienten. Mit dieser Arbeit wurde anhand präoperativer Befunde ein Algorithmus entwickelt, mit welchem die Prognose des klinisch lokalisierten Prostatakarzinoms bereits vor einer operativen Therapie abgeschätzt werden kann. Hierzu wurden multiple präoperative Befunde, welche bei der Diagnose des Prostatakarzinoms erhoben werden, bezüglich ihres Einflusses auf einen PSA-Progress nach radikaler Prostatektomie geprüft. Dies erfolgte mittels einer univariaten Kaplan-Meier Analyse sowie einer multivariaten Statistik (Cox-Regression und CART-Analyse. Schwerpunkt bildete hierbei die Einbeziehung der Ergebnisse der systematischen Sextanten-Biopsie der Prostata. Alle präoperativen Befunde haben in der univariaten Kaplan-Meier Analyse einen signifikanten Einfluß auf ein PSA-Rezidiv. In der Cox-Regression hatte der Anteil an niedrigdifferenziertem Prostatakarzinom den größten Einfluß auf das Auftreten eines Tumorprogresses, gefolgt von der Anzahl der positiven Stanzen in der Biopsie und dem präoperativen PSA-Wert; alle anderen Parameter hatten keinen unabhängig signifikanten Einfluß auf den Tumorprogress. Mittels der zusätzlich durchgeführten CART Analyse konnten verschiedene Risikogruppen definiert werden, deren Rezidivrisiko bei 3 % für Patienten mit geringem Rezidivrisiko sowie 80 % für solche mit einem hohen Rezidivrisiko 2 Jahre nach der Operation betrug. Der niedrigdifferenzierte Tumoranteil hat somit den größten Einfluß auf die Prognose eines klinisch lokalisierten Prostatakarzinoms. Anhand der präsentierten CART-Analysen wurden einfach anwendbare Entscheidungsbäume entwickelt, mit denen eine Abschätzung des Therapieerfolges des klinisch lokalisierten Prostatakarzinoms bereits vor einer Operation möglich ist.

  5. Aneurysmatic dissection of an aberrant right subclavian artery; Disseziierendes Aneurysma einer aberranten Arteria subclavia dextra: Diagnose mittels Ultrafast-CT

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    Reittner, P. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Allgemeine Radiologie; Stacher, R. [Universitaetsklinik fuer Radiologie, Graz (Austria). Abt. fuer Allgemeine Radiologie

    1996-01-01

    Diagnosis with Ultrafast-CT: An aneurysm of an aberrant right subclavian artery is a very rare cause for dysphagia. We describe such a case in a 67-year-old patient, diagnosed with Ultrafast-CT and discuss it together in concert with the embryology and the radiological findings. (orig.) [Deutsch] Eine aberrierende Arteria subclavia dextra ist eine seltene Ursache fuer Dysphagie. Anhand eines 67jaehrigen Patienten werden Embryologie und radiologische Charakteristika, diagnostiziert mittels Ultrafast-CT, diskutiert. (orig.)

  6. Early clinical phase of patient's management after polytrauma using 1- and 4-slice helical CT; Fruehes klinisches Management nach Polytrauma mit 1- und 4-Schicht-Spiral-CT

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    Kloeppel, R.; Kahn, T. [Klinik und Poliklinik fuer Diagnostische Radiologie, Universitaetsklinikum Leipzig (Germany); Schreiter, D. [Chirurgische Intensivtherapieabteilung, Zentrum fuer Chirurgie, Universitaetsklinikum Leipzig (Germany); Dietrich, J. [Abt. Neuroradiologie der Klinik und Poliklinik fuer Diagnostische Radiologie, Universitaetsklinikum Leipzig (Germany); Josten, C. [Klinik und Poliklinik fuer Unfall- und Wiederherstellungschirurgie, Zentrum fuer Chirurgie, Universitaetsklinikum Leipzig (Germany)

    2002-07-01

    In the early clinical phase the comprehensive imaging of patients with multiple trauma using helical CT is already established. Aim of this study was to assess whether MSCT may improve the patient management and the diagnostic results.The procedure is designed as follows: after life-thretening treatment x-ray of chest and ultrasound are carried out in the emergency room. Then the patient is moved to CT. From 1998 to december 2000 241 patients were examined using a single slice helical CT (Somatom plus 4), in 2001 79 patients using a 4-slice helical CT (Somatom VZ, Siemens Med.Sol.). After CT selected radiograms of the extremities were taken.359 of 360 procedures were carried out successfully. Excluding 1 case (death during 1-sl. h CT) all relevant lesions of head, neck, and body were diagnosed. Although the patients had an injury severity score of {approx}30. The change from 1slice-helical CT to 4 slice-helical CT allowed us to reduce the stay in the CT room from 28 to 16 min. The total lethality decreased by {approx}4%.Advantages for the patient arose from the standardized examination protocol using multislice CT. If integrated in an interdisciplinary management concept, it is a good compromise between examination time, comprehensive diagnostic imaging, life-saving therapeutic procedures, and therapy planning. (orig.) [German] Die klinische Erstversorgung Polytraumatisierter schliesst inzwischen in vielen Unfallkliniken den fruehzeitigen Einsatz der Spiral-CT ein. Kann die neuerlich eingefuehrte Mehrschicht-Spiral-CT Ergebnisse und Patientenmanagement weiter verbessern?Nach lebensrettenden Sofortmassnahmen, Thoraxroentgen und Notsonographie im Schockraum erfolgte die CT: Von 1998-2000 wurden 241 Patienten mit einem 1-Schicht-Spiral-CT (Somatom plus 4) und in 2001 79 Patienten mit einem 4-Schicht-Spiral-CT (Somatom VZ, beide Siemens Med. Sol.) untersucht. Klinisch ausgewaehlte Extremitaetenaufnahmen wurden ergaenzt.359 von 360 Untersuchungen verliefen erfolgreich

  7. Floating venous thrombi: diagnosis with spiral-CT-venography; Diagnose flottierender venoeser Thromben mittels Phlebo-Spiral-CT

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    Gartenschlaeger, M. [Mainz Univ. (Germany). Klinik fuer Radiologie; Klose, K.J. [Univ. Marburg, Medizinisches Zentrum fuer Innere Medizin, Abt. Poliklinik (Germany); Schmidt, J.A. [Univ. Marburg, Medizinisches Zentrum fuer Radiologie, Abt. fuer Strahlendiagnostik (Germany)

    1996-05-01

    Local application of contrast agent into an ipsilateral dorsal foot vein and spiral CT were used to examine 16 consecutive cases with deep venous thrombosis proven at conventional venography; in addition, colour Doppler flow imaging was performed. At conventional venography, 8/16 thrombi appeared to be floating and the remaining 8/16 were adherent to the vessel wall. Spiral-CT showed 15/16 thrombi to be adherent to the vessel wall; the floating thrombus correlated with findings in conventional venography. At colour Doppler flow imaging 3/16 thrombi were considered floating, one of them was discordant to conventional venography. The comparison of conventional venography to spiral-CT demonstrates complete agreement for adherence to vessel wall seen in conventional venography (p=1,0) and significant discordance in cases with free-floating appearance in conventional venography. Adherence of thrombi to the wall of the vessel at conventional venography is in agreement with computed tomography. Conventional venography probably overestimates the prevalence of free floating thrombi. (orig./MG) [Deutsch] Mittels lokaler Kontrastmittelapplikation in eine ipsilaterale Fussrueckenvene und Spiral-CT wurden 16 konsekutive Faelle konventionell phlebographisch gesicherter Phlebothrombose untersucht, zusaetzlich wurde die farbkodierte Doppler-Ultraschalluntersuchung durchgefuehrt. In der konventionellen Phlebographie waren 8/16 Thromben flottierend, die uebrigen 8/16 wandadhaerent. In der Spiral-CT zeigten sich Wandadhaerenzen in 15/16 Faellen; der nachgewiesene flottierende Thrombus stimmte mit der konventionellen Phlebographie ueberein. Im farbkodierten Doppler-Ultraschall erschienen die Thromben in 3/16 Faellen flottierend, darunter ein von der konventionellen Phlebographie abweichender Befund. Der Vergleich von konventioneller und CT-Phlebographie ergab eine komplette Uebereinstimmung fuer konventionell phlebographisch nachgewiesene Wandadhaerenz und eine signifikante Abweichung

  8. C-arm computed tomography for transarterial chemoperfusion and chemo-embolization of thoracic lesions; Transarterielle Chemoperfusion und -embolisation thorakaler Neoplasmen mittels C-Arm CT

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    Vogl, T.J.; Naguib, N.N.; Nour-Eldin, N.E.; Lehnert, T.; Mbalisike, E. [Klinikum der Johann-Wolfgang-Goethe-Universitaet, Institut fuer Diagnostische und Interventionelle Radiologie, Frankfurt am Main (Germany)

    2009-09-15

    To evaluate the role of C-arm CT for on-line fluoroscopy in regional transarterial chemoperfusion (TACP) and chemo-embolization (TPCE) of primary and secondary malignant thoracic lesions. From September 2008 to March 2009 a total of 31 patients (20 males and 11 females, average age: 61.7 years, range 22-84 years) with 53 thoracic malignant lesions from different origins (primary or secondary pulmonary carcinoma n=37, pleural mesothelioma n=16) were treated with TACP or TPCE using flat-detector CT (FD-CT). C-arm CT of the latest generation was used to localize the lesion before local chemotherapy (Artis Zeego, Siemens, Erlangen). For TACP a 220 rotation and a volume of 150 ml (ratio of 1:2 contrast/normal saline), delay 2 s and flow 12 ml/s was used. For TPCE a volume of 75 ml (ratio of 1:2 contrast/normal saline), delay 2 s and flow 3 ml/s was used. TPCE C-arm CT allowed the evaluation of the degree of perfusion of the tumor and the geographic areas of enhancement correlated with the post-interventional lipiodol uptake in MSCT. In TACP the intercostal arteries involved could be visualized and in 30% of interventions the catheter had to be repositioned for the following intervention. C-arm CT provides additional information on the vascular characteristics and perfusion of pulmonary lesions resulting in a change of interventional strategy in a relevant number of patients. (orig.) [German] Ziel der Arbeit war die Evaluation der Wertigkeit der C-Arm CT fuer die online gesteuerte regionale transarterielle Chemoperfusion (TACP) und die transpulmonale Chemoembolisation (TPCE) primaerer und sekundaerer thorakaler Neoplasmen Von September 2008 bis Maerz 2009 wurden 31 Patienten (11 Frauen/20 Maenner, Durchschnittsalter 61,7 Jahre) mit 53 unterschiedlichen thorakalen Neoplasmen (primaere oder sekundaere Lungenkarzinome [n=37], Pleuramesotheliome [n=16]) mittels TACP oder TPCE unter Einsatz der Flachdetektortechnologie (FD-CT) behandelt. Alle Behandlungen erfolgten an einem C

  9. Evaluation of percutaneous vertebroplasty in osteoporotic vertebral fractures using a combination of CT fluoroscopy and conventional lateral fluoroscopy; Perkutane Vertebroplastie osteoporosebedingter Wirbelkoerperfrakturen: Erfahrungen mit der CT-Fluoroskopie

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    Pitton, M.B.; Schneider, J.; Brecher, B.; Herber, S.; Mohr, W.; Thelen, M. [Klinik fuer Radiologie, Universitaetskliniken Mainz (Germany); Drees, P.; Eckardt, A.; Heine, J. [Klinik fuer Orthopaedie, Universitaetskliniken Mainz (Germany)

    2004-07-01

    cannulation of the vertebra had been changed before cement application resulting in a hole in the dorsolateral vertebral wall. However, all patients were discharged without evidence of neurologic complications. Multiplanar reconstructions of CT scans were used for the detection of extraosseous cement leaks: The incidence of extraosseous cement leaks was 4.1% in epidural veins, 6.5% in paravertebral vessels (6 veins, 2 arteries), and 17.9 and 11.4% respectively, for upper or lower and plates. At discharge, 25 patients (43.1%) were free of pain and 28 (48,3%) significantly improved with a considerable reduction of analgetic drugs. Significant complaints persisted in 5 patients (8.6%) with concomitant degenerative disease in four and vasculitis in one case. (orig.) [German] Zielsetzung: Klinisch-radiologische Pruefung der Vertebroplastie mittels CT-Fluoroskopie und seitlicher Durchleuchtung bei Patienten mit osteoporosebedingten Wirbelkoerperfrakturen. Material und Methoden: 58 Patienten (23 Maenner und 35 Frauen, Alter 69,7 {+-} 10,2 Jahre) mit schmerzhaften, osteoporosebedingten Wirbelkoerperfrakturen wurden mittels Vertebroplastie behandelt. Praeinterventionell erfolgte eine Spiral-CT mit sagittaler Rekonstruktion zur Befunddokumentation. Die Eingriffe erfolgten in Analgosedierung. Die Platzierung der Vertebroplastiekanuele und die Applikation des Knochenzementes erfolgten unter CT-Fluoroskopie und seitlicher Durchleuchtung. Bei unguenstiger Zementausbreitung wurde die Applikation fuer 30-60 s unterbrochen. Nach Polymerisation des Zementes an dieser Lokalisation wurde die Injektion bis zur ausreichenden Wirbelkoerperfuellung fortgesetzt. Das Ergebnis wurde mittels Spiral-CT mit sagittaler Rekonstruktion des behandelten Wirbelsaeulenabschnittes dokumentiert. Ergebnisse: Insgesamt wurden 123 Wirbelkoerper behandelt, 39 Brustwirbel- und 84 Lendenwirbelkoerper. Alle Eingriffe konnten in Analgosedierung und Lokalanaesthesie durchgefuehrt werden. Im Mittel wurden 2,1 {+-} 1,3 (1

  10. Radiological diagnosis of Klatskin's tumour; Radiologische Diagnostik von Klatskin-Tumoren

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    Pauls, S.; Juchems, M.S.; Brambs, H.-J. [Universitaetsklinikum Ulm (Germany). Abteilung Diagnostische Radiologie

    2005-11-01

    Patients with Klatskin's tumour present clinically unspecific symptoms such as painless jaundice and cholangitic discomfort. The only curative treatment is R0 resection of the tumour. To allow stage-specific therapy, accurate tumour staging is indispensable, the first step of which is abdominal sonography. If there is a suspect finding, cross-sectional imaging techniques like MRI or MDR-CT are used to clarify or stage the lesion, respectively. To estimate resectability, MRI together with MRC and MRI angiography are superior to MDR-CT. Biopsy using ERC is required before starting any specific treatment. If therapeutically relevant peritoneal carcinosis is clinically suspected although not radiologically confirmed, PET should also be performed. The value of PET/CT has to be evaluated in further studies. For optimal treatment, close cooperation between clinicians and radiologists is necessary. (orig.) [German] Patienten mit Klatskin-Tumoren werden klinisch durch unspezifische Symptome wie z. B. schmerzloser Ikterus oder cholangitische Beschwerden auffaellig. Eine R0-Resektion ist der einzige kurative Therapieansatz. Um eine stadiengerechte Therapie zu ermoeglichen, muss ein moeglichst exaktes Tumorstaging erfolgen. Primaer kommt die abdominelle Sonographie zum Einsatz. Zur Abklaerung eines unklaren Sonographiebefundes sowie zum Staging eines suspizierten Tumors werden Schnittbildverfahren MRT und MDR-CT benoetigt. Zur Beurteilung der lokalen Tumorresektabilitaet ist die MRT in Zusammenschau mit der MRC sowie MR-Angiographie der MDR-CT ueberlegen. Vor Einleitung einer Therapie sollte auf jeden Fall die Verdachtsdiagnose eines Klatskin-Tumors bioptisch mittels ERC gesichert werden. Wird klinisch trotz negativem Nachweis einer Peritonealkarzinose eine solche suspiziert, sollte bei Therapierelevanz (z. B. bei ansonsten fehlendem Nachweis einer Fernmetastasierung) eine PET ergaenzend durchgefuehrt werden. Der zukuenftige Stellenwert der PET/CT muss in weiteren Studien

  11. Retrospektive Analyse von Zufallsbefunden, die bei Patienten mit kutanem malignen Malignom durch (18) F-Fluordeoxyglucose-PET/CT erhoben wurden.

    Science.gov (United States)

    Conrad, Franziska; Winkens, Thomas; Kaatz, Martin; Goetze, Steven; Freesmeyer, Martin

    2016-08-01

    Bei der (18) F-Fluordeoxyglucose-Positronenemissionstomographie/Computertomographie (FDG-PET/CT) ergeben sich häufig Zufallsbefunde. In der vorliegenden Studie konzentrierten wir uns auf mittels FDG-PET/CT erhaltene Zufallsbefunde bei Patienten mit kutanem Melanom und überprüften deren Relevanz hinsichtlich weiterer diagnostischer Maßnahmen und Interventionen. Die Krankenakten von 181 konsekutiven Melanom-Patienten wurden retrospektiv ausgewertet, um das Management von Zufallsbefunden zu dokumentieren. Der Schwerpunkt lag dabei auf den histologischen Befunden. Bei 33 von 181 (18 %) Patienten lagen 39 relevante Zufallsbefunde vor, und zwar im Kolorektalbereich (n = 15 Patienten), in der Schilddrüse (n = 8), der Prostata (n = 2), dem Bewegungsapparat (n = 2), in Lymphknoten (n = 2), der Parotis (n = 1), den Mandeln (n = 1), den Nieren (n = 1) und der Gallenblase (n = 1). Bei 25 Patienten schlossen sich weitere diagnostische Verfahren an, wobei in 21 Fällen ein klinisches Korrelat nachgewiesen wurde. Bei 16 von 21 Patienten ergab sich eine Neoplasie, darunter fünf maligne Läsionen (vier Kolonkarzinome und ein Prostatakarzinom). Die Malignome wurden frühzeitig diagnostiziert und in der Mehrzahl der Fälle erfolgreich entfernt. Der Einsatz der FDG-PET/CT als Routine-Diagnostik wird in den Leitlinien empfohlen und ist indiziert bei malignem Melanom ab Stadium IIC. In dieser Studie wurden auf effektive Weise ansonsten nicht erkannte Krebserkrankungen, insbesondere Kolonkarzinome, detektiert. In den meisten Fällen war eine frühe Intervention möglich. Zufallsbefunde durch FDG-PET/CT sollten, unter Berücksichtigung des Zustands und der Wünsche des Patienten, mit den geeigneten diagnostischen Maßnahmen abgeklärt werden. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  12. Clinical value of FDG hybrid-PET in staging and restaging of malignant lymphoma. Compared with conventional diagnostic methods; Klinische Wertigkeit der Befunde von FDG-PET mittels Koinzidenz-Gammakamera beim Staging und Restaging maligner Lymphome. Ein Vergleich zu konventioneller Diagnostik

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    Pichler, R.; Maschek, W.; Hatzl-Griesenhofer, M.; Huber, H. [Allgemeines Krankenhaus Linz (Austria). Inst. fuer Nuklearmedizin; Wimmer, G.; Wahl, G.; Fridrik, M. [Allgemeines Krankenhaus Linz (Austria). I. Medizinische Abt.

    2000-09-01

    Aim of the present retrospective study was to validate the clinical value of F-18-FDG PET imaging in lymphoma patients with a dual head camera modified for coincidence detection. Staging before and after oncological treatment was compared with a conservative diagnostic approach. Methods: 48 patients (28 non-Hodgkin lymphoma, 20 Hodgkin's disease) received FDG-Hybrid-PET scans. Pretherapeutic staging was realized in 28 patients, 9 of them had control studies after they had completed therapy. Totally 29 persons were examined for posttherapeutic restaging. Computed tomography imaging and lymph node sonography was performed in all cases. Results were validated by clinical follow-up, in three cases a recidive was proven by biopsy. Results: CT and ultrasound detected 77 lesions in 28 patients compared with 100 visualized by PET, but this difference in pretherapeutic staging did not reach significance at p>0.05 by Fisher's t-test. Hybrid-PET obtained a sensitivity of 93%, a specifity of 79%, a positive of 82% and a negative predictive value of 92% for detection of residual disease. The values for CT+US were 87%, 64%, 72% and 88% respectively. Conclusion: FDG Hybrid-PET is as or even more accurate than standard morphologic diagnostic methods for prestaging in malignant lymphoma. Additionally, there is a substancial benefit for therapy monitoring of residual disease using coincidence detection PET with a 3/4-inch crystal gamma camera. (orig.) [German] Ziel der vorliegenden retrospektiven Studie war die Validierung der klinischen Wertigkeit von F-18-FDG-PET mittels Doppelkopf-Koinzidenz-Gammakamera bei Lymphompatienten. Die Ergebnisse von prae- und post-therapeutischem Staging wurden mit dem konservativ bildgebender Verfahren verglichen. Methoden: 48 Patienten (28 NHL, 20 Morbus Hodgkin) erhielten FDG-DK-PET-Untersuchungen. Ein praetherapeutisches Staging wurde bei 28 Patienten durchgefuehrt, 9 von diesen hatten weitere Kontrollstudien nach abgeschlossenem

  13. CT coronary angiography in patients with atrial fibrillation; CT-Koronarangiographie bei Patienten mit Vorhofflimmern

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    Kovacs, A.; Sommer, T.; Leiss, A.; Naehle, P.; Schild, H.; Flacke, S. [Universitaetsklinikum Bonn, Radiologische Klinik (Germany); Probst, C.; Welz, A. [Universitaetsklinikum Bonn, Klinik fuer Herzchirurgie (Germany)

    2005-12-15

    Purpose: Reliable visualization of the coronary arteries with multislice spiral CT angiography (MSCTA) in patients with atrial fibrillation (AF) remains a challenge despite retrospective ECG gating. A recently developed new algorithm automatically compensates dynamic changes in the heart rate during the scan, thus reducing misregistration and motion artifacts. The HeartBeat-RT algorithm combines a fixed percent delay determined from the first R wave and the fixed offset delay based on the second R wave in the ECG cycle. The purpose of this study was to find out the optimal reconstruction window in MSCTA in patients with AF for each of the three major coronary arteries during the cardiac cycle. Materials and methods: 20 patients with permanent AF were imaged on a 16-slice scanner (slice collimation: 16 x 0.75 mm; rotation time 0.42 s; 140 kV; 380 mAs; 120 ml Ultravist 370 {sup registered} i.v.). The patients had not received any previous drugs for heart frequency regulation. Acquisition was started after bolus tracking of a biphasic bolus of 120 ml Ultravist 370 injected intravenously. Each coronary segment was reconstructed at 0%-90% of the cardiac cycle in increments of 10%. For image analysis we used coronary segments as defined by the American Heart Association. Two blinded independent readers assessed the image quality in terms of visibility and artifacts (five-point rating scale 1=very poor, 2=poor, 3=fair, 4=good and 5=excellent) and the degree of stenosis (five-point rating scale 1=0%, 2=1%-49%, 3=50%-74%, 4=75%-99%, 5=100%) on axial slices, multiplanar reconstructions and three-dimensional volume-rendered images. (orig.)

  14. Imaging of bacterial infections of the sacroiliac joint; Darstellung bakterieller Infektionen im Sakroiliakalgelenk

    Energy Technology Data Exchange (ETDEWEB)

    Groves, C.; Cassar-Pullicino, V. [Radiology Department, Robert Jones and Agnes Hunt Orthopaedic Hospital Oswestry (United Kingdom)

    2004-03-01

    eindeutigen praedisponierenden Faktoren festzustellen. Die Zeitspanne zwischen dem ersten Auftreten der Symptome und der endgueltigen Diagnose ist in der Regel erheblich. Das klinische Bild ist oft unspezifisch und variabel, und die schwierige klinische Beurteilung kann darauf beruhen, dass es sich um einen relativ selten auftretenden Zustand handelt. Ausserdem ist die klinische Untersuchung der Sakroiliakalgelenke sehr problematisch. Die Diagnose basiert auf Anamnese und klinischen Befunden. Sie weisen zusammen mit Blutkultur und/oder einem ev. Gelenkspunktat auf eine Infektion im Sakroiliakalgelenk hin. Das haeufigste klinische Symptom bei bakteriellen Infektionen sind Schmerzen im unteren Teil der Wirbelsaeule oder im Gesaess. Mittels einer STIR-Sequenz, welche die Sakroiliakalgelenke gut darstellt, koennen Pathologien relativ einfach und aeusserst frueh entdeckt werden. Von allen bildgebenden Verfahren ist MRT daher die Methode der Wahl bezueglich Sensitivitaet und Spezifitaet. Falls eine MRT aufgrund geringer Verfuegbarkeit nicht durchfuehrbar ist, sollte als zweite Methode der Wahl die 3-Phasenknochenszintigraphie durchgefuehrt werden. Der konventionellen Roentgendiagnostik kommt weder in der Frueh- noch Verlaufsdiagnostik eine entscheidende Rolle zu. Eine CT-gefuehrte Gelenkpunktion kann in unklaren Faellen die diagnostische Treffsicherheit erhoehen. Eine Therapiekontrolle ist am besten mittels Tc99m Blutpool-Untersuchungen moeglich. Eine hochgradige klinische Verdachtsdiagnose und eine fruehe MRT-Untersuchung sind die wesentliche Voraussetzung fuer die exakte Diagnose einer bakteriellen Sakroiliitis. (orig.)

  15. LEXIKALISCHE MITTEL IN DER HOTELWERBUNG

    OpenAIRE

    Blažević, Nevenka

    2003-01-01

    Werbung ist das wichtigste Marketinginstrument in der Hotellerie. Bei jeder Werbekampagne ist die sprachliche Seite von großer Bedeutung. In diesem Beitrag wird die lexikalische Ebene der Prospekttexte analysiert. Es wird auf allgemeine sprachliche Merkmale dieser Textsorte verwiesen. In Hotelprospekten lassen sich zwei Funktionen erkennen: die Informationsfunktion und die Appellfunktion. Die Appellfunktion wird meistens durch Adjektive ausgedrückt. Bei der Auswahl der lexikalischen Mittel...

  16. CT-guided brachytherapy. A novel percutaneous technique for interstitial ablation of liver malignancies; CT-gesteuerte Brachytherapie. Eine neue perkutane Technik zur interstitiellen Ablation von Lebermetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Ricke, J.; Wust, P.; Stohlmann, A.; Beck, A.; Cho, C.H.; Pech, M.; Wieners, G.; Spors, B.; Werk, M.; Rosner, C.; Haenninen, E.L.; Felix, R. [Klinik fuer Strahlenheilkunde, Charite Virchow-Klinikum, Humboldt-Univ. zu Berlin (Germany)

    2004-05-01

    : Tumordurchmesser {>=} 5 cm bei sieben, enge Lagebeziehung zu Pfortader oder grossen Lebervenen bei zehn, enge Lagebeziehung zur Hepatikusgabel bei vier Patienten. Die Dosimetrie erfolgte ueber unmittelbar nach CT-gefuehrter Applikatorpositionierung akquirierte dreidimensionale CT-Datensaetze. Ergebnisse: Die mittlere Tumorgroesse betrug 4,6 cm (2,5-11 cm). Die minimale Dosis innerhalb des Tumorvolumens lag in Mittel bei 17 Gy (12-20 Gy). Der Volumenanteil gesunden Leberparenchyms mit einer Exposition > 5 Gy betrug 18% (5-39%) vom Lebergesamtvolumen abzueglich Tumorlast. Uebelkeit und Erbrechen traten bei sechs Patienten auf (28%). Ein Patient entwickelte eine Obstruktion des Ductus choledochus durch ein strahleninduziertes Tumoroedem in unmittelbarer Nachbarschaft. Leberenzymparameter und Bilirubinwerte zeigten regelhaft diskrete Anstiege ohne klinisches Korrelat. Die lokale Tumorkontrolle betrug 87% nach 6 Monaten und 70% nach 12 Monaten. Schiussfolgerung: CT-gesteuerte Brachytherapie ist sicher und effektiv. Die Technik ermoeglicht gegenueber thermischen Ablationsverfahren eine breitere Indikationsstellung hinsichtlich Tumorgroesse und Tumorlokalisation. (orig.)

  17. TIPSS: 10 years of experience; TIPSS: 10 Jahre klinische Erfahrung

    Energy Technology Data Exchange (ETDEWEB)

    Richter, G.M.; Brado, M.; Simon, C.; Radeleff, B.; Kauffmann, G.W. [Heidelberg Univ. (Germany). Abt. Radiodiagnostik; Noeldge, G.; Scharf, J.; Hansmann, J.

    1998-04-01

    Purpose: To demonstrate and document 10 years of clinical experience gathered by us with TIPSS and to discuss achievements, problems and outlook. Results: Variceal filling was widely reduced by TIPSS, and significantly reduced portal liver perfusion as assessed morphologically and rheologically. However, there was an immediate onset of compensated liver perfusion by increased arterial inflow. Total liver perfusion did not change significantly. In TIPSS portal decompression was readily achieved, the portosystemic gradient dropping from an average of 24 mm Hg to 10.5 mm Hg. In our series we could not demonstrate an increased incidence of hepatic encephalopathy during the 30-day post-TIPSS period. Early mortality was 4% and early rebleeding rate 3%. The 12-month re-intervention rate based on an invasive portography follow-up protocol was 76%, and the 24-month re-intervention rate was 90%. The definite occlusion rate was below 5%. Beyond a follow-up time span of 24-months the necessity for re-intervention dropped significantly: Less than one-third of our patients required some sort of re-intervention. (orig./AJ) [Deutsch] Ziel: Darstellung der nach 10jaehriger klinischer Anwendung von TIPSS gewonnenen Erfahrungen unter Beruecksichtigung der technischen Grundlagen, der Veraenderungen in der Haemodynamik der Leber und der Langzeitergebnisse. Ergebnisse: TIPSS reduziert die Varizenfuellung und verringert morphologisch und haemodynamisch die portale Perfusion. Die Gesamtleberperfusion aendert sich nicht signifikant. Unter TIPSS kommt es zu einer unmittelbaren Zunahme der arteriellen Leberperfusion. Die portale Drucksenkung erfolgt von einem portosystemischen Mitteldruck von 24 mmHg auf 10,5 mmHg im Durchschnitt. Die spontane hepatische Enzephalopathierate von etwa 20% aendert sich durch TIPSS nicht wesentlich. Die Fruehletalitaet betraegt 4% und die Nachblutungsrate 3%. Insbesondere die Standardisierung von Indikationen und Kontraindikationen, des Punktionsbesteckes, der

  18. Hemoglobine A1c. Ontwikkeling van een bepalingsmethode en enige klinische toepassingen

    NARCIS (Netherlands)

    Miedema, Kornelis

    1981-01-01

    In dit proefschrift wordt een kolomchromatografische bepalingsmethode van het HbA1c beschreven. Het belang van deze bepaling voor de controle van patiënten met diabetes mellites wordt in een aantal klinische studies nagegaan. ... Zie: Samenvatting

  19. The clinical use of mammography in the male; Klinische Relevanz der Mammographie beim Mann

    Energy Technology Data Exchange (ETDEWEB)

    Merkle, E [Ulm Univ. (Germany). Abt. Radiologie; Mueller, M [Ulm Univ. (Germany). Abt. Radiologie; Vogel, J [Ulm Univ. (Germany). Abt. Radiologie; Klatt, S [Ulm Univ. (Germany). Abt. Innere Medizin I; Goerich, J [Ulm Univ. (Germany). Abt. Radiologie; Berger, H G [Ulm Univ. (Germany). Allgemeinchirurgische Abt.; Brambs, H J [Ulm Univ. (Germany). Abt. Radiologie

    1996-01-01

    During a period of four years 104 mammograms were performed in 89 men. Mastectomies were carried out on 23 men (group 1). 66 patients (group 2) were followed up clinically and in 15 patients serial mammograms were obtained. In group 1 there were 5 patients with bilateral gynaecomastia, 9 with unilateral gynaecomastia and two with pseudogynaecomastia and there were 7 patients with malignancies. In group 2 there were 46 patients with bilateral gynaecomastia and 10 patients with unilateral gynaecomastia. Pseudogynaecomastia was found in 25 patients. There were 7 malignancies, of which 5 had been suspected clinically and one had been diagnosed as gynaecomastia by mammography. Two carcinomas in situ were missed clinically and also by mammography. When malignancy is not suspected on clinical grounds the first examination should be sonography. Where, however, malignancy is suspected, and for follow-up, mammography retains its primary position. (orig./MG) [Deutsch] In einem 4-Jahres-Zeitraum wurden bei 89 Maennern insgesamt 104 Mammogramme angefertigt. 23 Maenner (=Gruppe 1) wurden mastektomiert. 66 Patienten (=Gruppe 2) wurden klinisch und zum Teil mammographisch kontrolliert. Alle Mammogramme wurden in Unkenntnis des klinischen Befundes retrospektiv ausgewertet und, wenn moeglich, dem histologischen Ergebnis gegenuebergestellt. In der Gruppe 1 fand sich eine beidseitige Gynaekomastie in 5/23 Faellen, eine einseitige Form in 9/23 Faellen, eine Pseudogynaekomastie in 2/23 Faellen und ein Malignom in 7/23 Faellen. In Gruppe 2 ergab sich eine beidseitige Gynaekomastie in 46/81 Faellen gegenueber einer einseitigen Form in 10/81 Faellen. Eine Pseudogynaekomastie fand sich in 25/81 Faellen. Von 7 Malignomen waren 5 klinisch suspekt, wobei eines mammographisch als Gynaekomastie imponierte. Zwei In-situ-Karzinome waren sowohl mammographisch als auch klinisch okkult. Klinisch nicht malignomsuspekte Befunde sollten primaer der Mammasonographie zugefuehrt werden. Bei

  20. Klinische Studie zur Messung der Dimensionsstabilität von digitalen Ganzkieferabformungen und die Entwicklung einer neuen Messmethode

    OpenAIRE

    Kuhr, Fabian

    2016-01-01

    Digitale Abformungen mit intraoralen Scannern haben klinisch bereits bewiesen, dass sie einzelne Zähne detail- und dimensionsgenau aufnehmen und in dieser Hinsicht eine Alternative zur konventionellen zahnärztlichen Abformung bieten können. Ob dies klinisch auch mit dem Scannen gesamter Zahnreihen möglich ist, wurde bislang nicht untersucht. Sowohl für konventionelle wie auch für digitale Abformungen gibt es keine In-vivo-Studie, die eine Methode zur Überprüfung der dimensionsgetreuen Übertra...

  1. Sentinel-Lymphknoten-Biopsie des Melanoms mittels Indocyaningrün und "FOVIS"-System.

    Science.gov (United States)

    Göppner, Daniela; Nekwasil, Stephan; Jellestad, Anne; Sachse, Alexander; Schönborn, Karl-Heinz; Gollnick, Harald

    2017-02-01

    Der Nachweis metastatischer Infiltrate im Sentinel-Lymphkoten (SLN) gilt als wesentlicher prognostischer Faktor des Melanoms. Alternativ zur Farbstoffmethode mit Patentblau zum Goldstandard der SLN-Biopsie (SLNB) mittels Radiokolloid wird die fluoreszenzoptische Darstellung mit Hilfe von Indocyaningrün (ICG) und Nahinfrarot (NIR)-Kamerasystem kommuniziert. Im Vergleich zur konventionellen Methode wurde die Wertigkeit des ICG-/NIR-Verfahrens in Abhängigkeit vom Body-Mass-Index (BMI) des Patienten und der Konzentration von ICG bezüglich der Visualisierung des Lymphabstroms und des SLNs untersucht. An zehn Patienten wurde die SLNB mittels Technetium-99m, Patentblau und ICG durchgeführt. Die Fluoreszenz-Darstellung von Lymphbahnen und SLN erfolgte in Echtzeit mittels der NIR-Kameratechnik "FOVIS". Je nach erzielter Bildqualität wurde ICG in einer Dosis von 0,25 mg bis 2,5 mg intrakutan appliziert. Neun der zehn SLN wurden fluoreszenzoptisch identifiziert (90 %), alle zehn radioaktiv (100 %), nur acht (80 %) mittels ICG-Grünfärbung bzw. Patenblau-Markierung. Transdermal wurde ein SLN dargestellt (10 %). In Korrelation zum BMI waren höhere ICG-Mengen, bis zu 2,5 mg intrakutan absolut, in der Darstellung der Lymphbahnen von Vorteil. Die SLN-Fluoreszenzmarkierung mit dem ICG/NIR-Kamera-System "FOVIS" stellt eine sichere Alternative zur Farbstoffmethode mit Patentblau ergänzend zur Radiokolloidmethode mit Technetium-99m dar. Weitere Studien zur optimalen Dosierung von ICG und transdermalen Bildgebung in Relation zum BMI sind notwendig. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  2. Spiral CT for evaluation of chest trauma; Spiral-CT beim Thoraxtrauma

    Energy Technology Data Exchange (ETDEWEB)

    Roehnert, W. [Universitaetsklinikum Dresden (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Weise, R. [Universitaetsklinikum Dresden (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik

    1997-07-01

    After implementation of spiral CT in our department, we carried out an analysis for determining anew the value of CT as a modality of chest trauma diagnosis in the emergency department. The retrospective study covers a period of 10 months and all emergency patients with chest trauma exmined by spiral CT. The major lesions of varying seriousness covered by this study are: pneumothorax, hematothorax, pulmonary contusion or laceration, mediastinal hematoma, rupture of a vessel, injury of the heart and pericardium. The various fractures are not included in this study. In many cases, spiral CT within relatively short time yields significant diagnostic findings, frequently saving additional angiography. A rigid diagnostic procedure cannot be formulated. Plain-film chest radiography still remains a diagnostic modality of high value. (Orig.) [Deutsch] Nach Einfuehrung der Spiral-CT in unserer Einrichtung versuchten wir, den Stellenwert der Computertomographie in der Notfalldiagnostik des Thoraxtraumas neu zu bestimmen. Dazu wurden retrospektiv ueber einen Zeitraum von 10 Monaten alle mittels Spiral-CT untersuchten Notfallpatienten mit Thoraxverletzungen ausgewertet. Im Vordergrund standen folgende Befunde unterschiedlichen Schweregrades: Pneumothorax, Haematothorax, Lungenkontusion/-lazeration, Mediastinalhaematom, Gefaessruptur, Herz- und Herzbeutelverletzung. Auf die unterschiedlichen Frakturen wird bewusst nicht naeher eingegangen. In vielen Faellen liefert die Spiral-CT mit relativ geringem Zeitaufwand wesentliche diagnostische Aussagen. Haeufig kann auf eine Angiographie verzichtet werden. Ein starres diagnostisches Stufenschema laesst sich nicht definieren. Die Thoraxuebersichtsaufnahme besitzt einen unveraendert hohen Stellenwert. (orig.)

  3. Objektverfolgung bei einer vollständigen Fahrzeugumfeldüberwachung mittels Radar

    Science.gov (United States)

    Schuster, M.; Pech, T.; Reuter, J.; Wanielik, G.

    2014-11-01

    Für modernste Fahrerassistenzsysteme ist zunehmend eine vollständige Rundumüberwachung des fließenden Verkehrs erforderlich. In diesem Artikel wird ein Ansatz zur Überwachung des gesamten umliegenden Verkehrs mittels Radarsystemen präsentiert. Hierfür wurde ein Versuchsfahrzeug mit insgesamt sechs Radarsensoren ausgerüstet, um eine möglichst hohe Umfeld-Überwachung zu ermöglichen. Für diese Konfiguration wird ein auf GPDA basierendes Trackingsystem vorgestellt. Es wird auf das Problem ausgedehnter Ziele eingegangen, welches auftritt wenn sich ein Fremdfahrzeug neben dem Versuchsfahrzeug befindet, da hier Reflektionen von verschiedenen Reflektionszentren des Ziels aufgefangen werden. Dieser Effekt wird ausgenutzt, um mittels einer Track-zu-Track Fusion eine Längenschätzung des vorbeifahrenden Fahrzeugs zu ermöglichen.

  4. Mediastinal Hodgkin lymphomas in computertomography: exact CT-based volume assessment and approximations with simple geometric models; Mediastinale Hodgkin-Lymphone in der Computertomographie. Vergleich von exakter CT-gestuetzter Volumetrie und Volumenabschaetzung mit Hilfe einfacher geometrischer Modelle

    Energy Technology Data Exchange (ETDEWEB)

    Battmann, A. [Marburg Univ. (Germany). Abt. fuer Strahlendiagnostik; Dieckmann, K.; Resch, A.; Poetter, R. [Allgemeines Krankenhaus, Wien (Austria). Universitaetsklinik Strahlentherapie und Strahlenbiologie; Battmann, A. [Giessen Univ. (Germany). Zentrum fuer Pathologie

    2001-03-01

    ; results in the closest approximation compared to the true volume. In the course of clinical studies it might be helpful to apply this formula to determine the prognostic relevance of the tumor size and its development under therapy. (orig.) [German] Hintergrund: Ziel dieser Arbeit waren die Bestimmung eines moeglichst exakten Modells zur Abschaetzung der Volumina von Lymphommanifestationen im Vergleich zu computertomographisch bestimmten Tumorvolumina und eine Abschaetzung der zu erwartenden Fehlerbreite. Material und Methoden: Es wurden 30 CT-Untersuchungen mediastinaler Tumoren von an Morbus Hodgkin erkrankten Kindern fuer die Untersuchung herangezogen. Die CT-Aufnahmen wurden mittels einer an einen Framegrabber angeschlossenen CCD-Videokamera digitalisiert. Mit Hilfe der GLOBAL-LAB-Image-Software wurde die Tumormasse unter Ausschluss nicht tumorzugehoeriger Binnenstrukturen ermittelt. Im Anschluss wurden die Volumina einfacher geometrischer Figuren (Quader, Ellipsoid, Oktaeder) aus den Maximalausmessungen der Tumoren errechnet. Abschliessend erfolgte die Berechnung der Abweichung der Volumina der geometrischen Modelle von dem durch das Computerprogramm ermittelten echten Tumorvolumen. Ergebnisse: Das Volumenmodell 'Quader' ueberschaetzte das Tumorvolumen um 89 bis 268%. Das Volumenmodell 'Ellipsoid' ueberschaetzte die Tumorgroesse im Mittel um 29%. Das Modell 'Oktaeder' unterschaetzte die Tumorgroesse im Mittel um 18%. Eine Division des Quadervolumens durch 2,3 approximierte das geometrische am naechsten an das Realvolumen: Im Mittel wurde das Tumorvolumen bei Tumoren, deren Volumen 20 ml ueberschritt, um 2% ueberschaetzt. Eine suffiziente Abschaetzung von Tumoren, deren Volumen weniger als 20 ml betrug, war weder mittels dieser noch mit den uebrigen Approximationen moeglich. Schlussfolgerungen: Fuer die Bestimmung von Tumorvolumina bei mediastinalen Hodgkin-Lymphomen ab 20 ml Volumen bietet die Formel Quader /2,3 die bestmoegliche

  5. Untersuchungen zur Rauchgasentstickung mittels Schwefelwasserstoff in Tri-n-butylphosphat

    OpenAIRE

    Homann, Jörg

    2000-01-01

    In der vorliegenden Arbeit wurde die Reaktion von Stickstoffmonoxid (NO) mit Schwefelwassersoff (H2S) in Tri-n-butylphosphat (TBP) im Hinblick auf ein alternatives Verfahren zur Entstickung von Rauchgasen untersucht. Mittels einer gasvolumetrischen Absorptionsapparatur wurden zuerst Daten zur physikalischen Löslichkeit in TBP ermittelt, die für den Erhalt kinetischer Daten der stofftransportüberlagerten Reaktionen in TBP relevant sind. Es sind dies die Henrykoeffizienten von NO, H2S und die d...

  6. Clinical neuroanatomy - cranial MRI and CT. 4. rev. and enl. ed.; Klinische Neuroanatomie - kranielle MRT und CT

    Energy Technology Data Exchange (ETDEWEB)

    Lanfermann, Heinrich; Raab, Peter [Medizinische Hochschule Hannover (MHH) (Germany). Inst. fuer Diagnostische und Interventionelle Neuroradiologie; Kretschmann, Hans-Joachim; Weinrich, Wolfgang

    2015-07-01

    The book on clinical neuroanatomy - cranial MRI and CT covers the following issues: layered imaging diagnostics and reference structures; frontal layer, sagittal layers, transverse layers, brainstem, skull topography and the intracranial spaces and structures, facial skull topography, head-neck topography; neurofunctional systems, neurotransmitter and neuromodulators, surveillance material and techniques.

  7. Unresectable colorectal liver metastases. Percutaneous ablation using CT-guided high-dose-rate brachytherapy (CT-HDBRT); Nicht resektable kolorektale Lebermetastasen. Perkutane Ablation mittels CT-gesteuerter Hochdosisbrachytherapie (CT-HDBRT)

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Lutter, A.; Schnapauff, D.; Denecke, T.; Gebauer, B. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Hildebrandt, B. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Oncology; Puhl, G. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of General, Visceral and Transplantation Surgery; Wust, P. [Charite, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiation Oncology

    2014-06-15

    Purpose: To evaluate the clinical outcome of CT-guided high-dose-rate brachytherapy (CT-HDRBT) of unresectable colorectal liver metastases (CRLMs). Materials and Methods: Retrospective analysis of all consecutive patients with unresectable CRLMs treated with CT-HDRBT between January 2008 and November 2012. Treatment was performed by CT-guided catheter placement and high-dose-rate brachytherapy with an iridium-192 source. MRI follow-up was performed after 6 weeks and then every 3 months post-intervention. The primary endpoint was local tumor control (LTC); secondary endpoints included time to progression (TTP) and overall survival (OS). Results: 80 heavily pretreated patients with 179 metastases were available for MRI evaluation for a mean follow-up time of 16.9 months. The mean tumor diameter was 28.5 mm (range: 8 - 107 mm). No major complications were observed. A total of 23 (12.9%) local tumor progressions were observed. Lesions ≥ 4 cm in diameter showed significantly more local progression than smaller lesions (< 4 cm). 50 patients (62.5%) experienced systemic tumor progression. The median TTP was 6 months. 28 (43%) patients died during the follow-up period. The median OS after ablation was 18 months. Conclusion: CT-HDRBT is an effective technique for the treatment of unresectable CRLMs and warrants promising LTC rates compared to thermal ablative techniques. A combination with other local and systemic therapies should be evaluated in patients with lesions > 4 cm in diameter, in which higher progression rates are expected. (orig.)

  8. Repeat CT-scan assessment of lymph node motion in locally advanced cervical cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Bondar, Luiza; Velema, Laura; Mens, Jan Willem; Heijmen, Ben; Hoogeman, Mischa [Erasmus Medical Center Cancer Institute, Department of Radiation Oncology, 3008 AE, Rotterdam (Netherlands); Zwijnenburg, Ellen [Radboud University Medical Center, Department of Radiation Oncology, Nijmegen (Netherlands)

    2014-12-15

    In cervical cancer patients the nodal clinical target volume (CTV, defined using the major pelvic blood vessels and enlarged lymph nodes) is assumed to move synchronously with the bony anatomy. The aim of this study was to verify this assumption by investigating the motion of the major pelvic blood vessels and enlarged lymph nodes visible in CT scans. For 13 patients treated in prone position, four variable bladder-filling CT scans per patient, acquired at planning and after 40 Gy, were selected from an available dataset of 9-10 CT scans. The bladder, rectum, and the nodal-vessels structure containing the iliac vessels and all visible enlarged nodes were delineated in each selected CT scan. Two online patient setup correction protocols were simulated. The first corrected bony anatomy translations and the second corrected translations and rotations. The efficacy of each correction was calculated as the overlap between the nodal-vessels structure in the reference and repeat CT scans. The motion magnitude between delineated structures was quantified using nonrigid registration. Translational corrections resulted in an average overlap of 58 ± 13% and in a range of motion between 9.9 and 27.3 mm. Translational and rotational corrections significantly improved the overlap (64 ± 13%, p value = 0.007) and moderately reduced the range of motion to 7.6-23.8 mm (p value = 0.03). Bladder filling changes significantly correlated with the nodal-vessels motion (p < 0.001). The motion of the nodal-vessels was large, nonrigid, patient-specific, and only moderately synchronous with the bony anatomy. This study highlights the need for caution when reducing the CTV-to-PTV (PTV planning target volume) margin of the nodal CTV for highly conformal radiation techniques. (orig.) [German] Bei Zervixkarzinompatientinnen wird davon ausgegangen, dass das nodale klinische Zielvolumen (CTV, definiert anhand der grossen Blutgefaesse des Beckens und vergroesserter Lymphknoten) sich synchron mit

  9. Novel technique for high-precision stereotactic irradiation of mouse brains

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, J.; Woelfelschneider, J.; Derer, A.; Fietkau, R.; Gaipl, U.S.; Bert, C.; Frey, B. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Universitaetsklinikum Erlangen, Erlangen (Germany); Stache, C.; Buslei, R.; Hoelsken, A. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institute of Neuropathology, Universitaetsklinikum Erlangen, Erlangen (Germany); Schwarz, M.; Baeuerle, T. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institute of Radiology, Preclinical Imaging Platform Erlangen (PIPE), Universitaetsklinikum Erlangen, Erlangen (Germany)

    2016-11-15

    Small animal irradiation systems were developed for preclinical evaluation of tumor therapy closely resembling the clinical situation. Mostly only clinical LINACs are available, so protocols for small animal partial body irradiation using a conventional clinical system are essential. This study defines a protocol for conformal brain tumor irradiations in mice. CT and MRI images were used to demarcate the target volume and organs at risk. Three 6 MV photon beams were planned for a total dose of 10 fractions of 1.8 Gy. The mouse position in a dedicated applicator was verified by an X-ray patient positioning system before each irradiation. Dosimetric verifications (using ionization chambers and films) were performed. Irradiation-induced DNA damage was analyzed to verify the treatment effects on the cellular level. The defined treatment protocol and the applied fractionation scheme were feasible. The in-house developed applicator was suitable for individual positioning at submillimeter accuracy of anesthetized mice during irradiation, altogether performed in less than 10 min. All mice tolerated the treatment well. Measured dose values perfectly matched the nominal values from treatment planning. Cellular response was restricted to the target volume. Clinical LINAC-based irradiations of mice offer the potential to treat orthotopic tumors conformably. Especially with respect to lateral penumbra, dedicated small animal irradiation systems exceed the clinical LINAC solution. (orig.) [German] Kleintierbestrahlungsanlagen wurden entwickelt um praeklinische Studien in der Tumortherapie unter moeglichst klinischen Bedingungen durchzufuehren. Da an den meisten Instituten nur klinische LINACs zur Verfuegung stehen, werden Standardprotokolle zur Kleintierbestrahlung benoetigt, die konventionelle Systeme nutzen. In dieser Studie wird ein solches Protokoll fuer tumorkonforme Hirnbestrahlung von Maeusen definiert. CT- und MRT-Bilder wurden aufgenommen, um Zielvolumen und

  10. DMSA-scintigraphy in paediatrics: is the evaluation of the geometric mean necessary for the calculation of the differential renal function?; Partialfunktionsberechnung der Nieren mit DMSA in der Paediatrie: ist fuer die Bestimmung das geometrische Mittel notwendig?

    Energy Technology Data Exchange (ETDEWEB)

    Porn, U.; Alalp, S.; Fischer, S.; Dresel, S. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany); Rossmueller, B. [Inst. fuer Radiologische Diagnostik, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany); Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany); Inst. fuer Radiologische Diagnostik, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

    2001-08-01

    gelegenen Nieren nicht zu einer klinisch relevanten Fehlbeurteilung der PF, sodass in diesen Faellen auf Aufnahmen aus ventraler Projektion verzichtet werden kann. Bei dystop gelegenen Nieren ist dagegen die Berechnung des geometrischen Mittels zur PF-Bestimmung zu empfehlen. (orig.)

  11. Typisierung von HLA-Klasse-II-Merkmalen mittels des TaqMan-Verfahrens

    OpenAIRE

    Tremmel, Matthias

    2001-01-01

    In Anlehnung an die konventionelle SSP-PCR-Methode wurde ein Low-Resolution-Panel mittels des TaqMan-Prinzips entwickelt und es wurde exemplarisch für DR4 und DR15/16 gezeigt, daß die auf dem 5 Nuklease-Assay beruhende Methode fähig ist, auch einzelne Punktmutationen voneinander zu unterscheiden. Das Grundprinzip dieser Methode basiert ähnlich dem der PCR-SSP auf dem Verfahren der PCR und auf dem Ausnutzen genetischer Unterschiede. So kommt es nur zu einer Amplifizierung wenn beide Primer spe...

  12. Value of new MR techniques in MR-PET; Stellenwert neuer MR-Techniken in der MR-PET

    Energy Technology Data Exchange (ETDEWEB)

    Attenberger, U.I.; Schoenberg, S.O. [Universitaetsmedizin Mannheim, Medizinische Fakultaet Mannheim der Universitaet Heidelberg, Institut fuer klinische Radiologie und Nuklearmedizin, Mannheim (Germany); Quick, H.H. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institut fuer Medizinische Physik, Erlangen (Germany); Guimaraes, A. [Massachusetts General Hospital, Martinos Center for Biomedical Imaging, Department of Radiology, Charlestown (United States); Catalano, O. [University of Naples Federico II, Naples (Italy); Morelli, J.N. [The Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore (United States)

    2013-12-15

    wiederholte Untersuchungen durchlaufen muessen, und paediatrische Patienten relevant ist. Dabei koennen jedoch die Erfahrungen, die im Verlauf der letzten Jahre mit der Hybridtechnologie PET-CT gewonnen wurden, nicht direkt auf die MR-PET uebertragen werden. Ein wesentliches Beispiel hierfuer ist die Schwaechungskorrektur, fuer die in der PET-CT die mittels CT bestimmten Hounsfield-Einheiten verwendet werden. Da die in der PET emittierten 511-keV-Photonen durch das Koerpergewebe des Patienten geschwaecht werden, werden die CT-Datensaetze in sog. lineare Schwaechungskoeffizienten (''linear attenuation coefficients'', LAC) konvertiert. Da die Bilddatenakquisition in der MRT nicht auf einer Schwaechung von Roentgenstrahlung, sondern einer Messung der Protonendichte und von gewebespezifischen Relaxationszeiten basiert, muessen in der MR-PET alternative Verfahren zur Schwaechungskorrektur eingesetzt werden. Darueber hinaus bietet die MRT auch alternative Sequenz- und Akquisitionstechnologien, die es erlauben, bisherige Limitationen z. B. bzgl. der Bewegungskorrektur zu adressieren. Dieser Artikel berichtet ueber initiale klinische Erfahrungen mit einem voll integrierten MR-PET-System, wobei MR-Techniken zur Korrektur von Bewegungsartefakten, die Schwaechungskorrektur und die Reduktion von Metallartefakten im Zentrum stehen. (orig.)

  13. Ranking of CT in persistent vertigo after implantation of stapes prostheses; Stellenwert der Computertomographie bei persistierenden Gleichgewichtsstoerungen nach dem Einsatz von Stapesplastiken

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, S. [Leipzig Univ. (Germany). Klinik fuer Diagnostische Radiologie; Woldag, K. [Leipzig Univ. (Germany). Klinik und Poliklinik fuer Hals-Nasen-Ohren-Krankheiten; Meister, E.F. [Leipzig Univ. (Germany). Klinik und Poliklinik fuer Hals-Nasen-Ohren-Krankheiten; Reschke, I. [Leipzig Univ. (Germany). Klinik fuer Diagnostische Radiologie; Schulz, H.G. [Leipzig Univ. (Germany). Klinik fuer Diagnostische Radiologie

    1995-01-01

    10 of 150 patients had persistent vertigo after implanation of stapes prostheses. These patients were evaluated by high resolution CT in the axial and coronal plane. Scans showed in all cases findings which related to the symptoms. The CT findings were proved intraoperatively in 9 cases. A new indirect sign of a perilymphatic fistula is described in form of an air bulla at the end of the prosthesis. Retympanotomy could be planned better with the help of HR-CT. (orig.) [Deutsch] Von 150 Patienten zeigten 10 nach dem Einsatz einer Stapesprothese eine persistierende vestibulaere Symptomatik. Mittels der hochaufloesenden Felsenbein-CT in axialer und koronarer Schnittfuehrung konnten in allen Faellen in Symptomatik erklaerende Befunde erhoben werden. Eine operative Bestaetigung erfolgte in 9 Faellen. Als bisher in der Literatur in diesem Zusammenhang nicht beschriebenes, indirektes Zeichen einer Perilymphfistel wurde eine kleine Luftblase am Prothesenende nachgewiesen. Die HR-CT hat sich als wesentliche Erleichterung bei der Planung einer Retympanotomie erwiesen. (orig.)

  14. Volume-artifact reduction modality by helical CT of the anterior, middle and posterior carnial fossae. Comparison with conventional CT; Volumen-Artefakt-Reduktionstechnik mittels Spiral-CT in der vorderen, mittleren und hinteren Schaedelgrube. Vergleich mit der konventionellen kranialen CT

    Energy Technology Data Exchange (ETDEWEB)

    Dorenbeck, U.; Finkenzeller, T.; Hill, K.; Feuerbach, S.; Link, J. [Regensburg Univ. (Germany). Inst. fuer Roentgendiagnostik

    2000-04-01

    Purpose: The object of this study was to determine the extent to which a new volume-artifact reduction (VAR) modality using helical CT was able to reduce artifacts in the anterior, middle and posterior fossae in comparison with conventional CT (sequential mode). Methods: In a prospective, randomized trial, 50 patients underwent helical CT (VAR) and 50 underwent sequential CT. The results were evaluated by three radiologists; influences on image quality where scaled between 1 (no artifact) and 4 (not assessable). Eight regions of the anterior, middle and posterior fossae were evaluated. Results: On average, artifacts were scaled at 2.5 in helical CT (VAR) and 3.1 in conventional CT. Significant differences were seen at the eyeball, anterior to the petrosol bone, at the internal occipital crest, and at the level of the transverse sinus (p<0.005). Conclusions: Helical CT with the VAR modality is superior to conventional, sequential CT in the area of the anterior, middle and posterior fossae. (orig.) [German] Ziel: Das Ziel dieser Studie war herauszufinden, inwieweit ein neuer Volumen-Artefakt-Reduktionsmodus (VAR) im Spiral-CT in der vorderen, mittleren und hinteren Schaedelgrube gegenueber der Einzelschicht-CT zu einer Artefaktverringerung beitragen kann. Methoden: In einer prospektiven randomisierten Studie wurden 50 Untersuchungen mit Spiral-CT und 50 mit Einzelschicht-CT bezueglich Artefakten verglichen. Die Auswertung erfolgte durch drei Radiologen, die Bildqualitaet wurde in einer Skala zwischen 1 (kein Artefakt) und 4 (Beurteilung der Region wegen Artefakten nicht moeglich) angegeben. Acht anatomische Regionen in der vorderen, mittleren und hinteren Schaedelgrube wurden auf Beeintraechtigung durch Artefakte untersucht. Ergebnisse: Im Durchschnitt betrug die Bewertung fuer die Artefaktbeeintraechtigung beim Spiral-CT (VAR) 2,5 gegenueber 3,1 bei der Einzelschicht-CT. Der VAR-Modus ermoeglichte in der mittleren und hinteren Schaedelgrube sowie im Balbus oculi

  15. Abdominal fat-evaluation by use of single scan computed tomography; Computertomographische Bestimmung des intraabdominellen Fettvolumens mittels Einschicht-Messung

    Energy Technology Data Exchange (ETDEWEB)

    Jacobi, V. [Klinikum der Johann-Wolfgang-Goethe-Univ., Frankfurt am Main (Germany). Inst. fuer Allgemeine Roentgendiagnostik; Steinkamp, M. [Klinikum der Johann-Wolfgang-Goethe-Univ., Frankfurt am Main (Germany). Inst. fuer Allgemeine Roentgendiagnostik; Kirchner, J. [Klinikum der Johann-Wolfgang-Goethe-Univ., Frankfurt am Main (Germany). Inst. fuer Allgemeine Roentgendiagnostik; Fischer, H. [Klinikum der Johann-Wolfgang-Goethe-Univ., Frankfurt am Main (Germany). 2. Medizinische Klinik; Diedrich, C.F. [Klinikum der Johann-Wolfgang-Goethe-Univ., Frankfurt am Main (Germany). 2. Medizinische Klinik; Kollath, J. [Klinikum der Johann-Wolfgang-Goethe-Univ., Frankfurt am Main (Germany). 2. Medizinische Klinik

    1997-02-01

    Purpose: Several studies emphasised the importance of the relationship between intraabdominal and total body adipose tissue as a risk factor for the development of metabolic or cardiovascular diseases. Therefore, the aim of the present study was to examine whether a single scan computed tomography is able to determine the whole intraabdominal fat volume with high accuracy and reproducibility. Materials and methods: Regions of interests (ROIs) were drawn manually for measuring intraabdominal fat in 51 unsuspicious abdominal CT. Results: The sexual differentiation of adipose tissue already described in a lot of studies could be confirmed in this study. Fat still predominates in females in lower half of the body (gynoid obesity). In men it predominates in the upper half (android obesity). Significant correlation concerning measuring the whole intraabdominal fat volume could be found in L1-level in women (r=0.992) and in L2-level in men (r=0.992). Measurement of a single scan enables us to assess whole intraabdominal fat volume due to a special formula. Conclusion: The determination of intraabdominal fat measured by a single scan computed tomography is a procedure associated with high accuracy and reproducibility. (orig.) [Deutsch] Ziel: Da in zahlreichen Studien hervorgehobene Bedeutung des intraabdominellen Fettgewebes gegenueber dem Gesamtkoerperfett als Risikofaktor fuer die Entwicklung metabolischer und kardiovaskulaerer Erkrankungen fordert ein Verfahren zur annaehernd exakten Bestimmung des intraabdominellen Fettgewebes. Ziel der vorliegenden Studie war zu pruefen, ob mit genuegender Genauigkeit die Verwendung einer Einschicht-Methode einen gezielten Einsatz der Computertomographie ermoeglicht und welche Lokalisation der zu waehlenden Schicht die aussagekraeftigste Messung ermoeglicht. Material und Methode: Anhand von 51 Computertomographien des Abdomens anderer Indikation (Normalbefunde) wurde das gesamte intraabdominelle Fettvolumen semiautomatisch mittels ROI

  16. Clinical applications of proton magnetic resonance spectroscopy of the brain; Klinische Anwendungen der Protonen-Magnetresonanzspektroskopie des Gehirns

    Energy Technology Data Exchange (ETDEWEB)

    Laubenberger, J.; Bayer, S.; Thiel, T.; Hennig, J.; Langer, M. [Radiologische Universitaetsklinik Freiburg (Germany). Abt. Roentgendiagnostik

    1998-06-01

    In spite of all the scientific advances of the past few years, proton magnetic resonance spectroscopy of the brain has not attained the status of a routine examination technique with clinically accepted indications. The method should be considered as an additional option to MR imaging for inherited and acquired encephalopathic changes as well as, in future, for localization diagnosis of epilepsies. A proton magnetic resonance spectroscopic investigation without a prior intensive clinical and imaging investigation is not useful. Above all, factors influencing metabolite distribution such as for example, serum osmolability must be known. Methodological prerequisites for the clinical application of proton resonance spectroscopy are, first of all, a high stability of the chosen technique as well as a sufficiently certain quantification of metabolites and the availability of a reference group. The use of short echo times is necessary for the quantification of glutamine and the osmolyte myo-inositol. Indications for individual cases in which clinical investigations and MR topography cannot provide sufficient certainty and spectroscopy can furnish additional information are, in addition to uses in neuropediatrics, the suspicion of Alzheimer`s dementia, HIV encephalopathy in early manifestations, and unclarified depressions of consciousness accompanying liver cirrhosis. (orig.) [Deutsch] Die Protonen-Magnetresonanzspektroskopie des Gehirns ist trotz aller wissenschaftlicher Fortschritte der letzten Jahre noch nicht zu einer Routineuntersuchung mit anerkannter klinischer Indikationsstellung geworden. Die Untersuchung muss bei angeborenen und erworbenen enzephalopathischen Veraenderungen sowie in Zukunft in der Lokalisationsdiagnostik von Epilepsien als Zusatzoption zur MR-Bildgebung erachtet werden. Eine protonenspektroskopische Untersuchung ohne ausgiebige klinische und bildgebende Basisuntersuchung ist nicht sinnvoll. Insbesondere muessen Einflussfaktoren, wie z

  17. Konferenz Stadtmusikgeschichte in Mittel- und Osteuropa. Die Musik der Religionsgemeinschaften um 1900. Lipsko, 5.-6. listopadu 2004

    Czech Academy of Sciences Publication Activity Database

    Freemanová, Michaela

    2004-01-01

    Roč. 30, č. 4 (2004), s. 647-648 ISSN 1335-2458. [Konferenz Stadtmusikgeschichte in Mittel- und Osteuropa. Die Musik der Religionsgemeinschaften um 1900. Leipzig, 04.11.05-04.11.06] Institutional research plan: CEZ:AV0Z9058907 Keywords : music * religious community * 19th century Subject RIV: AL - Art, Architecture, Cultural Heritage

  18. CT-guided percutaneous neurolysis methods. State of the art and first results; CT-gesteuerte Neurolysen. Stand der Technik und aktuelle Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, B. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Richter, G.M. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Roeren, T. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Kauffmann, G.W. [Abt. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany)

    1996-09-01

    konnten sich im letzten Jahrzehnt als CT-gesteuerte Neurolyseverfahren aufgrund hoher Zielgenauigkeit in der klinischen Routine etablieren. Irreversible Komplikationen werden bei Einhalten der korrekten Technik und Verwendung duenner 21- oder 22-gg.-Nadeln nur sporadisch beschrieben. Wir beobachten bei 20 durchgefuehrten lumbalen Sympathikolysen 7 klinische Verbesserungen und 13 Amputationen. Die Literaturergebnisse der Methode schwanken demgegenueber bei der lumbalen Sympathikolyse von 39-89% klinischer Erfolgsrate, bei der thorakalen Sympathikolyse von 70-100% und bei der Zoeeliakusblockade von 0-100%. Die Hypothese, eine Extremitaetenerwaermung nach Sympathikolyse sei nur durch Stealeffekte zugunsten der Hautdurchblutung bedingt, konnte durch Flussmessungen widerlegt werden. Waehrend bei der lumbalen Sympathikolyse vor allem die Vorselektion des Patientenguts die unterschiedlichen Erfolgsraten erklaert, spielen bei den anderen Verfahren vor allem die Indikationsstellungen eine herausragende Rolle. Patienten mit palmarer Hyperhidrose profitieren mehr von der perkutanen Neurolyse als Patienten mit Raynaudsymptomatik, Patienten mit Pankreaskarzinom mehr als solche mit Pankreatitis. (orig./VHE)

  19. Uterine cervical cancer. Preoperative staging with magnetic resonance imaging; Zervixkarzinom. Praeoperatives Staging mittels Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Hamm, B. [Charite-Universitaetsmedizin Berlin, Campus Charite Mitte, Klinik fuer Radiologie, Berlin (Germany)

    2011-07-15

    The treatment of uterine cervical carcinoma is largely dependent on the tumor stage. Despite significant inaccuracies in the clinical examination, uterine cervical cancer remains the only gynecological form of cancer still largely staged according to clinical findings. Although imaging is still not included in the staging the recently published revised FIGO (Federation International de Gynecologie et d'Obstetrique) system encourages the use of modern cross-sectional imaging (magnetic resonance imaging MRI and computed tomography CT). Due to its high soft tissue contrast MRI allows excellent non-invasive assessment of the cervix with direct tumor delineation as well as assessment of the prognosis based on morphological factors. Studies in the literature report an accuracy of 93% for MRI in the preoperative assessment of tumor size and in the differentiation of operable from advanced cervical cancer. Therefore MRI is considered to be the optimal modality for diagnostic evaluation starting from FIGO stage IB1, for radiation therapy planning, and for exclusion of recurrence in follow-up. In this paper we give an overview of the role of magnetic resonance imaging in preoperative staging of uterine cervical cancer. (orig.) [German] Die Therapieplanung beim Zervixkarzinom ist weitgehend von der Stadieneinteilung nach FIGO (Federation International de Gynecologie et d'Obstetrique) abhaengig, die trotz erheblicher Ungenauigkeiten bei der klinischen Stadieneinteilung weiterhin aufgrund klinischer Untersuchungsbefunde erfolgt. Obwohl bildgebende Verfahren nach wie vor fuer die Stadieneinteilung nicht vorgesehen sind, wird im kuerzlich erschienen revidierten Stagingsystem der FIGO zum ersten Mal die Verwendung moderner Schnittbilddiagnostik (MRT und CT) befuerwortet. Die MRT ermoeglicht dank ihres hohen Weichteilkontrasts ein ausgezeichnetes nichtinvasives Staging des Zervixkarzinoms mit direkter Tumordarstellung sowie einer Prognoseabschaetzung anhand

  20. Intraläsionale Therapie niedrig maligner primär kutaner B-Zell-Lymphome mit Anti-CD20-Antikörper: Nebenwirkungen korrelieren mit gutem klinischen Ansprechen.

    Science.gov (United States)

    Eberle, Franziska C; Holstein, Julia; Scheu, Alexander; Fend, Falko; Yazdi, Amir S

    2017-03-01

    Die intraläsionale Gabe von Anti-CD20-Antikörpern (Rituximab) wurde als effektive Therapieoption für Patienten mit niedrig malignen primär kutanen B-Zell-Lymphomen beschrieben. Bis heute wurden allerdings keine Parameter identifiziert, welche reproduzierbar ein gutes klinisches Ansprechen dieser Therapie vorhersagen. Ziel dieser Studie ist, sowohl das klinische Ansprechen und die unerwünschten Nebenwirkungen als auch die Patientenwahrnehmung hinsichtlich intraläsionaler Injektionen von anti-CD20-Antikörpern zur Behandlung indolenter primär kutaner B-Zell-Lymphome im Vergleich mit anderen Therapien zu evaluieren. Elf Patienten mit einem primär kutanen B-Zell-Lymphom, namentlich primär kutanes Keimzentrumslymphom (n = 9) und primär kutanes Marginalzonenlymphom (n = 2), welche mittels intraläsionalem Anti-CD20-Antikörper behandelt wurden, wurden retrospektiv evaluiert hinsichtlich der Ansprechrate und unerwünschter Nebenwirkungen sowie in Bezug auf deren Selbsteinschätzung dieser und anderer Therapien des primär kutanen B-Zell-Lymphoms. Patienten, deren primär kutanes B-Zell-Lymphom mittels intraläsionaler Gabe von Anti-CD20-Antikörper behandelt wurde, zeigten ein komplettes oder partielles Ansprechen in 45 % beziehungsweise 27 % aller Patienten. Speziell Patienten mit grippeähnlichen Symptomen nach erfolgter Injektion zeigten ein gutes Ansprechen. Die Mehrheit der Patienten empfand die Therapie mit Rituximab als die beste Therapie im Vergleich zu anderen Therapien wie beispielsweise chirurgische Exzision oder Radiotherapie. Intraläsionales Rituximab ist eine effektive Therapie mit hoher Patientenzufriedenheit. Starke therapiebedingte Nebenwirkungen wie Fieber, Schüttelfrost und Kopfschmerzen nach Gabe von Rituximab könnten als Indikator für gute Wirksamkeit dienen. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  1. The transjugular portosystemic stent shunt (TIPSS) as an intervention in clinical complication of portal hypertension; Der transjugulaere portosystemische Stentshunt (TIPSS) als Intervention bei klinischen Komplikationen der portalen Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Thalhammer, A.; Jacobi, V.; Schwarz, W.; Balzer, J.; Abolmaali, N.; Vogl, T.J. [Frankfurt Univ. (Germany). Zentrum der Radiologie

    2001-10-01

    Most frequent complications in patients with liver cirrhosis are due to portal hypertension. Beside ascites circumvent vessles formate with vasodilatation. Due to counterregulation a secondary hyperaldosteronism develops with release of vasocontrictive agents. If conservative and endoscopic methods fail, indication for building a portosystemic shunt is given. The TIPSS procedure is less invasive than the surgical method of Warren-Shunt, so the radiological intervention has replaced surgery. Reducing the portal pressure by the shunt, the clinical complications change for the better. Still problems are defined as hepatic encephalopathy and right ventricular heart failure. Regular follow up investigations have to be performed to detect complications in the shunt. Using regular clinical and radiological check up TIPSS is of clinical benefit with good long term results. (orig.) [German] Die haeufigsten Komplikationen bei Patienten mit einer Leberzirrhose lassen sich auf das Vorliegen einer portalen Hypertension zurueckfuehren. Neben einer Aszitesbildung kommt es zur Vasodilatation mit Ausbildung portaler Umgehungskreislaeufe, gegenregulatorisch zu einem sekundaeren Hyperaldosteronismus und Ausschuettung vasokonstriktiver Substanzen. Sind mittels konservativer und endoskopischer Methoden die Komplikationen nicht mehr zu beherrschen, ist die Indikation zur Shuntanlage gegeben. Wegen der geringeren Invasivitaet einer TIPSS-Anlage gegenueber der operativen Methode eines Warren-Shunts hat sich die interventionell radiologische Methodik in den letzten Jahren immer mehr durchgesetzt. Durch den mittels Shuntanlage reduzierten Pfortaderdruck kommt es zu einer deutlichen klinischen Besserung der unterschiedlichen Komplikationen. Als klinisch problematische Symptome bei der Shuntanlage sind die hepatische Enzephalopathie und eine Zunahme der Rechtsherzbelastung zu werten. Um Komplikationen im Bereich des Shunts frueh zu erkennen, muss dieser engmaschig kontrolliert werden. Unter

  2. Grundwassermodellbildung – Hydrostratigraphische Bewertungen mittels GCI-PetroKf, Datenbank- und Geoinformationssystemen

    DEFF Research Database (Denmark)

    Koch, Alexander; Fuchs, Sven; Göbel, Patricia

    reimportiert und für die Verwendung in Geoinformationssystemen (i.e. ArcGIS) weiter aufbereitet. Über Interpolationsverfahren konnte innerhalb des Programmes ArcGIS ein lateraler Bezug zwischen den verschiedenen Mächtigkeiten hergestellt werden, um so auf weitere Inhomogenitäten im Aufbau des Grundwasserleiter......-Systems schließen zu können. Anschließend wurden mittels ArcGIS die Quartärbasis des Modellraums konstruiert, sowie Grundwasserisolinien- und Grundwasserdifferenzenkarten berechnet. Die Grundwasserdifferenzenkarten reproduzieren gut die Grundwasserabsenkungen im Bereich von lokalen Tagebauen. Insgesamt zeigen sich...... gute Übereinstimmungen mit früheren hydrogeologischen Untersuchungen im Projektgebiet. Die Kombination des PetroKf-Algorithmus mit der Aufbereitung in einer Datenbank, sowie der Weiterverarbeitung in ArcGIS, zeigt einen praktikablen Weg zur Entwicklung und Parametrisierung eines hydrogeologischen...

  3. Medizintechnik in der Tumororthopädie

    Science.gov (United States)

    Burgkart, Rainer; Gollwitzer, Hans; Holzapfel, Boris; Rudert, Maximilian; Rechl, Hans; Gradinger, Reiner

    Die Behandlung der Knochentumoren unterlag in den letzten 20 Jahren einem raschen und stetigen Wandel, was zum einen auf die verbesserten Therapieerfolge durch den Einsatz von neoadjuvanten Therapieformen zurückzuführen ist, und andererseits von medizintechnischen Entwicklungen bezüglich moderner Schnittbilddiagnostik, neuer 3D Operationsplanungsverfahren wie das Rapid Prototyping und adaptiv modularer Tumorendoprothesensystemen u. a. begleitet wurde. Gerade die technischen Entwicklungen haben dazu geführt, daß im Bereich der Extremitäten und der Wirbelsäule radikalere Eingriffe durchgeführt werden können, was die lokale Tumorkontrolle wesentlich verbessert hat. In zunehmenden Maße werden deshalb nicht nur Kurzzeiterfolge sondern auch mittel- und langfristige Fortschritte bei der Behandlung der malignen Knochentumoren einschließlich der Metastasenbehandlung erreicht. Grundlage der Therapie ist dabei immer primär die Sicherung der Diagnose mittels Biopsie und die bildgebende sowie histologische Stadieneinteilung des malignen Tumors. Nach der Tumorresektion kann die Rekonstruktion biologisch oder mit Endoprothesensystemen erfolgen. Gerade die weiterentwickelten modularen Systeme führen zu guten funktionellen Ergebnissen mit langen Standzeiten und einer reduzierten Komplikationsrate. Individuell angefertigte Implantate sind vor allem im Bereich der Rekonstruktion komplexer Beckentumoren von großer klinischer Bedeutung.

  4. Lung cancer screening with thoracic X-ray and CT. Current situation; Lungenkarzinomscreening mit Roentgenthorax oder CT. Aktuelle Datenlage

    Energy Technology Data Exchange (ETDEWEB)

    Stackelberg, O. von; Kauczor, H.U. [Universitaetsklinikum Heidelberg, Diagnostische und Interventionelle Radiologe, Heidelberg (Germany); Translationales Lungen Forschungszentrum Heidelberg (TLRC), Mitglied des Deutschen Zentrums fuer Lungenforschung (DZL), Heidelberg (Germany)

    2016-09-15

    Attempts at the early detection of lung cancer using imaging methods began as far back as the 1950s. Several studies attempted to demonstrate a reduction of lung cancer mortality by chest radiography screening but all were unsuccessful. Even the first small screening studies using computed tomography (CT) could not demonstrate a reduction in lung cancer-specific mortality until in 2011 the results of the largest randomized controlled low-dose CT screening study in the USA (NLST) were published. The NLST results could show a significant 20 % reduction of lung cancer mortality in elderly and heavy smokers using CT. Confirmation of the NLST results are urgently needed so that the data of the largest European study (NELSON) are eagerly awaited. Pooled with the data from several smaller European studies these results will provide important information and evidence for the establishment of future CT screening programs in Europe. Randomized controlled trials are the basis of evidence-based medicine; therefore, the positive results of the methodologically very good NLST study cannot be ignored, even if it is the only such study completed so far with highly convincing conclusions. The NLST results clearly demonstrate that positive effects for the health of the population can only be expected if the processes are clearly defined and the quality is assured. (orig.) [German] Bestrebungen zur Frueherkennung von Lungenkrebs mit bildgebenden Methoden gibt es schon lange. Alle Studien, die eine Reduktion der Lungenkrebsmortalitaet mittels Roentgenthoraxscreening nachzuweisen versuchten, scheiterten. Auch die ersten kleineren Screeningstudien mit der CT konnten keine Reduktion der Lungenkrebssterblichkeit nachweisen, bis 2011 die Ergebnisse der bisher groessten randomisierten kontrollierten Niedrigdosis-CT-Screeningstudie (NLST) aus den USA veroeffentlicht wurden. Diese konnten eine signifikante 20 %ige Reduktion der Lungenkrebssterblichkeit bei Personen, die aelter und starke

  5. Clinical aspects of acute inflammatory diseases of the brain; Klinisch-neurologische Aspekte akut-entzuendlicher Hirnerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Block, F.; Nolden-Koch, M. [RWTH Aachen (Germany). Neurologische Klinik

    2000-11-01

    Despite the progress, which has been made in diagnosis and therapy of encephalitis and bacterial meningitis, these acute inflammatory diseases of the brain still display a certain amount of morbidity and mortality. History, physical examination, analysis of serum and cerebrospinal fluid and radiological examination are the mainstay for the diagnosis of these diseases. With respect to the acute inflammatory diseases of the brain computed tomography and magnetic resonance imaging fulfil three purposes: 1. They can be used to clarify the diagnosis and to rule out other diseases. 2. They can identify the focus from which a bacterial meningitis can evolve. 3. Complications like edema, cerebral vasculitis, septic sinus thrombosis, hydrocephalus or abscess can be visualized. If the diagnosis is made early, the possible complications are recognized in good time and the appropriate therapy is started immediately, then morbidity and mortality can be kept at a minimum. (orig.) [German] Die bakterielle Meningitis und die Enzephalitis sind akut-entzuendliche Hirnerkrankungen, die trotz aller Fortschritte in der Diagnostik und Therapie mit einer nicht unerheblichen Morbiditaet und Mortalitaet behaftet sind. Die Anamnese, die koerperliche Untersuchung, die laborchemische Diagnostik von Blut und Liquor und die Bildgebung sind die wesentlichen Saeulen in der Diagnostik akut-entzuendlicher Hirnerkrankungen. Die Bildgebung, die mittels Computertomographie bzw. Kernspintomographie erfolgt, hat in diesem Zusammenhang 3 Aufgaben: 1. Sie kann dazu beitragen, die Diagnose zu sichern bzw. differentialdiagnostisch in Erwaegung zu ziehende Erkrankungen auszuschliessen oder nachzuweisen. 2. Sie kann bei der bakteriellen Meningitis entzuendliche Foci im Bereich der Nasennebenhoehlen, des Mastoids oder des Mittelohrs erkennen, die sofort operativ saniert werden muessen. 3. Komplikationen akut-entzuendlicher Hirnerkrankungen koennen bei entsprechendem klinischem Verdacht mittels Bildgebung

  6. Cerebral activation studies by PET and fMRT, clinical relevance?; Zerebrale Aktivierungsstudien mit PET und fMRT, klinische Relevanz?

    Energy Technology Data Exchange (ETDEWEB)

    Brandt, T. [Neurologische Klinik und Poliklinik, Klinikum Grosshadern, Muenchen Univ. (Germany)

    1997-03-01

    Cerebral activation studies by PET and fMRT will gain increasing clinical relevance for functional neuroanatomy (reading, speaking), localisation of largely unknown cortical functions (vestibular cortex), imaging of subjective complaints of functional impairments (pain, smell, memory), and documentation of neurological rehabilitation at neuronal level (regeneration, compensation, substitution, learning). (orig.) [Deutsch] Zerebrale Aktivierungsstudien mit PET und fMRT erlangen zunehmend klinische Bedeutung fuer die funktionelle Neuroanatomie einzelner und komplexer Hirnleistungen (Lesen, Sprechen), die Lokalisation bislang unzureichend erforschter Hirnfunktionen (vestibulaerer Kortex), die Objektivierung subjektiver Beschwerden und Funktionsausfaelle (Schmerz, Riechen, Gedaechtnis) und die Dokumentation neurologischer Rehabilitation auf neuronaler Ebene (Regeneration, Kompensation, Substitution, Lernen). (orig.)

  7. Cortical blindness after intoxication with heroin; Kortikale Blindheit nach Heroinintoxikation

    Energy Technology Data Exchange (ETDEWEB)

    Braendli, M. [Institut fuer Diagnostische Radiologie, Universitaetskliniken, Kantonspital Basel (Switzerland); Otte, A.; Mueller-Brand, J. [Institut fuer Nuklearmedizin, Universitaetskliniken, Kantonspital Basel (Switzerland)

    2000-07-01

    For the case reported, both morphological and functional diagnostic examination methods were applied, such as MRI and CT, or SPECT using ECD as a tracer. The bilateral, occipital lesion finally could be detected with the SPECT examinations, and SPECT findings were clearly better than MRI findings, whereas even restrospective analysis of the CT images failed to show the lesion. Thus the functional imaging method in this case of a discrete bilateral occipital lesion was the most sentitive method. (orig./CB) [German] In unserem Fallbeispiel wurden sowohl morphologische (MRT, CT) als auch funktionelle Bildgebung (SPECT unter Verwendung von ECD als Tracer) ad extensum zur Diagnosefindung verwendet. Die bilaterale okzipitale Defektbildung konnte schliesslich mittels SPECT-Untersuchung deutlich besser dargestellt werden als mittels MRT. In der CT gelangte der Befund - auch bei retrospektiver Betrachtung - ueberhaupt nicht zur Darstellung. Damit war die funktionelle Bildgebung im Falle dieser diskreten bilateralen okzipitalen Defektbildung die sensitivste Methode. (orig.)

  8. Fetal magnetic resonance imaging of thoracic and abdominal malformations; Fetale Magnetresonanztomographie thorakaler und abdomineller Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Woitek, R.; Asenbaum, U.; Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Brugger, P.C. [Medizinische Universitaet Wien, Zentrum fuer Anatomie und Zellbiologie, Wien (Austria)

    2013-02-15

    Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.) [German] Diagnose und Differenzialdiagnose fetaler thorakaler und abdomineller Malformationen. Ultraschall, MRT. MRT zur weiteren Abklaerung und genaueren Differenzierung bei vielen im Ultraschall gestellten Verdachtsdiagnosen. Verbesserte anatomische Darstellung mittels MRT und Darstellung unterschiedlicher Gewebezusammensetzung mittels verschiedener MR-Sequenzen. Die fetale MRT ist bei der angegebenen Fragestellung in die klinische Routine eingegangen und liefert weiterhin die Basis fuer wissenschaftliche Untersuchungen in diesem Bereich. Die fetale MRT liefert beim Vorliegen thorakaler oder abdomineller Malformationen komplementaer zum Ultraschall wichtige Zusatzinformationen, um die diagnostische Genauigkeit zu erhoehen, die Prognoseabschaetzung zu verbessern und ggf. eine bessere chirurgische Planung zu ermoeglichen. (orig.)

  9. PET-CT for nuclear medicine diagnostics of multiple myeloma; PET-CT in der nuklearmedizinischen Diagnostik des multiplen Myeloms

    Energy Technology Data Exchange (ETDEWEB)

    Dimitrakopoulou-Strauss, A. [Deutsches Krebsforschungszentrum (DKFZ), Klinische Kooperationseinheit Nuklearmedizin, Heidelberg (Germany)

    2014-06-15

    Functional or morphofunctional imaging modalities are used in myeloma patients for the diagnosis and therapy management within research protocols. Despite new staging criteria, which take into account the viability of a myeloma lesion, positron emission tomography (PET) is not used routinely. The impact of PET is therefore open. The role of PET and PET computed tomography (PET-CT) for the diagnosis and therapy management is discussed. The use of PET with 18F-fluorodeoxyglucose (FDG) allows the measurement of viable myeloma lesions and correlates with the stage of disease. A negative FDG examination correlates with a better prognosis. Furthermore, the number of focal lesions as well as the whole functional volume of myeloma lesions in FDG have a prognostic impact. Several studies have demonstrated the impact of FDG for the assessment of therapy monitoring and show that FDG is an earlier indicator for therapy response as compared to magnetic resonance imaging (MRI). The CT component of the new hybrid systems allows the assessment of osteolytic lesions in CT and their viability in FDG. The combination of PET with an MRT scanner allows the simultaneous measurement of bone marrow infiltration, focal lesions and their viability. The use of modern hybrid scanners, such as PET-CT and PET-MRT facilitates the simultaneous measurement of viable myeloma lesions, osteolytic lesions and bone marrow infiltration in the whole body; therefore, it is expected that these imaging modalities will play a greater role both in diagnosis and therapy management. (orig.) [German] Funktionelle oder morphologisch-funktionelle bildgebende Verfahren werden in der Diagnostik und im Therapiemanagement des multiplen Myeloms (MM) primaer fuer wissenschaftliche Zwecke eingesetzt. Ein routinemaessiger klinischer Einsatz ist trotz neuer Stadieneinteilung nicht erfolgt. Die Wertigkeit der Positronenemissionstomographie (PET) ist noch offen. Die Rolle von PET und PET-CT fuer die Diagnostik und das

  10. [COPD und Klangtherapie: Pilotstudie zur Wirksamkeit einer Behandlung mit Körpertambura bei COPD-Patienten].

    Science.gov (United States)

    Hartwig, Bernhard; Schmidt, Stefan; Hartwig, Isabella

    2016-01-01

    Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD; GOLD-Stadium A oder B) erbringen kann. Patienten und Methoden: 54 Probanden konnten je zur Hälfte in eine Behandlungsgruppe (Körpertambura) und eine aktive Kontrollgruppe (Atemtherapie) randomisiert werden. Eine Bestimmung der Lungenfunktionsmessparameter «Einsekundenkapazität» (FEV1) und «inspiratorische Vitalkapazität» (IVC) zu den Zeitpunkten T1 (Baseline), T2 (direkt nach Behandlung) und als Follow-up etwa 3 Wochen nach T1 (T3). Ergebnisse: Die Behandlungsgruppe zeigte sich der Kontrollgruppe in beiden Werten signifikant überlegen. Die Zeit-×-Gruppe-Interaktion (Varianzanalyse) ergab p = 0,001 (FEV1) bzw. p = 0,04 (IVC). Die Behandlungsgruppe zeigte bei beiden Werten eine Verbesserung von klinischer Relevanz. Schlussfolgerung: Diese Ergebnisse zeigen, dass die Klangbehandlung mittels einer Körpertambura - neben den schulmedizinischen, leitliniengerechten Therapien - eine zusätzliche, nebenwirkungsarme, aber durchaus klinisch wirksame Option für die Behandlung von COPD-Patienten darstellen kann, um deren Lebensqualität zu stabilisieren und zu verbessern. © 2016 S. Karger GmbH, Freiburg.

  11. Nagelbefall kann bei Patienten mit Psoriasis auf eine Enthesiopathie hinweisen.

    Science.gov (United States)

    Castellanos-González, Maria; Joven, Beatriz Esther; Sánchez, Julio; Andrés-Esteban, Eva María; Vanaclocha-Sebastián, Francisco; Romero, Pablo Ortiz; Díaz, Raquel Rivera

    2016-11-01

    Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren. Es wurde eine monozentrische prospektive Studie mit insgesamt 90 Psoriasis-Patienten durchgeführt, um mittels Ultraschall das Vorliegen von Enthesenanomalien zu untersuchen und eine Korrelation mit dem Befall der Nägel festzustellen. Enthesenanomalien wurden bei 23 Patienten (25,5 %) gefunden, von denen 19 (82,6 %) Nagelbefall aufwiesen. Bei 4 Patienten waren die Nägel nicht betroffen. Enthesiopathie lag bei 31,1 % (19/61) der Patienten mit Onychopathie vor, von den Patienten ohne Nagelbefall litten nur 13,8 % (4/29) an Enthesiopathie (p = 0,07). Zwischen dem Target-NAPSI-Score und dem Vorliegen einer Enthesiopathie bestand eine signifikante Korrelation. Eine signifikante Korrelation bestand darüber hinaus auch zwischen dem Vorliegen einer Enthesiopathie und der Anzahl der betroffenen Nägel (p = 0,035). Klinische Belege für eine Onychopathie können der Schlüssel für die frühe Diagnose einer Enthesiopathie bei Psoriasis-Patienten sein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  12. Clinical application of functional MRI for chronic epilepsy; Klinischer Einsatz der funktionellen MRT bei chronischer Epilepsie

    Energy Technology Data Exchange (ETDEWEB)

    Woermann, F.G.; Labudda, K. [Krankenhaus Mara, Epilepsiezentrum Bethel, Abteilung fuer Magentresonanztomographie, Bielefeld (Germany)

    2010-02-15

    Functional magnetic resonance imaging (fMRI) is frequently used in the presurgical diagnostic procedure of epilepsy patients, in particular for lateralization of speech and memory and for localization of the primary motor cortex to delineate the epileptogenic lesion from eloquent brain areas. fMRI is one of the non-invasive procedures in the presurgical diagnostic process, together with medical history, seizure semiology, neurological examination, interictal and ictal EEG, structural MRI, video EEG monitoring and neuropsychology. This diagnostic sequence leads either to the decision for or against elective epilepsy surgery or to the decision to proceed with invasive diagnostic techniques (Wada test, intra-operative or extra-operative cortical stimulation). It is difficult to evaluate the contribution of the fMRI test in isolation to the validity of the entire diagnostic sequence. Complications such as memory loss and aphasia in temporal lobe resections or paresis after frontal lobe resections are rare and rarely of disastrous extent. This further complicates the evaluation of the clinical relevance of fMRI as a predictive tool. In this article studies which investigated the concordance between fMRI and other diagnostic gold standards will be presented as well as the association between presurgical fMRI and postsurgical morbidity. (orig.) [German] Die funktionelle Magnetresonanztomographie (fMRT) wird im Rahmen der Epilepsiediagnostik vor epilepsiechirurgischen Eingriffen insbesondere zur Lateralisation von Sprache und Gedaechtnis und zur Lokalisation der Zentralregion eingesetzt, um den eloquenten Kortex von der epilepsieverursachenden, chirurgisch zugaenglichen Laesion abzugrenzen. Dabei ist die fMRT Teil einer Sequenz nichtinvasiver klinischer Tests (Anamnese, Anfall-Semiologie, neurologischer Status, interiktales und iktales EEG, strukturelles MRT, Video-EEG-Monitoring, Neuropsychologie). Das Ergebnis dieser Sequenz ist die Entscheidung fuer oder gegen einen

  13. Synthese von analogen Filtern auf einer rekonfigurierbaren Hardware-Architektur mittels eines Genetischen Algorithmus

    Directory of Open Access Journals (Sweden)

    S. Trendelenburg

    2008-05-01

    Full Text Available Rekonfigurierbare Analog-Arrays (FPAAs sind der Versuch, die Vorteile der aus der digitalen Welt bekannten FPGAs (Flexibilität, Entwurfsgeschwindigkeit auch für analoge Anwendungen verfügbar zu machen. Aufgrund der Vielfalt der analogen Schaltungstechnik ist die Abbildung von vorgegebenen Schaltungskonzepten auf eine FPAA-Architektur nicht immer einfach lösbar.

    Diese Arbeit stellt einen neuen Ansatz für die Synthese von Filtern auf einer FPAA-Architektur für zeitkontinuierliche Analogfilter mittels eines Genetischen Algorithmus (GA vor. Anhand eines Matlab-Modells des FPAA, das eine gute übereinstimmung mit Simulationen des FPAA auf Transistorebene aufweist, wurde gezeigt, dass eine große Vielzahl verschiedener Filterstrukturen auf dieser Architektur dargestellt werden kann. Daraufhin wurde ein Genetischer Algorithmus entwickelt, der es erlaubt, aus einer gegebenen Filterspezifikation Konfigurationsdatensätze zu synthetisieren, die den gewünschten Filter auf die FPAA-Architektur abbilden.

  14. Altheim geothermal plant. Power generation by means of an ORC turbogenerator; Geothermieanlagen Altheim. Stromerzeugung mittels Organic-Rankine-Cycle Turbogenerator

    Energy Technology Data Exchange (ETDEWEB)

    Pernecker, G [Marktgemeindeamt Altheim (Austria)

    1997-12-01

    The report describes the project of the Austrian market town of Altheim to generate electricity by means of an ORC turbogenerator using low-temperature thermal water. The project is to improve the technical and economic situation of the existing industrial-scale geothermal project. (orig.) [Deutsch] Der Bericht beschreibt das Vorhaben der Marktgemeinde Altheim in Oberoesterreich, Strom mittels eines Organic-Rankine-Cycle-Turbogenerators unter Verwendung niedrig temperierten Thermalwassers zu produzieren. Ziel bzw. der Zweck des Projektes ist es, die technische und wirtschaftliche Situation der bestehenden Grossthermieanlage zu verbessern. (orig.)

  15. Adaptive fractionated stereotactic Gamma Knife radiotherapy of meningioma using integrated stereotactic cone-beam-CT and adaptive re-planning (a-gkFSRT)

    Energy Technology Data Exchange (ETDEWEB)

    Stieler, F.; Wenz, F.; Abo-Madyan, Y.; Schweizer, B.; Polednik, M.; Herskind, C.; Giordano, F.A.; Mai, S. [University of Heidelberg, Department of Radiation Oncology, University Medical Center Mannheim, Mannheim (Germany)

    2016-11-15

    The Gamma Knife Icon (Elekta AB, Stockholm, Sweden) allows frameless stereotactic treatment using a combination of cone beam computer tomography (CBCT), a thermoplastic mask system, and an infrared-based high-definition motion management (HDMM) camera system for patient tracking during treatment. We report on the first patient with meningioma at the left petrous bone treated with adaptive fractionated stereotactic radiotherapy (a-gkFSRT). The first patient treated with Gamma Knife Icon at our institute received MR imaging for preplanning before treatment. For each treatment fraction, a daily CBCT was performed to verify the actual scull/tumor position. The system automatically adapted the planned shot positions to the daily position and recalculated the dose distribution (online adaptive planning). During treatment, the HDMM system recorded the intrafractional patient motion. Furthermore, the required times were recorded to define a clinical treatment slot. Total treatment time was around 20 min. Patient positioning needed 0.8 min, CBCT positioning plus acquisition 1.65 min, CT data processing and adaptive planning 2.66 min, and treatment 15.6 min. The differences for the five daily CBCTs compared to the reference are for rotation: -0.59 ± 0.49 /0.18 ± 0.20 /0.05 ± 0.36 and for translation: 0.94 ± 0.52 mm/-0.08 ± 0.08 mm/-1.13 ± 0.89 mm. Over all fractions, an intrafractional movement of 0.13 ± 0.04 mm was observed. The Gamma Knife Icon allows combining the accuracy of the stereotactic Gamma Knife system with the flexibility of fractionated treatment with the mask system and CBCT. Furthermore, the Icon system introduces a new online patient tracking system to the clinical routine. The interfractional accuracy of patient positioning was controlled with a thermoplastic mask and CBCT. (orig.) [German] Das Gamma Knife Icon (Elekta AB, Stockholm, Schweden) ermoeglicht die stereotaktische Behandlung von Patienten mittels Cone-beam-Computertomographie (CBCT

  16. Framework for radiation pneumonitis risk stratification based on anatomic and perfused lung dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Dhami, Gurleen; Zeng, Jing; Patel, Shilpen A.; Rengan, Ramesh [University of Washington School of Medicine, Department of Radiation Oncology, Seattle, WA (United States); Vesselle, Hubert J.; Kinahan, Paul E.; Miyaoka, Robert S. [University of Washington School of Medicine, Department of Radiology, Seattle, WA (United States); Bowen, Stephen R. [University of Washington School of Medicine, Department of Radiation Oncology, Seattle, WA (United States); University of Washington School of Medicine, Department of Radiology, Seattle, WA (United States)

    2017-05-15

    Vorbehandlung. CT-Scans zur Bestrahlungsplanung wurden zusammen mit in der Vorbehandlung durchgefuehrten [{sup 99m}Tc]MAA-SPECT/CT-Perfusionsscans von 20 Patienten mit definitiver Thorax-Bestrahlung aufgezeichnet. Klinische Strahlenpneumonitis wurde als Grad ≥ 2 definiert (CTCAEv4-Gradierung). Anatomische Lungendosis-Volumen-Parameter wurden mittels Behandlungsplanungsscans erhoben und perfundierte Dosis-Volumen-Parameter mittels SPECT/CT-Scans waehrend der Vorbehandlung berechnet. Gleichwertige Dosen von 2 Gy/Fraktion wurden in der Lunge berechnet, um abweichende Behandlungsregime und raeumliche Schwankungen der lungengaengigen Dosis (EQD2{sub lung}) auszugleichen. Anatomische (MLD) und funktionale Parameter der Lungendosis (pMLD{sub 70%}) wurden als Praediktoren einer Strahlenpneumonitis vom Grad ≥ 2 (AUC > 0,93; p < 0,01) bestimmt. Gepaarte anatomische und funktionale dosimetrische Parameter (z. B. MLD und pMLD{sub 70%}) koennten die Vorhersagegenauigkeit weiter erhoehen. Nicht alle Patienten mit hoher anatomischer Lungendosis (MLD > 13,6 GyEQD2{sub lung}; 19,3 Gy bei Patienten mit 60 Gy in 30 Fraktionen) entwickelten eine Strahlenpneumonitis, jedoch alle, die zur perfundierten Lunge zudem eine hohe mittlere Dosis aufwiesen (pMLD{sub 70%} > 13,3 GyEQD2). Die vorlaeufige Anwendung des Rahmenwerks ergab bei dem begrenzten Patientenkollektiv Unterschiede zwischen anatomischer und perfundierter Lungendosimetrie. Zusaetzliche Parameter der perfundierten Lunge koennten bei der Risikostratifizierung von Patienten bezueglich einer Strahlenpneumonitis helfen, insbesondere bei Behandlungsplaenen mit hoher anatomischer Lungendosis. Weitere Untersuchungen sind noetig. (orig.)

  17. Genetische Veränderungen an primären Prostatakarzinom-Biopsien in Korrelation zum klinischen Verlauf

    Directory of Open Access Journals (Sweden)

    Steiner T

    2002-01-01

    Full Text Available Die der Entstehung des Prostatakarzinoms zugrundeliegenden bzw. mit einem Progreß vergesellschafteten genetischen Veränderungen sind noch weitgehend unbekannt. Ziel der vorliegenden retrospektiven Untersuchung war die Erfassung genetischer Aberrationen an paraffineigebettetem Material primärer Prostatakarzinom-Biopsien und die Korrelation der Daten zum klinischen Verlauf. In 28 karzinomtragenden primären Prostatabiopsien wurden die Tumorareale gekennzeichnet. Nach Dissektion der Tumorzellen wurden die Proben mittels "comparative genomic hybridization" (CGH analysiert. Daten zum klinischen Verlauf der Patienten wurden erfaßt. Die mittlere Nachbeobachtungszeit betrug 36 Monate, alle Patienten wurden hormonablativ behandelt. 11 Patienten (39 % wiesen unter laufender Therapie einen Tumorprogreß auf. In 25 (88 % der 28 untersuchten Tumorareale konnten genetische Aberrationen detektiert werden, im Mittel fanden wir 4,8 Aberrationen je Tumor. Das Verhältnis Verlust / Zugewinn betrug 1,3 / 1. Folgende chromosomale Veränderungen wurden häufig festgestellt: Verluste von 6q in 40 %; von 8p in 32 %; von 16q in 21 %; von 18q in 21 %; Zugewinne von 8q in 32 %; von 17 in 43 %. In Korrelation zum klinischen Verlauf fand sich ein Zugewinn von 8q signifikant häufiger bei Patienten, welche im Beobachtungszeitraum einen Tumorprogreß entwickelten (64 % vs. 12 %; p = 0,0001. In der primären Tumorbiopsie waren bei progredienten Patienten im Mittel 5,3, bei Patienten ohne Tumorprogreß 3,8 Aberrationen je Tumor nachzuweisen. Unsere Ergebnisse zeigen, daß Veränderungen der Chromosomen 6q, 8, 16q, 17 und 18q regelmäßig beim Prostatakarzinom auftreten. Karzinome mit klinisch ungünstigem Verlauf weisen bereits in der primären Biopsie eine hohe genetische Instabilität auf.

  18. Ultrasound-guided image fusion with computed tomography and magnetic resonance imaging. Clinical utility for imaging and interventional diagnostics of hepatic lesions; Ultraschallgestuetzte Bildfusion mittels CT und MRT. Klinische Bedeutung fuer die bildgebende und interventionelle Diagnostik von Leberlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Clevert, D.A.; Helck, A.; Paprottka, P.M.; Trumm, C.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Zengel, P. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Klinik fuer Hals-, Nasen- und Ohrenheilkunde, Muenchen (Germany)

    2012-01-15

    Abdominal ultrasound is often the first-line imaging modality for assessing focal liver lesions. Due to various new ultrasound techniques, such as image fusion, global positioning system (GPS) tracking and needle tracking guided biopsy, abdominal ultrasound now has great potential regarding detection, characterization and treatment of focal liver lesions. Furthermore, these new techniques will help to improve the clinical management of patients before and during interventional procedures. This article presents the principle and clinical impact of recently developed techniques in the field of ultrasound, e.g. image fusion, GPS tracking and needle tracking guided biopsy and discusses the results based on a feasibility study on 20 patients with focal hepatic lesions. (orig.) [German] Bei der Bildfusion von Ultraschall mit anderen schnittbildgebenden Verfahren (CT, MRT) handelt es sich um ein relativ neuartiges Verfahren, welches unter Studienbedingungen jedoch bereits erfolgreich eingesetzt wurde. In der folgenden Machbarkeitsstudie soll der Nutzen weiterfuehrender Anwendungen der sonographischen Bildfusion, dem so genannten Global-Positioning-System- (GPS-) und Needle-Tracking, untersucht werden. Dabei handelt es sich um Instrumente, die insbesondere die Diagnostik und das Staging (GPS-Tracking) bzw. die bioptische Abklaerung (Needle-Tracking) von Patienten mit fokalen Leberlaesionen erleichtern. In diesem Artikel werden das Prinzip und die Anwendungsmoeglichkeiten dieser neuen Techniken anhand konkreter Beispiele in einem Kollektiv von 20 Patienten mit fokalen Leberlaesionen vorgestellt und erlaeutert. (orig.)

  19. Five years of proton therapy of tumours of the eye at Hahn-Meitner Institute, Berlin; Fuenf Jahre Protonentherapie von Augentumoren am Hahn-Meitner-Institut Berlin

    Energy Technology Data Exchange (ETDEWEB)

    Heufelder, J.; Cordini, D.; Heese, J.; Homeyer, H.; Kluge, H.; Morgenstern, H. [Hahn-Meitner-Inst. Berlin, Augentumortherapie (Germany); Fuchs, H. [Hahn-Meitner-Inst. Berlin, Augentumortherapie (Germany); Augenklinik, Charite - Universitaetsmedizin Berlin, Campus Benjamin Franklin (Germany); Hoecht, S.; Nausner, M.; Hinkelbein, W. [Klinik fuer Radioonkologie und Strahlentherapie, Charite - Universitaetsmedizin Berlin, Campus Benjamin Franklin (Germany); Bechrakis, N.E.; Foerster, M.H. [Augenklinik, Charite - Universitaetsmedizin Berlin, Campus Benjamin Franklin (Germany)

    2004-07-01

    Eye tumors (choroidal melanomas, iris melanomas, and choroidal hemangiomas) are being treated with 68 MeV protons since 1998 at the Ion Beam Laboratory of the Hahn-Meitner Institute of Berlin (Germany's first proton therapy center), in cooperation with the Charite University Hospital in Berlin, Campus Benjamin Franklin. The proton beam, generated via a combination of Van de Graaff accelerator and cyclotron, is prepared by passive shaping for conformal tumor irradiation. A digital X-ray verification of the tumor location with the patient in sitting position limits the position uncertainties to a maximum of 0,3 mm. The treatment planning is performed using the program EYEPLAN. OCTOPUS, a CT-based planning program developed in cooperation with the German Cancer Research Center of Heidelberg, is under pre-clinical testing. Thus far, more than 400 patients have been irradiated. The first results are comparable to those obtained in other proton therapy centers. At the end of 2002, the University Hospital of Essen has also become a cooperation partner of the Hahn-Meitner Institute. (orig.) [German] Seit 1998 werden am Ionenstrahllabor des Hahn-Meitner-Instituts Berlin (Deutschlands erster Einrichtung zur Protonentherapie) im Rahmen eines Kooperationsvertrages mit der Charite - Universitaetsmedizin Berlin, Campus Benjamin Franklin, Augentumoren (Aderhautmelanome, Irismelanome und Aderhauthaemangiome) mit 68-MeV-Protonen bestrahlt. Der mittels einer Kombination aus Van de Graaff-Beschleuniger und Zyklotron erzeugte Protonenstrahl wird passiv fuer eine konformale Bestrahlung des Tumors aufbereitet. Eine digitale Roentgenkontrolle der Lagerung des sitzenden Patienten beschraenkt die Lagerungsunsicherheit auf maximal 0,3 mm. Fuer die Bestrahlungsplanung wird das modellbasierte Planungsprogramm EYEPLAN verwendet. In vorklinischer Erprobung befindet sich das mit dem Deutschen Krebsforschungszentrum Heidelberg entwickelte CT-basierte Planungsprogramm OCTOPUS. Bisher wurden

  20. Diagnostic imaging of compression neuropathy; Bildgebende Diagnostik von Nervenkompressionssyndromen

    Energy Technology Data Exchange (ETDEWEB)

    Weishaupt, D.; Andreisek, G. [Universitaetsspital, Institut fuer Diagnostische Radiologie, Zuerich (Switzerland)

    2007-03-15

    Compression-induced neuropathy of peripheral nerves can cause severe pain of the foot and ankle. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although clinical examination combined with electrophysiological studies remain the cornerstone of the diagnostic work-up, in certain cases, imaging may provide key information with regard to the exact anatomic location of the lesion or aid in narrowing the differential diagnosis. In other patients with peripheral neuropathies of the foot and ankle, imaging may establish the etiology of the condition and provide information crucial for management and/or surgical planning. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. Bony abnormalities contributing to nerve compression are best assessed by radiographs and CT. Knowledge of the anatomy, the etiology, typical clinical findings, and imaging features of peripheral neuropathies affecting the peripheral nerves of the foot and ankle will allow for a more confident diagnosis. (orig.) [German] Kompressionsbedingte Schaedigungen peripherer Nerven koennen die Ursache hartnaeckiger Schmerzen im Bereich des Sprunggelenks und Fusses sein. Eine fruehzeitige Diagnose ist entscheidend, um den Patienten der richtigen Therapie zuzufuehren und potenzielle Schaedigungen zu vermeiden oder zu verringern. Obschon die klinische Untersuchung und die elektrophysiologische Abklaerungen die wichtigsten Elemente der Diagnostik peripherer Nervenkompressionssyndrome sind, kann die Bildgebung entscheidend sein, wenn es darum geht, die Hoehe des Nervenschadens festzulegen oder die Differenzialdiagnose einzugrenzen. In gewissen Faellen kann durch Bildgebung sogar die Ursache der Nervenkompression gefunden werden. In anderen Faellen ist die Bildgebung wichtig bei der Therapieplanung, insbesondere dann, wenn die Laesion chirurgisch angegangen wird. Magnetresonanztomographie (MRT) und Sonographie ermoeglichen eine

  1. Percutaneous CT-guided treatment of osteoidosteomas: combination of drill biopsy and subsequent ethanol injection; Perkutane CT-gesteuerte Behandlung von Osteoidosteomen: kombiniertes Vorgehen mit einem Hohlbohrer und nachfolgender Aethanolinjektion

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Keulers, P. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Vorwerk, D. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Heller, K.D. [Orthopaedische Klinik, RWTH Aachen (Germany); Fuezesi, L. [Inst. fuer Pathologie, RWTH Aachen (Germany); Guenther, R.W. [Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany)

    1995-03-01

    The purpose of this study was the clinical evaluation of a percutaneous treatment modality in patients with an osteoidosteoma. 6 patients with an osteoidosteoma of the upper (n=1) and lower (n=5) extremity which were confirmed on plain film radiographs and computed tomography underwent CT controlled drill biopsy of the nidus with subsequent injection of 96% ethanol into the biopsy channel to sclerose probably remaining remnants of the nidus. The procedure was started under local anaesthesia, but drilling of the nidus was carried out under a short general anaesthesia using ketamine. The intervention was successful in all patients. No postinterventional infection occurred and no recurrence was observed in any of the patients in a follow-up time between 0.5 and 2 years. (orig./MG) [Deutsch] Zielsetzung der Untersuchungen war die klinische Erprobung eines perkutanen Verfahrens zur Behandlung von Osteoidosteomen. Bei 6 Patienten mit einem nativradiologisch und computertomographisch nachgewiesenen Osteoidosteom im Bereich der oberen (n=1) und der unteren Extremitaet (n=5) wurde perkutan unter CT-Kontrolle der Nidus ausgebohrt und ueber den Bohrkanal 96%iger Alkohol nachinjiziert, um etwaige Nidusreste zu sklerosieren. Der Eingriff wurde in Lokalanaesthesie begonnen, die Ausbohrung des Nidus unter einer Ketanestkurznarkose durchgefuehrt. Das Vorgehen war bei allen Patienten erfolgreich. In keinem Fall wurde eine postinterventionelle Infektion beobachtet. Ueber den Nachbeobachtungszeitraum von 0,5 bis zu 2,5 Jahren trat bei keinem der Patienten ein Rezidiv auf. (orig./MG)

  2. Malformations and abnormalities of the petrous portion of the temporal bone; Fehlbildungen und Missbildungen des Felsenbeins

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Heumueller, I. [Westpfalzklinikum Kaiserslautern, Institut fuer Radiologie, Kaiserslautern (Germany)

    2014-04-15

    High-resolution computed tomography (HRCT) is the procedure of choice in the diagnostics of abnormalities of the middle and inner ear. It allows a detailed presentation of anatomical features and achieves the prerequisites for selection of the various therapeutic options. The highly diverse abnormalities can be described using detailed imaging analyses. Malformations with an abnormally developed modiolus are assumed to be early embryological defects, such as the classical Mondini dysplasia. The essential therapeutic option for middle ear deformities is still a cochlear implant. The domain of magnetic resonance imaging (MRI) is not only in the analysis of the cochlear nerve and for exclusion of fibrosis or ossification of the labyrinth but is also able to visualize details of isolated malformations, such as an extended vestibular aqueduct or subtle alterations to the vestibule or can visualize them better in comparison to CT. Radiological diagnostics are used not only for classification but also to recognize typical clinical problem situations and play a key role in the diagnostics of hearing disorders and selection of the optimal therapeutic procedure. (orig.) [German] Die hochaufloesende CT ist das Verfahren der Wahl in der Diagnostik von Fehlbildungen des Mittel- und Innenohrs. Sie erlaubt die detaillierte Darstellung anatomischer Details und schafft die Voraussetzung fuer die unterschiedlichen Therapieoptionen. Durch detaillierte bildgebenden Analysen koennen die unterschiedlichsten Fehlbildungen beschrieben werden. Fehlbildungen mit einem nicht normal ausgebildeten Modiolus werden als fruehere embryologische Schaedigungen als die klassische Mondini-Dysplasie angesehen. Die wesentliche therapeutische Option bei Mittelohrfehlbildung bleibt das Kochleaimplantat. Die Domaene der MRT liegt nicht nur in der Analyse des N. cochlearis und im Ausschluss von Fibrosierungen oder Ossifikationen des Labyrinths, sondern darueber hinaus ist sie in der Lage, Details einzelner

  3. SPECT/CT for staging and treatment monitoring in oncology. Applications in differentiated thyroid cancer and liver tumors; SPECT/CT zum initialen Staging und Therapiemonitoring in der Onkologie. Indikationen beim differenzierten Schilddruesenkarzinom und bei Lebertumoren

    Energy Technology Data Exchange (ETDEWEB)

    Weber, K.; Berger, F.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Innenstadt, Institut fuer Klinische Radiologie, Muenchen (Germany); Mustafa, M.; Bartenstein, P.; Haug, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Nuklearmedizin, Muenchen (Germany)

    2012-07-15

    and SPECT/CT provides more accurate imaging of the arterial supply of the liver and of potential outflows of micro-spheres into other organs. SPECT/CT allows evaluation and quantification of the uptake of liver tumors. Improved postablative staging in patients with differentiated thyroid cancer by SPECT/CT in comparison to radioiodine whole body scans can be achieved. Improved planning and monitoring of SIRT therapies utilizing SPECT/CT leads to optimized therapeutic doses within liver lesions. Integration of SPECT/CT into the clinical standard for postablative staging in patients with DTC is recommended as well as utilization of SPECT/CT during the planning process, for dose calculation and treatment monitoring of SIRT therapies. (orig.) [German] In den letzten Jahren hat die Hybridbildgebung mit Verbindung von funktioneller und morphologischer Information zur Diagnostik zahlreicher Erkrankungen zunehmend an Bedeutung gewonnen. Bei Patienten mit differenziertem Schilddruesenkarzinom (DTC) wird nach erfolgter Radiojodtherapie (RJT) ein planares Ganzkoerperszintigramm zum Staging durchgefuehrt. Die diagnostische Genauigkeit dieser szintigraphischen Methode ist jedoch aufgrund limitierter raeumlicher Aufloesung begrenzt. Die Radioembolisation von mit {sup 90}Yttrium beladenen Mikrosphaeren (selektive interne Radiotherapie, SIRT) ermoeglicht eine wenig invasive Therapie primaerer und sekundaerer Lebertumoren. Zur Vermeidung von Nebenwirkungen der Mikrosphaeren durch einen Abstrom in Darm, Magen und Lunge muss vor Therapiebeginn eine Darstellung des durch die leberversorgenden Arterien versorgten Gebiets mittels {sup 99m}Tc-MAA ({sup 99m}Technetium-makroaggregiertes Albumin) und einer Szintigraphie erfolgen. Auch hier limitiert die begrenzte morphologische Information der Szintigraphie das Therapiemonitoring. {sup 131}Jod-Ganzkoerperszintigramm zum Nachweis einer erfolgreichen Ablation und Staging ca. 3-4 Tage postablativ bei Patienten mit DTC. Ueberwachung des

  4. CT findings in acute small bowel diverticulitis; Computertomographie bei akuter Duenndarmdivertikulitis

    Energy Technology Data Exchange (ETDEWEB)

    Ferstl, F.J.; Obert, R. [Radiologisch-Nuklearmedizinisches Zentrum (RNZ) am St. Theresienkrankenhaus Nuernberg (Germany)

    2004-02-01

    Small bowel diverticulitis is a rare cause of an acute abdomen. Originating from acquired diverticula of the jejunum, less often of the ileum, or Meckel diverticulum, the symptoms are non-specific, simulating other acute inflammatory disorders, such as appendicitis, cholecystitis or colonic diverticulitis. The diagnosis of small bowel diverticulitis is solely based on radiologic findings, with computed tomography (CT) regarded as the method of choice. In recent years, a number of case reports have described the spectrum of the CT features in acute small bowel diverticulitis and its dependence on the severity of the inflammatory process. Typical findings are an inflamed diverticulum, inflammatory mesenteric infiltration, extraluminal gas collection and mural edema of adjacent small bowel loops with resultant separation of bowel loops. An enterolith is rarely found in an inflamed diverticulum. Complications include abscesses, fistulae, small bowel obstruction and free perforation with peritonitis. Small bowel diverticulitis can be a diagnostic problem if it involves the terminal ileum or Meckel's diverticulum. For preoperative confirmation of the presumed diagnosis of small bowel diverticulitis on CT, an enteroclysis for acquired diverticula or a technetium scan for Meckel's diverticulum should be performed. We present the CT findings in three patients of acute small bowel diverticulitis, two affecting the jejunum and one a Meckel's diverticulum. (orig.) [German] Die akute Duenndarmdivertikulitis ist eine seltene Ursache eines akuten Abdomens. Ausgehend von den erworbenen Divertikeln des Jejunums, seltener des Ileums, oder von einem Meckel-Divertikel, manifestiert sich die Divertikulitis klinisch durch eine unspezifische Symptomatik, die zuerst an die haeufigeren, akutentzuendlichen Erkrankungen des Abdomens wie z. B. Appendizitis, Cholezystitis oder Kolondivertikulitis denken laesst. Die Duenndarmdivertikulitis kann praeoperativ nur durch

  5. Spontaneous intracerebral hemorrhage: the clinical neuroradiological view; Die spontane intrazerebrale Blutung aus klinisch-neuroradiologischer Sicht

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W. [Technische Hochschule Aachen (Germany). Klinikum

    1999-10-01

    Intracerebral hemorrhage is a common cause of acute neurological deterioration and a frequent indication for emergency neuroimaging. Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. It is often not possible to differentiate intracerebral hemorrhage from cerebral ischemia by clinical examination. The therapeutic decision between thrombolysis or conservative therapy is comprised by the etiology. To exclude intracerebral hemorrhage as the cause of clinical symptoms, a CT is usually performed. Localisation and extension of the acute intracerebral hemorrhage are easy to detect. Subacute and chronic intracerebral hemorrhage are better delineated with magnetic resonance imaging. The different signal of the hemorrhage can be used for the age of the intracerebral hemorrhage. The cause of a non-traumatic intracerebral hemorrhage is in over 60% hypertony, less frequent alcoholism, malformation, or amyloid angiopathy. Uncommon causes of hemorrhage are head trauma, blood dyscrasia, tumor or venous thrombosis. Non-traumatic intracerebral hemorrhage are most common in patients between 50 and 70 years. In younger patients a malformation should be excluded with a cerebral angiography. Intracerebral hemorrhages are usually conservatively treated, in some cases an operative decompression is performed. (orig.) [German] Die intrazerebrale Blutung ist eine haeufige Ursache akut auftretender neurologischer Symptome und fuehrt oft zu einer notfallmaessigen neuroradiologischen Untersuchung. Etwa 15% der 'Schlaganfaelle' sind auf eine intrazerebrale Blutung zurueckzufuehren. Intrazerebrale Blutungen sind klinisch oft nicht von ischaemischen Infarkten zu unterscheiden. Eine Computertomographie ist zur Zeit fuer die Diagnosesicherung - und damit auch zur weiterfuehrenden Therapie - unerlaesslich. Ausdehnung und Lokalisation der akuten intrazerebralen Blutung koennen damit schnell und sicher erfasst werden. Subakute und chronische Blutungen sind dagegen

  6. Clinical use of digital retrospective image fusion of CT, MRI, FDG-PET and SPECT - fields of indications and results; Klinischer Einsatz der digitalen retrospektiven Bildfusion von CT, MRT, FDG-PET und SPECT - Anwendungsgebiete und Ergebnisse

    Energy Technology Data Exchange (ETDEWEB)

    Lemke, A.J.; Niehues, S.M.; Amthauer, H.; Felix, R. [Campus Virchow-Klinikum, Klinik fuer Strahlenheilkunde, Charite, Universitaetsmedizin Berlin (Germany); Rohlfing, T. [Dept. of Neurosurgery, Stanford Univ. (United States); Hosten, N. [Inst. fuer Diagnostische Radiologie, Ernst-Moritz-Arndt-Univ. Greifswald (Germany)

    2004-12-01

    Purpose: To evaluate the feasibility and the clinical benefits of retrospective digital image fusion (PET, SPECT, CT and MRI). Materials and methods: In a prospective study, a total of 273 image fusions were performed and evaluated. The underlying image acquisitions (CT, MRI, SPECT and PET) were performed in a way appropriate for the respective clinical question and anatomical region. Image fusion was executed with a software program developed during this study. The results of the image fusion procedure were evaluated in terms of technical feasibility, clinical objective, and therapeutic impact. Results: The most frequent combinations of modalities were CT/PET (n = 156) and MRI/PET (n = 59), followed by MRI/SPECT (n = 28), CT/SPECT (n = 22) and CT/MRI (n = 8). The clinical questions included following regions (more than one region per case possible): neurocranium (n = 42), neck (n = 13), lung and mediastinum (n = 24), abdomen (n = 181), and pelvis (n = 65). In 92.6% of all cases (n = 253), image fusion was technically successful. Image fusion was able to improve sensitivity and specificity of the single modality, or to add important diagnostic information. Image fusion was problematic in cases of different body positions between the two imaging modalities or different positions of mobile organs. In 37.9% of the cases, image fusion added clinically relevant information compared to the single modality. Conclusion: For clinical questions concerning liver, pancreas, rectum, neck, or neurocranium, image fusion is a reliable method suitable for routine clinical application. Organ motion still limits its feasibility and routine use in other areas (e.g., thorax). (orig.)

  7. Dental CT in the planning of surgery. Role in the oromaxillofacial area from the dentist's point of view; Dental-CT zur Planung chirurgischer Eingriffe. Bedeutung im oro-maxillofazialen Bereich aus zahnaerztlicher Sicht

    Energy Technology Data Exchange (ETDEWEB)

    Solar, P. [Universitaetsklinik fuer Zahn-, Mund- und Kieferheilkunde Wien (Austria). Abt. fuer Orale Chirurgie; Gahleitner, A. [Universitaetsklinik fuer Radiodiagnostik Wien (Austria). Abt. fuer Osteologie

    1999-12-01

    moderner Telekommunikationssysteme auch erleichtert wird. Dental-CT hat primaer dort ihre Aufgabe, wo klinische und konventionell radiologische Verfahren keine exakte Beurteilbarkeit der Situation ermoeglichen. Vor allem in der modernen Implantologie ergeben sich durch den Einsatz spezieller Computerprogramme Moeglichkeiten der Operationsplanung, welche mit zweidimensionalen Roentgenverfahren nicht moeglich sind. Die Anforderungen von zahnaerzlich-implantologischer Seite an das Roentgen sind: Klare Darstellung der aeusseren Knochenkonturen und des Mandibularkanals, eindeutige raeumliche Zuordnung der einzelnen Schnittbilder zueinander, Verzerrungsfreiheit in den orthoradialen Ebenen (Schnittebenen tatsaechlich im rechten Winkel auf die aeusseren Tangenten), Vermessbarkeit und Ausgabenmoeglichkeit auf einem Bildtraeger ohne Qualitaetsverlust. (orig.)

  8. MRT of scaphoid pseudo-arthrosis using Gd-DTPA. Staging and clinical correlation; MRT der Skaphoidpseudarthrose mit Gd-DTPA. Stadieneinteilung und klinische Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Beutel, F. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Wilhelm, K. [LMU Muenchen (Germany). Abt. fuer Handchirurgie; Tempka, A. [Freie Univ. Berlin (Germany). Klinik fuer Unfall- und Wiederherstellungschirurgie; Schedel, H. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Haas, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Felix, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik

    1994-11-01

    During a period of two years, 134 patients with pseudo-arthrosis of the scaphoid were examined by conventional radiography and by MRI in the course of a prospective study. The aim of the study was to define radiological staging using contrast enhanced MRI in order to improve the prognostic criteria. All MRI examinations were carried out with a 1.5 Tesla scanner (SP63) using a surface coil and T{sub 1} weighted spin echo sequences in sagittal and frontal projection and frontal FLASH T{sub 2}-sequences and axial spin echo T{sub 2} sequences. The T{sub 1} weighted SE sequences in frontal projection were carried out before and after iv contrast (0.1 mmol Gd-DTPA/kg KG). All sequences were compared with conventional radiographs and the operative findings. Eight patients in stage 0 showed high signal intensity of both fragments in T{sub 1} weighted SE sequences and at surgery there was good vascularisation. In 22 cases there was reduced signal intensity in at least one fragment (stage I). 45 patients with scaphoid pseudo-arthrosis showed complete signal loss but marked contrast uptake with still vital nuclei at surgery (stage II). In 22 patients, there was no increase in signal intensity after contrast and complete loss of vitality of the fragments at surgery. Staging was not possible in 37 patients because of previous operative intervention. The use of contrast enhanced MRI provides additional information compared with conventional radiography or plain MRI. (orig.) [Deutsch] Im Rahmen einer prospektiven Studie wurden in einem Zeitraum von 2 Jahren 134 Patienten mit einer Skaphoidpseudarthrose (SPA) vergleichend konventionell roentgenologisch und magnetresonanztomographisch untersucht. Ziel der Studie war die Erstellung einer klinisch radiologischen Stadieneinteilung mit Hilfe der kontrastverstaerkten MRT zur Verbesserung von Prognosekriterien. Alle MRT-Untersuchungen wurden an einem 1,5 Tesla-Geraet (SP63) mittels einer Oberflaechenspule unter Verwendung von T{sub 1

  9. Stabile KHK und Hypertonie: Diagnostik, medikamentöse Therapie und Revaskularisierungsstrategien

    OpenAIRE

    Elsner D

    2008-01-01

    Nicht nur eine koronare Herzerkrankung (KHK) sondern auch Mikrozirkulationsstörungen führen bei Hypertonikern häufig zum Symptom der Angina pectoris. Grundpfeiler in der Diagnostik der KHK sind die entsprechenden Belastungstests. Allerdings ist die Aussagekraft bei Hypertonikern, insbesondere von Belastungs- EKG und Myokardszintigramm, eingeschränkt. Goldstandard bleibt daher die Koronarangiographie. Basis der Therapie der KHK ist die Modifikation des Lebensstils und Ausschaltung bz...

  10. Spiral hydro-CT of the pancreas in the thin-slice method; Hydrospiral-CT des Pankreas in Duennschichttechnik

    Energy Technology Data Exchange (ETDEWEB)

    Richter, G.M. [Abt. fuer Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Simon, C. [Abt. fuer Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany)]|[Abt. Allgemeine Chirurgie, Chirurgische Universitaetsklinik Heidelberg (Germany); Hoffmann, V. [Abt. fuer Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); DeBernardinis, M. [Abt. fuer Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany); Seelos, R. [Abt. Allgemeine Chirurgie, Chirurgische Universitaetsklinik Heidelberg (Germany); Senninger, N. [Abt. Allgemeine Chirurgie, Chirurgische Universitaetsklinik Heidelberg (Germany); Kauffmann, G.W. [Abt. fuer Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg (Germany)

    1996-05-01

    151 konsekutive Patienten mit Verdacht auf Pankreastumor untersucht. Hydro-CT-Technik: Patientenlagerung in 30 RAO, Darmparalyse durch 40 mg Buscopan, Magen- und Duodenaldistension mittels 1,5 l Wasser oral, individualisierte Boluskinetik Spiral-CT mit 3 mm Inkrement, 6 mm Tischvorschub und 3 mm Rekonstruktion, 130 ml nichtionisches KM (5 ml/s). Folgende Punkte wurden festgehalten und bewertet: 1. Tumordetektion ja/nein; 2. Differenzierung eines festgestellten Tumors in maligne oder benigne an Hand festgelegter Kriterien; 3. computertomographische Differentialdiagnostik der Tumoren; 4. Beurteilung der Resektabilitaet. Bei positivem Tumornachweis wurde als Goldstandard die intraoperative und histologische Bewertung und bei negativem Tumornachweis eine 6 monatige tumorfreie Nachsorgeperiode festgelegt. Die Praevalenz einer Raumforderung des Pankreas betrug etwa 38% in der Gesamtgruppe. Dabei erreichte die Hydro-CT eine Gesamtgenauigkeit in der Tumordetektion von 97,4% bei einer Sensitivitaet von 100% und einer Spezifitaet von 95,9%. Bei der Differenzierung eines malignen versus eines benignen Tumors ergab sich eine Gesamtgenauigkeit von 89,7% bei einer Sensitivitaet von 92,5% und einer Spezifitaet von 83,3%. 58 Patienten wurden operiert. Die Gesamtgenauigkeit der Resektabilitaetsbeurteilung erreichte 95% bei einer Sensitivitaet von 90,5% und einer Spezifitaet von 100%. (orig./MG)

  11. Spinal canal stenosis; Spinalkanalstenose

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P.; Boutchakova, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)

    2014-11-15

    Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. (orig.) [German] Die Spinalkanalstenose ist eine umschriebene, knoechern-ligamentaer bedingte Einengung des Spinalkanals, die zur Kompression der Nervenwurzeln oder des Duralsacks fuehren kann. Die lumbale Spinalkanalstenose manifestiert sich klinisch als Komplex aus Rueckenschmerzen sowie sensiblen und motorischen neurologischen Ausfaellen, die in der Regel belastungsabhaengig sind (Claudicatio spinalis). Die bildgebende Diagnostik mittels Magnetresonanztomographie, Computertomographie und Myelographie spielt eine entscheidende Rolle bei der optimalen patientenbezogenen Therapieentscheidung. (orig.)

  12. [Bewusstes Erinnern und bewusstes Vergessen : der juristische Umgang mit der Vergangenheit in den Ländern Mittel- und Osteuropas / hrsg. v. Angelika Nußberger, Caroline von Gall. (Jus Internationale et Europaeum ; 52). Mohr Siebeck, Tübingen 2011.

    Index Scriptorium Estoniae

    Luts-Sootak, Marju, 1966-

    2014-01-01

    Arvustus: Bewusstes Erinnern und bewusstes Vergessen : der juristische Umgang mit der Vergangenheit in den Ländern Mittel- und Osteuropas / hrsg. v. Angelika Nußberger, Caroline von Gall (Jus Internationale et Europaeum ; 52). Mohr Siebeck, Tübingen 2011. 400 S.

  13. Sacroiliitis in children with spondyloarthropathy: therapeutic effect of CT-guided intra-articular corticosteroid injection; Sakroiliitis bei Kinder mit Spondylarthropathie: Therapeutischer Effekt der CT-gestuetzten intraartikulaeren Kortikosteroid-Injektionen

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, T.; Hermann, K.G.A.; Diekmann, F.; Hamm, B. [Humboldt-Universitaet, Berlin (Germany). Universitaetsklinikum Charite, Inst. fuer Radiologie; Biedermann, T. [HELIOS Klinikum Berlin (Germany). II. Klinik fuer Kinderheilkunde und Jugendmedizin, Abt. Kinderrheumatologie; Braun, J. [Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus (Germany); Bollow, M. [Augusta-Krankenhaus, Bochum (Germany). Inst. fuer Radiologie

    2003-06-01

    . The follow-up dynamic MRI (0.1 mmol/kg body weight) during therapy showed a statistically significant lower contrast-enhancement in both groups (group 1: 117{+-}43% versus 38{+-}24%, p<0.05; group 2: 127{+-}59% versus 38{+-}22%, p<0.05). One third of the patients of group 2 showed progression of joint destruction despite absence of subjective complaints. (orig.) [German] Ziel: Prospektive Pruefung des therapeutischen Effektes der CT-gesteuerten intraartikulaeren Kortikosteroid-Injektion entzuendlicher Sakroiliakalgelenke (SIG) bei Kindern mit juveniler Spondylarthropathie (jSpA) im Vergleich zur konventionellen Therapie mit nichtsteroidalen Antirheumatika (NSAR) sowie Bestimmung der Wertigkeit der Magnetresonanztomographie (MRT) bei der Indikationsstellung und der Therapieverlaufskontrolle. Material und Methode: Bei 89 Kindern mit bekannter jSpA wurden mittels dynamischer MRT uni- oder bilaterale Sakroiliitiden diagnostiziert. Bei allen 89 Patienten wurde daraufhin eine Therapie mit NSAR eingeleitet bzw. bereits bestehende Therapien fortgesetzt. Vier Wochen nach der diagnostischen MRT wurden zwei Gruppen definiert: 33 Patienten mit klinischem Response auf NSAR (Gruppe 1) und 56 Nonresponder (Gruppe 2). Die Patienten der Gruppe 2 wurden unter Belassung der NSAR zusaetzlich einer CT-gestuetzten (Low-Dose-Technik) intraartikulaeren Kortikosteroid-Injektion zugefuehrt, wobei insgesamt 83 SIG punktiert und infiltriert wurden (27 bilateral, 29 unilateral). Die Indikationsstellung zur Intervention beruhte auf der zuvor MR-tomographisch gesicherten Entzuendungsaktivitaet. Klinische Therapieverlaufskontrollen erfolgten in 8- bis 12-woechigen Intervallen ueber einen Zeitraum von 20 Monaten. MRT-Verlaufskontrollen wurden bei allen 56 Kindern der Gruppe 2 und bei 15 von 33 Kindern der Gruppe 1 in einem Zeitraum von 8{+-}4 Monaten nach der Erstuntersuchung durchgefuehrt. Ergebnisse: Ingesamt 87,5% der komplikationslos punktierten Kinder der Gruppe 2 (Standardtherapie

  14. Modern diagnostic assessment of the upper urinary tract using multislice CT urography; Moderne Diagnostik des oberen Harntraktes mittels Mehrschicht-CT-Urographie

    Energy Technology Data Exchange (ETDEWEB)

    Kemper, J.; Adam, G.; Nolte-Ernsting, C. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

    2006-11-15

    The advent of Multislice Computed Tomography (MSCT) has made evaluation of the entire urinary tract with high-resolution sections during a single breath-hold a reality. Acquisition of multiple thin overlapping slices provides excellent two-dimensional (2D) and three-dimensional (3D) reformations of the urinary tract. The concept of 'Multislice CT Urography (MSCTU)' has emerged from this technical improvement. As a result, a wide range of pathologies inside and outside the urinary tract can be identified. During the last several years, MSCTU has challenged intravenous urography (IVU) in the evaluation of urinary tract abnormalities. Compared with IVU, MSCT(U) is more sensitive and specific in the detection and characterization of a variety of urinary tract disorders, including renal masses and urolithiasis. The main advantage of IVU has been its ability to offer excellent delineation of kidney basin cup system and ureteral anatomy and to depict subtle uroepithelial abnormalities. MSCTU has already shown promising results for overcoming this challenge. Optimal opacification and distension appear to be an essential requirement for a thorough evaluation of the collecting system. Dedicated preparation strategies have been developed to meet these technical difficulties. The biggest disadvantage of MSCTU is the significant radiation exposure. For broad routine clinical application, there is still a need for dose reduction protocols despite the ongoing technical developments in MSCTU. In this article, we outline the different concepts of technical processing for MSCTU and summarize the current role of MSCTU in the evaluation of the upper urinary tract. (orig.)

  15. Simulation of the beam guiding of the SAPHIR experiment by means of a differential-equation model; Simulation der Strahlfuehrung des SAPHIR-Experiments mittels eines Differentialgleichungsmodells

    Energy Technology Data Exchange (ETDEWEB)

    Greve, T.

    1991-08-01

    This paper shows the numerical simulation of a beam line by means of a model of differential equations simulating the beam line from the Bonn Electron Stretcher Accelerator ELSA to the SAPHIR spectrometer. Furthermore a method for calculating the initial values based on measurements of beam profiles is being discussed. (orig.). [Deutsch] Diese Arbeit zeigt die numerische Simulation einer Strahlfuehrung mittels eines Differentialgleichungsmodells anhand der Strahlfuehrung vom Bonner ELSA-Beschleuniger zum SAPHIR-Experiment. Weiterhin wird eine Methode zur Gewinnung der Startwerte aus Strahlprofilmessungen diskutiert. (orig.).

  16. Monitoring of lead batteries by means of optical-fibre refractometry; Ueberwachung von Bleiakkumulatoren mittels Faseroptischer Refraktometrie

    Energy Technology Data Exchange (ETDEWEB)

    Gernhold, H P; Hanitsch, R

    1994-12-31

    Electricity storage is an integral part of photovoltaic systems. At the moment, the most economical device for this is the lead battery. Battery life is determined by the charging technique applied and by the efficiency of monitoring. The optimum charging technique is selected in dependence of battery age and charge state. The authors present a method for online charge state monitoring in which the acid concentration is measured by means of optical-fibre refractometry. (orig.) [Deutsch] Ein aeusserst wichtiger Teilbereich von Photovoltaik-Anlagen ist die Speicherung von elektrischer Energie. Diesen Zweck erfuellen Bleiakkumulatoren zur Zeit am wirtschaftlichsten. Es hat sich gezeigt, dass sowohl die angewandte Ladetechnik als auch eine gute Batterieueberwachung entscheidend fuer die Lebensdauer dieser Systemkomponente sind. Die Wahl der optimalen Ladetechnik richtet sich wiederum nach dem Alter und dem Entladegrad der Batterie. Gegenstand dieser Arbeit ist es, eine Methode vorzustellen, mit der die Saeuredichte mittels faseroptischer Refraktometrie gemessen und so der Ladezustand jeder einzelnen Batteriezelle zu jedem Zeitpunkt on-line ueberwacht werden kann. (orig.)

  17. Pretherapeutic and posttherapeutic laryngeal imaging; Prae- und posttherapeutische Larynxbildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Becker, M.; Burkhardt, K.; Allal, A.S.; Dulguerov, P.; Ratib, O.; Becker, C.D. [Hopitaux Universitaires de Geneve, Abteilung fuer Hals-Nasen-Ohren-Radiologie, Geneve (Switzerland)

    2009-01-15

    endoskopischer Biopsie) beigeordnet und ergaenzen diese komplementaer. Eine sehr genaue Kenntnis der submukoesen Tumorausbreitungswege, der diagnostischen Zeichen der Tumorinfiltration und deren Konsequenzen fuer Stadieneinteilung und Therapie sind unentbehrlich fuer die Interpretation von CT-, MRT- und PET-CT-Bildern. Sowohl CT als auch MRT sind hochsensitive Untersuchungen zum Nachweis der neoplastischen Infiltration des praeepi- und paraglottischen Raums, der Subglottis und des Knorpels. Die Spezifitaet ist jedoch mit beiden Methoden weniger hoch als zunaechst erwartet, wodurch eine Tendenz zum Ueberschaetzen der Tumorausbreitung resultiert. Neuere Untersuchungen haben jedoch gezeigt, dass die Spezifitaet der MRT mittels Anwendung neuer diagnostischer Kriterien signifikant verbessert werden kann, da eine Unterscheidung zwischen Tumor und peritumoraler Entzuendung in vielen Faellen moeglich ist. Der sehr hohe negative Vorhersagewert der beiden Schnittbildverfahren ist aus klinischer Sicht wichtig, da er es ermoeglicht, die neoplastische Knorpelinfiltration auszuschliessen. Beide Methoden verbessern signifikant die praetherapeutische Stagingtreffsicherheit, wenn sie zusaetzlich zur Endoskopie eingesetzt werden. Bei submukoesen Tumoren liefern sowohl CT als auch MRT wertvolle Hinweise auf eine moegliche Aetiologie, auf das Ausmass des submukoesen Wachstums und die geeignete Biopsiestelle. Sie spielen auch eine wichtige Rolle bei der Diagnose von Laryngozelen, der Abklaerung von N.-laryngeus-recurrens-Paresen und Larynxfrakturen. (orig.)

  18. Investigations on uncertainties in patient positioning for prostate treatment with EPID; Untersuchungen zur Positionierungsgenauigkeit bei Prostatakonformationsbestrahlungen mittels Portal-Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bakai, A.; Nuesslin, F. [Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany). Abt. Medizinische Physik; Paulsen, F.; Plasswilm, L.; Bamberg, M. [Universitaetsklinik fuer Radioonkologie, Tuebingen (Germany). Abt. Strahlentherapie

    2002-02-01

    : Konformationstechniken, wie sie heutzutage routinemaessig fuer Patienten mit Prostatakarzinom angewandt werden erlauben, durch Adaption der Bestrahlungsfelder an das Planungszielvolumen (PTV) umliegendes Normalgewebe zu schonen. Um die Vorteile dieser Techniken jedoch vollstaendig nutzen zu koennen, ist die korrekte Patientenpositionierung eine wichtige Voraussetzung. In dieser Studie wurde mittels Portal-Imaging (EPID) untersucht, welche Positionierungsgenauigkeiten im Beckenbereich unter Verwendung unterschiedlicher Lagerungshilfen moeglich sind. Patienten und Methode: Fuer die Studie wurden 15 Patienten mit Prostatakarzinom ausgewaehlt, die teils mit, teils ohne Rektumballon bzw. Beckenmaske an einem Linearbeschleuniger mit Viellamellenblenden (MLC) bestrahlt wurden. Von jedem Patienten wurden mehrfach aus orthogonalen Richtungen mittels eines Portal-Imaging-Systems Aufnahmen angefertigt und anschliessend mit den Planungs-DRRs (digitally reconstructed radiographs) sowie den Simulationsaufnahmen verglichen. Ergebnisse: Trotz unterschiedlicher Lagerungshilfen konnten fuer saemtliche Patientengruppen Gesamtpositionierungsungenauigkeiten von durchschnittlich 4,0 mm (lateral), 4,5 mm (kraniokaudal) sowie 1,7 mm (dorsoventral) festgestellt werden. Mit Beckenmaske war der laterale Positionierungsfehler zwar reduziert, gleichzeitig jedoch der kraniokaudale Positionierungsfehler verstaerkt. Der Gesamtpositionierungsfehler teilte sich dabei in einen systematischen und einen statistischen Anteil auf, fuer deren verlaessliche Abschaetzung sechs bis acht EPID-Aufnahmen erforderlich waren. Schlussfolgerungen: Mittels Portal-Imaging ist es moeglich, aus einer geringen Anzahl von Verifikationsaufnahmen fuer jeden Patienten den systematischen und statistischen Positionierungsfehler zu ermitteln. Der erfolgreiche Einsatz von Lagerungshilfen zur Patientenpositionierung erfordert jedoch - insbesondere im Hinblick auf IMRT - eine weitere Optimierung. (orig.)

  19. Evaluation of injuries of the upper cervical spine in a postmortem study with digital radiography, CT and MRI; Evaluation experimentell erzeugter Verletzungen der oberen Halswirbelsaeule mit digitaler Roentgentechnik, Computertomographie und Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Obenauer, S.; Herold, T.; Fischer, U.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik; Fadjasch, G.; Saternus, K.S. [Goettingen Univ. (Germany). Abt. fuer Rechtsmedizin; Koebke, J. [Koeln Univ. (Germany). Anatomisches Inst.

    1999-12-01

    obere Halswirbelsaeulen-Praeparate wurden nach definiertem Rotationstrauma sowie nach Praeparation mittels digitaler Roentgentechnik (DIMA Soft P41, Fa. Feinfokus), mittels CT (CTi, High Speed, GE) in konventioneller und in Spiraltechnik (Kollimation 1 mm, Pitch 1.0) sowie mit Hilfe der MRT (Magnetom Vision Siemens) in 2D- und 3D-Technik untersucht. Ergebnisse: Die Praeparation zeigte 6 Wirbelkoerperfrakturen, 5 Densfrakturen, 1 Fraktur des vorderen Atlasbogens, 4 knoecherne Ausrisse an den okzipitalen Kondylen und 6 Laesionen der Ligg. alaria. Die digitale Praeparateradiographie dokumentierte alle Frakturen und die 4 knoechernen Ausrissfrakturen am Condylus occipitalis. In der CT konnten alle Frakturen und ligamentaeren Verletzungen erkannt werden. Die 2D MRT wies 9 Frakturen sicher und 3 fraglich nach; die 3D MRT zeigte 7 Frakturen sicher und 5 fraglich. Von den 4 Ausrissfrakturen konnten 2 mit der 2D MRT und 1 mit der 3D MRT nachgewiesen werden. Ligamentaere Verletzungen waren sicher in der 2D MRT in 2/6 Faellen und in der 3D MRT in 1 Fall zu erkennen. Diskussion: In postmortalen Studien zeigt die CT gegenueber der digitalen Radiographie und der MRT in der Detektion von Frakturen und ligamentaeren Verletzungen der oberen Halswirbelsaeule eine Ueberlegenheit, wobei diese Ergebnisse nur bedingt auf Patienten nach Hochgeschwindigkeitstrauma uebertragbar sind. (orig.)

  20. Uncommon presentation of cryptogenic organizing pneumonia with miliary pattern in the thorax; Ungewoehnliche Manifestation einer kryptogen organisierenden Pneumonie mit miliarem Verschattungsmuster im Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Langen, H.J.; Biewener, C. [Missionsaerztliche Klinik, Radiologische Abteilung, Wuerzburg (Germany); Ruediger, T. [Universitaet Wuerzburg, Pathologisches Institut, Wuerzburg (Germany); Jany, B. [Missionsaerztliche Klinik, Abteilung fuer Innere Medizin, Wuerzburg (Germany)

    2008-03-15

    A 28-year-old female with worsening dyspnea showed miliary nodules of 2 mm in diameter on chest X-ray and high-resolution CT (HRCT). Histological evaluation and clinical outcome revealed an uncommon presentation of cryptogenic organizing pneumonia. (orig.) [German] Bei einer 28-jaehrigen Patientin mit zunehmender Dyspnoe wurden auf der Thoraxroentgenaufnahme und in der hochaufloesenden CT (HRCT) homogen verteilte monomorphe miliare Fleckschatten von ca. 2 mm Durchmesser nachgewiesen. Die histologische Sicherung und der klinische Verlauf ergaben eine kryptogen organisierende Pneumonie, die sich bildmorphologisch ungewoehnlicherweise nur mit miliaren Knoetchen manifestierte. (orig.)

  1. Clinical nuclear medicine in radiation therapy - state and perspectives; Klinische Nuklearmedizin in der Strahlentherapie - Stand und Perspektiven

    Energy Technology Data Exchange (ETDEWEB)

    Schultze, J. [Kiel Univ. (Germany). Klinik fuer Strahlentherapie (Radioonkologie)

    1995-08-01

    Clinical nuclear medicine has severely changed due to the technical and pharmacological developments within the last 15 years. An evaluation of the importance of nuclear medicine for treatment planning purposes in radiation therapy revealed in 20.6% of the cases relevant new information due to the scans. That nevertheless the demand for nuclearmedical examinations is decreasing might be a result of an increasing alienation between nuclear medicine and referring physicians of other specialities. Therefore a reapproach of nuclear medicine with her main clinical partners is desireable which could be achieved e.g. by exchange of rotating house officers, participation in tumor conferences and consiliary statements to scan indications. (orig.) [Deutsch] Die klinische Nuklearmedizin hat sich durch die technischen und pharmakologischen Entwicklungen der letzten 15 Jahre erheblich veraendert. Eine Evaluation der Bedeutung nuklearmedizinischer Verfahren fuer die Bestrahlungsplanung in der Strahlentherapie hat in 20,6% der Faelle eine untersuchungsbedingte, planungsrelevante Information erbracht, auf die nicht verzichtet werden konnte. Dass die Nachfrage nach nuklearmedizinischen Untersuchungen in diesem Bereich trotzdem ruecklaeufig ist, duerfte Ergebnis einer zunehmenden Entfremdung der Zuweiser aus den verwandten Faechern von der Nuklearmedizin sein. Es ist deshalb eine Wiederannaeherung der Nuklearmedizin an ihre klinischen Hauptpartner wuenschenswert, die durch Austausch von Rotationsassistenten, die Beteiligung an Tumorkonferenzen und die konsiliarische Stellungnahme zu Untersuchungsindikationen erreicht werden koennte. (orig.)

  2. Contrast media in renal insufficiency - risk and prevention; Auswirkungen einer intravasalen Roentgenkontrastmittelgabe auf die Nierenfunktion - Risiken und Praevention

    Energy Technology Data Exchange (ETDEWEB)

    Erley, C.M.; Bader, B.D. [Tuebingen Univ. (Germany). Abt. fuer Innere Medizin III

    2000-10-01

    The use of iodinated contrast media (CM) continues to be a common cause of hospital-acquired acute renal failure (ARF) and its development increases the in-hospital mortality significantly. Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity. We review recent insights into the pathogenesis of this complication and summarize prophylacttic strategies focussing on hydration, vasoactive pharmacological agents, alternative contrast media and 'prophylactic hemodialysis'. (orig.) [German] Das durch Roentgenkontrastmittelgabe initiierte Nierenversagen, die sogenannte Kontrastmittelnephropathie (KMN), stellt - insbesondere bei Patienten mit eingeschraekuter Nierenfunktion - nach wie vor ein erhebliches medizinisches Problem dar, dessen Auftreten mit einer deutlich erhoehten Krankenhausmortalitaet verbunden ist. Die Genese der KMN ist nach wie vor nicht eindeutig geklaert. Neben haemodynamischen Veraenderungen durch die Kontrastmittel spielen tubulotoxische Schaeden eine Rolle. Die vorliegende Uebersicht beschreibt die zur Zeit bekannten pathophysiologischen Vorgaenge bei der KMN und die moeglichen Praeventivmassnahmen mit besonderem Augenmerk auf die klinisch relevanten Themen der Hydratation, der prophylaktischen Gabe vasoaktiver Substanzen, den Einsatz alternativer Kontrastmittel und die Entfernung von Roentgenkontrastmitteln (KM) mittels Haemodialyse. (orig.)

  3. ''Routine'' brain CT in psychiatric patients - does it make sense?; ''Routine''-Schaedel-CT in der psychiatrischen Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Pickuth, D.; Heywang-Koebrunner, S.H.; Spielmann, R.P. [Martin-Luther-Universitaet Halle-Wittenberg, Halle (Germany). Klinik und Poliklinik fuer Diagnostische Radiologie

    1999-11-01

    Purpose: To prospectively assess the spectrum of brain CT findings in psychiatric patients and to determine the number of patients that had an underlying cause for the symptoms. Patients and methods: Over a period of six months, 142 patients (78 males, 64 females; median age 61 [18-91] years) were referred for CT brain scans. Their scans were reviewed, along with the clinical information that was provided in the request form. All the hard copies were reviewed to assess areas of ischaemia, infarction, atrophy, tumours, and haematomas. The majority of requests were to exclude vascular event or space-occupying lesions. Clinical indications included mood disorders (depression, mania), schizophrenic disorders, dementia, personality and behavioural disorders. Results: 31 (22%) were normal. 111 (78%) had varying degrees of ischaemia, infarction and cerebral/cerebellar atrophy. 7 (4.9%) had space-occupying lesions which included two gliomas and five meningiomas. There were two chronic subdural haematomas and one arteriovenous malformation. Conclusion: 1. In our series, pathologic findings in 'routine' brain CT's were encountered in 78%. 2. The incidence of brain tumours was 4.9%, compared with 0.00005% of the general population. 3. CT scanning in psychiatric patients is cost-effective and especially indicated when there is an atypical presentation, or inadequate response to standard treatment. (orig.) [German] Hintergrund: Bei psychiatrischen Patienten wird vielerorts routinemaessig eine kraniale Computertomographie (CCT) durchgefuehrt. Ob der Nutzen die Kosten rechtfertigt, wurde im Rahmen einer Prospektivstudie untersucht. Patienten und Methode: In einem Zeitraum von 6 Monaten wurde bei 142 psychiatrischen Patienten (78 Maenner, 64 Frauen, 18-91 Jahre, Median 61 Jahre) ein CCT angefertigt. Die Untersuchung erfolgt nativ in 5-mm-Schichtdicke, bei klinischem Verdacht auf eine intrakraniale Raumforderung auch kontrastverstaerkt. Ueberweisungsdiagnosen waren v

  4. Grundlagen der ultraschallgezielten transurethralen Stammzelltherapie der Harn-Inkontinenz

    Directory of Open Access Journals (Sweden)

    Strasser H

    2005-01-01

    Full Text Available In präklinischen Studien wurden Sicherheit und Durchführbarkeit von durch transurethralen Ultraschall geführten Injektionen von autologen Myo- und Fibroblasten zur Behandlung der Stressinkontinenz untersucht. Zwischen 2002 und März 2005 wurden 129 inkontinente Patienten (Alter 36–85 Jahre, 92 Frauen, 37 Männer in eine klinische Studie aufgenommen, um zu untersuchen, ob die Stressinkontinenz effektiv mittels durch transurethralen Ultraschall geführte Injektionen von autologen Myo- und Fibroblasten behandelt werden kann. Die Patienten litten an Stress- oder gemischter Harninkontinenz. Vor und nach der Therapie wurden ein definierter Inkontinenz-Score, Veränderungen der Lebensqualität sowie Morphologie und Funktion von Urethra und Rhabdosphinkter bewertet. Der transurethrale Ultraschall wurde zur Untersuchung und Visualisierung des unteren Harntraktes verwendet. Zusätzlich wurden vor und nach der Behandlung urodynamische und Labortests durchgeführt. Es wurden kleine Muskelbiopsien am Oberarm unter Lokalanästhesie entnommen und die Zellen in einem GMP-Labor zum Wachstum gebracht. Die Fibroblasten wurden fallweise mit einer kleinen Menge an Kollagen als Trägermaterial (ca. 2,5 ml gemischt. Mittels transurethralem Ultraschall und einer speziell entwickelten Injektionsvorrichtung wurden die Fibroblasten in die urethrale Mukosa zur Atrophiebehandlung injiziert. Die Myoblasten wurden direkt in den Rabdosphinkter zur Muskelrekonstruktion injiziert. Bei 108 Patienten konnte die Harninkontinenz nach der Injektion geheilt werden. Die postoperative Lebensqualität sowie die Dicke von Urethra und Rhabdosphinkter und die Aktivität und Kontraktilität des Rhabdosphinkter waren nach der Behandlung wesentlich verbessert. Bei 21 Patienten kam es zu einer Verbesserung der Harninkontinenz. Es traten keine Nebenwirkungen oder Komplikationen auf.

  5. Fragmentierungsarten von Nierensteinen unter extrakorporaler Stoßwellenlithotripsie: eine multivariate Analyse

    Directory of Open Access Journals (Sweden)

    Aeberli D

    1999-01-01

    Full Text Available Das primäre Ziel dieser retrospektiven Studie war die Evaluation von routinemäßig anwendbaren Kriterien, welche die Fragmentierung von Nierensteinen unter extrakorporaler Stoßwellenlithotripsie (ESWL voraussagen können. Die Serie umfaßte 202 konsekutive Patienten (121 Männer, 81 Frauen mit einem medianen Alter von 48 Jahren (19-81 Jahre, die an der Urologischen Universitätsklinik Bern mit dem originalen Dornier HM-3 behandelt wurden. Einschlußkriterien waren Einzelsteine von 10-30 mm Größe mit Lage im Nierenbeckenkelchsystem. Die Steine wurden im Abdomen-Leerbild nach ihrer Lage, Größe, Form, Dichte (im Vergleich zur 12. Rippe, Struktur und Oberfläche beurteilt. Weiter wurden Alter, Geschlecht und Body-Mass-Index des Patienten berücksichtigt. Die Desintegration wurde am 1. Tag nach ESWL mittels Abdomen-Leerbild dokumentiert. Zielwert der Analyse war die binäre Variable steinfrei versus Restfragmente, gegen die alle präoperativen Parameter mittels multivariater logistischer Regression getestet wurden. Die Erfolgsrate betrug 95,5 %; 42 Patienten (20,8 % waren steinfrei und 151 Patienten (74,7 % hatten sog. klinisch insignifikante Restfragmente (5 mm oder kleiner. Von den Männern waren 14,9 %, von den Frauen 29,6 % steinfrei (p = 0,01. Alle anderen Parameter erreichten keine statistische Signifikanz, möglicherweise aufgrund zu kleiner Subgruppen (fehlende statistische Macht. Die Desintegrationsrate des HM-3 für Nierensteine ist insgesamt ausgezeichnet, bei Frauen noch besser als bei Männern. Gerade wegen dieser hohen Erfolgsrate wären größere Patientenzahlen notwendig, um eventuelle Unterschiede zwischen den präinterventionellen Parametern definieren zu können.

  6. Preoperative assessment of asymptomatic adnexal masses by positron emission tomography and F-18-fluorodeoxyglucose; Praeoperative Dignitaetsbeurteilung asymptomatischer Adnextumoren mittels Positronen-Emissions-Tomographie und F-18-Fluordeoxyglukose

    Energy Technology Data Exchange (ETDEWEB)

    Fenchel, S.; Kotzerke, J.; Reske, S.N. [Ulm Univ. (Germany). Abt. Nuklearmedizin; Stoehr, I.; Grab, D.; Kreienberg, R. [Ulm Univ. (Germany). Frauenklinik; Nuessle, K.; Rieber, A.; Brambs, H.J. [Ulm Univ. (Germany). Abt. Radiologie 1 (Roentgendiagnostik)

    1999-08-01

    Aim: To evaluate use of F-18-FDG-PET in assessment of dignity of asymptomatic adnexal masses. Methods: 85 asymptomatic patients with suspicious, asymptomatic adnexal masses were evaluated. Static FDG-PET (Exact HR+ or ECAT 931) imaging of the abdomen was performed following application of 222-555 MBq F-18-FDG. Iterative reconstruction was applied. PET data were analysed visually, at first without and second together with MRT images. Final diagnosis was made by histopathology. Results: FDG-PET allowed correct identification of 4 of 8 malignant adnexal tumors. False negative results were obtained in 2 adenocarcinomas stage pT1a and 2 borderline-tumors. In 60 out of 77 benign adnexal masses malignancy could be excluded. False positive FDG-uptake, partly because of misinterpretation of gastrointestinal activity, was found in 3 inflammatory processes, 1 teratoma, 1 benign schwannoma, 1 dermoid cyst, 1 benign thecoma, 1 serous cyst, 1 serous cystadenoma, 2 mucinous cystadenomas, 2 corpus luteum cysts, 3 endometriosic cysts and 1 sactosalpinx. The overall sensitivity and specifity of FDG-PET alone were 50% and 78%. Evaluation together with MRT images showed a sensitivity of 50% and a specifity of 86%. (orig.) [Deutsch] Ziel: Es wurde untersucht, ob die FDG-PET zu einer Verbesserung der Dignitaetsbeurteilung asymptomatischer, sonographisch malignomsuspekter Ovarialtumoren beitragen kann. Methode: 85 Patientinnen mit malignomsuspekten, asymptomatischen Adnextumoren unterzogen sich einer FDG-PET Untersuchung. Emissionsaufnahmen des Abdomens wurden ca. 1 h nach i.v. Injektion von 222-555 MBq F-18-FDG angefertigt (Exact HR + bzw. ECAT 931). Die Bildrekonstruktion erfolgte iterativ. Die PET-Aufnahmen wurden visuell ausgewertet, zum einen ohne andere bildgebende Verfahren, zum anderen zusammen mit der Kernspintomographie. Die Validierung erfolgte mittels Histologie. Ergebnisse: Histologisch fanden sich 8 Malignome, von denen 4 mittels FDG-PET als richtig positiv erkannt wurden

  7. Cryotherapy of malignant tumors: MR imaging in comparison with pathological changes in mice; Kryotherapie maligner Tumoren: Untersuchungen mittels MRT im Tierexperiment und Vergleich mit morphologischen Veraenderungen

    Energy Technology Data Exchange (ETDEWEB)

    Romaneehsen, B.; Anders, M.; Roehrl, B.; Hast, H.J.; Schiffer, I.; Neugebauer, B.; Teichmann, E.; Schreiber, W.G.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Hengstler, J.G. [Mainz Univ. (Germany). Inst. fuer Toxikologie

    2001-07-01

    Aim of our study was to investigate the efficacy of 7 F cryoprobes for percutaneous use morpho- and histologically, to examine the role of apoptosis after cryotherapy, and to compare contrast-enhanced MRI with histopathological findings at different time intervals in a tumor-mouse model. Methods: Percutaneous cryotherapy was performed in 15 immunocompromised nude mice with subcutaneously implanted tumors using the non-small-cell lung cancer cell line Lu 1. In group a) 7 mice were sacrificed after definite time intervals and histological examinations were done for evaluation of necrosis and apoptosis (HE; TUNEL assay); 2 mice are in long-term follow-up. In group b) in 6 mice tumor destruction and perfusion before and after freezing were investigated with native and contrast-enhanced MR imaging (T{sub 1}- and T{sub 2}-weighted spin-echo) and compared with histopathological findings. Histological control were done in 2 untreated mice. Results: We observed fast tumor-reduction within two weeks (ca. 50%). On long-term follow-up (> 6 months) no recurrence has been noticed so far. Tumors were well vascularized prior to treatment and did not-show contrast enhancement an any time after cryotherapy. A narrow contrast-enhanced zone was seen on the tumor border subcutaneously as a sign of peripheral hyperemia and central vascular stasis after cryotherapy. On histology there was evidence of both apoptosis and necrosis. (orig.) [German] Evaluierung der Durchfuehrbarkeit und Effizienz einer perkutanen Kryotherapie mittels 7-F-Kryosonde in Nacktmaeusen. Erheben des histopathologischen Befundes der Kryolaesion nach definierten Zeitintervallen und Ueberpruefung einer moeglichen Rolle der Apoptose nach Kryotherapie. Darstellung morphologischer Veraenderungen des Tumors und des angrenzenden Gewebes im Anschluss an die Kryotherapie mittels kontrastmittelunterstuetzter MRT. Methodik: Zweiminuetige Kryotherapie subkutan implantierter Tumoren eines nicht-kleinzelligen Bronchialkarzinoms

  8. Imaging in syndrome complex diabetes mellitus. Current standards and future perspectives; Bildgebung im Syndromkomplex Diabetes mellitus. Stellenwert und Chancen

    Energy Technology Data Exchange (ETDEWEB)

    Hetterich, H.; Schafnitzel, A. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Bamberg, F. [Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany)

    2015-04-01

    Diabetes mellitus is a highly prevalent multisystemic disorder with numerous potential complications and substantial socioeconomic consequences. In many cases, the patient history, physical examination and laboratory tests are not sufficient for a comprehensive evaluation of complicating disorders. Imaging modalities, such as sonography, computed tomography (CT) and magnetic resonance imaging (MRI) are of major significance in the evaluation of complicating disorders of diabetes according to current guidelines. Examples include assessment of coronary artery disease, peripheral artery disease, stroke and diabetic foot syndrome. Technical developments allow a substantial reduction in radiation dose and scan time in CT and MRI, respectively and could therefore justify a broader application in this patient population. In the future CT and MRI could also be used for the early detection of diabetic complications. Furthermore, they could also be used for risk stratification, e.g. measurement of hepatic fat content and evaluation of atherosclerosis in whole body MRI. Prior to widespread application of advanced imaging techniques in this patient population, improved outcomes with respect to survival, quality of life and cost-effectiveness need to be demonstrated. Diagnostic imaging modalities for the evaluation of the syndrome complex of diabetic disorders should be used according to the current guidelines but the use is predicted to increase given the high potential in this population. (orig.) [German] Diabetes mellitus ist eine hochpraevalente Multisystemerkrankung mit zahlreichen Komplikationen und bedeutenden soziooekonomischen Konsequenzen. Die Folgeerkrankungen koennen oft nicht abschliessend mittels Anamnese, koerperlicher Untersuchung und laborchemischen Verfahren evaluiert werden. Radiologische Verfahren wie die Sonographie, Computertomographie (CT) und Magnetresonanztomographie (MRT) haben gemaess verschiedener Leitlinien einen festen Stellenwert bei der

  9. Verbesserte Visualisierung der Koronararterien in MSCT-Daten mit direkter Vergleichbarkeit zur Angiographie

    Science.gov (United States)

    Lacalli, Christina; Jähne, Marion; Wesarg, Stefan

    In diesem Beitrag stellen wir neue, automatisierte Verfahren zur Visualisierung der Koronararterien einerseits und für eine direkte Vergleichbarkeit mit konventionellen Angiogrammen andererseits vor. Unser Ansatz umfasst Methoden für die automatische Extraktion des Herzens aus kontrastverstärkten CT-Daten, sowie für die Maskierung grosser kontrastmittelgefüllter Kavitäten des Herzens, um die Sichtbarkeit der Koronararterien bei der Darstellung mittels Volumenrendering zu verbessern. Zum direkten Vergleich mit konventionellen Angiographien wurde ein Verfahren zur automatischen Generierung von Projektionsansichten aus den CT-Daten entwickelt.

  10. Kino filmų titrai kaip kalbų mokymosi priemonė. Untertitel als Mittel zum Fremdsprachenerwerb

    Directory of Open Access Journals (Sweden)

    Alina Baravykaitė

    2007-01-01

    Full Text Available Das in den letzten Jahren spürbare Bestreben der litauischen Gesetzgeber, Untertitelung von Fernsehfilmen zwecks Fremdsprachenerwerb gesetzlich anzuordnen, löste eine Auseinandersetzung in der Öffentlichkeit aus, die sich in der Presse sowie im Internet widerspiegelt und als Anstoß zum vorliegenden Beitrag dient. Diese Arbeit stellt den Versuch dar, die Möglichkeiten und Grenzen der Untertitelung als eines Mittels zum Fremdsprachenerwerb zu untersuchen. Auf Grund der fehlenden wissenschaftlichen Forschungen in diesem Bereich sollen dabei empirische Betrachtungen und die vergleichende Textanalyse von Original und Übersetzung als Hilfe dienen. Auch wenn die Relevanz der Untertitelung für den Fremdsprachenerwerb nicht bestreitbar ist, ist sie aber zugleich nicht zu überschätzen: Durch die lediglich für diese Form der audiovisuellen Übersetzung charakteristischen Merkmale (kurze Einblendezeit, kondensierte Sprache und begrenzte Übertragungsmöglichkeiten von Realia-Begriffen, Phraseologismen, Intertextualismen, dem Wortspiel etc. bleiben dem Zuschauer oft sprachliche Stilmittel vorenthalten und der in allen Übersetzungsbereichen vorkommende unausweichliche Sinn- und Wirkungsverlust des Originals wird erheblich verstärkt. Anbetracht der erwähnten Aspekte und der häufigen fehlerhaften Übersetzungen sollen Untertitel nur als Hilfsmittel beim Fremdsprachenerwerb angewendet werden, wobei herkömmliche Lehr- und Lernstrategien von Fremdsprachen in den Vordergrund treten müssen.

  11. Clinical neuroanatomy and diagnostic imaging and evaluation of the brain. MRI and CT atlas. 3. new rev. and enl. ed.; Klinische Neuroanatomie und kranielle Bilddiagnostik. Atlas der Magnetresonanztomographie und Computertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Kretschmann, H.J. [Medizinische Hochschule Hannover (Germany); Weinrich, W. [Krankenhaus Nordstadt, Klinikum Hannover (Germany)

    2003-07-01

    New features of this 3rd German edition are: - Number of the MR and CT images almost doubled, all pictures now in large format, displaying much more brain structures. - New knowledge and insight incorporated in the text and pictures. (orig./CB) [German] In der vorliegenden 3. Auflage wurden die MR- und CT-Bilder des Bildatlas durch grossformatige Abbildungen ersetzt. Ihre Anzahl wurde nahezu verdoppelt. In den nun grossen Abbildungen konnte die Zahl der bezeichneten Hirnstrukturen wesentlich erhoeht werden. Neues Wissen wurde in den Text und in die Abbildungen aufgenommen. (orig./AJ)

  12. Towards clinical implementation of ultrafast combined kV-MV CBCT for IGRT of lung cancer. Evaluation of registration accuracy based on phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Arns, Anna; Blessing, Manuel; Fleckenstein, Jens; Stsepankou, Dzmitry; Boda-Heggemann, Judit; Simeonova-Chergou, Anna; Hesser, Juergen; Lohr, Frank; Wenz, Frederik; Wertz, Hansjoerg [University Medical Center Mannheim, University of Heidelberg, Department of Radiation Oncology, Mannheim (Germany)

    2016-05-15

    Atemanhaltephase von 15 s kann ein 3D kV-MV CBCT aufgenommen werden. Dies reduziert Bewegungsartefakte und erhoeht den Patientenkomfort. Im Hinblick auf die klinische Implementierung wurde die Positionierungsgenauigkeit untersucht und mit klinisch-etablierten Bildgebungstechniken verglichen. Ein inhomogenes Thoraxphantom mit 4 tumoraehnlichen Inlays wurde in 10 vordefinierten Positionen aufgenommen und auf ein Planungs-CT registriert. Die neue kV-MV CBCT Bildgebungstechnik (90 -Rotation) wurde mit einem klinisch etablierten kV-Chest CBCT (360 ) sowie mit einem nichtklinischen kV-CBCT und einem niedrigdosierten MV-CBCT (je 180 ) verglichen. Manuelle Registrierung, automatische Registrierung vom Hersteller und eine eigens entwickelte Methode der automatischen Registrierung auf Basis des MATLAB-Registrierungs-Toolkits wurden angewandt. Die hochpraezise Phantompositionierung mit optischem Tracking reduzierte den systematischen Fehler auf 0,05 mm. Die gemittelten stochastischen Positionierungsfehler waren 0,5 ± 0,3 mm in rechts-links, 0,4 ± 0,4 mm in anteroposterior und 0,0 ± 0,4 mm in kraniokaudaler Richtung fuer kV-MV CBCT mit manueller Registrierung (mit einem maximalen Fehler von 1,4 mm). Das klinische kV-Chest CBCT ergab einen mittleren Fehler von 0,2 mm (andere Modalitaeten: 0,4-0,8 mm). Die beiden automatischen Registrierungsverfahren zeigten aehnliche Ergebnisse. Die Vergleichsstudie der Positionierungsgenauigkeit zwischen neuen kV-MV-CBCTs und klinisch-etablierter Volumenbildgebung zeigte weiterhin eine Registrierungsgenauigkeit unter 1 mm. Durch Reduktion der Bildaufnahmezeit auf eine Atemanhaltephase ist die kV-MV CBCT eine ideale Technik in stereotaktischer ablativer Strahlentherapie z. B. der Lunge. (orig.)

  13. Konkomitantes Auftreten von Lichen sclerosus und Hashimoto-Thyreoiditis

    Directory of Open Access Journals (Sweden)

    Eberz B

    2009-01-01

    Full Text Available Der Lichen sclerosus (LS zählt zu den chronisch entzündlichen Hauterkrankungen, der auf dem Boden einer Immundysregulierung entsteht. Per 01.06.2009 war die Prävalenz des klinisch und stanzbioptisch diagnostizierten anogenitalen Lichen sclerosus in einer allgemein gynäkologischen Praxis in Mürzzuschlag 9,1 % (278/3040 Patientinnen. Die frühzeitige Abklärung chronischer Vulvabeschwerden unter standardmäßiger Einbeziehung einer Vulvabiopsie erlaubte es, auch Frühformen des LS zu erfassen. Nach klinischer und stanzbioptischer Diagnose eines LS wird in Anlehnung an die "Guidelines for the Management of Lichen Sclerosus" [1] ein serologisches Screening auf Autoantikörper (TPO-AK, TG-AK, Parietalzell- und antinukleäre Antikörper durchgeführt. Bei 263 unserer 278 LS-Patientinnen wurde ein serologisches Screening auf Autoimmunerkrankungen durchgeführt. Insgesamt hatten 58/263 LS-Patientinnen pathologisch erhöhte Thyroidperoxidase-(TPO- und/oder Thyreoglobulin- (TG- Antikörpertiter (23 %, davon 50/263 (19 % auch eine sonographisch bestätigte Hashimoto-Thyreoiditis. Bei 50 % dieser Hashimoto-Patientinnen war bereits im Vorfeld eine Hypothyreose bekannt, bei den restlichen 25 Patientinnen handelte es sich allerdings um eine Erstdiagnose im Rahmen des Screenings für LS. Aufgrund der hohen Prävalenz von Hashimoto-Thyreoiditis in LS-Patientinnen empfehlen wir bei allen Frauen mit LS ein Screening auf TPO- und TG-Antikörper. Bei erhöhten Titern sollte eine Abklärung mittels Schilddrüsensonogramm sowie eine Bestimmung von basalem "thyroid-stimulating hormone" (TSH, freiem T3 und freiem T4 erfolgen. In der Schilddrüsensprechstunde sollten Frauen mit Hashimoto-Thyreoiditis gezielt nach chronischen bzw. rezidivierenden anogenitalen Beschwerden, insbesondere Pruritus, Brennen oder Dyspareunie befragt werden. Bei positiver Anamnese ist eine Zuweisung an einen auf Vulvaerkrankungen spezialisierten Facharzt für Gynäkologie sinnvoll.

  14. First clinical experience with extended planning and navigation in an interventional MRI unit; Erste klinische Erfahrungen mit einer erweiterten Eingriffsplanung und Navigation am interventionellen MRT

    Energy Technology Data Exchange (ETDEWEB)

    Moche, M.; Schneider, J.P.; Schulz, T.; Voerkel, C.; Kahn, T.; Busse, H. [Klinik und Poliklinik fuer Diagnostische Radiologie, Universitaetsklinikum Leipzig (Germany); Schmitgen, A.; Bublat, M. [Fraunhofer-Inst. fuer Angewandte Informationstechnik, St. Augustin (Germany); Trantakis, C. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinikum Leipzig (Germany); Bennek, J. [Klinik und Poliklinik fuer Kinderchirurgie, Univ. Leipzig (Germany)

    2004-07-01

    Purpose: To present an advanced concept for patient-based navigation and to report on our first clinical experience with interventions in the cranium, of soft-tissue structures (breast, liver) and in the musculoskeletal system. Materials and Methods: A PC-based navigation system was integrated into an existing interventional MRI environment. Intraoperatively acquired 3D data were used for interventional planning. The information content of these reference data was increased by integration of additional image modalities (e. g., fMRI, CT) and by color display of areas with early contrast media enhancement. Within 18 months, the system was used in 123 patients undergoing interventions in different anatomic regions (brain: 64, paranasal sinus: 9, breast: 20, liver: 17, bone: 9, muscle: 4). The mean duration of 64 brain interventions was compared that of 36 procedures using the scanner's standard navigation. Results: In contrast with the continuous scanning mode of the MR system (0.25 fps), the higher quality as well as the real time display (4 fps) of the MR images reconstructed from the 3D reference data allowed adequate hand-eye coordination. With our system, patient movement and tissue shifts could be immediately detected intraoperatively, and, in contrast to the standard procedure, navigation safely resumed after updating the reference data. The navigation system was characterized by good stability, efficient system integration and easy usability. Despite additional working steps still to be optimized, the duration of the image-guided brain tumor resections was not significantly longer. (orig.) [German] Ziel: Vorstellung eines erweiterten Konzepts zur patientenbasierten Navigation sowie erste klinische Bewertung der durchgefuehrten Massnahmen im Kopf, Weichteil- und muskuloskeletalen Bereich. Material und Methode: Ein PC-basiertes Navigationssystem wurde in eine vorhandene interventionelle MRT-Umgebung integriert. Intraoperativ akquirierte 3-D

  15. Image fusion of MRI and fMRI with intraoperative MRI data: methods and clinical relevance for neurosurgical interventions; Fusion von MRT-, fMRT- und intraoperativen MRT-Daten. Methode und klinische Bedeutung am Beispiel neurochirurgischer Interventionen

    Energy Technology Data Exchange (ETDEWEB)

    Moche, M.; Busse, H.; Dannenberg, C.; Schulz, T.; Schmidt, F.; Kahn, T. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Diagnostische Radiologie; Schmitgen, A. [GMD Forschungszentrum Informationstechnik GmbH-FIT, Sankt Augustin (Germany); Trantakis, C.; Winkler, D. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinikum Leipzig (Germany)

    2001-11-01

    The aim of this work was to realize and clinically evaluate an image fusion platform for the integration of preoperative MRI and fMRI data into the intraoperative images of an interventional MRI system with a focus on neurosurgical procedures. A vertically open 0.5 T MRI scanner was equipped with a dedicated navigation system enabling the registration of additional imaging modalities (MRI, fMRI, CT) with the intraoperatively acquired data sets. These merged image data served as the basis for interventional planning and multimodal navigation. So far, the system has been used in 70 neurosurgical interventions (13 of which involved image data fusion - requiring 15 minutes extra time). The augmented navigation system is characterized by a higher frame rate and a higher image quality as compared to the system-integrated navigation based on continuously acquired (near) real time images. Patient movement and tissue shifts can be immediately detected by monitoring the morphological differences between both navigation scenes. The multimodal image fusion allowed a refined navigation planning especially for the resection of deeply seated brain lesions or pathologies close to eloquent areas. Augmented intraoperative orientation and instrument guidance improve the safety and accuracy of neurosurgical interventions. (orig.) [German] Ziel dieser Arbeit waren die Realisierung und klinische Bewertung einer Bildfusion praeoperativer MRT- und fMRT-Bilder mit intraoperativen Datensaetzen eines interventionellen MRT-Systems am Beispiel neurochirurgischer Eingriffe. Ein vertikal offenes 0,5-T-MRT-System wurde mit einem erweiterten Navigationssystem ausgestattet, welches eine Integration zusaetzlicher Bildinformationen (Hochfeld-MRT, fMRT, CT) in die intraoperativ akquirierten Datensaetze erlaubt. Diese fusionierten Bilddaten wurden zur Interventionsplanung und multimodalen Navigation verwendet. Bisher wurde das System bei insgesamt 70 neurochirurgischen Eingriffen eingesetzt, davon 13

  16. Clinical indications for high-resolution MRI diagnostics of the peripheral nervous system; Klinische Indikationen hochaufloesender MRT-Diagnostik des peripheren Nervensystems

    Energy Technology Data Exchange (ETDEWEB)

    Godel, T. [Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany); Weiler, M. [Universitaetsklinikum Heidelberg, Neurologische Klinik, Heidelberg (Germany)

    2017-03-15

    Peripheral neuropathies are common and diagnostically often challenging disorders. Difficulties particularly exist in lesion localization and recognition of complex spatial lesion patterns. Medical history taking, neurological examination, neurophysiological tests and nerve ultrasonography represent the gold standard in the diagnosis of peripheral nerve lesions but have known methodical limitations. The use of 3 Tesla magnetic resonance neurography (MRN) is an additional diagnostic imaging tool recently developed for the high-resolution visualization of long segments of peripheral nerves. Reasonable clinical indications for MRN are exemplarily presented. Using MRN a direct visualization and thus precise localization of focal and non-focal peripheral nerve lesions of various origins can be achieved with high spatial resolution down to the anatomical level of nerve fascicles. Using MRN large anatomical areas of the peripheral nervous system (PNS) can be covered in a single examination session, spatial nerve lesion patterns can be evaluated and the underlying causes can often be detected. The MRN is a valuable supplement to the diagnostic work-up of the PNS, especially in cases that cannot be clarified with standard diagnostic methods. Evaluation of the spatial nerve lesion pattern gives additional information on the origin of the underlying disease. Reasonable indications for MRN are the assessment of proximal nerve structures including the brachial and lumbosacral nerve plexi, the clarification of inconclusive diagnostic results, preoperative, postoperative and posttraumatic assessments, the identification of fascicular nerve lesions and the differential diagnosis of an alleged somatoform disorder. (orig.) [German] Periphere Neuropathien sind haeufige und diagnostisch mitunter anspruchsvolle Erkrankungen. Schwierigkeiten bestehen v. a. bei der Laesionslokalisation und Erkennung komplexer Laesionsmuster. Anamnese, klinisch-neurologische Untersuchung

  17. Patient's quality of life after high-dose radiation therapy for thoracic carcinomas. Changes over time and influence on clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Christina [University Clinic Giessen and Marburg, Clinic for Radiotherapy and Radiation Oncology, Marburg (Germany); Ruppiner Kliniken GmbH, Clinic for Radiotherapy and Radiation Oncology, Neuruppin (Germany); Engenhart-Cabillic, Rita; Vorwerk, Hilke [University Clinic Giessen and Marburg, Clinic for Radiotherapy and Radiation Oncology, Marburg (Germany); Schmidt, Michael; Huhnt, Winfried; Blank, Eyck; Sidow, Dietrich; Buchali, Andre [Ruppiner Kliniken GmbH, Clinic for Radiotherapy and Radiation Oncology, Neuruppin (Germany)

    2017-02-15

    Ergebnis, das Ueberleben und die Korrelation mit therapieinduzierten Nebenwirkungen. Analysiert wurden 81 Patienten mit thorakalen Tumoren, die mittels Radio(chemo)therapie behandelt wurden. Zur Objektivierung der QoL wurden der EORTC QLQ-C30 und der EORTC QLQ-LC13 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire) verwendet. QoL-Daten wurden vor Strahlentherapie (RT) sowie 6 Wochen, 12 Wochen, 6 Monate und 1 Jahr nach RT gesammelt. Zusaetzlich wurden weitere Faktoren wie das klinische Ergebnis, Ueberleben und Nebenwirkungen analysiert. Saemtliche Funktionsskalen zeigten ein Maximum oder zumindest eine Erholung 12 Wochen nach RT. Symptome mit hohem durchschnittlichen Symptomscore (> 40) zu allen Untersuchungszeitpunkten waren Fatigue, Dyspnoe und Husten. Schlaflosigkeit, periphere Neuropathie, Appetitverlust, Dyspnoe (aus QLQ-LC13) und alle Schmerzparameter zeigten durchschnittlich eine mittlere Punktzahl (10-40). Niedrige durchschnittliche Punktzahlen (< 10) hatten Uebelkeit und Erbrechen, Diarrhoe, Wunden im Mundbereich und Haemoptysis. Keine signifikante Korrelation mit den zugehoerigen Symptomskalen bestand zwischen klinisch vorhandener Dysphagie und Pneumonitis. Kein QoL-Parameter hatte signifikanten Einfluss auf klinische Kontrolle oder Gesamtueberleben. Die besten Werte oder zumindest eine Erholung der Funktionsskalen zeigen sich 12 Wochen nach RT. Die Symptomskalen spiegeln die haeufigsten tumor- oder therapiebezogenen Symptome wieder. Die QoL hat keinen signifikanten Einfluss auf klinische Kontrolle oder Gesamtueberleben. (orig.)

  18. Comparison of CT numbers between cone-beam CT and multi-detector CT

    International Nuclear Information System (INIS)

    Kim, Dong Soo; Han, Won Jeong; Kim, Eun Kyung

    2010-01-01

    To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, ρ(g/cm 3 ), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were ρ=0.001 H+1.07 with R2 value of 0.999 for Somatom Emotion, ρ=0.002 H+1.09 with R2 value of 0.991 for Alphard VEGA, ρ=0.001 H+1.43 with R2 value of 0.980 for i-CAT and ρ=0.001 H+1.30 with R2 value of 0.975 for Implagraphy. CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

  19. Comparison of CT numbers between cone-beam CT and multi-detector CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Soo; Han, Won Jeong; Kim, Eun Kyung [Department of Oral and Maxillofacial Radiology, School of Dentistry, Dankook University, Cheonan (Korea, Republic of)

    2010-06-15

    To compare the CT numbers on 3 cone-beam CT (CBCT) images with those on multi-detector CT (MDCT) image using CT phantom and to develop linear regressive equations using CT numbers to material density for all the CT scanner each. Mini CT phantom comprised of five 1 inch thick cylindrical models with 1.125 inches diameter of materials with different densities (polyethylene, polystyrene, plastic water, nylon and acrylic) was used. It was scanned in 3 CBCTs (i-CAT, Alphard VEGA, Implagraphy SC) and 1 MDCT (Somatom Emotion). The images were saved as DICOM format and CT numbers were measured using OnDemand 3D. CT numbers obtained from CBCTs and MDCT images were compared and linear regression analysis was performed for the density, {rho}(g/cm{sup 3}), as the dependent variable in terms of the CT numbers obtained from CBCTs and MDCT images. CT numbers on i-CAT and Implagraphy CBCT images were smaller than those on Somatom Emotion MDCT image (p<0.05). Linear relationship on a range of materials used for this study were {rho}=0.001 H+1.07 with R2 value of 0.999 for Somatom Emotion, {rho}=0.002 H+1.09 with R2 value of 0.991 for Alphard VEGA, {rho}=0.001 H+1.43 with R2 value of 0.980 for i-CAT and {rho}=0.001 H+1.30 with R2 value of 0.975 for Implagraphy. CT numbers on i-CAT and Implagraphy CBCT images were not same as those on Somatom Emotion MDCT image. The linear regressive equations to determine the density from the CT numbers with very high correlation coefficient were obtained on three CBCT and MDCT scan.

  20. Acute abdomen. Clinical background and demands on imaging; Akutes Abdomen. Klinische Begriffsbestimmung und Anforderungen an die Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Graeb, C.; Jauch, K.W. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Chirurgie, Muenchen (Germany); Reiser, M.; Graser, A. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2010-03-15

    The term ''acute abdomen'' does not describe a specific disease entity but is more a critical clinical state which incorporates very heterogeneous clinical presentations. The prognosis of any disease depends on the time frame from the onset of symptoms to the initiation of a specific therapy. For this reason there are special expectations by clinicians regarding the diagnostic assessment provided by radiology which is expected to deliver an immediate diagnosis supporting further therapeutic decisions. Along with the patient's clinical history, physical examination and blood tests, radiological diagnostics are essential for enabling a specific treatment. From a surgical point of view the radiologist is expected to help in differentiating between cases with indications for emergency surgery and cases eligible for elective surgery or conservative treatment. (orig.) [German] Der Begriff ''akutes Abdomen'' stellt keine eigenstaendige Erkrankung dar, sondern beschreibt einen kritischen klinischen Zustand, unter dessen Oberbegriff sich die unterschiedlichsten Krankheitsbilder subsumieren lassen. Das Zeitintervall zwischen dem Auftreten der ersten Symptome bis zur Einleitung einer gezielten Therapie ist fuer die Prognose der Patienten der entscheidende Faktor. Aus diesem Grund bestehen besondere Anforderungen an die bildgebende Diagnostik, die dazu beitragen soll, innerhalb kuerzester Zeit eine moeglichst genaue Diagnose zu stellen. Neben Anamnese, klinischer Untersuchung und Labordiagnostik stellt die radiologische Untersuchung einen wesentlichen Baustein vor der Therapieeinleitung dar. Aus chirurgischer Sicht muessen Krankheitsbilder, die eine sofortige Notfalloperation erforderlich machen, von Erkrankungen differenziert werden, die eine elektive Chirurgie oder ein konservatives Vorgehen indizieren. (orig.)

  1. Clinical Application of colored three-dimensional CT (3D-CT) for brain tumors using helical scanning CT (HES-CT)

    International Nuclear Information System (INIS)

    Ogura, Yuko; Katada, Kazuhiro; Fujisawa, Kazuhisa; Imai, Fumihiro; Kawase, Tsukasa; Kamei, Yoshifumi; Kanno, Tetsuo; Takeshita, Gen; Koga, Sukehiko

    1995-01-01

    We applied colored three-dimensional CT (colored 3D-CT) images to distinguish brain tumors from the surrounding vascular and bony structures using a work station system and helical scanning CT (HES-CT). CT scanners with a slip-ring system were employed (TCT-900S and X vigor). A slice thickness of 2 mm and bed speed of 2 mm/s were used. The volume of contrast medium injected was 60 to 70 ml. Four to 8 colors were used for the tissue segmentation on the workstation system (xtension) using the data transferred from HES-CT. Tissue segmentation succeeded on the colored 3D-CT images in all 13 cases. The relationship between the tumors and the surrounding structures were easily recognized. The technique was useful to simulate operative fields, because deep structures could be visualized by cutting and drilling the colored 3D-CT volumetric data. On the basis of our findings, we suggest that colored 3D-CT images should be used as a supplementary aid for preoperative simulation. (author)

  2. Ultra-low dose CT attenuation correction for PET/CT

    International Nuclear Information System (INIS)

    Xia Ting; Kinahan, Paul E; Alessio, Adam M; De Man, Bruno; Manjeshwar, Ravindra; Asma, Evren

    2012-01-01

    A challenge for positron emission tomography/computed tomography (PET/CT) quantitation is patient respiratory motion, which can cause an underestimation of lesion activity uptake and an overestimation of lesion volume. Several respiratory motion correction methods benefit from longer duration CT scans that are phase matched with PET scans. However, even with the currently available, lowest dose CT techniques, extended duration cine CT scans impart a substantially high radiation dose. This study evaluates methods designed to reduce CT radiation dose in PET/CT scanning. We investigated selected combinations of dose reduced acquisition and noise suppression methods that take advantage of the reduced requirement of CT for PET attenuation correction (AC). These include reducing CT tube current, optimizing CT tube voltage, adding filtration, CT sinogram smoothing and clipping. We explored the impact of these methods on PET quantitation via simulations on different digital phantoms. CT tube current can be reduced much lower for AC than that in low dose CT protocols. Spectra that are higher energy and narrower are generally more dose efficient with respect to PET image quality. Sinogram smoothing could be used to compensate for the increased noise and artifacts at radiation dose reduced CT images, which allows for a further reduction of CT dose with no penalty for PET image quantitation. When CT is not used for diagnostic and anatomical localization purposes, we showed that ultra-low dose CT for PET/CT is feasible. The significant dose reduction strategies proposed here could enable respiratory motion compensation methods that require extended duration CT scans and reduce radiation exposure in general for all PET/CT imaging. (paper)

  3. Ultra-low dose CT attenuation correction for PET/CT

    Science.gov (United States)

    Xia, Ting; Alessio, Adam M.; De Man, Bruno; Manjeshwar, Ravindra; Asma, Evren; Kinahan, Paul E.

    2012-01-01

    A challenge for PET/CT quantitation is patient respiratory motion, which can cause an underestimation of lesion activity uptake and an overestimation of lesion volume. Several respiratory motion correction methods benefit from longer duration CT scans that are phase matched with PET scans. However, even with the currently-available, lowest dose CT techniques, extended duration CINE CT scans impart a substantially high radiation dose. This study evaluates methods designed to reduce CT radiation dose in PET/CT scanning. Methods We investigated selected combinations of dose reduced acquisition and noise suppression methods that take advantage of the reduced requirement of CT for PET attenuation correction (AC). These include reducing CT tube current, optimizing CT tube voltage, adding filtration, CT sinogram smoothing and clipping. We explored the impact of these methods on PET quantitation via simulations on different digital phantoms. Results CT tube current can be reduced much lower for AC than that in low dose CT protocols. Spectra that are higher energy and narrower are generally more dose efficient with respect to PET image quality. Sinogram smoothing could be used to compensate for the increased noise and artifacts at radiation dose reduced CT images, which allows for a further reduction of CT dose with no penalty for PET image quantitation. Conclusion When CT is not used for diagnostic and anatomical localization purposes, we showed that ultra-low dose CT for PET/CT is feasible. The significant dose reduction strategies proposed here could enable respiratory motion compensation methods that require extended duration CT scans and reduce radiation exposure in general for all PET/CT imaging. PMID:22156174

  4. Clinical application of gated CT and dynamic CT

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, T; Oyama, Y; Ashida, H; Uji, T [Saint Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1980-03-01

    Gated CT and dynamic CT were outlined. Experiences of portal hypertension accompanied by venous mass in posterior mediastinum and the usefulness of dynamic CT for this disease were described. Gated CT of the heart could visualize intracardiac structures and morphological abnormalities by improving technique of post-data-aquisition correlation. Changes with time in CT images of normal kidneys were discussed on patients whose unilateral or bilateral kidneys were thought to be normal and who had received dynamic scan. Dynamic scan could visualize well blood circulation and mechanism of urine excretion in the kidney, which suggests a possibility of CT to detect not only morphological abnormalities but also functional disturbance of the kidney. The effectiveness of conventional CT study might be promoted in dynamic CT of the head.

  5. Accuracy of renal volume assessment in children by three-dimensional sonography; Nierenvolumetrie im Kindesalter: Genauigkeit der dreidimensionalen Sonographie im Vergleich zur konventionellen Sonographie und CT/MRT

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, G.A.; Riccabona, M.; Bohdal, G. [Klinik fuer Radiologie, Universitaetsklinikum Graz (Austria); Quehenberger, F. [Inst. fuer medizinische Informatik, Statistik und Dokumentation, Universitaetsklinikum Graz (Austria)

    2003-04-01

    Purpose: Prospective evaluation of the accuracy of three-dimensional ultrasound (3DUS) to assess the renal parenchymal volume. Materials and Methods: CT, MRI, 2DUS and 3DUS were used to measure the renal volume in 40 patients (range: neonate to 17 years; mean age: 8.95 years). The 3DUS was determined with a Voluson 730 (Kretztechnik, GE) or an external 3D-system (EchoTech, GE) using electromagnetic positioning sensors attached to conventional 2DUS-equipment. The 2DUS volume was calculated with the ellipsoid equation and the 3DUS volume computed with the system integrated software. For CT and MRI, planimetric analysis was used to determine the renal parenchymal volume, whereby the dilated collecting system of a hydronephrosis was subtracted to obtain the real renal parenchymal volume. The results of 2DUS and 3DUS were compared to the results of CT and MRI, and inter- and intraobserver variabilities were calculated. Results: In 74 of 77 kidneys, the 3DUS study was of diagnostic quality. The accuracy of the 3DUS volumes compared well to the CT and MRI volumes with a mean difference of -1.8 {+-} 4.6% versus a mean difference of -2.4 {+-} 15.4% for 2DUS. In normal kidneys, the accuracy was -2.6 {+-} 4.4% for 3DUS and -3.8 {+-} 14.7% for 2DUS. In hydronephrosis, the accuracy was +4.0 {+-} 5.9% and +9.6 {+-} 21.3%, respectively, indicating that 3DUS is more accurate than 2DUS, particularly in kidneys with a dilated collecting system. Inter- and intraobserver variabilities were {+-} 7.3% and {+-} 5.3%. Conclusion: For assessing the renal parenchymal volume in children, 3DUS is feasible and comparable to CT and MRI. (orig.) [German] Studienziel: Prospektive Evaluation der Genauigkeit des drei-dimensionalen Ultraschalls (3DUS) bei der Volumetrie der kindlichen Niere im Vergleich zur CT/MRT. Methode: Bei 40 Patienten (Alter: 0 - 17 Jahre) mit einer klinisch indizierten CT/MRT des Abdomens oder des Harntrakts wurde zusaetzlich ein 2D- und 3DUS inklusive Volumetrie des

  6. Visualization of coronary arteries in CT as assessed by a new 16 slice technology and reduced gantry rotation time: first experiences; Darstellung der Herzkranzgefaesse im CT mittels neuer 16-Zeilen-Technologie und reduzierter Rotationszeit: erste Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Heuschmid, M.; Kuettner, A.; Kopp, A.F.; Claussen, C.D. [Abt. Radiologische Diagnostik, Universitaetsklinikum Tuebingen (Germany); Flohr, T.; Schaller, S.; Hartung, A.; Ohnesorge, B. [Siemens Medical Solutions, Forchheim (Germany); Wildberger, J.E. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum (RWTH) Aachen (Germany); Lell, M.; Baum, U. [Abt. Innere Medizin IV (Kardiologie), Universitaetsklinikum Tuebingen (Germany); Schroeder, S. [Inst. fuer Diagnostische Radiologie, Universitaetsklinikum Erlangen (Germany)

    2002-06-01

    Purpose: First evaluation of image quality of a new 16-slice multidetector-row computed tomography (MDCT) for the assessment of coronary artery disease and lesion detection of the coronary arteries. Materials and Methods: On a newly developed 16-slice CT scanner (SOMATOM Sensation 16, Siemens, Forchheim, Germany) a calcium score as well as a contrast-enhanced CT angiography (CTA) were performed on 4 patients with retrospective ECG-gating and a gantry rotation time of 420 ms to exclude or follow-up coronary heart disease. CTA was performed after injecting 120 ml contrast media intravenously. After medication with a {beta}-Blocker, the heart rate was between 55 and 67 bpm. Results: The scan time for calcium score was 12s, for CTA 18s (scan range 15 and 12 cm, respectively). Volume score was between 0 and 256.4. In the CT angiography the entire coronary tree could be visualized in all patients up to the very distal subsegmental branches. In two patients a complete occlusion of the RCA and the LAD were depicted, respectively. In one of these patients, a large aneurysm of the left anterior ventricular wall was also delineated. Conclusion: Considering our first experiences with the new 16-slice technology, an excellent visualization of the entire coronary tree including the very distal and side branches due to substantially increased spatial resolution seems to be achievable. In these patients the acquired image quality raises the hope for improved, non-invasive cardiac diagnostics. In larger studies, the clinical impact of this new technology needs to be further investigated. (orig.) [German] Ziel: Darstellung erster Ergebnisse zur Bildqualitaet eines neuen 16-Zeilen Multidetektor-Computertomographen (MDCT) bei der Diagnostik der koronaren Herzerkrankung (KHK) und hochgradiger Stenosen der Herzkranzgefaesse. Material und Methode: Mit einem neuen 16-Zeilen-Computertomographen (SOMATOM Sensation 16, Siemens, Forchheim) wurde bei 4 Patienten zum Ausschluss oder

  7. Influence of age and menstrual cycle on mammography and MR imaging of the breast; Einfluss von Alter und Menstruationszyklus auf Mammographie und MR-Mammographie

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Schimpfle, M.; Ohmenhaeuser, K.; Claussen, C.D. [Tuebingen Univ. (Germany). Abt. fuer Radiologische Diagnostik

    1997-09-01

    Age and menstrual cycle have an important influence on the breast. This well-known fact is experienced in the daily routine of gynecologists and radiologists. The number of publications addressing the effect of these influences on imaging, however, is surprisingly low. The aim of this work is to describe the influences of age and menstrual cycle on the breast and to address their clinical relevance for mammography and MR mammography. Therefore, own data are presented concerning the age and menstrual cycle influences on breast parenchyma in dynamic MR mammography. Literature data are used to correlate mammography and MR imaging findings with these influences. The changes of the breast due to age and menstrual cycle have important direct implications on performing and reading conventional mammography and MR mammography. The knowledge of these changes is also helpful in the interpretation of findings when comparing different methods. Finally, the data gained by using imaging methods enable important basic insights into physiology and physiopathology of the breast in vivo. (orig.) [Deutsch] Alter und Menstruationszyklus stellen wichtige Einflussfaktoren auf die Mamma dar. Diese Tatsache ist klinisch lange bekannt und im Alltag des Gynaekologen wie Radiologen staendig praesent. Dagegen ist die Anzahl der Publikationen zu den Auswirkungen dieser Einfluesse auf die Bildgebung erstaunlich niedrig. Ziel dieser Arbeit ist es, die alters- und zyklusabhaengigen Veraenderungen der Mamma und deren klinische Relevanz fuer die Mammographie und MR-Mammographie darzustellen. Zu diesem Zweck werden aus einer eigenen Studie Daten der dynamischen MR-Tomographie zum Alters- und Zykluseinfluss auf das Mammaparenchym praesentiert. Darueber hinaus werden diese Einflussfaktoren mit mammographischen und MR-tomographischen Daten aus der Literatur korreliert. Dabei zeigt sich, dass sich aus den alters- und menstruationszyklusbedingten Veraenderungen der Brust wichtige unmittelbare

  8. Rekonstruktion mit Netz beim komplexen Prolaps der Frau: Was hilft es der Patientin wirklich?

    Directory of Open Access Journals (Sweden)

    Hierl J

    2010-01-01

    Full Text Available Einleitung: Der komplexe Genitaldeszensus der Frau geht oftmals mit einer deutlichen Einschränkung der Lebensqualität (LQ einher. Dennoch ist der Endpunkt der meisten klinischen Analysen rein anatomischer und funktioneller Natur. In der vorliegenden Untersuchung wurden die Einflüsse der operativen Rekonstruktion mit einem Netz prospektiv auf die LQ evaluiert. Patienten und Methoden: Bei insgesamt 111 Patientinnen mit Deszensus erfolgte zwischen 08/2005 und 12/2007 eine operative Versorgung mittels vaginaler Netzeinlage (anteriorer bzw. kompletter Mesh-Repair. Die LQ wurde prospektiv prä- und postoperativ anhand standardisierter LQ-Fragebögen erfasst. Ergebnisse: Präoperativ zeigte sich bei den Patientinnen eine signifikant reduzierte LQ gegenüber einem Normalkollektiv (p 0,01. Bei 7 % der Patientinnen mit anteriorem, und bei 11 % mit komplettem Mesh-Repair lag postoperativ kein adäquates klinisches Ergebnis vor. In diesem Kollektiv zeigte sich kein signifikanter Unterschied in den LQ-Tests prä- und postoperativ. Bei gutem postoperativem Ergebnis zeigte sich in der Gruppe mit anteriorer Netzeinlage lediglich bei 45 % (p = 0,021, bei kompletter Netzeinlage nur bei 31 % (p = 0,041 eine signifikant verbesserte LQ. Bei kleiner Fallzahl und kurzem Nachbeobachtungszeitraum kann eine gültige Aussage bezüglich der LQ nach Deszensuschirurgie mit Netzeinlage jedoch noch nicht getroffen werden.

  9. PET/CT in lymphoma patients; PET-CT bei Lymphompatienten

    Energy Technology Data Exchange (ETDEWEB)

    Steinert, H.C. [Universitaetsspital Zuerich, Klinik und Poliklinik fuer Nuklearmedizin (Switzerland)

    2004-11-01

    First results of PET/CT in Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) are reported. From March 2001 to August 2004 822 PET/CT were performed at our clinic in lymphoma patients for primary staging, restaging after therapy, and diagnosis of recurrence. For coregistration non contrast-enhanced low-dose CT were used. Due to the exact anatomic localization of {sup 18}F-FDG accumulating lesions equivocal or false positive PET findings are avoided. In comparison to contrast enhanced CT, PET/CT has a higher sensitivity and specificity in patients with HD and aggressive NHL. Integration of PET/CT in treatment planning of radiation therapy optimizes the field volume. Even in the initial phase of clinical evaluation, PET/CT has proven useful in staging and restaging of lymphoma. The exact anatomic localization of the PET findings is essential for a precise report, for treatment planning of radiation therapy, and for planning surgical biopsy. (orig.) [German] Erste Ergebnisse der PET-CT bei Morbus Hodgkin (HD) und den aggressiven Non-Hodgkin-Lymphomen (NHL) werden beschrieben. Von Maerz 2001 bis August 2004 wurden 822 PET-CT bei Lymphompatienten zum primaeren Staging, zum Restaging nach Therapie und zur Rezidivdiagnostik an unserer Klinik durchgefuehrt. Fuer die Koregistration wurde ein Low-dose-CT ohne i.v.-Kontrastmittel verwendet. Durch die exakte anatomische Zuordnung der {sup 18}F-FDG aufnehmenden Laesionen wurden unklare oder falsch-positive PET-Befunde vermieden. Die PET-CT erzielte im Vergleich zur KM-verstaerkten CT eine hoehere Sensitivitaet und Spezifitaet bei Patienten mit HD und aggressiven NHL. Die Integration der PET-CT in die Planung der Strahlentherapie fuehrte zu einer Optimierung der Feldgrenzen. Die PET-CT hat sich bereits in der Phase der initialen klinischen Evaluation als wertvoll beim Staging und Restaging von Lymphomen erwiesen. Die exakte anatomische Zuordnung der PET-Informationen ist fuer eine sichere Befundung

  10. CT of hepatocellular carcinoma. Analysis of contrast-enhanced CT using CT arteriography

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, H; Tanaka, T; Hori, S; Tokunaga, K; Yoshioka, H [Osaka Univ. (Japan). Faculty of Medicine

    1981-02-01

    Although changes in the CT appearance resulting from contrast enhancement (CE) for hepatocellular carcinoma have been considered in association with vascularity of tumors, no detailed studies have yet been made. We analyzed changes in the CT appearance following CE by comparing with hepatic arteriogram and CT arteriogram (CTA) performed during intraarterial infusion of contrast medium. When tumors showing low density in the plain CT were enhanced by contrast, the results were variable, ranging from intensification of the low density to replacement by high density, and the results were classified into L/sub 0/ to L/sub 3/ according to vascularity of tumors. The results after CE could also be classified into I/sub 0/ to I/sub 3/ when tumors showed isodensity in the plain CT. There was a correlation between vascularity presumed from CE and vascularity by CTA. It may be concluded that tumor vascularity could be estimated by the findings of CE which might indicate a possibility of qualitative diagnosis of tumors.

  11. Can the 'Assessment Drives Learning' effect be detected in clinical skills training? - Implications for curriculum design and resource planning [Der “Assessment Drives Learning”-Effekt beim Training klinisch-praktischer Fertigkeiten - Implikationen für die Curriculumsgestaltung und die Planung von Ressourcen

    Directory of Open Access Journals (Sweden)

    Buss, Beate

    2012-11-01

    utilisation of voluntary skills-lab training in order to reach a sufficient concordance between students’ requirements and faculty offers, as well as resource management.[german] Zielsetzung: Die Vermittlung klinisch-praktischer Fertigkeiten ist von entscheidender Bedeutung für die Berufsfähigkeit angehender Ärzte. Prozedurale Fertigkeiten werden dabei häufig zu allererst in sogenannten Skills-Labs trainiert, die eine geschützte Lernumgebung gewährleisten. Die Implementierung und auch Pflege von Skills-Labs stellt allerdings eine nicht geringfügige finanzielle Herausforderung dar. Aus diesem Grund hat sich die vorliegende Arbeit zum Ziel gesetzt, die Besuchsfrequenzen und –muster im Rahmen freiwilliger Skills-Lab-Unterrichtseinheiten zu untersuchen, um folgende Frage zu beantworten: Kann der in der Literatur beschriebene, motivationspsychologische Effekt des “Assessment drives learning” festgestellt werden und spiegelt sich dieser in dem Besuchsverhalten von Studierenden in freiwilligen Skills-Lab-Unterrichtseinheiten wider? Ausgehend von den Studienergebnissen sollen Empfehlungen für die Curriculumsplanung und das Ressourcenmanagement abgeleitet werden.Methode:. Eine retrospektive, deskriptive Analyse studentischen Inanspruchnahmeverhaltens sowohl von freiwilligen „Basic“- als auch „Advanced“ Skills-Lab-Unterrichtseinheiten wurde durchgeführt. Hierzu wurden Teilnahmemuster von 340 Medizinstudierenden des dritten Studienjahres verschiedener Jahrgänge an der Medizinischen Fakultät Heidelberg näher untersucht.Ergebnisse: Die Studierenden zeigten besonders zu Beginn und am Ende des Semesters eine Präferenz für die Teilnahme an freiwilligen “Basic“ Skills-Lab-Unterrichtseinheiten, die für die klinisch-praktische Prüfung relevant sind. Freiwillige “Advanced“ Skills-Lab”-Unterrichtseinheiten ohne Bezug zur klinisch-praktischen Prüfung wurden vor allem zu Beginn des Semesters genutzt, mit einem Rückgang der Besuche gegen Ende des Semesters

  12. Absorbed dose in CT. Comparison by CT dose index

    International Nuclear Information System (INIS)

    Yamamoto, Kenji; Akazawa, Hiroshi; Andou, Takashi

    2002-01-01

    Few reports have discussed the absorbed dose on CT units with increased scanning capacity even with the current widespread adoption of multi-slice CT units. To compare and investigate the dose indexes among CT units, we measured the absorbed dose on CT units operating in Nagano Prefecture Japan. The measurements showed proportionality between phantom absorbed dose and the exposured mAs values in conventional scanning operation. Further, the measurements showed that the absorbed dose in the center of the phantom differed by about 2.1-fold between the highest and lowest levels on individual CT units. Within a single company, multi-slice CT units of the same company gave absorbed doses of about 1.3 to 1.5 times those of conventional single-slice CT units under the same exposured conditions of conventional scanning. When the scanning pitch was reduced in helical scanning, the absorbed dose at the center of the phantom increased. (author)

  13. Imaging of head and neck tumors -- methods: CT, spiral-CT, multislice-spiral-CT

    International Nuclear Information System (INIS)

    Baum, Ulrich; Greess, Holger; Lell, Michael; Noemayr, Anton; Lenz, Martin

    2000-01-01

    Spiral-CT is standard for imaging neck tumors. In correspondence with other groups we routinely use spiral-CT with thin slices (3 mm), a pitch of 1.3-1.5 and an overlapping reconstruction increment (2-3 mm). In patients with dental fillings a short additional spiral parallel to the corpus of the mandible reduces artifacts behind the dental arches and improves the diagnostic value of CT. For the assessment of the base of the skull, the orbital floor, the palate and paranasal sinuses an additional examination in the coronal plane is helpful. Secondary coronal reconstructions of axial scans are helpful in the evaluation of the crossing of the midline by small tumors of the tongue base or palate. For an optimal vascular or tissue contrast a sufficient volume of contrast medium and a start delay greater than 70-80 s are necessary. In our opinion the best results can be achieved with a volume of 150 ml, a flow of 2.5 ml/s and a start delay of 80 s. Dynamic enhanced CT is only necessary in some special cases. There is clear indication for dynamic enhanced CT where a glomus tumor is suspected. Additional functional CT imaging during i-phonation and/or Valsalva's maneuver are of great importance to prove vocal cords mobility. Therefore, imaging during i-phonation is an elemental part of every thorough examination of the hypopharynx and larynx region. Multislice-spiral-CT allows almost isotropic imaging of the head and neck region and improves the assessment of tumor spread and lymph node metastases in arbitrary oblique planes. Thin structures (the base of the skull, the orbital floor, the hard palate) as well as the floor of the mouth can be evaluated sufficiently with multiplanar reformations. Usually, additional coronal scanning is not necessary with multislice-spiral-CT. Multislice-spiral-CT is especially advantageous in defining the critical relationships of tumor and lymph node metastases and for functional imaging of the hypopharynx and larynx not only in the

  14. CT of portal vein tumor thrombosis. Usefulness of dynamic CT

    Energy Technology Data Exchange (ETDEWEB)

    Takemoto, Kazumasa; Inoue, Yuichi; Tanaka, Masahiro; Nemoto, Yutaka; Nakamura, Kenji [Osaka City Univ. (Japan). Faculty of Medicine

    1983-08-01

    We evaluated CT findings of portal vein tumor thrombosis in 16 hepatomas by plain, contrast and dynamic CT. Plain and contrast CT findings were an enlargement of the portal vein (81%), intraluminal low density area (63%). Dynamic CT enhanced the diagnostic capability of the tumor thrombus as a relatively low density area because of the marked enhancement of the portal vein. In addition, dynamic CT newly demonstrated hyperdense peripheral ring (35%) and arterio portal shunt (35%). It is advisable to select the scan level to include the portal vein when dynamic CT is performed in the patient of hepatocellular carcinoma.

  15. CT findings of pancreatic carcinoma. Evaluation with the combined method of early enhancement CT and high dose enhancement CT

    International Nuclear Information System (INIS)

    Itoh, Shigeki; Endo, Tokiko; Isomura, Takayuki; Ishigaki, Takeo; Ikeda, Mitsuru; Senda, Kouhei.

    1995-01-01

    Computed tomographic (CT) findings of pancreatic ductal adenocarcinoma were studied with the combined method of early enhancement CT and high dose enhancement CT in 72 carcinomas. Common Findings were change in pancreatic contour, abnormal attenuation in a tumor and dilatation of the main pancreatic duct. The incidence of abnormal attenuation and dilatation of the main pancreatic duct and bile duct was constant regardless of tumor size. The finding of hypoattenuation at early enhancement CT was most useful for demonstrating a carcinoma. However, this finding was negative in ten cases, five of which showed inhomogenous hyperattenuation at high dose enhancement CT. The detection of change in pancreatic contour and dilatation of the main pancreatic duct was most frequent at high dose enhancement CT. The finding of change in pancreatic contour and/or abnormal attenuation in a tumor could be detected in 47 cases at plain CT, 66 at early enhancement CT and 65 at high dose enhancement CT. Since the four cases in which neither finding was detected by any CT method showed dilatated main pancreatic duct, there was no case without abnormal CT findings. This combined CT method will be a reliable diagnostic technique in the imaging of pancreatic carcinoma. (author)

  16. CT in neuromuscular disorders: A comparison of CT and histology

    International Nuclear Information System (INIS)

    Vliet, A.M. van der; Thijssen, H.O.M.; Merx, J.L.; Joosten, E.

    1988-01-01

    The value of CT-examination of the muscles compared to histology was studied in a retrospective analysis of 30 patients with clinical suspicion of neuromuscular disorder. In the evaluation of the CT-results descriptive criteria were used. The histologic diagnosis came from needle-biopsies taken from the quadriceps muscle. Considering the whole group of neuromuscular disorders, CT has an overall accuracy of 84.8%, a positive predictive value of 95.5% and a negative predictive value of 63.6%. This makes the use of CT as a diagnostic tool in neuromuscular disorders a reliable examination technique. In patients with a polymyositis there is even a 100% correlation between CT findings and biopsy results. Discrepancy between the biopsy results is remarkable of the quadriceps muscle and the CT findings: The number of abnormal histological findings is twice the number of abnormal CT findings. Using the more proximal gluteal region as a biopsy site would have decreased this discrepancy and would therefore have given a better correlation between CT and histology. The choice of protocol in determining the levels to be scanned is of great importance in achieving good reproducability in follow-up CT examinations. (orig.)

  17. Combined SPECT/CT and PET/CT for breast imaging

    Energy Technology Data Exchange (ETDEWEB)

    Russo, Paolo [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy); Larobina, Michele [Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Via Tommaso De Amicis, 95, Naples I-80145 (Italy); Di Lillo, Francesca [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy); Del Vecchio, Silvana [Università di Napoli Federico II, Dipartimento di Scienze Biomediche Avanzate, Via Pansini, 5, Naples I-80131 (Italy); Mettivier, Giovanni, E-mail: mettivier@na.infn.it [Università di Napoli Federico II, Dipartimento di Fisica, Via Cintia, Naples I-80126 (Italy); INFN Sezione di Napoli, Via Cintia, Naples I-80126 (Italy)

    2016-02-11

    In the field of nuclear medicine imaging, breast imaging for cancer diagnosis is still mainly based on 2D imaging techniques. Three-dimensional tomographic imaging with whole-body PET or SPECT scanners, when used for imaging the breast, has performance limits in terms of spatial resolution and sensitivity, which can be overcome only with a dedicated instrumentation. However, only few hybrid imaging systems for PET/CT or SPECT/CT dedicated to the breast have been developed in the last decade, providing complementary functional and anatomical information on normal breast tissue and lesions. These systems are still under development and clinical trials on just few patients have been reported; no commercial dedicated breast PET/CT or SPECT/CT is available. This paper reviews combined dedicated breast PET/CT and SPECT/CT scanners described in the recent literature, with focus on their technological aspects.

  18. CT portography by multidetector helical CT. Comparison of three rendering models

    International Nuclear Information System (INIS)

    Nakayama, Yoshiharu; Imuta, Masanori; Funama, Yoshinori; Kadota, Masataka; Utsunomiya, Daisuke; Shiraishi, Shinya; Hayashida, Yoshiko; Yamashita, Yasuyuki

    2002-01-01

    The purpose of this study was to assess the value of multidetector CT portography in visualizing varices and portosystemic collaterals in comparison with conventional portography, and to compare the visualizations obtained by three rendering models (volume rendering, VR; minimum intensity projection, MIP; and shaded surface display, SSD). A total of 46 patients with portal hypertension were examined by CT and conventional portography for evaluation of portosystemic collaterals. CT portography was performed by multidetector CT (MD-CT) scanner with a slice thickness of 2.5 mm and table feed of 7.5 mm. Three types of CT portographic models were generated and compared with transarterial portography. Among 46 patients, 48 collaterals were identified on CT transverse images, while 38 collaterals were detected on transarterial portography. Forty-four of 48 collaterals identified on CT transverse images were visualized with the MIP model, while 34 and 29 collaterals were visualized by the VR and SSD methods, respectively. The average CT value for the portal vein and varices was 198 HU with data acquisition of 50 sec after contrast material injection. CT portography by multidetector CT provides excellent images in the visualization of portosystemic collaterals. The images of collaterals produced by MD-CT are superior to those of transarterial portography. Among the three rendering techniques, MIP provides the best visualization of portosystemic collaterals. (author)

  19. CT portography by multidetector helical CT. Comparison of three rendering models

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Yoshiharu; Imuta, Masanori; Funama, Yoshinori; Kadota, Masataka; Utsunomiya, Daisuke; Shiraishi, Shinya; Hayashida, Yoshiko; Yamashita, Yasuyuki [Kumamoto Univ. (Japan). School of Medicine

    2002-12-01

    The purpose of this study was to assess the value of multidetector CT portography in visualizing varices and portosystemic collaterals in comparison with conventional portography, and to compare the visualizations obtained by three rendering models (volume rendering, VR; minimum intensity projection, MIP; and shaded surface display, SSD). A total of 46 patients with portal hypertension were examined by CT and conventional portography for evaluation of portosystemic collaterals. CT portography was performed by multidetector CT (MD-CT) scanner with a slice thickness of 2.5 mm and table feed of 7.5 mm. Three types of CT portographic models were generated and compared with transarterial portography. Among 46 patients, 48 collaterals were identified on CT transverse images, while 38 collaterals were detected on transarterial portography. Forty-four of 48 collaterals identified on CT transverse images were visualized with the MIP model, while 34 and 29 collaterals were visualized by the VR and SSD methods, respectively. The average CT value for the portal vein and varices was 198 HU with data acquisition of 50 sec after contrast material injection. CT portography by multidetector CT provides excellent images in the visualization of portosystemic collaterals. The images of collaterals produced by MD-CT are superior to those of transarterial portography. Among the three rendering techniques, MIP provides the best visualization of portosystemic collaterals. (author)

  20. CT arterial portography and CT arteriography with a triple-lumen balloon catheter

    International Nuclear Information System (INIS)

    Murakami, T.; Oi, H.; Hori, M.; Kim, T.; Takahashi, S.; Matsushita, M.; Narumi, Y.; Nakamura, H.

    1997-01-01

    Purpose: To evaluate the usefulness of the triple-lumen balloon catheter in the serial performance of CT arterial portography (CT-AP) and CT arteriography (CT-A). Material and Methods: A combined CT-AP and CT-A examination of 58 patients was carried out in which a cobra-type triple-lumen balloon catheter was used. CT-AP was performed by injecting contrast medium either into the splenic artery through a side-hole in the catheter proximal to the balloon inflated in the common hepatic artery, or into the superior mesentric artery through an end-hole in the catheter. Then CT-A was serially performed by delivering contrast medium either to the common hepatic artery or the proper hepatic artery from the end-hole, or to the accessory right hepatic artery through a side-hole proximal to the inflated balloon. Results: Sufficient CT-APs were obtained in 53 of the 58 patients (91%), CT-A in 42 (72%), and both in 42 (72%). Incomplete CT-AP was due to technical failure or anatomical anomaly, as was incomplete CT-A. No complications were seen. (orig.)

  1. CT-Urography; Urografia CT

    Energy Technology Data Exchange (ETDEWEB)

    Dalla Palma, Ludovico; Grotto, Maurizio [Trieste Univ., Trieste (Italy). Dipartimento di scienze cliniche, morfologiche e tecnologiche, UCO di radiologia; Morra, Aldo [CRO, Aviano (Italy). Reparto di radiologia

    2005-09-15

    In this paper we present an overview of CT-Urography. With the advent of multislice CT scanners and the evolution of image processing methods this technique now affords optimal urographic images comparable to those obtained with conventional techniques. We describe the acquisition techniques and protocols used by the various authors. Effective radiation dose has conditioned the use of CT-Urography so that the tendency today is to reduce the number of scans by performing, after the non enhanced scan, a single contrast-enhanced scan comprising both the nephrographic and urographic phase. With the use of multislice CT the quality of the urogram improves with the number of slices. We illustrate a variety of processing techniques, multiplanar reconstruction (MPR), maximum (MIP) and average intensity projection (AIP) and volume rendering (VR) and present a series of upper urinary tract tumours testifying to the superiority of the AIP technique over MIP. We then review the results of comparative studies of CT-Urography with conventional urography in upper urinary tract diagnostics. Finally, we describe the advantages and limitations of CT-Urography. [Italian] Gli Autori presentano una panoramica sulla Urografia TC (Uro TC). L'avvento della TC multistrato e l'evoluzione delle tecniche di elaborazione consentono di ottenere dei quadri urografici ottimali comparativi con quelli convenzionali. Vengono ricordate le varie tecniche di acquisizione e i protocolli usati dai vari Autori. La dose effettiva di radiazioni ha rappresentato uno dei fattori condizionanti per cui oggi prevale l'orientamento di ridurre il numero di scansioni, considerando dopo la scansione senza mezzo di contrasto un'unica scansione contrasto grafica comprendente sia la fase nefrografica che quella urografica. Con l'uso della TC multistrato la qualita dell'urogramma migliora con l'aumento del numero degli strati. Vengono descritte le varie tecniche di elaborazione, la

  2. Comparison of CT and PET/CT for biopsy guidance in oncological patients

    Energy Technology Data Exchange (ETDEWEB)

    Cerci, Juliano J.; Bogoni, Mateos; Cunha Pereira, Carlos; Cerci, Rodrigo J.; Krauzer, Cassiano; Vicente Vitola, Joao [Quanta - Diagnostico e Terapia, Curitiba, PR (Brazil); Tabacchi, Elena; Fanti, Stefano [University Hospital S. Orsola-Malpighi, Nuclear Medicine Department, Bologna (Italy); Delbeke, Dominique [Vanderbilt University, Nashville, TN (United States); Giacometti Sakamoto, Danielle [Byori - Laboratorio de Patologia, Curitiba (Brazil)

    2017-08-15

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant

  3. Comparison of CT and PET/CT for biopsy guidance in oncological patients

    International Nuclear Information System (INIS)

    Cerci, Juliano J.; Bogoni, Mateos; Cunha Pereira, Carlos; Cerci, Rodrigo J.; Krauzer, Cassiano; Vicente Vitola, Joao; Tabacchi, Elena; Fanti, Stefano; Delbeke, Dominique; Giacometti Sakamoto, Danielle

    2017-01-01

    To compare FDG PET/CT and CT for the guidance of percutaneous biopsies with histological confirmation of lesions. We prospectively evaluated 323 patients of whom 181 underwent FDG PET/CT-guided biopsy (total 188 biopsies) and 142 underwent CT-guided biopsy (total 146 biopsies). Biopsies were performed using the same PET/CT scanner with a fluoroscopic imaging system. Technical feasibility, clinical success and complication rates in the two groups were evaluated. Of the 188 biopsies with PET/CT guidance, 182 (96.8%) were successful with conclusive tissue samples obtained and of the 146 biopsies with CT guidance, 137 (93.8%) were successful. Therefore, 6 of 188 biopsies (3.1%) with PET/CT guidance and 9 of 146 (6.1%) with CT guidance were inconclusive (p = 0.19). Due to inconclusive histological results, 4 of the 188 lesions (2.1%) were rebiopsied with PET/CT guidance and 3 of 146 lesions (2.0%) were rebiopsied with CT guidance. Histology demonstrated that 142 of 188 lesions (75.5%) were malignant, and 40 (21.2%) were benign in the PET/CT-guided group, while 89 of 146 lesions (60.9%) were malignant and 48 (32.8%) were benign in the CT-guided group (p = 0.004 and 0.01, respectively). Patients with a histological diagnosis of benign lesion had no recurrence of disease with a minimum of 6 months follow-up. Of the 188 PET/CT-guided biopsies, 6 (3.1%) were repeat biopsies due to a previous nondiagnostic CT-guided biopsy performed in a different diagnostic centre. The interval between the two biopsies was less than a month in all cases. Histology revealed five malignant lesions and one benign lesion among these. The complication rate in the PET/CT-guided biopsy group was 12.7% (24 of 188), while in the CT-guided group, was 9.5% (14 of 146, p = 0.26). Therefore, there was no significant difference in complication rates between PET/CT and CT guidance. PET/CT-guided biopsy is already known to be a feasible and accurate method in the diagnostic work-up of suspected malignant

  4. Visualization of pulmonary vein stenosis after radio frequency ablation for treatment of atrial fibrillation using multidetector computed tomography with retrospective gating; Darstellung von Pulmonalvenenstenosen nach Radiofrequenzablation zur Behandlung von Vorhofflimmern unter Verwendung der Multidetektor Computertomographie mit retrospektivem Gating

    Energy Technology Data Exchange (ETDEWEB)

    Trabold, T.; Kuettner, A.; Heuschmid, M.; Kopp, A.F.; Claussen, C.D. [Radiologische Klinik, Abt. fuer Radiologische Diagnostik, Univ. Tuebingen (Germany); Burgstahler, C.; Mewis, C.; Schroeder, S.; Kuehlkamp, V. [Medizinische Klinik III, Abt. fuer Kardiologie, Univ. Tuebingen (Germany)

    2003-01-01

    Purpose: With the number of radio frequency ablations (RFA) for treatment of chronic atrial fibrillation increasing, the diagnostic evaluation for RFA associated pulmonary vein stenosis is getting more important. This study investigates the feasibility of the visualization of pulmonary vein stenosis using non-invasive multidetector computed tomography. Materials and Methods: Twenty-eight patients were examined following RFA-treatment. A 4-slice (20 patients) and a 16-slice (8 patients) multidetector CT scanner (SOMATOM Volume Zoom and Sensation 16, Siemens, Forchheim, Germany) with retrospective gating was used to assess the pulmonary veins. Lesion severity was determined on a semi-quantitative scale (< 30%, 30 - 50%, > 50%). Results: CT was performed without any complications in all patients. Diagnostic image quality could be obtained in all examinations. The pulmonary veins showed lesions < 30% in four patients, lesions of 30 - 50% in five patients and a stenosis > 50% in one patient. Eighteen patients showed no lesions. Conclusion: Multidetector CT of the pulmonary veins seems to be able to visualize high-grade and low-grade lesions, but larger catheter-controlled studies are needed for further assessment of the diagnostic accuracy and clinical reliability of this noninvasive method. (orig.) [German] Ziel: Mit steigender Anzahl von Radiofrequenzablationen (RFA) zur Behandlung des chronischen Vorhofflimmerns wird die Diagnostik von RFA assoziierten Pulmonalvenenstenosen zunehmend wichtiger. Ziel dieser Studie war es, die Moeglichkeit der Darstellung von Pulmonalvenenstenosen mittels der nichtinvasiven Multidetektor-Computertomographie zu untersuchen. Material und Methoden: 28 Patienten wurden im Anschluss an eine RFA-Behandlung untersucht. Die Untersuchung wurde an einem 4-Zeilen- (20 Patienten) bzw. 16-Zeilen- (8 Patienten) Multidetektor-CT (SOMATOM Volume Zoom bzw. Sensation 16, Siemens, Forchheim, Germany) mit retrospektivem Gating durchgefuehrt. Der

  5. Optimization of Protocol CT, PET-CT, whole body; Optimizacion de protocolo CT, en PET-CT, de cuerpo entero

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, Fredys Santos, E-mail: fsantos@ccss.sa.cr [Caja Costarricense de Seguro Social (ACCPR/CCSS), San Jose (Costa Rica). Area Control de Calidade Y Proteccion Radiologica; Namias, Mauro, E-mail: mnamias@gmail.com [Comision Nacional de Energia Atomica (FCDN/CNEA), Buenos Aires (Argentina). Fundacion Centro Diagnostico Nuclear

    2013-11-01

    The objective of this study was to optimize the acquisition protocols and processing existing of the CT PET/CT scanner for clinical use of Nuclear Diagnostic Center Foundation, a way to minimize the radiation dose while maintaining diagnostic image quality properly. Dosimetric data of PET / CT service were surveyed and obtained the baseline against which we compare and define strategies and modifications to develop online. We selected transaxial up to the pulmonary hilum and liver slices as the anatomical regions of interest that led to the standardization of the study.

  6. New possibilities in the diagnosis of ischemia. CT-FFR and CT-Perfusion; Neue Moeglichkeiten der Ischaemiediagnostik. CT-FFR und CT-Perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Lehmkuhl, Lukas [Herz- und Gefaessklinik, Bad Neustadt an der Saale (Germany). Abt. fuer Radiologie; Krieghoff, Christian [Herzzentrum Leipzig (Germany); Gutberlet, Matthias [Herzzentrum Leipzig (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Leipzig Univ. (Germany). Kardiologische Bildgebung

    2017-12-15

    Coronary CT-angiography (CCTA) plays an increasing role in the primary diagnostics of coronary artery disease (CAD) according to the present guidelines but also in clinical reality. The sensitivity and negative predictive value of CCTA is very high, but the specificity could still be improved. Newer techniques to assess myocardial ischemia like CT-FFR and CT-Perfusion may help to achieve that goal.

  7. The role of positron-emission-tomography (F-18-FDG-PET) in the staging and follow-up of lung cancer and in the evaluation of focal pulmonary abnormalities; Positronenemissionstomographie (PET) mit F-18-FDG in der Diagnostik des Bronchialkarzinoms und zur Dignitaetsabklaerung von pulmonalen Raumforderungen

    Energy Technology Data Exchange (ETDEWEB)

    Baum, R.P. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Bonnet, R.B. [Zentralklinik Bad Berka (Germany). Klinik fuer Pneumologie; Presselt, N. [Zentralklinik Bad Berka (Germany). Klinik fuer Thorax- und Gefaesschirurgie; Leonhardi, J. [Zentralklinik Bad Berka (Germany). Inst. fuer Bildgebende Diagnostik

    2001-04-01

    bronchial carcinomas (except for slowly growing neuroendocrine tumors like carcinoids which show rarely an increased FDG metabolism). The specificity of FDG-PET is in the range of >80%. (orig.) [German] Prospektive Studien zeigten im Direktvergleich von PET und Spiral-CT eine deutlich hoehere diagnostische Genauigkeit der PET im Lymphknotenstaging des Bronchialkarzinoms (insbesondere mediastinal, d.h. N2- oder N3-Befall). Mittels FDG-PET koennen auch normal grosse Lymphknoten (im CT<10 mm) als tumorbefallen charakterisiert werden (Upstaging). Andererseits kann die PET aufgrund der hoeheren Spezifitaet eine Metastasierung in computertomographisch vergroesserten Lymphknoten oftmals ausschliessen (Downstaging in bis zu 30% der untersuchten Patienten). Eine Aenderung des therapeutischen Prozedere durch die PET-Untersuchung ergab sich bei bis zu 30% aller Patienten und unter Einschluss der Fernmetastasen bei ueber 40% der untersuchten Patienten. Nebennierenmetastasen (Sensitivitaet 100%, Spezifitaet 80%), als auch Leber-, Knochen- und parenchymatoese Lungenmetastasen und abdominelle und zervikale Lymphknotenmetastasen werden mit hoher Sensitivitaet und Spezifitaet detektiert. Bei zerebralen Metastasen ist die MRT im Nachweis eindeutig ueberlegen, bei sehr kleinen Lungenlaesionen (<5 mm) ist die Spiral-CT sensitiver. Der Nachweis des lokalen Rezidivs eines zuvor operierten Lungenkarzinoms ist mit einer Sensitivitaet von 83-100% (Mittel 95%) und einer Spezifitaet von 62-100% (Mittel 81%) moeglich. Auch zur Therapiekontrolle ist die FDG-PET geeignet, da die Abnahme des Glukosemetabolismus mit dem Therapieerfolg korreliert. Problematisch sind inflammatorische Veraenderungen in den ersten Wochen nach Strahlentherapie ('Strahlenpneumonitis'), die ebenfalls zu einem gesteigerten Glukosemetabolismus fuehren koennen, weshalb ein groesserer Zeitabstand (mehrere Wochen bis Monate) nach Strahlentherapie sinnvoll ist. Die FDG-PET hat sich in der Differenzialdiagnostik von

  8. CT of laryngotracheal trauma

    International Nuclear Information System (INIS)

    Lupetin, A.R.; Daffner, R.H.

    1991-01-01

    This paper evaluates the usefulness of CT for the diagnosis of traumatic laryngotracheal abnormalities. The authors retrospectively evaluated the neck CT studies of 50 patients (36 males, 14 females; age range, 16-75 years) who presented to a level I trauma center after suffering a blunt or penetrating laryngotracheal injury. CT results were correlated with endoscopic or surgical findings in 43 cases. Three groups emerge. CT positive: hyloid bone or laryngotracheal cartilage injury; CT positive: soft-tissue injury only; and CT negative. In group 1, CT demonstrated all bony or cartilaginous injuries proved at surgery or suggested at endoscopy. CT failed to demonstrate laryngotracheal separation in 1 case. In group 2, CT demonstrated all soft-tissue injuries suggested at endoscopy. In group 3, CT findings agreed with those of endoscopy in 7 cases, but minor soft-tissue findings seen at endoscopy were missed in 3 cases. Seven patients were studied only with CT. Ct is an accurate technique for detecting bony or cartilaginous laryngotracheal traumatic abnormalities. However, laryngotracheal separation and minor soft-tissue injuries can be missed

  9. Accuracy of spiral CT and 3D reconstruction in the detection of acute pulmonary embolism - development of an animal model using porcine lungs and technical specimens. Development of an animal model using porcine lungs and technical specimens; Diagnostik der akuten Lungenembolie mittels Spiral-CT und 3D-Rekonstruktion. Entwicklung eines Tiermodells und technischer Probekoerper im Ex-vivo-Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Ries, B.G. [Klinik und Poliklinik fuer Radiologie, Univ. Mainz (Germany); Klinik fuer Radiologische Diagnostik, RWTH Aachen (Germany); Kauczor, H.U.; Thelen, M. [Klinik und Poliklinik fuer Radiologie, Univ. Mainz (Germany); Konerding, M.A. [Anatomisches Inst., Mainz Univ (Germany)

    2001-02-01

    Purpose: To develop a model for simulation the CT morphologic situation of acute pulmonary embolism, to evaluate the accuracy of spiral CT and 3D reconstruction in the detection of artificial emboli and to investigate the influence of the orientation of emboli depending on z-axis orientation. Materials and Methods: Standardized artificial emboli made of wax and of defined size and shape were positioned into the pulmonary arteries of porcine lungs. Castings of the embolized pulmonary arterial trees were made by injection of a special opaque resin. After performance of spiral CT the data sets of the emboli and the pulmonary arteries were post-processed. The 3D segmentations were compared with the anatomic preparation to evaluate the accuracy of spiral CT/3D reconstruction-technique. Technical specimens simulating CT-morphology of acute embolized vessels underwent spiral CT in six different positions with respect to the z-axis. The CT data were reconstructed using a standardized and a contrastadapted method with interactive correction. The 3D emboli were analysed under qualitative aspects, and measurements of their extent were done. Results: In nearly 91%, there was complete agreement between CT and the corresponding findings at the anatomical preparation. Measurements of the 3D reconstructed technical specimens showed discrepancies of shape and size in dependence of the size of the original preparation, orientation and reconstruction technique. Overestimation up to 4 mm and underestimation to 2,2 mm were observed. Measurements of preparations with heights from 14 to 26 mm showed variances of {+-}1,5 mm ({proportional_to}6-11%). Conclusion: The presented models are suitable to simulate CT morphology of acute pulmonary embolism under ex-vivo conditions. Accuracy in the detection of artificial emboli using spiral CT/3D reconstruction is affected by localization, size and orientation of the emboli and the reconstruction technique. (orig.) [German] Ziel: Die Entwicklung

  10. CT-Urography

    International Nuclear Information System (INIS)

    Dalla Palma, Ludovico; Grotto, Maurizio; Morra, Aldo

    2005-01-01

    In this paper we present an overview of CT-Urography. With the advent of multislice CT scanners and the evolution of image processing methods this technique now affords optimal urographic images comparable to those obtained with conventional techniques. We describe the acquisition techniques and protocols used by the various authors. Effective radiation dose has conditioned the use of CT-Urography so that the tendency today is to reduce the number of scans by performing, after the non enhanced scan, a single contrast-enhanced scan comprising both the nephrographic and urographic phase. With the use of multislice CT the quality of the urogram improves with the number of slices. We illustrate a variety of processing techniques, multiplanar reconstruction (MPR), maximum (MIP) and average intensity projection (AIP) and volume rendering (VR) and present a series of upper urinary tract tumours testifying to the superiority of the AIP technique over MIP. We then review the results of comparative studies of CT-Urography with conventional urography in upper urinary tract diagnostics. Finally, we describe the advantages and limitations of CT-Urography [it

  11. CT vs 68Ge attenuation correction in a combined PET/CT system: evaluation of the effect of lowering the CT tube current

    International Nuclear Information System (INIS)

    Kamel, Ehab; Hany, Thomas F.; Burger, Cyrill; Treyer, Valerie; Schulthess von, Gustav K.; Buck, Alfred; Lonn, Albert H.R.

    2002-01-01

    With the introduction of combined positron emission tomography/computed tomography (PET/CT) systems, several questions have to be answered. In this work we addressed two of these questions: (a) to what value can the CT tube current be reduced while still yielding adequate maps for the attenuation correction of PET emission scans and (b) how do quantified uptake values in tumours derived from CT and germanium-68 attenuation correction compare. In 26 tumour patients, multidetector CT scans were acquired with 10, 40, 80 and 120 mA (CT 10 , CT 40 , CT 80 and CT 120 ) and used for the attenuation correction of a single FDG PET emission scan, yielding four PET scans designated PET CT10 -PET CT120 . In 60 tumorous lesions, FDG uptake and lesion size were quantified on PET CT10 -PET CT120 . In another group of 18 patients, one CT scan acquired with 80 mA and a standard transmission scan acquired using 68 Ge sources were employed for the attenuation correction of the FDG emission scan (PET CT80 , PET 68Ge ). Uptake values and lesion size in 26 lesions were compared on PET CT80 and PET 68Ge . In the first group of patients, analysis of variance revealed no significant effect of CT current on tumour FDG uptake or lesion size. In the second group, tumour FDG uptake was slightly higher using CT compared with 68 Ge attenuation correction, especially in lesions with high FDG uptake. Lesion size was similar on PET CT80 and PET 68Ge . In conclusion, low CT currents yield adequate maps for the attenuation correction of PET emission scans. Although the discrepancy between CT- and 68 Ge-derived uptake values is probably not relevant in most cases, it should be kept in mind if standardised uptake values derived from CT and 68 Ge attenuation correction are compared. (orig.)

  12. Assessment of hemodynamic changes in patients with renal artery stenosis by means of the cine MR phase-contrast technique; Einstufung haemodynamischer Veraenderungen bei Nierenarterienstenosen mittels MR-Cine-Phasenkontrastflussmessungen

    Energy Technology Data Exchange (ETDEWEB)

    Schoenberg, S.O.; Knopp, M.V.; Bock, M.; Essig, M.; Hawighorst, H.; Zuna, I.; Schad, L.; Kaick, G. van [Deutsches Krebsforschungszentrum, Heidelberg (Germany). Forschungsschwerpunkt Radiologische Diagnostik und Therapie; Kallinowski, F.; Allenberg, J.R. [Chirurgische Universitaetsklinik, Heidelberg (Germany). Sektion Gefaesschirurgie; Just, A. [Heidelberg Univ. (Germany). 1. Physiologisches Inst.

    1997-08-01

    Purpose: To evaluate the use of high-temporal resolution cine MR phase-contrast flow measurements for assessment of flow dynamics in renal artery stenosis (RAS). Material and methods: In a dog model, cine MR flow measurements were validated by comparing the MR flow data to an invasive transit-time ultrasound reference technique for different degrees of RAS. Cardiac-gated MR flow curves were recorded in 56 renal arteries of 28 patients with a temporal resolution of at least 32 ms. In all cases RAS was confirmed by digital subtraction angiography (DSA). Abnormalities of flow dynamics were assessed in the calculated flow curves using the MR parameters mean flow, maximum velocity, and time to systolic maximum. Results: By means of the MR blood flow paremeters high-grade stenoses (>50%, n=23) were detected with sensitivity of 100% and specificity of 94% with reference to DSA. The overall differentiation between stenoses (n=37) and non-stenosed vessels (n=19) revealed a sensitivity of 87% and a specificity of 100%. Conclusion: Analysis of cardiac-gated MR flow curves provides a non-invasive method to assess the hemodynamic significance of RAS and thus allows a functional evaluation in relation to the morphologic characteristics of the stenosis. (orig.) [Deutsch] Ziel der Untersuchung war die Beurteilung der Haemodynamik bei Nierenarterienstenosen mittels Cine-MR-Phasenkontrastflussmessungen. In einem Hundemodell wurde die Cine-MR-Flussmessung validiert, indem fuer unterschiedliche Stenosegrade Vergleichsmessungen mit einer invasiven Transitzeit-Ultraschallreferenztechnik durchgefuehrt wurden. EKG-getriggerte MR-Flusskurven wurden bei 28 Patienten in 56 Nierenarterien mit einer Zeitaufloesung von mindestens 32 ms aufgenommen. Alle Nierenarterienstenosen wurden mittels digitaler Subtraktionsangiographie gesichert. Stoerungen in der renalen Haemodynamik wurden anhand der berechneten MR-Flusskurven mit Hilfe der Parameter `Mittelfluss, `maximale Geschwindigkeit` und `Zeit

  13. Haemophilic arthropathy of the knee. Gd-DTPA enhanced MRT. Clinical and radiological correlation; Haemophile Arthropathie des Kniegelenkes. Gd-DTPA-verstaerkte MRT: klinische und roentgenologische Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Naegele, M. [Radiologische Universitaetsklinik, Bonn (Germany); Kunze, V. [Radiologische Universitaetsklinik, Bonn (Germany); Hamann, M. [Radiologische Universitaetsklinik, Bonn (Germany); Eickhoff, H. [Orthopaedische Klinik, Krankenhaus Troisdorf (Germany); Koch, W. [Orthopaedische Klinik, Krankenhaus Troisdorf (Germany); Oldenburg, J. [Inst. fuer Experimentelle Haematologie und Transfusionsmedizin, Bonn (Germany); Reiser, M. [Muenchen Univ. (Germany). Inst. fuer Radiologische Diagnostik; Steudel, A. [Radiologische Universitaetsklinik, Bonn (Germany)

    1994-02-01

    17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRT before and after i.v. bolus injection of Gadolinium-DTPA (0,1 mmol/kg body weight). After contrast enhancement, synovial proliferations exhibited an increase of signal intensity (SI) of FFE and SE images of 47.7% and 37.4% respectively, whereas muscle and fatty tissue, tendons, bone marrow and joint effusion revealed only minor increase in SI. The gradient of signal intensity (ratio SI/time) of pannus was 39,6% min. Gd-DTPA enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.) [Deutsch] Es wurden 17 Patienten mit einer haemophilen Arthropathie der Kniegelenke mit der statischen und dynamischen MRT vor und nach i.v. Bolusgabe von Gadolinium-DTPA (0,1 mmol/kg KG) untersucht. Nach Kontrastmittelgabe konnte ein Anstieg der Signalintensitaet des Pannus von 37,4% auf SE- und von 47,7% auf FFE-Aufnahmen gemessen werden. Der Gradient des Signalintensitaetsanstieges (%/Zeit) lag fuer Pannus bei 39,6%/min. Die Kontrastmittelgabe steigerte die Abgrenzbarkeit des Pannus von Gelenkerguss und den Gelenkbinnenstrukturen. Begleitend durchgefuehrte klinische und roentgenologische Bewertungen des Schweregrades der Arthropathie korrelierten nicht mit dem Signalintensitaetsverhalten des Pannus nach Kontrastmittelgabe. (orig.)

  14. Whole-body CT. Spiral and multislice CT. 2. tot. rev. and enl. ed.; Ganzkoerper-Computertomographie. Spiral- und Multislice-CT

    Energy Technology Data Exchange (ETDEWEB)

    Prokop, M.; Galanski, M.; Schaefer-Prokop, C.; Molen, A.J. van der

    2007-07-01

    Spiral and multidetector techniques have improved the diagnostic possibilities of CT, so that image analysis and interpretation have become increasingly complex. This book represents the current state of the art in CT imaging, including the most recent technical scanner developments. The second edition comprises the current state of knowledge in cT imaging. There are new chapters on image processing, application of contrasting agents and radiation dose. All organ-specific pathological findings are discussed in full. There are hints for optimum use and interpretation of CT, including CT angiography, CT colonography, CT-IVPL, and 3D imaging. There is an introduction to cardio-CT, from calcium scoring and CTA of the coronary arteries to judgement of cardiac morphology. There are detailed scan protocols with descriptions of how to go about parameter selection. Practical hints are given for better image quality and lower radiation exposure of patients, guidelines for patient preparation and complication management, and more than 1900 images in optimum RRR quality. (orig.)

  15. Image Registration for PET/CT and CT Images with Particle Swarm Optimization

    International Nuclear Information System (INIS)

    Lee, Hak Jae; Kim, Yong Kwon; Lee, Ki Sung; Choi, Jong Hak; Kim, Chang Kyun; Moon, Guk Hyun; Joo, Sung Kwan; Kim, Kyeong Min; Cheon, Gi Jeong

    2009-01-01

    Image registration is a fundamental task in image processing used to match two or more images. It gives new information to the radiologists by matching images from different modalities. The objective of this study is to develop 2D image registration algorithm for PET/CT and CT images acquired by different systems at different times. We matched two CT images first (one from standalone CT and the other from PET/CT) that contain affluent anatomical information. Then, we geometrically transformed PET image according to the results of transformation parameters calculated by the previous step. We have used Affine transform to match the target and reference images. For the similarity measure, mutual information was explored. Use of particle swarm algorithm optimized the performance by finding the best matched parameter set within a reasonable amount of time. The results show good agreements of the images between PET/CT and CT. We expect the proposed algorithm can be used not only for PET/CT and CT image registration but also for different multi-modality imaging systems such as SPECT/CT, MRI/PET and so on.

  16. The effect of the cranial bone CT numbers on the brain CT numbers

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, Hitoshi; Kobayashi, Shotai; Koide, Hiromi; Yamaguchi, Shuhei; Okada, Kazunori; Shimote, Koichi; Tsunematsu, Tokugoro (Shimane Medical Univ., Izumo (Japan))

    1989-06-01

    The effects of the cranial size and the computed tomography (CT) numbers of the cranial bone on that of the brain were studied in 70 subjects, aged from 30 to 94 years. The subjects had no histories of cerebrovascular accidents and showed no abnormalities in the central nervous system upon physical examinations and a CT scan. We measured the average attenuation values (CT numbers) of each elliptical region (165 pixels, 0.39 cm{sup 2}) at the bilateral thalamus and at twelve areas of the deep white matter. Multiple regression analysis was used to assess the effects of age, cranial size, and cranial bone CT numbers on the brain CT numbers. The effect of the cranial bone CT numbers on the brain CT numbers was statistically significant. The brain CT numbers increased with the increase in the cranial bone CT numbers. There was, however, no significant correlation between brain CT numbers and cranial size. In measuring the brain CT numbers, it is desirable that consideration be given to the cranial bone CT numbers. (author).

  17. Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT.

    Science.gov (United States)

    Parsa, Azin; Ibrahim, Norliza; Hassan, Bassam; van der Stelt, Paul; Wismeijer, Daniel

    2015-01-01

    The first purpose of this study was to analyze the correlation between bone volume fraction (BV/TV) and calibrated radiographic bone density Hounsfield units (HU) in human jaws, derived from micro-CT and multislice computed tomography (MSCT), respectively. The second aim was to assess the accuracy of cone beam computed tomography (CBCT) in evaluating trabecular bone density and microstructure using MSCT and micro-CT, respectively, as reference gold standards. Twenty partially edentulous human mandibular cadavers were scanned by three types of CT modalities: MSCT (Philips, Best, the Netherlands), CBCT (3D Accuitomo 170, J Morita, Kyoto, Japan), and micro-CT (SkyScan 1173, Kontich, Belgium). Image analysis was performed using Amira (v4.1, Visage Imaging Inc., Carlsbad, CA, USA), 3Diagnosis (v5.3.1, 3diemme, Cantu, Italy), Geomagic (studio(®) 2012, Morrisville, NC, USA), and CTAn (v1.11, SkyScan). MSCT, CBCT, and micro-CT scans of each mandible were matched to select the exact region of interest (ROI). MSCT HU, micro-CT BV/TV, and CBCT gray value and bone volume fraction of each ROI were derived. Statistical analysis was performed to assess the correlations between corresponding measurement parameters. Strong correlations were observed between CBCT and MSCT density (r = 0.89) and between CBCT and micro-CT BV/TV measurements (r = 0.82). Excellent correlation was observed between MSCT HU and micro-CT BV/TV (r = 0.91). However, significant differences were found between all comparisons pairs (P micro-CT BV/TV (P = 0.147). An excellent correlation exists between bone volume fraction and bone density as assessed on micro-CT and MSCT, respectively. This suggests that bone density measurements could be used to estimate bone microstructural parameters. A strong correlation also was found between CBCT gray values and BV/TV and their gold standards, suggesting the potential of this modality in bone quality assessment at implant site. © 2013 John Wiley & Sons A/S. Published by

  18. Combined CT Angiography and CT Venography in Thromboembolic disease: clinical impact

    International Nuclear Information System (INIS)

    Bouzas, R.; Migueles, Y.; Gomez, S.; Mallo, R.; Garcia-Tejedor, J. L.; Diaz Vega, M. J.

    2002-01-01

    Combined CT Venography and Pulmonary Angiography was described in 1998 as a tool for diagnostic Thromboembolic Disease. The purpose is to relate our own experience with this technique in a population with suspected pulmonary embolism. 46 consecutive patients with suspected pulmonary embolism underwent combined CT Venography after Pulmonary CT Angiography to depict Deep Venous Thrombosis (DVT). CT Venography where obtained with a 3 minutes delay from injection, without additional intravenous contrast, from upper abdomen to fibular head. A prospective study from emergency reports where used. The reports where aimed by nine different radiologist at diary emergency room (images where not retrospective review). We report if a pulmonary embolus or deep venous thrombus or another alternative diagnostic where done. An endo luminal thrombus in any pulmonary arteries was assessed as a positive study for PE. A Thrombus in the leg veins or in an abdominal vein without diminished size of vein was assessed as an acute DVT. In those patients with a CT negative to Thromboembolic Disease was the clinician who decide if more proves where needed. Those patients without evidence in CT of Thromboembolic Disease where asked for symptoms related to the episode in a 3 months period after initial CT. Patients free of symptoms for 3 months without anticoagulation therapy where considered true negative for CT. CT shows Thromboembolic Disease in 23 of 46 patients. 21PE, 14 DVT 2 of 14 patients with DVT don't show PE, CT excluded thromboembolic disease in 23 patients and in 15 of those patients an alternative diagnostic was shown. In 22 of those 23 patients CT excluded correctly Thromboembolic Disease. One patient result in a false negative CT, Pulmonary Angiography of that patient shows us a subsegmentary embolus. (Author) 9 refs

  19. Operation planning for a pondage power station chain by means of linear programming and genetic optimisation; Einsatzplanung fuer eine Flusskraftwerkskette im Schwellbetrieb mittels LP und genetischer Optimierung

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, H.; Huelsemann, M.

    1997-12-31

    This paper presents a system package which serves as a simulation and optimisation tool for daily operation planning for a hydroelectric cascade. The purpose of the planning is to maximise (the differentially weighted) production of electrical energy given a certain set of specifications and secondary conditions. Optimal operation management is achieved using a two-stage approach: first pre-optimisation by means of linear programming, followed by detail optimisation using a Genetic Algorithm based on a non-linear, dynamic model of the power station and reservoir chain. [Deutsch] Im Beitrag wird ein Systempaket als Simulations- und Optimierungswerkzeug zur taeglichen Betriebsplanung einer Wasserkraftwerkskaskade vorgestellt. Ziel der Wasserbewirtschaftung ist es, unter den gegebenen Vorgaben und Randbedingungen die (bewertete) Erzeugung elektrischer Energie zu maximieren. Das optimale Fahrplanmanagement wird durch einen zweistufigen Loesungsansatz realisiert: Mit einer Vor-Optimierung mittels Linearer Programmierung (LP), gefolgt von einer detaillierten Optimierung mit einem Genetischen Algorithmus, der auf ein nichtlineares, dynamisches Simulationsmodell fuer die Kette aus Kraftwerken und Stauraeumen zugreift. (orig./RHM)

  20. Picture analysis in CT-HF and its CT photographs

    International Nuclear Information System (INIS)

    Kubota, Kazuo; Kohirasawa, Hideo; Shinojima, Masayasu; Tokui, Mitsuru; Seo, Kunihiko.

    1980-01-01

    CT (computed tomography) apparatus is rarely used yet in the field of dentistry, though it seems useful. It is possibly because of the artefacts caused by the metallic parts attached to teeth, the large partial volume effect due to many bones and the problems of positioning and reproducibility. After considering the various requirements of the CT apparatuses in dental field, CT-HF (of T/R type) was chosen as such apparatus, and installed as the first in dentistry. In the CT-HF apparatus, the inner diameter of the gantry is up to 300 mm, and the position of a tomographic plane is only 40 mm away from the front of gantry. Mainly the usefulness of scanography in positioning and the usefulness of the CT apparatus in the picture analysis and processing in dental field are described. (J.P.N.)

  1. Additional value of PET-CT in the staging of lung cancer: comparison with CT alone, PET alone and visual correlation of PET and CT

    International Nuclear Information System (INIS)

    Wever, W. de; Marchal, G.; Bogaert, J.; Verschakelen, J.A.; Ceyssens, S.; Mortelmans, L.; Stroobants, S.

    2007-01-01

    Integrated positron emission tomography (PET) and computed tomography (CT) is a new imaging modality offering anatomic and metabolic information. The purpose was to evaluate retrospectively the accuracy of integrated PET-CT in the staging of a suggestive lung lesion, comparing this with the accuracy of CT alone, PET alone and visually correlated PET-CT. Fifty patients undergoing integrated PET-CT for staging of a suggestive lung lesion were studied. Their tumor, node, metastasis (TNM) statuses were determined with CT, PET, visually correlated PET-CT and integrated PET-CT. These TNM stages were compared with the surgical TNM status. Integrated PET-CT was the most accurate imaging technique in the assessment of the TNM status. Integrated PET-CT predicted correctly the T status, N status, M status and TNM status in, respectively, 86%, 80%, 98%, 70% versus 68%, 66%,88%, 46% with CT, 46%, 70%, 96%, 30% with PET and 72%, 68%, 96%, 54% with visually correlated PET-CT. T status and N status were overstaged, respectively, in 8% and 16% with integrated PET-CT, in 20% and 28% with CT, in 16% and 20% with PET, in 12% and 20% with visually correlated PET-CT and understaged in 6% and 4% with integrated PET-CT, versus 12% and 6% with CT, 38% and 10% with PET and 12% with visually correlated PET-CT. Integrated PET-CT improves the staging of lung cancer through a better anatomic localization and characterization of lesions and is superior to CT alone and PET alone. If this technique is not available, visual correlation of PET and CT can be a valuable alternative. (orig.)

  2. Metal artifact reduction of CT scans to improve PET/CT

    NARCIS (Netherlands)

    Van Der Vos, Charlotte S.; Arens, Anne I.J.; Hamill, James J.; Hofmann, Christian; Panin, Vladimir Y.; Meeuwis, Antoi P.W.; Visser, Eric P.; De Geus-Oei, Lioe Fee

    2017-01-01

    In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans

  3. Metal Artifact Reduction of CT Scans to Improve PET/CT

    NARCIS (Netherlands)

    Vos, C.S. van der; Arens, A.I.J.; Hamill, J.J.; Hofmann, C.; Panin, V.Y.; Meeuwis, A.P.W.; Visser, E.P.; Geus-Oei, L.F. de

    2017-01-01

    In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans

  4. Restaging of patients with lymphoma. Comparison of low dose CT (20 mAs) with contrast enhanced diagnostic CT in combined [18F]-FDG PET/CT

    International Nuclear Information System (INIS)

    Fougere, C. la; Pfluger, T.; Schneider, V.; Hacker, M.; Broeckel, N.; Bartenstein, P.; Tiling, R.; Morhard, D.; Hundt, W.; Becker, C.

    2008-01-01

    Aim: assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [ 18 F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CE-CT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for > 6 months. Results: region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/CE-CT as compared to PET/LD-CT. Conclusion: overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma. (orig.)

  5. CT and PET-CT of a Dog with Multiple Pulmonary Adenocarcinoma

    Science.gov (United States)

    KIM, Jisun; KWON, Seong Young; CENA, Rohani; PARK, Seungjo; OH, Juyeon; OUI, Heejin; CHO, Kyoung-Oh; MIN, Jung-Joon; CHOI, Jihye

    2013-01-01

    ABSTRACT A 10-year-old, intact female Yorkshire terrier had multiple pulmonary nodules on thoracic radiography and ultrasonography with no lesions elsewhere. Computed tomography (CT) and positron emission tomography and computed tomography (PET-CT) using 18F-fluorodeoxyglucose (FDG) were performed to identify metastasis and undetected primary tumors. On CT examination, pulmonary nodules had a hypoattenuating center with thin peripheral enhancement, suggesting ischemic or necrotizing lesion. In PET-CT at 47 min after intravenous injection of 11.1 MBq/kg of FDG, the maximum standardized uptake value of each pulmonary nodule was about from 3.8 to 6.4. There were no abnormal lesions except for four pulmonary nodules on the CT and PET-CT. Primary lung tumor was tentatively diagnosed, and palliative therapy using 2 mg/kg tramadol and 2.2 mg/kg carprofen twice per day was applied. After the dog’s euthanasia due to deteriorated clinical signs and poor prognosis, undifferentiated pulmonary adenocarcinoma was diagnosed through histopathologic and immunochemistry examination. To the best of the authors’ knowledge, this is the first study of CT and PET-CT features of canine pulmonary adenocarcinoma. In this case, multiple pulmonary adenocarcinoma could be determined on the basis of FDG PET-CT through screening the obvious distant metastasis and/or lymph node invasions and excluding unknown primary tumors. PMID:24389742

  6. CT paging arteriography with a multidetector-row CT. Advantages in splanchnic arterial imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Seiji [Keio Univ., Tokyo (Japan). School of Medicine

    1999-11-01

    The purpose of this study is to assess the utility of CT paging arteriography with a multidetector-row CT as a replacement for conventional angiography in the evaluation of splanchnic arterial anomalies. Sixty-three patients underwent CT paging arteriography with a multidetector-row CT. In the 56 patients with conventional angiographic correlation, there was only one minor disagreement with CT paging arteriography. In the 7 patients who underwent IVDSA (intra venous digital subtraction angiography), CT paging arteriography defined four hepatic arterial anomalies which could not be depicted by IVDSA. In conclusion, CT paging arteriography provides noninvasive means to identify splanchnic arterial anomalies. (author)

  7. Low-dose non-enhanced CT versus full-dose contrast-enhanced CT in integrated PET/CT studies for the diagnosis of uterine cancer recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro [Institute of Biomedical Research and Innovation, Department of PET Diagnosis, Kobe (Japan); Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Suzuki, Kayo [Institute of Biomedical Research and Innovation, Department of PET Diagnosis, Kobe (Japan); Nakamoto, Yuji [Kyoto University Hospital, Department of Diagnostic Radiology, Kyoto (Japan); Onishi, Yumiko; Sakamoto, Setsu; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Senda, Michio [Institute of Biomedical Research and Innovation, Department of Molecular Imaging, Kobe (Japan); Kita, Masato [Kobe City Medical Center General Hospital, Department of Obstetrics and Gynecology, Kobe (Japan)

    2010-08-15

    To evaluate low-dose non-enhanced CT (ldCT) and full-dose contrast-enhanced CT (ceCT) in integrated {sup 18}F-fluorodeoxyglucose (FDG) PET/CT studies for restaging of uterine cancer. A group of 100 women who had undergone treatment for uterine cervical (n=55) or endometrial cancer (n=45) underwent a conventional PET/CT scans with ldCT, and then a ceCT scan. Two observers retrospectively reviewed and interpreted the PET/ldCT and PET/ceCT images in consensus using a three-point grading scale (negative, equivocal, or positive) per patient and per lesion. Final diagnoses were obtained by histopathological examination, or clinical follow-up for at least 6 months. Patient-based analysis showed that the sensitivity, specificity and accuracy of PET/ceCT were 90% (27/30), 97% (68/70) and 95% (95/100), respectively, whereas those of PET/ldCT were 83% (25/30), 94% (66/70) and 91% (91/100), respectively. Sensitivity, specificity and accuracy did not significantly differ between two methods (McNemar test, p=0.48, p=0.48, and p=0.13, respectively). There were 52 sites of lesion recurrence: 12 pelvic lymph node (LN), 11 local recurrence, 8 peritoneum, 7 abdominal LN, 5 lung, 3 supraclavicular LN, 3 liver, 2 mediastinal LN, and 1 muscle and bone. The grading results for the 52 sites of recurrence were: negative 5, equivocal 0 and positive 47 for PET/ceCT, and negative 5, equivocal 4 and positive 43 for PET/ldCT, respectively. Four equivocal regions by PET/ldCT (local recurrence, pelvic LN metastasis, liver metastasis and muscle metastasis) were correctly interpreted as positive by PET/ceCT. PET/ceCT is an accurate imaging modality for the assessment of uterine cancer recurrence. Its use reduces the frequency of equivocal interpretations. (orig.)

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses ... CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known ...

  9. Inflammation and tumors of the temporal bone; Entzuendungen und Tumoren des Schlaefenbeins

    Energy Technology Data Exchange (ETDEWEB)

    Burian, M. [Universitaetsklinik fuer Hals-, Nasen- und Ohrenkrankheiten, Allgemeines Krankenhaus, Wien (Austria)

    1997-12-01

    The term `inflammation of the middle ear` covers a couple of deseases which range from the acute otitis media to the middle ear cholesteatoma. However, a clear characterization of a certain pathology is essential for any further treatment. Therefore this article presents a short overview about the different types of infections and their clinical manifestation. The tumors of the temporal bone show a great variety in their incidence. Even if tumors like the acoustic neurinoma or the paraganglioma are compareable common, the chondroblastoma of the temporal bone is absolutely rare. In spite of these differences the individual temporal bone neoplasias are shortly mentioned herein. (orig.) [Deutsch] Der Begriff Mittelohrentzuendung umfasst ein weites Spektrum von Krankheiten welches von der akuten Mittelohrentzuendung bis hin zum Cholesteatom reicht. Es soll in diesem Artikel eine kurze Uebersicht ueber die verschiedenen Entzuendungen gegeben werden, wobei vor allem auf eine klare Begriffsdefinition der einzelnen Entzuendungsformen und deren klinisches Erscheinungsbild geachtet wurde. Bei den Tumoren des Schlaefenbeins ist ein grosser Unterschied in der Inzidenz der einzelnen Tumoren gegeben. Waehrend Neubildungen wie das Akustikusneurinom oder das Paragangliom vergleichsweise haeufig im klinischen Alltag zu sehen sind, stellen Veraenderungen wie das Chondroblastom eine Raritaet dar. Trotz dieses Unterschieds im Vorkommen der verschiedenen Tumoren, wurde versucht, einen kurzen Gesamtueberblick ueber die Tumore des Mittel- und Innenohres zu geben. (orig.)

  10. Use of dexpanthenol and aloe vera to influence the irradiation response of the oral mucous membrane (mouse); Beeinflussung der Strahlenreaktion der Mundschleimhaut (Maus) durch Dexpanthenol {+-} Aloe vera

    Energy Technology Data Exchange (ETDEWEB)

    Schlichting, S. [Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Dresden Univ. (Germany); Spekl, K.; Doerr, W. [Klinik und Poliklinik fuer Strahlentherapie und Radioonkologie, Dresden Univ. (Germany)]|[Experimentelles Zentrum, Medizinische Fakultaet Carl Gustav Carus, Dresden Univ. (Germany)

    2004-07-01

    In summarising the outcome of the present study it can be said spraying the agent on the oral mucous membrane once a day had an effect on the incidence of mucous membrane ulceration in the case of both placebo and dexpanthenol treatment. However, there was no significant difference between placebo and dexpanthenol treatment, the only finding being a slight prolongation of latency time through aloe vera. These experimental findings give good reason to critically reconsider the clinical use of dexpanthenol as a supportive treatment for the prevention of radiogenic mucositis enoralis following irradiation of tumours in the head and neck region. However thorough oral lavage is an effective means of moderating the irradiation response of the oral mucous membrane. [German] Zusammenfassend ist festzustellen, dass in den vorliegenden Versuchen mit einmal taeglichem Aufspruehen des Praeparates auf die Mundschleimhaut sowohl die Placebo - wie auch die Dexpanthenol-Behandlung die Inzidenz von Schleimhautulzerationen modifiziert hat; zwischen Placebo- und Dexpanthenol-Behandlung ergab sich jedoch kein signifikanter Unterschied. Lediglich eine geringe Verlaengerung der Latenzzeit durch Aloe vera war zu beobachten. Auf der Basis dieser experimentellen Ergebnisse muss der klinische Einsatz von Dexpanthenol im Rahmen der Supportivtherapie zur Prophylaxe der radiogenen Mucositis enoralis bei der Bestrahlung von Kopf-Hals-Tumoren kritisch ueberdacht werden. Regelmaessige, intensive Mundspuelungen sind jedoch ein probates Mittel zur Verminderung der Strahlenreaktion der Mundschleimhaut. (orig.)

  11. Spinal CT scan, 1

    International Nuclear Information System (INIS)

    Nakagawa, Hiroshi

    1982-01-01

    Methods of CT of the cervical and thoracic spines were explained, and normal CT pictures of them were described. Spinal CT was evaluated in comparison with other methods in various spinal diseases. Plain CT revealed stenosis due to spondylosis or ossification of posterior longitudinal ligament and hernia of intervertebral disc. CT took an important role in the diagnosis of spinal cord tumors with calcification and destruction of the bone. CT scan in combination with other methods was also useful for the diagnosis of spinal injuries, congenital anomalies and infections. (Ueda, J.)

  12. Optimization of Protocol CT, PET-CT, whole body

    International Nuclear Information System (INIS)

    Gutierrez, Fredys Santos; Namias, Mauro

    2013-01-01

    The objective of this study was to optimize the acquisition protocols and processing existing of the CT PET/CT scanner for clinical use of Nuclear Diagnostic Center Foundation, a way to minimize the radiation dose while maintaining diagnostic image quality properly. Dosimetric data of PET / CT service were surveyed and obtained the baseline against which we compare and define strategies and modifications to develop online. We selected transaxial up to the pulmonary hilum and liver slices as the anatomical regions of interest that led to the standardization of the study

  13. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray ... What is CT Scanning of the Head? Computed tomography, more commonly known as a CT or CAT ...

  14. Usefulness of multi-plane dynamic subtraction CT (MPDS-CT) for intracranial high density lesions

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Ryo; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan)

    1996-02-01

    We present a new CT technique using the high speed CT scanner in detection and evaluation of temporal and spatial contrast enhancement of intracranial high density lesions. A multi-plane dynamic subtraction CT (MPDS-CT) was performed in 21 patients with intracranial high density lesions. These lesions consisted of 10 brain tumors, 7 intracerebral hemorrhages and 4 vascular malformations (2 untreated, 2 post-embolization). Baseline study was first performed, and 5 sequential planes of covering total high density lesions were selected. After obtaining the 5 sequential CT images as mask images, three series of multi-plane dynamic CT were performed for the same 5 planes with an intravenous bolus injection of contrast medium. MPDS-CT images were reconstructed by subtracting dynamic CT images from the mask ones. MPDS-CT were compared with conventional contrast-enhanced CT. MPDS-CT images showed the definite contrast enhancement of high density brain tumors and vascular malformations which were not clearly identified on conventional contrast-enhanced CT images because of calcified or hemorrhagic lesions and embolic materials, enabling us to eliminate enhanced abnormalities with non-enhanced areas such as unusual intracerebral hemorrhages. MPDS-CT will provide us further accurate and objective information and will be greatly helpful for interpreting pathophysiologic condition. (author).

  15. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Abdomen and Pelvis Computed tomography (CT) of the abdomen and pelvis is a ... is CT Scanning of the Abdomen/Pelvis? Computed tomography, more commonly known as a CT or CAT ...

  16. Radiation exposure during CT-guided biopsies: recent CT machines provide markedly lower doses.

    Science.gov (United States)

    Guberina, Nika; Forsting, Michael; Ringelstein, Adrian; Suntharalingam, Saravanabavaan; Nassenstein, Kai; Theysohn, Jens; Wetter, Axel

    2018-03-28

    To examine radiation dose levels of CT-guided interventional procedures of chest, abdomen, spine and extremities on different CT-scanner generations at a large multicentre institute. 1,219 CT-guided interventional biopsies of different organ regions ((A) abdomen (n=516), (B) chest (n=528), (C) spine (n=134) and (D) extremities (n=41)) on different CT-scanners ((I) SOMATOM-Definition-AS+, (II) Volume-Zoom, (III) Emotion6) were included from 2013-2016. Important CT-parameters and standard dose-descriptors were retrospectively examined. Additionally, effective dose and organ doses were calculated using Monte-Carlo simulation, following ICRP103. Overall, radiation doses for CT interventions are highly dependent on CT-scanner generation: the newer the CT scanner, the lower the radiation dose imparted to patients. Mean effective doses for each of four procedures on available scanners are: (A) (I) 9.3mSv versus (II) 13.9mSv (B) (I) 7.3mSv versus (III) 11.4mSv (C) (I) 6.3mSv versus (II) 7.4mSv (D) (I) 4.3mSv versus (II) 10.8mSv. Standard dose descriptors [standard deviation (SD); CT dose index vol (CTDI vol ); dose-length product (DLP body ); size-specific dose estimate (SSDE)] were also compared. Effective dose, organ doses and SSDE for various CT-guided interventional biopsies on different CT-scanner generations following recommendations of the ICRP103 are provided. New CT-scanner generations involve markedly lower radiation doses versus older devices. • Effective dose, organ dose and SSDE are provided for CT-guided interventional examinations. • These data allow identifying organs at risk of higher radiation dose. • Detailed knowledge of radiation dose may contribute to a better individual risk-stratification. • New CT-scanner generations involve markedly lower radiation doses compared to older devices.

  17. Diagnosis of tracheal instability: inspiratory and expiratory spiral CT and cine CT

    International Nuclear Information System (INIS)

    Heussel, C.P.; Thelen, M.; Kauczor, H.U.; Hafner, B.; Lill, J.

    2000-01-01

    Purpose: In tracheo- and bronchomalacia, localization and determination of collapse is necessary for planning a surgical procedure. We compared inspiratory and spiral CT, cine CT, and bronchoscopy and evaluated the relevance of each method. Methods: Seventeen patients with suspected or verified tracheal stonosis or collapse underwent paired inspiratory and exspiratory spiral CT and cine CT during continuous respiration (temporal increment 100 ms). The tracheal cross-sectional area was calculated and compared. Results: In addition to bronchoscopy, further information concerning localization, extent, collapse, stability of the tracheal wall, distal portions of the stenosis, and extraluminal compressions was obtained. A significantly higher degree of tracheal collapse was seen using cine CT compared to paired spiral CT (p [de

  18. Implications of CT noise and artifacts for quantitative 99mTc SPECT/CT imaging

    International Nuclear Information System (INIS)

    Hulme, K. W.; Kappadath, S. C.

    2014-01-01

    Purpose: This paper evaluates the effects of computed tomography (CT) image noise and artifacts on quantitative single-photon emission computed-tomography (SPECT) imaging, with the aim of establishing an appropriate range of CT acquisition parameters for low-dose protocols with respect to accurate SPECT attenuation correction (AC). Methods: SPECT images of two geometric and one anthropomorphic phantom were reconstructed iteratively using CT scans acquired at a range of dose levels (CTDI vol = 0.4 to 46 mGy). Resultant SPECT image quality was evaluated by comparing mean signal, background noise, and artifacts to SPECT images reconstructed using the highest dose CT for AC. Noise injection was performed on linear-attenuation (μ) maps to determine the CT noise threshold for accurate AC. Results: High levels of CT noise (σ ∼ 200–400 HU) resulted in low μ-maps noise (σ ∼ 1%–3%). Noise levels greater than ∼10% in 140 keV μ-maps were required to produce visibly perceptible increases of ∼15% in 99m Tc SPECT images. These noise levels would be achieved at low CT dose levels (CTDI vol = 4 μGy) that are over 2 orders of magnitude lower than the minimum dose for diagnostic CT scanners. CT noise could also lower (bias) the expected μ values. The relative error in reconstructed SPECT signal trended linearly with the relative shift in μ. SPECT signal was, on average, underestimated in regions corresponding with beam-hardening artifacts in CT images. Any process that has the potential to change the CT number of a region by ∼100 HU (e.g., misregistration between CT images and SPECT images due to motion, the presence of contrast in CT images) could introduce errors in μ 140 keV on the order of 10%, that in turn, could introduce errors on the order of ∼10% into the reconstructed 99m Tc SPECT image. Conclusions: The impact of CT noise on SPECT noise was demonstrated to be negligible for clinically achievable CT parameters. Because CT dose levels that affect

  19. Performance evaluation of the General Electric eXplore CT 120 micro-CT using the vmCT phantom

    Energy Technology Data Exchange (ETDEWEB)

    Bahri, M.A., E-mail: M.Bahri@ulg.ac.be [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); Warnock, G.; Plenevaux, A. [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); Choquet, P.; Constantinesco, A. [Biophysique et Medecine Nucleaire, Hopitaux universitaires de Strasbourg, Strasbourg (France); Salmon, E.; Luxen, A. [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); Seret, A. [ULg-Liege University, Cyclotron Research Centre, Liege, Bat. 30, Allee du 6 aout, 8 (Belgium); ULg-Liege University, Experimental Medical Imaging, Liege (Belgium)

    2011-08-21

    The eXplore CT 120 is the latest generation micro-CT from General Electric. It is equipped with a high-power tube and a flat-panel detector. It allows high resolution and high contrast fast CT scanning of small animals. The aim of this study was to compare the performance of the eXplore CT 120 with that of the eXplore Ultra, its predecessor for which the methodology using the vmCT phantom has already been described . The phantom was imaged using typical a rat (fast scan or F) or mouse (in vivo bone scan or H) scanning protocols. With the slanted edge method, a 10% modulation transfer function (MTF) was observed at 4.4 (F) and 3.9-4.4 (H) mm{sup -1} corresponding to 114 {mu}m resolution. A fairly larger MTF was obtained by the coil method with the MTF for the thinnest coil (3.3 mm{sup -1}) equal to 0.32 (F) and 0.34 (H). The geometric accuracy was better than 0.3%. There was a highly linear (R{sup 2}>0.999) relationship between measured and expected CT numbers for both the CT number accuracy and linearity sections of the phantom. A cupping effect was clearly seen on the uniform slices and the uniformity-to-noise ratio ranged from 0.52 (F) to 0.89 (H). The air CT number depended on the amount of polycarbonate surrounding the area where it was measured; a difference as high as approximately 200 HU was observed. This hindered the calibration of this scanner in HU. This is likely due to the absence of corrections for beam hardening and scatter in the reconstruction software. However in view of the high linearity of the system, the implementation of these corrections would allow a good quality calibration of the scanner in HU. In conclusion, the eXplore CT 120 achieved a better spatial resolution than the eXplore Ultra (based on previously reported specifications) and future software developments will include beam hardening and scatter corrections that will make the new generation CT scanner even more promising.

  20. Pediatric CT angiography

    International Nuclear Information System (INIS)

    Siegel, M.J.

    2005-01-01

    Advances in CT technology are having profound impact on imaging children and have made CT angiography possible even in neonates. Even with the tiny anatomy of neonates, small volumes of contrast material, and small venous access catheters, successful CT angiography can be performed with attention to detail. Meticulous attention to patient preparation, the proper selection of technical factors, and optimal delivery of contrast material are crucial. Data post-processing and the creation of 3-D reconstructions are also essential in establishing a correct diagnosis. The applications fo CT angiography are different in children than in adults and most applications in children involve assessment of congenital and postoperative vascular and cardiac diseases. The use of CT angiography offers the opportunity to eliminate the long periods of sedation associated with MR and reduce the radiation exposure associated with conventional angiography. Generally, the benefits of CT angiography in children outweigh the risk, namely that of radiation exposure. However, care must still be taken to minimize the radiation exposure. (orig.)

  1. Preoperative 4D CT Localization of Nonlocalizing Parathyroid Adenomas by Ultrasound and SPECT-CT.

    Science.gov (United States)

    Hinson, Andrew M; Lee, David R; Hobbs, Bradley A; Fitzgerald, Ryan T; Bodenner, Donald L; Stack, Brendan C

    2015-11-01

    To evaluate 4-dimensional (4D) computed tomography (CT) for the localization of parathyroid adenomas previously considered nonlocalizing on ultrasound and single-photon emission CT with CT scanning (SPECT-CT). To measure radiation exposure associated with 4D-CT and compared it with SPECT-CT. Case series with chart review. University tertiary hospital. Nineteen adults with primary hyperparathyroidism who underwent preoperative 4D CT from November 2013 through July 2014 after nonlocalizing preoperative ultrasound and technetium-99m SPECT-CT scans. Sensitivity, specificity, predictive values, and accuracy of 4D CT were evaluated. Nineteen patients (16 women and 3 men) were included with a mean age of 66 years (range, 39-80 years). Mean preoperative parathyroid hormone level was 108.5 pg/mL (range, 59.3-220.9 pg/mL), and mean weight of the excised gland was 350 mg (range, 83-797 mg). 4D CT sensitivity and specificity for localization to the patient's correct side of the neck were 84.2% and 81.8%, respectively; accuracy was 82.9%. The sensitivity for localizing adenomas to the correct quadrant was 76.5% and 91.5%, respectively; accuracy was 88.2%. 4D CT radiation exposure was significantly less than the radiation associated with SPECT-CT (13.8 vs 18.4 mSv, P = 0.04). 4D CT localizes parathyroid adenomas with relatively high sensitivity and specificity and allows for the localization of some adenomas not observed on other sestamibi-based scans. 4D CT was also associated with less radiation exposure when compared with SPECT-CT based on our study protocol. 4D CT may be considered as first- or second-line imaging for localizing parathyroid adenomas in the setting of primary hyperparathyroidism. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  2. Coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2009-07-01

    Coronary CT angiography has attained increasing scientific attention at academic institutions and has become a highly accurate diagnostic modality. Extending this knowledge into a practice setting is the purpose of 'Coronary CT Angiography'. This book will assist you in integrating cardiac CT into your daily practice, while also giving an overview of the current technical status and applications. The specific features of scanners from all four main vendors are also presented providing an objective overview of noninvasive coronary angiography using CT. (orig.)

  3. Non-destructive, preclinical evaluation of root canal anatomy of human teeth with flat-panel detector volume CT (FD-VCT); Zerstoerungsfreie praeklinische Evaluation der Wurzelkanalanatomie menschlicher Zaehne mittels Flaechendetektor-Volumen-CT (FD-VCT)

    Energy Technology Data Exchange (ETDEWEB)

    Heidrich, G.; Hassepass, F.; Dullin, C.; Grabbe, E. [Universitaetsklinikum Goettingen, Abt. Diagnostische Radiologie (Germany); Attin, T.; Hannig, C. [Universitaetsklinikum Goettingen, Abt. fuer Zahnerhaltung, Praeventive Zahnheilkunde und Paradontologie (Germany)

    2005-12-15

    Purpose: Successful endodontic diagnostics and therapy call for adequate depiction of the root canal anatomy with multimodal diagnostic imaging. The aim of the present study is to evaluate visualization of the endodont with flat-panel detector volume CT (FD-VCT). Materials and methods: 13 human teeth were examined with the prototype of a FD-VCT. After data acquisition and generation of volume data sets in volume rendering technology (VRT), the findings obtained were compared to conventional X-rays and cross-section preparations of the teeth. Results: The anatomical structures of the endodont such as root canals, side canals and communications between different root canals as well as dentricles could be detected precisely with FD-VCT. The length of curved root canals was also determined accurately. The spatial resolution of the system is around 140 {mu}m. Only around 73% of the main root canals detected with FD-VCT and 87% of the roots could be visualized with conventional dental X-rays. None of the side canals, shown with FD-VCT, was detectable on conventional X-rays. In all cases the enamel and dentin of the teeth could be well delineated. No differences in image quality could be discerned between stored and freshly extracted teeth, or between primary and adult teeth. (orig.)

  4. The clinical, radiological, and scan-examination in horses with backproblems; Die klinische, röntgenologische und szintigraphische Untersuchung bei den sogenannten Rückenproblemen des Pferdes

    Energy Technology Data Exchange (ETDEWEB)

    Nowak, M. [Tierklinik Hochmoor, Gescher (Germany)

    1988-09-15

    In 21 horses with the anamnesis backproblems there had been a clinical, scan- and X-ray-examination of the thoracal and lumbar vertebra in special consideration of the spinosus process and the dorsal intervertebral joint. But there was not always a relation between the clinical signs and X-rays or scan results. Not all positive X-rays found their corresponding scan activity and not all scan activities took place in X-rays. In many cases there was pathological change of the spinosus process and arthropathy of the dorsal intervertebral joint at the same time. Only with X-raying it is not possible to decide to operate the thoracolumbal, interspinale syndrom (TIS) or not [German] Bei 2l Pferden mit dem Vorbericht 'Rückenleiden' wurden klinisch, röntgenologisch und szintigraphisch die Brust- und Lendenwirbelsäule unter besonderer Berücksichtigung der Dornfortsätze und der dorsalen Intervertebralgelenke untersucht. Die erhobenen klinischen, röntgenologischen und szintigraphischen Befunde stimmten nicht immer überein. So waren nicht alle erhobenen Röntgenbefunde szintigraphisch aktiv, und für die szintigraphisch aktiven Zonen konnten nicht immer rötgenologische Befunde erhoben werden. Bei den Veränderungen der Dornfortsätze lagen oft gleichzeitig Arthrosen der dorsalen Intervertebralgelenke vor. Die Indikation ftir die Operation des thorakolumbalen, interspinalen Syndroms (TIS) kann deshalb nicht mit der Röntgenuntersuchung der Dornfortsätze allein gestellt werden.

  5. Indications for chest CT. Retrospective study of cases with normal chest CT

    International Nuclear Information System (INIS)

    Obata, Shiro

    1995-01-01

    The usefulness of computed tomography (CT) in thoracic radiology is now well appreciated, and the number of chest CTs has greatly increased. There are, however, many chest CT cases that are completely or almost completely normal. Indications for chest CT should be re-evaluated considering the cost and radiation exposure associated with the examination. Reviewing the reports of 4930 chest CT examinations performed in three hospitals during the period of two years, the author found 620 (12.6%) negative CT examinations. In 312 of the 620, the CT was requested because of 'abnormal shadow' on chest radiograph. When the same chest radiographs were re-evaluated by two radiologists, no abnormality was noted in 257 cases (82.4%). CT examinations were considered justified in only 55 cases (17.6%). There was a significant difference in the frequency of normal chest CT examinations between the university hospital and two other hospitals. The causes of false positive interpretation of chest radiographs were analyzed, and it was felt that fundamental knowledge necessary to interpret chest radiographs was lacking. The importance of close cooperation between clinicians and radiologists should be emphasized. (author)

  6. Micro-CT and nano-CT analysis of filling quality of three different endodontic sealers.

    Science.gov (United States)

    Huang, Yan; Celikten, Berkan; de Faria Vasconcelos, Karla; Ferreira Pinheiro Nicolielo, Laura; Lippiatt, Nicholas; Buyuksungur, Arda; Jacobs, Reinhilde; Orhan, Kaan

    2017-12-01

    To investigate voids in different root canal sealers using micro-CT and nano-CT, and to explore the feasibility of using nano-CT for quantitative analysis of sealer filling quality. 30 extracted mandibular central incisors were randomly assigned into three groups according to the applied root canal sealers (Total BC Sealer, Sure Seal Root, AH Plus) by the single cone technique. Subsequently, micro-CT and nano-CT were performed to analyse the incidence rate of voids, void fraction, void volume and their distribution in each sample. Micro-CT evaluation showed no significant difference among sealers for the incidence rate of voids or void fraction in the whole filling materials (p > 0.05), whereas a significant difference was found between AH Plus and the other two sealers using nano-CT (p nano-CT results displayed higher void volume in AH Plus among all the sealers and regions (p nano-CT analysis, when round root canals were treated by the single cone technique. The disparate results suggest that the higher resolution of nano-CT have a greater ability of distinguishing internal porosity, and therefore suggesting the potential use of nano-CT in quantitative analysis of filling quality of sealers.

  7. Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Yoshikawa, Takeshi; Takenaka, Daisuke; Fujisawa, Yasuko; Sugihara, Naoki; Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Sugimura, Kazuro

    2017-01-01

    Purpose: To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT) Materials and methods: Twenty-three consecutive smokers (15 men and 8 women, mean age: 69.7 ± 8.7 years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV 1 . Results: Each inter-observer agreement was rated as substantial (Sub-CT: κ = 0.69, p < 0.0001; DE-CT: κ = 0.64, p < 0.0001; SPECT/CT: κ = 0.64, p < 0.0001). Functional lung volume for each method showed significant to good correlation with%FEV 1 (Sub-CT: r = 0.72, p = 0.0001; DE-CT: r = 0.74, p < 0.0001; SPECT/CT: r = 0.66, p = 0.0006). Conclusion: Xenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers.

  8. Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers

    Energy Technology Data Exchange (ETDEWEB)

    Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe (Japan); Yoshikawa, Takeshi [Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe (Japan); Takenaka, Daisuke [Department of Radiology, Hyogo Cancer Center, Akashi (Japan); Fujisawa, Yasuko; Sugihara, Naoki [Toshiba Medical Systems Corporation, Otawara (Japan); Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Sugimura, Kazuro [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine (Japan)

    2017-01-15

    Purpose: To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT) Materials and methods: Twenty-three consecutive smokers (15 men and 8 women, mean age: 69.7 ± 8.7 years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV{sub 1}. Results: Each inter-observer agreement was rated as substantial (Sub-CT: κ = 0.69, p < 0.0001; DE-CT: κ = 0.64, p < 0.0001; SPECT/CT: κ = 0.64, p < 0.0001). Functional lung volume for each method showed significant to good correlation with%FEV{sub 1} (Sub-CT: r = 0.72, p = 0.0001; DE-CT: r = 0.74, p < 0.0001; SPECT/CT: r = 0.66, p = 0.0006). Conclusion: Xenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers.

  9. Non-enhanced CT versus contrast-enhanced CT in integrated PET/CT studies for nodal staging of rectal cancer

    International Nuclear Information System (INIS)

    Tateishi, Ukihide; Maeda, Tetsuo; Morimoto, Tsuyoshi; Miyake, Mototaka; Arai, Yasuaki; Kim, E.E.

    2007-01-01

    The purpose of the present study was to determine the diagnostic accuracy of non-enhanced CT and contrast-enhanced CT in integrated PET/CT studies for preoperative nodal staging of rectal cancer. Retrospective analysis was performed in 53 patients with pathologically proven rectal cancer who had been referred for preoperative staging. All patients underwent integrated PET/CT consisting of non-enhanced and contrast-enhanced CT followed by whole-body fluorine-18-fluorodeoxyglucose ([ 18 F]FDG) PET. Both non-enhanced and contrast-enhanced PET/CT images were evaluated separately by two observers in consensus. The reference standard was histopathologic results. For nodal staging of rectal cancer, we compared diagnostic accuracy on a per-patient basis between the two modalities. Nodal staging was correctly determined with non-enhanced studies in 37 patients (70%) and with contrast-enhanced studies in 42 patients (79%). On a per-patient basis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of regional lymph node staging were 85%, 68%, 83%, 72%, and 79%, respectively, with contrast-enhanced studies, and 85%, 42%, 73%, 62%, and 70%, respectively, with non-enhanced studies. The difference in the accuracy of nodal staging between the two modalities was not significant (p = 0.063). Compared with non-enhanced studies, contrast-enhanced studies determined more correctly the status of pararectal lymph nodes (p 0.002), internal iliac lymph nodes (p = 0.004), and obturator lymph nodes (p < 0.0001). Contrast-enhanced PET/CT is superior to non-enhanced PET/CT for precise definition of regional nodal status in rectal cancer. (orig.)

  10. Whole-body CT. Spiral and multislice CT. 2. tot. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Prokop, M.; Galanski, M.; Schaefer-Prokop, C.; Molen, A.J. van der

    2007-01-01

    Spiral and multidetector techniques have improved the diagnostic possibilities of CT, so that image analysis and interpretation have become increasingly complex. This book represents the current state of the art in CT imaging, including the most recent technical scanner developments. The second edition comprises the current state of knowledge in cT imaging. There are new chapters on image processing, application of contrasting agents and radiation dose. All organ-specific pathological findings are discussed in full. There are hints for optimum use and interpretation of CT, including CT angiography, CT colonography, CT-IVPL, and 3D imaging. There is an introduction to cardio-CT, from calcium scoring and CTA of the coronary arteries to judgement of cardiac morphology. There are detailed scan protocols with descriptions of how to go about parameter selection. Practical hints are given for better image quality and lower radiation exposure of patients, guidelines for patient preparation and complication management, and more than 1900 images in optimum RRR quality. (orig.)

  11. Diagnosis of colorectal tumors; Diagnostik von kolorektalen Tumoren. Mehrschichtcomputertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Pegios, W.; Jacobi, V.; Schaefer, S.; Abolmaali, N.; Luboldt, W. [Institut fuer Diagnostische und Interventionelle Radiologie, Johann-Wolfgang-Goethe-Universitaet Frankfurt (Germany)

    2003-02-01

    With the introduction of multislice CT extensive volumetric data sets can be quickly acquired in high spatial resolution. The high spatial resolution reduces partial volume effects and enables multiplanar reconstructions. Regarding the colorectum this means that the colon can be assessed if the colon is sufficiently cleaned and distended, and that transmural infiltration of colorectal carcinoma and liver metastases can be better detected. T-staging of colon cancer is less important than T-staging of rectal cancer. Based on the higher contrast MRI is superior to CT in T-staging of rectal cancer and in the differentiation between scarring tissue and recurrence of carcinoma. (orig.) [German] Mit Einfuehrung der Mehrschicht-CT lassen sich umfangreiche Volumendatensaetze schnell und mit hoher Aufloesung erfassen. Die hohe raeumliche Aufloesung reduziert Teilvolumeneffekte und ermoeglicht multiplanare Rekonstruktionen. In Bezug auf das Kolorektum bedeutet dies, dass das Kolon bei ausreichender Darmreinigung und -distension gut beurteilbar ist und transmurale Infiltrationen von kolorektalen Karzinomen sowie Lebermetastasen leichter zu erkennen sind.Bei Kolonkarzinomen hat das T-Staging weniger klinische Relevanz als bei Rektumkarzinomen. Aufgrund des hoeheren Kontrasts ist die MRT der CT im T-Staging von Rektumkarzinomen sowie in der Unterscheidungzwischen Narben- und Rezidivtumorgewebe ueberlegen. (orig.)

  12. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses ... of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  13. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses special ... the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  14. Perfusion CT in acute stroke

    International Nuclear Information System (INIS)

    Eckert, Bernd; Roether, Joachim; Fiehler, Jens; Thomalla, Goetz

    2015-01-01

    Modern multislice CT scanners enable multimodal protocols including non-enhanced CT, CT angiography, and CT perfusion. A 64-slice CT scanner provides 4-cm coverage. To cover the whole brain, a 128 - 256-slice scanner is needed. The use of perfusion CT requires an optimized scan protocol in order to reduce exposure to radiation. As compared to non-enhanced CT and CT angiography, the use of CT perfusion increases detection rates of cerebral ischemia, especially small cortical ischemic lesions, while the detection of lacunar and infratentorial stroke lesions remains limited. Perfusion CT enables estimation of collateral flow in acute occlusion of large intra- or extracranial arteries. Currently, no established reliable thresholds are available for determining infarct core and penumbral tissue by CT perfusion. Moreover, perfusion parameters depend on the processing algorithms and the software used for calculation. However, a number of studies point towards a reduction of cerebral blood volume (CBV) below 2 ml/100 g as a critical threshold that identifies infarct core. Large CBV lesions are associated with poor outcome even in the context of recanalization. The extent of early ischemic signs on non-enhanced CT remains the main parameter from CT imaging to guide acute reperfusion treatment. Nevertheless, perfusion CT increases diagnostic and therapeutic certainty in the acute setting. Similar to stroke MRI, perfusion CT enables the identification of tissue at risk of infarction by the mismatch between infarct core and the larger area of critical hypoperfusion. Further insights into the validity of perfusion parameters are expected from ongoing trials of mechanical thrombectomy in stroke.

  15. Spiral CT versus conventional CT in the preoperative assessment of metallic intraocular foreign bodies

    International Nuclear Information System (INIS)

    Prokesch, R.; Bankier, A.; Ba-Ssalamah, A.; Imhof, H.; Lakits, A.; Scholda, C.

    1998-01-01

    Purpose: To compare the effectiveness of spiral CT versus conventional CT in the preoperative assessment of metallic intraocular foreign bodies. Results: All foreign bodies were detected by each scanning modality on the axial and on the reconstructed planes. The quality of the axial images was similar for spiral and conventional CT. The spiral technique provided high-quality reconstructed images which allowed accurate localization of the foreign bodies in all cases. Reconstructions by conventional technique were inadequate for preoperative assessment. The examination time for the total orbital volume was 18 s for spiral CT and 52 s for conventional CT. Radiation dose delivered to the lens was 35 mGy for spiral CT and 56 mGy for conventional CT axial scanning. Conclusion: Spiral CT multiplanar offers several significant advantages for the preoperative assessment of metallic intraocular foreign bodies compared to the conventional CT technique in clinical practice, including short examination time, minimized motion artifacts, reduced radiation exposure, and accurate localization. (orig.) [de

  16. CT and MR imaging of the kidney and adrenal glands: CT of the kidney

    International Nuclear Information System (INIS)

    Levine, E.

    1987-01-01

    Because of its high diagnostic yield, safety, and cost-effectiveness, CT has become a major imaging technique for evaluating the kidney. CT is highly accurate for determining the nature and extent of renal masses, and this has become the main indication for renal CT. However, CT is also valuable in assessing patients with renal cystic disease, trauma, inflammatory disease, infarction, hemorrhage and hydronephrosis of unknown cause. This presentation reviews the normal CT anatomy of the kidneys and the usefulness of CT in the diagnosis of all these conditions. Examination techniques are discussed with particular emphasis on avoiding diagnostic pitfalls and tailoring the examination to the nature of the clinical problem. CT findings in various renal disorders are compared with those of other imaging techniques, particularly US and angiography, and the place of CT in the diagnostic approach to these disorders is considered

  17. Improved attenuation correction for respiratory gated PET/CT with extended-duration cine CT: a simulation study

    Science.gov (United States)

    Zhang, Ruoqiao; Alessio, Adam M.; Pierce, Larry A.; Byrd, Darrin W.; Lee, Tzu-Cheng; De Man, Bruno; Kinahan, Paul E.

    2017-03-01

    Due to the wide variability of intra-patient respiratory motion patterns, traditional short-duration cine CT used in respiratory gated PET/CT may be insufficient to match the PET scan data, resulting in suboptimal attenuation correction that eventually compromises the PET quantitative accuracy. Thus, extending the duration of cine CT can be beneficial to address this data mismatch issue. In this work, we propose to use a long-duration cine CT for respiratory gated PET/CT, whose cine acquisition time is ten times longer than a traditional short-duration cine CT. We compare the proposed long-duration cine CT with the traditional short-duration cine CT through numerous phantom simulations with 11 respiratory traces measured during patient PET/CT scans. Experimental results show that, the long-duration cine CT reduces the motion mismatch between PET and CT by 41% and improves the overall reconstruction accuracy by 42% on average, as compared to the traditional short-duration cine CT. The long-duration cine CT also reduces artifacts in PET images caused by misalignment and mismatch between adjacent slices in phase-gated CT images. The improvement in motion matching between PET and CT by extending the cine duration depends on the patient, with potentially greater benefits for patients with irregular breathing patterns or larger diaphragm movements.

  18. Selected clinically established and scientific techniques of diffusion-weighted MRI. In the context of imaging in oncology; Ausgewaehlte klinisch etablierte und wissenschaftliche Techniken der diffusionsgewichteten MRT. Im Kontext der onkologischen Bildgebung

    Energy Technology Data Exchange (ETDEWEB)

    Freitag, M.T.; Bickelhaupt, S.; Ziener, C.; Mosebach, J.; Schlemmer, H.P. [Deutsches Krebsforschungszentrum, Abteilung fuer Radiologie, Heidelberg (Germany); Meier-Hein, K. [Deutsches Krebsforschungszentrum, Abteilung fuer medizinische Informatik, Heidelberg (Germany); Radtke, J.P. [Deutsches Krebsforschungszentrum, Abteilung fuer Radiologie, Heidelberg (Germany); Universitaetsklinik Heidelberg, Abteilung fuer Urologie, Heidelberg (Germany); Kuder, T.A.; Laun, F.B. [Deutsches Krebsforschungszentrum, Abteilung fuer Medizinische Physik in der Radiologie, Heidelberg (Germany)

    2016-02-15

    werden durch Schaltung einer speziellen Gradientenabfolge mithilfe echoplanarer Auslesetechnik mehrere, mindestens jedoch 2 Bilderserien akquiriert, die die Diffusionseigenschaften des Gewebes wiedergeben. Eine der ersten klinisch etablierten Anwendungen ist die DWI bei der Prostata-MRT, die in den international anerkannten PI-RADS- und ESUR-Leitlinien bereits fest integriert ist. In naher Zukunft wird die klinische Etablierung der DWI auch fuer die Mamma-MRT erwartet, hier wurden Spezifitaetswerte und negative praediktive Werte von 94 bzw. 92 % berichtet. Die DWI kann auch als Ganzkoerperbildgebung fuer Patienten mit systemischen Knochenmarkerkrankungen wie dem multiplen Myelom oder zur Frage nach dem Ausmass der Skelettmetastasierung zuverlaessig eingesetzt werden. Neue Techniken der DWI, wie die ''intravoxel incoherent motion DWI'', die Kurtosis-Bildgebung oder histogrammbasierte Auswertungen stellen vielversprechende und innovative Verfahren dar, um Tumordetektion oder Therapieansprechen zunehmend quantitativer durchfuehren zu koennen. (orig.)

  19. A modified VMAT adaptive radiotherapy for nasopharyngeal cancer patients based on CT-CT image fusion

    International Nuclear Information System (INIS)

    Jin, Xiance; Han, Ce; Zhou, Yongqiang; Yi, Jinling; Yan, Huawei; Xie, Congying

    2013-01-01

    To investigate the feasibility and benefits of a modified adaptive radiotherapy (ART) by replanning in the initial CT (iCT) with new contours from a repeat CT (rCT) based on CT-CT image fusion for nasopharyngeal cancer (NPC) patients underwent volumetric modulated arc radiotherapy (VMAT). Nine NPC patients underwent VMAT treatment with a rCT at 23rd fraction were enrolled in this study. Dosimetric differences for replanning VMAT plans in the iCT and in the rCT were compared. Volumetric and dosimetric changes of gross tumor volume (GTV) and organs at risk (OARs) of this modified ART were also investigated. No dosimetric differences between replanning in the iCT and in the rCT were observed. The average volume of GTV decreased from 78.83 ± 38.42 cm 3 in the iCT to 71.44 ± 37.46 cm 3 in the rCT, but with no significant difference (p = 0.42).The average volume of the left and right parotid decreased from 19.91 ± 4.89 cm 3 and 21.58 ± 6.16 cm 3 in the iCT to 11.80 ± 2.79 cm 3 and 13.29 ± 4.17 cm 3 in the rCT (both p < 0.01), respectively. The volume of other OARs did not shrink very much. No significant differences on PTV GTV and PTV CTV coverage were observed for replanning with this modified ART. Compared to the initial plans, the average mean dose of the left and right parotid after re-optimization were decreased by 62.5 cGy (p = 0.05) and 67.3 cGy (p = 0.02), respectively, and the V5 (the volume receiving 5 Gy) of the left and right parotids were decreased by 7.8% (p = 0.01) and 11.2% (p = 0.001), respectively. There was no significant difference on the dose delivered to other OARs. Patients with NPC undergoing VMAT have significant anatomic and dosimetric changes to parotids. Repeat CT as an anatomic changes reference and re-optimization in the iCT based on CT-CT image fusion was accurate enough to identify the volume changes and to ensure safe dose to parotids

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  1. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  2. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ...

  3. Pancreatic neuroendocrine neoplasms; Neuroendokrine Neoplasien des Pankreas

    Energy Technology Data Exchange (ETDEWEB)

    Beiderwellen, K.; Lauenstein, T.C. [Universitaetsklinikum Essen, Institut fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Essen (Germany); Sabet, A.; Poeppel, T.D. [Universitaetsklinikum Essen, Klinik fuer Nuklearmedizin, Essen (Germany); Lahner, H. [Universitaetsklinikum Essen, Klinik fuer Endokrinologie und Stoffwechselerkrankungen, Essen (Germany)

    2016-04-15

    Pancreatic neuroendocrine neoplasms (NEN) account for 1-2 % of all pancreatic neoplasms and represent a rare differential diagnosis. While some pancreatic NEN are hormonally active and exhibit endocrine activity associated with characteristic symptoms, the majority are hormonally inactive. Imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) or as combined PET/CT play a crucial role in the initial diagnosis, therapy planning and control. Endoscopic ultrasound (EUS) and multiphase CT represent the reference methods for localization of the primary pancreatic tumor. Particularly in the evaluation of small liver lesions MRI is the method of choice. Somatostatin receptor scintigraphy and somatostatin receptor PET/CT are of particular value for whole body staging and special aspects of further therapy planning. (orig.) [German] Neuroendokrine Neoplasien (NEN) des Pankreas stellen mit einem Anteil von 1-2 % aller pankreatischen Tumoren eine seltene Differenzialdiagnose dar. Ein Teil der Tumoren ist hormonell aktiv und faellt klinisch durch charakteristische Symptome auf, wohingegen der ueberwiegende Anteil hormonell inaktiv ist. Bildgebende Verfahren wie Sonographie, Computertomographie (CT), Magnetresonanztomographie (MRT) und nicht zuletzt Positronenemissionstomographie (PET oder kombiniert als PET/CT) spielen eine zentrale Rolle fuer Erstdiagnose, Therapieplanung und -kontrolle. Die Endosonographie und die multiphasische CT stellen die Referenzmethoden zur Lokalisation des Primaertumors dar. Fuer die Differenzierung insbesondere kleiner Leberlaesionen bietet die MRT die hoechste Aussagekraft. Fuer das Ganzkoerperstaging und bestimmte Aspekte der Therapieplanung lassen sich die Somatostatinrezeptorszintigraphie und v. a. die Somatostatinrezeptor-PET/CT heranziehen. (orig.)

  4. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  5. Postoperative CT in pancreas transplantation

    International Nuclear Information System (INIS)

    Powell, F.E.; Harper, S.J.F.; Callaghan, C.J.; Shaw, A.; Godfrey, E.M.; Bradley, J.A.; Watson, C.J.E.; Pettigrew, G.J.

    2015-01-01

    Aim: To examine the usage and value of computed tomography (CT) following simultaneous pancreas and kidney (SPK) transplantation. Materials and methods: Indications for postoperative CT, key findings, and their influence on management were determined by retrospective analysis. Results: Ninety-eight patients underwent 313 CT examinations. Common indications for the examinations included suspected intra-abdominal collection (31.1%) and elevated serum amylase/lipase (24.1%). CT findings most frequently showed non-specific mild inflammation (27.6%), a normal scan (17.1%) and fluid collections (16.3%). High capillary blood glucose (CBG) was associated with resultant CT demonstration of graft vascular abnormalities, but otherwise, particular clinical indications were not associated with specific CT findings. Conclusion: Clinical findings in patients with SPK transplants are non-specific. The pattern of abnormalities encountered is significantly different to those seen in native pancreatic disease and demands a tailored protocol. CT enables accurate depiction of vascular abnormalities and fluid collections, thus reducing the number of surgical interventions that might otherwise be required. Elevated CBG should prompt urgent CT to exclude potentially reversible vascular complications. - Highlights: • The value of CT following simultaneous pancreas and kidney transplantation was assessed. • 313 CT scans were performed on 98 patients between January 2005 and August 2010. • Elevated blood glucose was associated with CT findings of graft vascular anomalities. • CT was particularly useful in directing operative versus non-operative intervention.

  6. Spinal CT scan, 2

    International Nuclear Information System (INIS)

    Nakagawa, Hiroshi

    1982-01-01

    Plain CT described fairly accurately the anatomy and lesions of the lumbar and sacral spines on their transverse sections. Since hernia of the intervertebral disc could be directly diagnosed by CT, indications of myelography could be restricted. Spinal-canal stenosis of the lumbar spine occurs because of various factors, and CT not only demonstrated the accurate size and morphology of bony canals, but also elucidated thickening of the joints and yellow ligament. CT was also useful for the diagnosis of tumors in the lumbar and sacral spines, visualizing the images of bone changes and soft tissues on the trasverse sections. But the diagnosis of intradural tumors required myelography and metrizamide CT. CT has become important for the diagnosis of spinal and spinal-cord diseases and for selection of the route of surgical arrival. (Chiba, N.)

  7. CT manifestations of liver abscess

    International Nuclear Information System (INIS)

    Yan Jianfeng; Peng Yongjun

    2006-01-01

    Objective: To study CT findings of hepatic abscess. Methods: CT findings and clinical materials of 38 patients with liver abscess verified by aspiration were retrospectively viewed. All patients were examined by non-enhanced and contrast enhanced CT. Results: In 25 cases, inhomogeneous hypodense lesions with unclear demarcation were found on non-enhanced CT. On contrast enhanced CT scan, target or cluster enhancement was found Additionally, air was found within some lesions. In the rest 13 cases with early stage liver abscess, no typical sign was found on non-enhanced CT, while rosette sign and continued enhancement sign were demonstrated after the contrast agent was given. Conclusion: Various CT findings are found in different stages of liver abscess. The diagnosis and differential diagnosis should be based on CT manifestations and clinical history as well. (authors)

  8. Radiation exposure during paediatric CT in Sudan: CT dose, organ and effective doses

    International Nuclear Information System (INIS)

    Suliman, I.I.; Khamis, H.M.; Ombada, T.H.; Alzimami, K.; Alkhorayef, M.; Sulieman, A.

    2015-01-01

    The purpose of this study was to assess the magnitude of radiation exposure during paediatric CT in Sudanese hospitals. Doses were determined from CT acquisition parameters using CT-Expo 2.1 dosimetry software. Doses were evaluated for three patient ages (0-1, 1-5 and 5-10 y) and two common procedures (head and abdomen). For children aged 0-1 y, volume CT air kerma index (C vol ), air Kerma-length product and effective dose (E) values were 19.1 mGy, 265 mGy.cm and 3.1 mSv, respectively, at head CT and those at abdominal CT were 8.8 mGy, 242 mGy.cm and 7.7 mSv, respectively. Those for children aged 1-5 y were 22.5 mGy, 305 mGy.cm and 1.1 mSv, respectively, at head CT and 12.6 mGy, 317 mGy.cm, and 5.1 mSv, respectively, at abdominal CT. Dose values and variations were comparable with those reported in the literature. Organ equivalent doses vary from 7.5 to 11.6 mSv for testes, from 9.0 to 10.0 mSv for ovaries and from 11.1 to 14.3 mSv for uterus in abdominal CT. The results are useful for dose optimisation and derivation of national diagnostic reference levels. (authors)

  9. CT of the knee

    International Nuclear Information System (INIS)

    Ghelman, B.

    1987-01-01

    CT can be combined with arthrography of the knee to study the following abnormalities: meniscal tears and cysts, synovial plicae, chondromalacia patellae, and osteochondritis dissecans. The CT-arthrogram images present abnormalities in a manner that resembles the ''in situ'' surgical findings, allowing management decisions to be made with greater confidence. The CT techniques for imaging the knee after arthrography are discussed, as is the use of plain CT

  10. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed ... nasal cavity by small openings. top of page What are some common uses of the procedure? CT ...

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... the limitations of CT Scanning of the Head? What is CT Scanning of the Head? Computed tomography, ... than regular radiographs (x-rays). top of page What are some common uses of the procedure? CT ...

  12. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... preferable over CT scanning. top of page Additional Information and Resources RTAnswers.org: Radiation Therapy for Bladder ...

  13. A 17-year-old student with therapy-resistant pneumonia; Siebzehnjaehrige Schuelerin mit therapieresistenter Pneumonie

    Energy Technology Data Exchange (ETDEWEB)

    Rauch, N.; Greminger, P. [Kantonsspital St. Gallen, Departement Innere Medizin, Fachbereich Allgemeine Innere Medizin, St. Gallen (Switzerland); Ullmer, E. [Kantonsspital St. Gallen, Departement Innere Medizin, Fachbereich Pneumologie, St. Gallen (Switzerland); Matt, D. [Kantonsspital St. Gallen, Institut fuer Radiologie, St. Gallen (Switzerland)

    2010-06-15

    If empiric antibiotic treatment is not successful in a case of suspected pneumonia further investigations are required. We present a case where originally an intralobar, bronchopulmonary sequestration could clearly be diagnosed by a thoracic CT scan. A 3D reconstruction revealed the pathognomonic arterial supply from the thoracic aorta and the venous drainage via pulmonary vein to the left atrium. Therefore, elective resection of the sequestration was indicated. (orig.) [German] Fuehrt eine empirische Antibiotikatherapie bei einer vermeintlichen Pneumonie nicht zum Erfolg, sind weiterfuehrende Abklaerungen angezeigt. In unserem Fallbeispiel konnte ursaechlich im Thorax-CT zweifelsfrei die Diagnose eines intralobaeren Lungensequesters gestellt werden. Mittels 3D-Rekonstruktion konnten die als pathognomonisch geltende zufuehrende Arterie aus der thorakalen Aorta sowie der venoese Abfluss ueber die Pulmonalvene zum linken Vorhof dargestellt und die daraufhin indizierte elektive Resektion des Sequesters veranlasst werden. (orig.)

  14. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  15. CT after transsphenoidal surgery

    International Nuclear Information System (INIS)

    Tazawa, Satoru

    1991-01-01

    Two hundred and ten CT studies of 95 patients after transsphenoidal surgery were reviewed. Spheno-ethmoid opacificaiton, intrasellar hematoma and gas bubbles were noted within 2 weeks after surgery. Bone defect of the sellar floor and bone stent were seen on coronal scans in most cases. The packing material frequently disappeared on follow-up studies. Hormonal assessment of the functioning tumor, according to which the effect of treatment was evaluated, was correlated with CT findings. Because differentiation between postoperative changes and residual mass was difficult, there was no definite CT criteria to indicate residual functioning tumor except upward convexity of the diaphragma sellae on CT more than 3 months after surgery. Initial follow up CT study is recommended to be performed at about 3 months after surgery, at which time the immediate postoperative inflammatory changes have been disappeared. The incidence of recurrence was 3/47 (6%), which was shown on follow-up CT from 4 to 10 years after surgery. Therefore, subsequent CT study should be done in every year or two, taking the clinical symptoms and hormonal data into consideration. (author)

  16. CT after transsphenoidal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Tazawa, Satoru [Tohoku Univ., Sendai (Japan). School of Medicine

    1991-03-01

    Two hundred and ten CT studies of 95 patients after transsphenoidal surgery were reviewed. Spheno-ethmoid opacificaiton, intrasellar hematoma and gas bubbles were noted within 2 weeks after surgery. Bone defect of the sellar floor and bone stent were seen on coronal scans in most cases. The packing material frequently disappeared on follow-up studies. Hormonal assessment of the functioning tumor, according to which the effect of treatment was evaluated, was correlated with CT findings. Because differentiation between postoperative changes and residual mass was difficult, there was no definite CT criteria to indicate residual functioning tumor except upward convexity of the diaphragma sellae on CT more than 3 months after surgery. Initial follow up CT study is recommended to be performed at about 3 months after surgery, at which time the immediate postoperative inflammatory changes have been disappeared. The incidence of recurrence was 3/47 (6%), which was shown on follow-up CT from 4 to 10 years after surgery. Therefore, subsequent CT study should be done in every year or two, taking the clinical symptoms and hormonal data into consideration. (author).

  17. Indeterminate lesions on planar bone scintigraphy in lung cancer patients: SPECT, CT or SPECT-CT?

    International Nuclear Information System (INIS)

    Sharma, Punit; Kumar, Rakesh; Singh, Harmandeep; Bal, Chandrasekhar; Malhotra, Arun; Julka, Pramod Kumar; Thulkar, Sanjay

    2012-01-01

    The objective of the present study was to compare the role of single photon emission computed tomography (SPECT), computed tomography (CT) and SPECT-CT of selected volume in lung cancer patients with indeterminate lesions on planar bone scintigraphy (BS). The data of 50 lung cancer patients (53 ± 10.3 years; range 30-75; male/female 38/12) with 65 indeterminate lesions on planar BS (January 2010 to November 2010) were retrospectively evaluated. All of them underwent SPECT-CT of a selected volume. SPECT, CT and SPECT-CT images were independently evaluated by two experienced readers (experience in musculoskeletal imaging, including CT: 5 and 7 years) in separate sessions. A scoring scale of 1 to 5 was used, in which 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign and 5 is definitely benign. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each modality, taking a score ≤2 as metastatic. With receiver operating characteristic (ROC) curve analysis, areas under the curve (AUC) were calculated for each modality and compared. Clinical and imaging follow-up and/or histopathology were taken as reference standard. For both readers SPECT was inferior to CT (P = 0.004, P = 0.022) and SPECT-CT (P = 0.003, P = 0.037). However, no significant difference was found between CT and SPECT-CT for reader 1 (P = 0.847) and reader 2 (P = 0.592). The findings were similar for lytic as well as sclerotic lesions. Moderate inter-observer agreement was seen for SPECT images (κ = 0.426), while almost perfect agreement was seen for CT (κ = 0.834) and SPECT-CT (κ = 0.971). CT alone and SPECT-CT are better than SPECT for accurate characterisation of indeterminate lesions on planar BS in lung cancer patients. CT alone is not inferior to SPECT-CT for this purpose and might be preferred because of shorter acquisition time and wider availability. (orig.)

  18. Evaluation of CT in hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nakao, Norio; Miura, Yukio; Ohnishi, Mitsunori; Kamikon-ya, Norihiko; Sakamoto, Yoshisato; Miura, Takashi; Sakamoto, Kiyoshi; Takayasu, Yoshio

    1985-06-01

    In order to evaluate the diagnostic ability of CT in hepatocellular carcinoma, four kinds of CT images were comparatively studied by the accuracy and ROC (receiver operating characteristic) curve analysis. As a result, it was clarified that CT images were evaluated more objectively by ROC curve analysis than by accuracy. The diagnostic ability of existence and differentiation of tumor in the liver were higher in order of plain CT, contrast enhanced CT (CECT), bolus CT and CT arteriography (CTA). Therefore, in an usual CT examination intended to make differential diagnosis in space occupying liver disease, bolus CT seems to be indispensable, and also CTA is essential where diagnosis is difficult even by bolus CT.

  19. Low-dose Dental-CT

    International Nuclear Information System (INIS)

    Gahleitner, A.; Imhof, H.; Homolka, P.; Fuerhauser, R.; Freudenthaler, J.; Watzek, G.

    2000-01-01

    Dental-CT is a relatively new, increasingly used investigation technique in dental radiology. Several authors have stated that the indication for Dental-CT has to be chosen on a strict basis, due to high dose values. This article describes the technique of performing dental-CT and calculates the effective dose based on published data and own measurements as well as the dose reduction potential to achieve an optimized protocol for Dental-CT investigations. (orig.) [de

  20. Dose calculation with respiration-averaged CT processed from cine CT without a respiratory surrogate

    International Nuclear Information System (INIS)

    Riegel, Adam C.; Ahmad, Moiz; Sun Xiaojun; Pan Tinsu

    2008-01-01

    Dose calculation for thoracic radiotherapy is commonly performed on a free-breathing helical CT despite artifacts caused by respiratory motion. Four-dimensional computed tomography (4D-CT) is one method to incorporate motion information into the treatment planning process. Some centers now use the respiration-averaged CT (RACT), the pixel-by-pixel average of the ten phases of 4D-CT, for dose calculation. This method, while sparing the tedious task of 4D dose calculation, still requires 4D-CT technology. The authors have recently developed a means to reconstruct RACT directly from unsorted cine CT data from which 4D-CT is formed, bypassing the need for a respiratory surrogate. Using RACT from cine CT for dose calculation may be a means to incorporate motion information into dose calculation without performing 4D-CT. The purpose of this study was to determine if RACT from cine CT can be substituted for RACT from 4D-CT for the purposes of dose calculation, and if increasing the cine duration can decrease differences between the dose distributions. Cine CT data and corresponding 4D-CT simulations for 23 patients with at least two breathing cycles per cine duration were retrieved. RACT was generated four ways: First from ten phases of 4D-CT, second, from 1 breathing cycle of images, third, from 1.5 breathing cycles of images, and fourth, from 2 breathing cycles of images. The clinical treatment plan was transferred to each RACT and dose was recalculated. Dose planes were exported at orthogonal planes through the isocenter (coronal, sagittal, and transverse orientations). The resulting dose distributions were compared using the gamma (γ) index within the planning target volume (PTV). Failure criteria were set to 2%/1 mm. A follow-up study with 50 additional lung cancer patients was performed to increase sample size. The same dose recalculation and analysis was performed. In the primary patient group, 22 of 23 patients had 100% of points within the PTV pass γ criteria

  1. CT pelvimetry

    International Nuclear Information System (INIS)

    Vicens, J.L.; Charles, G.; Le Berre, J.; Flageat, J.

    1989-01-01

    Pelvimetry aims at providing the obstetrician with information on the size and morphology of the female pelvis, thus enabling him to assess the obstetrical prognosis as accurately as possible. Computed tomography (CT) has several advantages, in particular the lower mother and fetus radiation dose. After a brief description of obstetrical anatomy, the usual CT exploration method is presented and its results are considered in terms of measurements, indices and morphological findings. If performed with a very strict exploration procedure, CT pelvimetry is a very reliable, fact and comfortable method of examination. All these advantages, combined with the minimized patient dose, should lead to an increasingly widespread use of this technique [fr

  2. Detection of skeletal muscle metastasis: torso FDG PET-CT versus contrast-enhanced chest or abdomen CT.

    Science.gov (United States)

    So, Young; Yi, Jeong Geun; Song, Inyoung; Lee, Won Woo; Chung, Hyun Woo; Park, Jeong Hee; Moon, Sung Gyu

    2015-07-01

    Skeletal muscle metastasis (SMM) in cancer patients has not been sufficiently evaluated regarding prevalence and proper method of detection. To determine the prevalence of SMM and compare the diagnostic competencies for SMM of torso F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) and contrast-enhanced chest or abdomen CT. We investigated 18,225 PET-CT studies of 6359 cancer patients performed from 2005 to 2012. The PET-CT studies describing potential SMM were retrieved and the corresponding medical records were reviewed. The gold standard for SMM was histopathologically-proven SMM or imaging study-based disease progression. The detectability of SMM was compared between PET-CT and contrast-enhanced CT. Twenty-six patients had 84 SMM lesions, representing a SMM prevalence of 0.41%. Lung cancer was the most common SMM-associated malignancy (54%) and the gluteal/pelvic girdle muscle was the most frequently involved SMM site (37%). All 84 SMM lesions were visualized on PET-CT (100%). Of these PET-CT positive 84 SMM lesions, 51 lesions were in the CT field of view (FOV) (61%), whereas 33 lesions were out of the CT FOV (39%). Among these 51 lesions, 17 lesions showed rim-enhancing nodules/masses (33%), eight lesions showed homogeneously enhancing nodules (16%), three lesions showed heterogeneously enhancing nodules (6%), and 23 SMM lesions (45%) were non-diagnostic by CT. All 51 SMM lesions within CT FOV were detected on PET-CT (100%), whereas only 28 were visualized on CT (54.9%), resulting in a significant difference (P SMM was revealed by PET-CT. The prevalence of SMM was as low as 0.41% in the current large cohort of cancer patients. Torso PET-CT was a more competent modality than contrast-enhanced CT in the detection of SMM. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. CT-based postimplant dosimetry of prostate brachytherapy. Comparison of 1-mm and 5-mm section CT

    International Nuclear Information System (INIS)

    Tanaka, Osamu; Hayashi, Shinya; Kanematsu, Masayuki; Matsuo, Masayuki; Hoshi, Hiroaki; Nakano, Masahiro; Maeda, Sanaho; Deguchi, Takashi; Hoshi, Hiroaki

    2007-01-01

    The aim of this study was to compare the outcomes between 1-mm and 5-mm section computed tomography (CT)-based postimplant dosimetry. A series of 21 consecutive patients underwent permanent prostate brachytherapy. The postimplant prostate volume was calculated using 1-mm and 5-mm section CT. One radiation oncologist contoured the prostate on CT images to obtain the reconstructed prostate volume (pVol), prostate V 100 (percent of the prostate volume receiving at least the full prescribed dose), and prostate D 90 (mean dose delivered to 90% of the prostate gland). The same radiation oncologist performed the contouring three times to evaluate intraobserver variation and subjectively scored the quality of the CT images. The mean ±1 standard deviation (SD) postimplant pVol was 20.17±6.66 cc by 1-mm section CT and 22.24±8.48 cc by 5-mm section CT; the difference in the mean values was 2.06 cc (P 100 was 80.44%±7.06% by 1-mm section CT and 77.33%±10.22% by 5-mm section CT. The mean postimplant prostate D 90 was 83.28%±10.81% by 1-mm section CT and 78.60%±15.75% by 5-mm section CT. In the evaluation of image quality, 5-mm section CT was assigned significantly higher scores than 1-mm section CT. In regard to intraobserver variation, 5-mm section CT revealed less intraobserver variation than 1-mm section CT. Our current results suggested that the outcomes of postimplant dosimetry using 1-mm section CT did not improved the results over those obtained using 5-mm section CT in terms of the quality of the CT image or reproducibility. (author)

  4. Frauen. Kultur. Mittel- und Osteuropa oder: Über den langsamen Einzug der gender studies in die slawistischen Kulturwissenschaften Women. Culture. Middle and Eastern Europe or: On the Slow Introduction of gender studies into the Slavonic Cultural Sciences

    Directory of Open Access Journals (Sweden)

    Barbara Wurm

    2001-03-01

    Full Text Available Der vorliegende Sammelband, entstanden anläßlich einer Konferenz, die im September 1997 vom Institut für Slawistik der Universität Innsbruck in Zusammenarbeit mit der österreichischen UNESCO-Kommission veranstaltet wurde, untersucht aus soziologischer, kulturhistorischer, literatur- und filmwissenschaftlicher Perspektive verschiedenste Aspekte der Institutionalisierung und Repräsentation von „Frauen in der Kultur“ Mittel- und Osteuropas.This anthology, the result of a conference organized in September 1997 by the Institute for Slavonic studies at the University of Innsbruck in co-operation with the Austrian UNESCO commission, examines various aspects of the institutionalization and representation of women in Middle and Eastern European culture from a sociological and cultural historical perspective and from that of literary and film sciences.

  5. FDG-PET/contrast-enhanced CT as a post-treatment tool in head and neck squamous cell carcinoma: comparison with FDG-PET/non-contrast-enhanced CT and contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Suenaga, Yuko; Kitajima, Kazuhiro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Ishihara, Takeaki; Sasaki, Ryohei [Kobe University Graduate, School of Medicine, Department of Radiology, Division of Radiation Oncology, Kobe (Japan); Otsuki, Naoki; Nibu, Ken-ichi [Kobe University Graduate, School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Kobe (Japan); Minamikawa, Tsutomu [Kobe University Graduate School of Medicine, Department of Oral and Maxillofacial Surgery, Kobe (Japan); Kiyota, Naomi [Kobe University Hospital, Department of Medical Oncology and Hematology, Kobe (Japan)

    2016-04-15

    To evaluate the accuracy of PET/CT using {sup 18}F-fluorodeoxyglucose (FDG) with IV contrast for suspected recurrent head and neck squamous cell carcinoma (HNSCC). One hundred and seventy patients previously treated for HNSCC underwent PET/CT, consisting of non-contrast-enhanced and contrast-enhanced CT, to investigate suspected recurrence. Diagnostic performance of PET/contrast-enhanced CT (PET/ceCT), PET/non-contrast-enhanced CT (PET/ncCT) and contrast-enhanced CT (ceCT) for local or regional recurrence, distant metastasis, overall recurrence and second primary cancer was evaluated. The reference standard included histopathology, treatment change and imaging follow-up. The patient-based areas under the receiver operating characteristic curves (AUC) for ceCT, PET/ncCT and PET/ceCT were 0.82, 0.96 and 0.98 for local recurrence, 0.73, 0.86 and 0.86 for regional recurrence, 0.86, 0.91 and 0.92 for distant metastasis, 0.72, 0.86 and 0.87 for overall recurrence, and 0.86, 0.89 and 0.91 for a second primary cancer. Both PET/ceCT and PET/ncCT statistically showed larger AUC than ceCT for recurrence, and the difference between PET/ceCT and PET/ncCT for local recurrence reached a significant level (p = 0.039). The accuracy of PET/ceCT for diagnosing overall recurrence was high, irrespective of the time interval after the last treatment (83.3-94.1 %). FDG-PET/CT was a more accurate HNSCC restaging tool than ceCT. The added value of ceCT at FDG-PET/CT is minimal. (orig.)

  6. Comparison SPECT-CT with PET-CT in several applications of small-animal models

    International Nuclear Information System (INIS)

    Pan Yifan; Song Shaoli; Huang Gang

    2009-01-01

    With the development of medical science, monitoring dynamic biologic processes in small-animal models of diseases has become one of the most important approaches in medical studies. Important physiologic parameters that traditionally have been characterized by nuclear medicine imaging include blood flow, biochemical metabolism, and cellular receptors. Recently, nuclear medicine has been greatly facilitated by the newer development of dual-modality integrated imaging systems (SPECT-CT and PET-CT), which provide functional and anatomical images in the same scanning session, with the acquired images co-registered by means of the hardware. The purpose of this review is to compare SPECT-CT with PET-CT in several applications of small-animal models. Conclusicn: PET-CT for small animal modes in nledical research in the applications has great advantages, but SPECT-CT is still a very important role, and research low cost. (authors)

  7. Improved quantitation and reproducibility in multi-PET/CT lung studies by combining CT information.

    Science.gov (United States)

    Holman, Beverley F; Cuplov, Vesna; Millner, Lynn; Endozo, Raymond; Maher, Toby M; Groves, Ashley M; Hutton, Brian F; Thielemans, Kris

    2018-06-05

    Matched attenuation maps are vital for obtaining accurate and reproducible kinetic and static parameter estimates from PET data. With increased interest in PET/CT imaging of diffuse lung diseases for assessing disease progression and treatment effectiveness, understanding the extent of the effect of respiratory motion and establishing methods for correction are becoming more important. In a previous study, we have shown that using the wrong attenuation map leads to large errors due to density mismatches in the lung, especially in dynamic PET scans. Here, we extend this work to the case where the study is sub-divided into several scans, e.g. for patient comfort, each with its own CT (cine-CT and 'snap shot' CT). A method to combine multi-CT information into a combined-CT has then been developed, which averages the CT information from each study section to produce composite CT images with the lung density more representative of that in the PET data. This combined-CT was applied to nine patients with idiopathic pulmonary fibrosis, imaged with dynamic 18 F-FDG PET/CT to determine the improvement in the precision of the parameter estimates. Using XCAT simulations, errors in the influx rate constant were found to be as high as 60% in multi-PET/CT studies. Analysis of patient data identified displacements between study sections in the time activity curves, which led to an average standard error in the estimates of the influx rate constant of 53% with conventional methods. This reduced to within 5% after use of combined-CTs for attenuation correction of the study sections. Use of combined-CTs to reconstruct the sections of a multi-PET/CT study, as opposed to using the individually acquired CTs at each study stage, produces more precise parameter estimates and may improve discrimination between diseased and normal lung.

  8. Physics and basic technology of CT

    International Nuclear Information System (INIS)

    Mahesh, Mahadevappa

    2017-01-01

    Computed Tomography is one of the prime imaging modalities in any hospital around the globe. From its inception in 1973, CT technology have advanced leaps and bounds in medical diagnosis. Advances in X-ray tubes, detection technologies and image reconstruction methods led to the development of multiple-row detector CT (MDCT) technologies in early 2000, that has been the impetus for new fields such as Cardiovascular CT, Hybrid CT (PET-CT and SPECT-CT), CT Perfusion, Cone Beam CT, etc. It is now possible to image the entire organ (such as heart) in less than 0.3 seconds providing isotropic resolution images with high temporal resolution. With all X-ray imaging modalities, including CT, the concern is the radiation dose. Since CT procedures are one of the major imaging procedures performed in any hospital, it is important to optimize CT protocols in order to provide quality images at optimal radiation dose

  9. SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

    Energy Technology Data Exchange (ETDEWEB)

    Wang, H; Barbee, D; Wang, W; Pennell, R; Hu, K; Osterman, K [Department of Radiation Oncology, NYU Langone Medical Center, New York, NY (United States)

    2016-06-15

    Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CT for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.

  10. SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

    International Nuclear Information System (INIS)

    Wang, H; Barbee, D; Wang, W; Pennell, R; Hu, K; Osterman, K

    2016-01-01

    Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CT for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses uses special x-ray equipment ... story here Images × Image Gallery Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content ...

  12. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head Computed tomography (CT) of the head uses special x-ray equipment ... story here Images × Image Gallery Patient undergoing computed tomography (CT) scan. View full size with caption Pediatric Content ...

  13. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT ...

  14. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT ...

  15. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT ...

  16. CT of the heart

    International Nuclear Information System (INIS)

    Lipton, M.J.

    1986-01-01

    Advances based upon the detector elements instead of X-ray film have greatly increased the power of X-ray imaging. Computed tomography (CT) creates cross sectional rather than projected images. Recently, high speed CT devices have been developed for cardiovascular studies. The Cine-CT scanner employs a scanning electron beam deflected on an extended tungsten target ring. Fast scans of 50 millisecond exposures at multiple levels can provide information concerning blood flow in vessels and tissues, myocardial wall motion, valve integrity, coronary bypass graft patency and proximal coronary artery anatomy. Cine-CT dynamic scanning can also provide volume imaging with small quantities (0.05 - 1.5 ml/kg) of contrast medium administered via peripheral vein injections. Cine-CT provides simultaneous measurements of cardiac dimensions and function and is rapidly becoming a new tool for quantitating myocardial blood flow, cardiac chamber volumes and wall mechanics. The future outlook is very promising for this three-dimensional cine-CT technique with high spatial resolution. High speed CT should provide unique diagnostic information and as the technology continues to improve at a rapid speed, this new imaging modality could be a challenge for angiography. (Auth.)

  17. CT-docking patient stretcher

    International Nuclear Information System (INIS)

    Mirvis, S.E.; Owens, E.; Maslyn, J.; Rizutto, M.

    1990-01-01

    This paper assesses the use of a patient stretcher that directly docks to a CT scanner for acutely injured and/or critically ill patients. The stretcher permits performance of radiography and acts as a platform for critical care monitoring and patient support devices. During a 1-year period, the prototype CT-docking stretcher was used for 35 patients sustaining acute trauma and 25 patients from critical care units. Observations were elicited from physicians, nurses and technologists concerning the advantages or disadvantages of the docking stretcher. Advantages of the CT-docking stretcher included time saved in moving patients to the CT table from the admitting/emergency ward, transfer of critically ill patients onto the stretcher in the controlled environment of the intensive care unit rather than the CT suite, increasing CT throughput by direct docking of the patient stretcher to the CT scanner rather than manual transfer of complex support and monitoring devices with the patient, decreased risk associated with physical movement of patients with potentially unstable spinal injuries or unstable physiologic status, and decrease in potential for injury to medical personnel performing patient transfer

  18. Radiation dose and cancer risk from pediatric CT examinations on 64-slice CT: A phantom study

    International Nuclear Information System (INIS)

    Feng Shiting; Law, Martin Wai-Ming; Huang Bingsheng; Ng, Sherry; Li Ziping; Meng Quanfei; Khong, Pek-Lan

    2010-01-01

    Objective: To measure the radiation dose from CT scans in an anthropomorphic phantom using a 64-slice MDCT, and to estimate the associated cancer risk. Materials and methods: Organ doses were measured with a 5-year-old phantom and thermoluminescent dosimeters. Four protocols; head CT, thorax CT, abdomen CT and pelvis CT were studied. Cancer risks, in the form of lifetime attributable risk (LAR) of cancer incidence, were estimated by linear extrapolation using the organ radiation doses and the LAR data. Results: The effective doses for head, thorax, abdomen and pelvis CT, were 0.7 mSv, 3.5 mSv, 3.0 mSv, 1.3 mSv respectively. The organs with the highest dose were; for head CT, salivary gland (22.33 mGy); for thorax CT, breast (7.89 mGy); for abdomen CT, colon (6.62 mGy); for pelvis CT, bladder (4.28 mGy). The corresponding LARs for boys and girls were 0.015-0.053% and 0.034-0.155% respectively. The organs with highest LARs were; for head CT, thyroid gland (0.003% for boys, 0.015% for girls); for thorax CT, lung for boys (0.014%) and breast for girls (0.069%); for abdomen CT, colon for boys (0.017%) and lung for girls (0.016%); for pelvis CT, bladder for both boys and girls (0.008%). Conclusion: The effective doses from these common pediatric CT examinations ranged from 0.7 mSv to 3.5 mSv and the associated lifetime cancer risks were found to be up to 0.16%, with some organs of higher radiosensitivity including breast, thyroid gland, colon and lungs.

  19. CT arteriography of the upper abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Hasuo, K; Matsuura, K; Baba, H; Numaguchi, Y; Komaki, S [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1980-04-01

    The technique of CT arteriography was introduced, and CT images of the upper abdomen were explained. Very clear enhancement of parenchyma and vessels (especially portal vein) of the object organs could be obtained by CT arteriography of the upper abdomen, anatomical structures of organs were identified more easily by CT arteriography than by conventional CT, and the amount of information obtained was increased by using CT arteriography. However, the indication of CT arteriography must be limited, because of its complexity that CT arteriography is performed after angiography and involves the invasion of patients' bodies. As described in many reports, CT arteriography is useful for malignant tumors of the liver, and it is worthwhile, especially when surgery for hepatocellular carcinoma is considered. CT arteriography for organs except the liver has not been discussed sufficiently. Therefore, an application of this method for other organs must be decided after consideration of the balance of the amount of information obtained by CT arteriography with invasion to patients.

  20. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams Blood Clots CT Perfusion of the Head CT Angiography ( ...

  1. Functional CT imaging: load-dependent visualization of the subchondral mineralization by means of CT osteoabsorptionmetry (CT-OAM)

    International Nuclear Information System (INIS)

    Linsenmaier, U.; Schlichtenhorst, K.; Pfeifer, K.J.; Reiser, M.; Kersting, S.; Putz, R.; Mueller-Gerbl, M.

    2003-01-01

    Purpose: Functional computed tomography for visualization and quantification of subchondral bone mineralization using CT osteoabsorptiometry (CT-OAM). Materials and Methods: Tarsometatarsal (TMT) and metatarsophalangeal (MTP) joints of 46 human hallux valgus (HV) specimens were examined (sagittal 1/1/1 mm) on a single slice CT scanner SCT (Somatom Plus 4, Siemens AG). Subchondral bone pixels were segmented and assigned to 10 density value groups (triangle 100 HU, range 200 - 1200 HU) the pixels using volume rendering technique (VRT). The data analysis considered the severity of HV as determined by the radiographically measured HV-angle (a.p. projection). Results: CT-OAM could generate reproducible densitograms of the distribution pattern of the subchondral bone density for all four joint surfaces (TMT and MTP joints). The bone density localization enables the assignment to different groups, showing a characteristic HV-angle-dependent distribution of the maximum bone mineralization of the load-dependent densitogram (p [de

  2. CT diagnosis of the primary lung cancer and usefulness of biopsy under CT

    International Nuclear Information System (INIS)

    Fujisawa, Hidefumi; Kushihashi, Tamio

    2011-01-01

    CT especially plays an important role in imaging diagnosis of lung cancer (LC) which gives quite multiple CT findings and this paper describes details to be noted for CT findings of individual lung lesion and cancer according to 5 classes below, together with usefulness of CT-guided biopsy and positron emission tomography (PET) usage. Explained are as follows: Important points in histopathology and CT findings from adenomatous hyperplasia (AH) to atypical AH (pre-invasive lesion); Differential CT diagnosis of benignity or malignancy of pulmonary nodes and tumors; Typical CT findings of LC of peripheral type of invasive or exclusive proliferative type, and pulmonary hillar type; Atypical CT findings of LC/having atypical inner structure such as presenting atypical calcification and atypical cavity/having atypical morphology such as presenting pneumonia-like finding, exhibiting regular or linear edge, and existing at atypical region like extrapleural lumen /having atypical progression rate such as showing rapid or slow doubling time of the volume and shrinking tentatively during the progress/of juvenile LC/and generated from background lung diseases such as interstitial pneumonia, tuberculosis, pneumoconiosis like asbestosis, pneumosilicosis, and pulmonary emphysema and bulla; and Regional ground glass opacity. As well, authors mention about the usefulness of CT-guided needle biopsy of the pulmonary lesion which enables to take the nodal specimen as small as <10 mm. Most frequent complication of the biopsy is pneumothorax (10-50%). How to use PET for LC examination is also commented with its usability and limitation. (T.T.)

  3. CT of thymoma

    Energy Technology Data Exchange (ETDEWEB)

    Sone, S.; Higashihara, T.; Morimoto, S.; Ikezoe, J.; Arisawa, J. (Osaka Univ. (Japan). Faculty of Medicine)

    1982-08-01

    Based on 17 patients with thymoma (8 with myasthenia gravis and 9 free from it); 1. The effectiveness of CT, conventional radiography and pneumomediastinography in the detection of thymomas was determined and the results compared. 2. The CT findings of thymomas were discussed and the CT features which seemed to suggest malignant thymomas were evaluated. The results were as follows: 1. Of the 17 cass with thymomas, 13 were diagnosed from p-a films, 13 from lateral films, and 16 from CT. Of the 16 thymomas, 14 were diagnosed from lateral tomography. Mass densities were shown in all 15 cases in which pneumomediastinography were performed. 2. Benign thymomas showed round or oval smoothly marginated mass. The fatty plane between the mass and the mediastinal structures was nicely preserved. 3. Malignant thymoma frequently showed a plaque-like mass with more or less irregular or lobulated contours with obliteration of the fatty planes of the cardiovascular structures. Tumor calcification was shown in 4 of 10 malignant thymomas. 4. Slight tumor invasion to the mediastinal pleura and lung was difficult to predict from the CT images.

  4. Iterative metal artifact reduction improves dose calculation accuracy. Phantom study with dental implants

    Energy Technology Data Exchange (ETDEWEB)

    Maerz, Manuel; Mittermair, Pia; Koelbl, Oliver; Dobler, Barbara [Regensburg University Medical Center, Department of Radiotherapy, Regensburg (Germany); Krauss, Andreas [Siemens Healthcare GmbH, Forchheim (Germany)

    2016-06-15

    Zahnimplantaten entworfen. Von den Phantomen wurden CT-Scans angefertigt und mittels des iMAR-Algorithmus korrigiert. Um die Wiedergabetreue der Hounsfield-Einheiten zu testen, wurden die korrigierten und nichtkorrigierten CT-Daten gegen synthetische CT-Daten verglichen. IMRT- und VMAT-Plaene wurden in Oncentra v4.3 berechnet und zur Beurteilung der Genauigkeit der Dosisberechnung mit Gafchromic trademark -EBT3-Filmmessungen verglichen. Die Anwendung von iMAR erhoeht die Wiedergabetreue der Hounsfield-Einheiten. Die durchschnittliche Abweichung zu den synthetischen Daten faellt in Gewebebereichen ohne Metall von 283 HU auf 33 HU und in Metallbereichen von 1006 HU auf 408 HU. Die Genauigkeit der Dosisberechnungen konnte fuer alle Phantome und Plaene signifikant verbessert werden. Die mittlere Akzeptanzrate der Gammaevaluation mit 3 % Dosistoleranz und 3 mm Ortstoleranz steigt von 90,6 auf 96,2%, wenn Artefakte mittels iMAR korrigiert werden. Mit Hilfe von iMAR konnten die Artefakte zu grossen Teilen entfernt werden, was zu einer signifikanten Erhoehung der Dosisberechnungsgenauigkeit fuehrt. (orig.)

  5. Physiological and technical limitations of functional magnetic resonance imaging (fMRI) - consequences for clinical use; Physiologische und technische Grenzen der funktionellen Magnetresonanztomographie und die damit verbundenen Konsequenzen fuer die klinische Anwendung

    Energy Technology Data Exchange (ETDEWEB)

    Wuestenberg, T. [Neurologische Klinik der Charite, Humboldt-Universitaet Berlin (Germany); Neurologische Klinik der Charite, Humboldt-Universitaet Berlin, Schumannstrasse 20/21, 10117, Berlin (Germany); Jordan, K. [Institut fuer Psychologie II, Otto-von-Guericke-Universitaet Magdeburg (Germany); Giesel, F.L. [Abteilung fuer onkologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum Heidelberg (Germany); Villringer, A. [Neurologische Klinik der Charite, Humboldt-Universitaet Berlin (Germany)

    2003-07-01

    Functional magnetic resonance imaging (fMRI) is the most common noninvasive technique in functional neuroanatomy. The capabilities and limitations of the method will be discussed based on a short review of the current knowledge about the neurovascular relationship. The focus of this article is on current methodical and technical problems regarding fMRI-based detection and localization of neuronal activity. Main error sources and their influence on the reliability and validity of fMRI-methods are presented. Appropriate solution strategies will be proposed and evaluated. Finally, the clinical relevance of MR-based diagnostic methods are discussed. (orig.) [German] Die funktionelle Magnetresonanztomographie (fMRT) ist eines der wichtigsten Verfahren der funktionellen Neuroanatomie. Aufbauend auf einer kurzen Darstellung des aktuellen Wissensstands bzgl. des Zusammenhangs zwischen lokaler neuronaler Aktivitaet und haemodynamischer Reaktion werden ausgewaehlte Moeglichkeiten und Grenzen des Verfahrens fuer die klinische Anwendung diskutiert. Der Schwerpunkt liegt dabei auf der Darstellung der derzeitigen methodischen und technischen Einschraenkungen hinsichtlich einer fMRT-basierten Detektion und Lokalisierung neuronaler Aktivitaet. Es werden die Hauptfehlerquellen und ihre Auswirkungen auf die Reliabilitaet und Validitaet des Verfahrens erlaeutert und aktuelle Loesungsansaetze diskutiert. Abschliessend erfolgt eine Bewertung der aktuellen klinischen Relevanz funktioneller MR-Diagnosemethoden. (orig.)

  6. Preoperative evaluation of renal anatomy and renal masses with helical CT, 3D-CT and 3D-CT angiography.

    Science.gov (United States)

    Toprak, Uğur; Erdoğan, Aysun; Gülbay, Mutlu; Karademir, Mehmet Alp; Paşaoğlu, Eşref; Akar, Okkeş Emrah

    2005-03-01

    The aim of this prospective study was to determine the efficacy of three-dimensional computed tomography (3D-CT) and three-dimensional computed tomographic angiography (3D-CTA) that were reconstructed by using the axial images of the multiphasic helical CT in the preoperative evaluation of renal masses and demonstration of renal anatomy. Twenty patients that were suspected of having renal masses upon initial physical examination and ultrasonographic evaluation were examined through multiphasic helical CT. Two authors executed CT evaluations. Axial images were first examined and then used to reconstruct 3D-CT and 3D- CTA images. Number, location and size of the renal masses and other findings were noted. Renal vascularization and relationships of the renal masses with the neighboring renal structures were further investigated with 3D-CT and 3D-CTA images. Out of 20 patients, 13 had histopathologically proven renal cell carcinoma. The diagnoses of the remaining seven patients were xanthogranulomatous pyelonephritis, abscess, simple cyst, infected cyst, angiomyolipoma, oncocytoma and arteriovenous fistula. In the renal cell carcinoma group, 3 patients had stage I, 7 patients had stage II, and 3 patients had stage III disease. Sizes of renal cell carcinoma masses were between 23 mm to 60 mm (mean, 36 mm). Vascular invasion was shown in 2 renal cell carcinoma patients. Collecting system invasion was identified in 11 of 13 renal cell patients. These radiologic findings were confirmed with surgical specimens. Three-dimensional CT and 3D-CTA are non-invasive, effective imaging techniques for the preoperative evaluation of renal masses.

  7. Biologicals en biosimilars : de rol van spiegelbepalingen in therapieoptimalisering en kostenbesparingen

    NARCIS (Netherlands)

    Schmitz, E.M.H.; Meier, A.J.L.; Benoy-de Keuster, S.; Blokpoel, J.F.; Traksel, R.A.M.; Scharnhorst, V.; Derijks, L.J.J.; Broeren, M.A.C.

    2016-01-01

    Therapieoptimalisering van anti-TNFα biologicals kan efficiënt gedaan worden met behulp van het meten van geneesmiddelspiegels, gevolgd door dosisadvies op maat ofwel therapeutic drug monitoring. Om spiegelmetingen in de klinische praktijk te bevorderen heeft het kenniscentrum klinische chemie een

  8. Psychiatric Comorbidity in Epilepsy

    NARCIS (Netherlands)

    Swinkels, Wilhelmina Adriana Maria

    2006-01-01

    Het proefschrift beschrijft de relatie tussen epilepsie en psychiatrische stoornissen. Voor het onderzoek werden zowel klinische als poliklinische patiënten met epilepsie onderzocht op het voorkomen van DSM as I klinische stoornissen en as II persoonlijkheidsstoornissen. De resultaten werden

  9. Leerboek immunologie

    NARCIS (Netherlands)

    Rijkers, Ger T.; Kroese, Frans G.M.; Kallenberg, Cees G. M.; Derksen, R H W M

    2016-01-01

    Dit nieuwe leerboek maakt een duidelijke koppeling tussen de theoretische basisconcepten en de klinische praktijk. Met behulp van diverse aansprekende klinische voorbeelden, verdiepingsstof en alledaagse casuïstiek behandelen de auteurs de eigenschappen en functies van honderden moleculen en cellen

  10. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT is less sensitive to patient movement ...

  11. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT is less sensitive to patient movement ...

  12. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT is less sensitive to patient movement ...

  13. Dynamic CT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Caruso, Damiano; Eid, Marwen; Schoepf, U. Joseph; Jin, Kwang Nam; Varga-Szemes, Akos; Tesche, Christian; Mangold, Stefanie

    2016-01-01

    Highlights: • CT myocardial perfusion provides functional assessment of the myocardium. • CCTA is limited in determining the hemodynamic significance of coronary stenosis. • CT-MPI can accurately detect hemodynamically significant coronary artery stenosis. - Abstract: Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT based technologies. Coronary CT angiography has been shown to reliably assess coronary anatomy and detect high risk coronary artery disease. However, this technique is limited to anatomical assessment, thus non-invasive techniques for functional assessment of the heart are necessary. CT myocardial perfusion is a new CT based technique that provides functional assessment of the myocardium and allows for a comprehensive assessment of coronary artery disease with a single modality when combined with CTA. This review aims to discuss dynamic CT myocardial perfusion as a new technique in the assessment of CAD.

  14. Brain tumor and CT, 1

    International Nuclear Information System (INIS)

    Suzuki, Nobuyuki; Katada, Kazuhiro; Shinomiya, Youichi; Sano, Hirotoshi; Kanno, Tetsuo

    1981-01-01

    It is very important for a neurosurgeon to know the consistency of a brain tumor preoperatively, since the information which is of much use in indicating the likely difficulty of the operation, which operative tools should be selected, the amount of bleeding to be expected from the tumor, and so on. The authors, therefore, tried to evaluate the consistency of brain tumors preoperatively 27 cases in which the margin of the tumor was made clear with a homogeneous stain were studied concerning the relationship between the tumor consistency and the CT findings. The results are as follows: 1) A higher CT number on a plain CT indicated a harder consistency of the tumor. 2) A lesser contrast index (CT number on enhancement CT/CT number on plain CT) showed a harder consistency of the tumor. (author)

  15. Dynamic CT myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Caruso, Damiano [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome “Sapienza”, Latina (Italy); Eid, Marwen [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Jin, Kwang Nam [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Varga-Szemes, Akos [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Tesche, Christian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich (Germany); Mangold, Stefanie [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen (Germany); and others

    2016-10-15

    Highlights: • CT myocardial perfusion provides functional assessment of the myocardium. • CCTA is limited in determining the hemodynamic significance of coronary stenosis. • CT-MPI can accurately detect hemodynamically significant coronary artery stenosis. - Abstract: Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT based technologies. Coronary CT angiography has been shown to reliably assess coronary anatomy and detect high risk coronary artery disease. However, this technique is limited to anatomical assessment, thus non-invasive techniques for functional assessment of the heart are necessary. CT myocardial perfusion is a new CT based technique that provides functional assessment of the myocardium and allows for a comprehensive assessment of coronary artery disease with a single modality when combined with CTA. This review aims to discuss dynamic CT myocardial perfusion as a new technique in the assessment of CAD.

  16. Comparison of SPECT/CT, MRI and CT in diagnosis of skull base bone invasion in nasopharyngeal carcinoma.

    Science.gov (United States)

    Zhang, Shu-xu; Han, Peng-hui; Zhang, Guo-qian; Wang, Rui-hao; Ge, Yong-bin; Ren, Zhi-gang; Li, Jian-sheng; Fu, Wen-hai

    2014-01-01

    Early detection of skull base invasion in nasopharyngeal carcinoma (NPC) is crucial for correct staging, assessing treatment response and contouring the tumor target in radiotherapy planning, as well as improving the patient's prognosis. To compare the diagnostic efficacy of single photon emission computed tomography/computed tomography (SPECT/CT) imaging, magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of skull base invasion in NPC. Sixty untreated patients with histologically proven NPC underwent SPECT/CT imaging, contrast-enhanced MRI and CT. Of the 60 patients, 30 had skull base invasion confirmed by the final results of contrast-enhanced MRI, CT and six-month follow-up imaging (MRI and CT). The diagnostic efficacy of the three imaging modalities in detecting skull base invasion was evaluated. The rates of positive findings of skull base invasion for SPECT/CT, MRI and CT were 53.3%, 48.3% and 33.3%, respectively. The sensitivity, specificity and accuracy were 93.3%, 86.7% and 90.0% for SPECT/CT fusion imaging, 96.7%, 100.0% and 98.3% for contrast-enhanced MRI, and 66.7%, 100.0% and 83.3% for contrast-enhanced CT. MRI showed the best performance for the diagnosis of skull base invasion in nasopharyngeal carcinoma, followed closely by SPECT/CT. SPECT/CT had poorer specificity than that of both MRI and CT, while CT had the lowest sensitivity.

  17. PET/CT and radiotherapy

    International Nuclear Information System (INIS)

    Messa, C.; CNR, Milano; S. Gerardo Hospital, Monza; Di Muzio, N.; Picchio, M.; Bettinardi, V.; Gilardi, M.C.; CNR, Milano; San Raffaele Scientific Institute, Milano; Fazio, F.; CNR, Milano; San Raffaele Scientific Institute, Milano; San Raffaele Scientific Institute, Milano

    2006-01-01

    This article reviews the state of the art of PET/CT applications in radiotherapy, specifically its use in disease staging, patient selection, treatment planning and treatment evaluation. Diseases for which radiotherapy with radical intent is indicated will be considered, as well as those in which PET/CT may actually change the course of disease. The methodological and technological aspects of PET/CT in radiotherapy are discussed, focusing on the problem of target volume definition with CT and PET functional imaging and the problem of tumor motion with respect to imaging and dose delivery

  18. Slice sensitivity profiles and pixel noise of multi-slice CT in comparison with single-slice CT

    International Nuclear Information System (INIS)

    Schorn, C.; Obenauer, S.; Funke, M.; Hermann, K.P.; Kopka, L.; Grabbe, E.

    1999-01-01

    Purpose: Presentation and evaluation of slice sensitivity profile and pixel noise of multi-slice CT in comparison to single-slice CT. Methods: Slice sensitivity profiles and pixel noise of a multi-slice CT equiped with a 2D matrix detector array and of a single-slice CT were evaluated in phantom studies. Results: For the single-slice CT the width of the slice sensitivity profiles increased with increasing pitch. In spite of a much higher table speed the slice sensitivity profiles of multi-slice CT were narrower and did not increase with higher pitch. Noise in single-slice CT was independent of pitch. For multi-slice CT noise increased with higher pitch and for the higher pitch decreased slightly with higher detector row collimation. Conclusions: Multi-slice CT provides superior z-resolution and higher volume coverage speed. These qualities fulfill one of the prerequisites for improvement of 3D postprocessing. (orig.) [de

  19. Adenocarcinoma Prostate With Neuroendocrine Differentiation: Potential Utility of 18F-FDG PET/CT and 68Ga-DOTANOC PET/CT Over 68Ga-PSMA PET/CT.

    Science.gov (United States)

    Parida, Girish Kumar; Tripathy, Sarthak; Datta Gupta, Shreya; Singhal, Abhinav; Kumar, Rakesh; Bal, Chandrasekhar; Shamim, Shamim Ahmed

    2018-04-01

    Ga-PSMA PET/CT is the upcoming imaging modality for staging, restaging and response assessment of prostate cancer. However, due to neuroendocrine differentiation in some of patients with prostate cancer, they express somatostatin receptors instead of prostate specific membrane antigen. This can be exploited and other modalities like Ga-DOTANOC PET/CT and F-FDG PET/CT should be used in such cases for guiding management. We hereby discuss a similar case of 67-year-old man of adenocarcinoma prostate with neuroendocrine differentiation, which shows the potential pitfall of Ga-PSMA PET/CT imaging and benefit of Ga-DOTANOC PET/CT and F-FDG PET/CT in such cases.

  20. NMR-CT scanner

    International Nuclear Information System (INIS)

    Kose, Katsumi; Sato, Kozo; Sugimoto, Hiroshi; Sato, Masataka.

    1983-01-01

    A brief explanation is made on the imaging methods for a practical diagnostic NMR-CT scanner : A whole-body NMR-CT scanner utilizing a resistive magnet has been developed by Toshiba in cooperation with the Institute for Solid State Physics, the University of Tokyo. Typical NMR-CT images of volunteers and patients obtained in the clinical experiments using this device are presented. Detailed specifications are also shown about the practical NMR-CTs which are to be put on the market after obtaining the government approval. (author)

  1. CT and HR-CT of exogenous allergic alveolitis

    International Nuclear Information System (INIS)

    Lederer, A.; Kullnig, P.; Pongratz, M.

    1992-01-01

    The CT changes on conventional and high resolution CT in 14 patients with exogeneous allergic alveolitis (EAA) were analysed retrospectively. There were 8 patients with clinically subacute disease, 5 patients in a chronic stage and 1 patient with acute EAA. The appearances and their distribution were examined. Seven of the 8 patients in the subacute stage showed a ground glass pattern and multiple nodules of less than 2 mm. All patients in the chronic stage showed a combination of fine infiltrates, small nodules and irregular linear densities; distortion of the pulmonary pattern was present in 3 cases. The patient with acute EAA showed diffuse dense areas of consolidation in both lungs as well as multiple nodules and a ground glass pattern. The CT appearances of EAA correspond with the basic micropathology and, within the clinical context, permit diagnostic classification. (orig.) [de

  2. Coronary calcium screening with dual-source CT: reliability of ungated, high-pitch chest CT in comparison with dedicated calcium-scoring CT

    Energy Technology Data Exchange (ETDEWEB)

    Hutt, Antoine; Faivre, Jean-Baptiste; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Duhamel, Alain; Deken, Valerie [CHRU et Universite de Lille, Department of Biostatistics (EA 2694), Lille (France); Molinari, Francesco [Centre Hospitalier General de Tourcoing, Department of Radiology, Tourcoing (France)

    2016-06-15

    To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening. One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT). Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa = 0.95; 95 % CI 0.93-0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r = 0.05, p = 0.575) or heart rate (r = -0.06, p = 0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136). Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations. (orig.)

  3. Clinical applications of SPECT-CT

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [University Hospital Bonn (Germany). Dept. of Nuclear Medicine

    2014-06-01

    Covers the full spectrum of clinical applications of SPECT/CT in diagnosis of benign and malignant diseases. Includes chapters on the use of SPECT/CT for dosimetry and for therapy planning. Completely up to date. Many helpful illustrations. SPECT/CT cameras have considerably improved diagnostic accuracy in recent years. Such cameras allow direct correlation of anatomic and functional information, resulting in better localization and definition of scintigraphic findings. In addition to this anatomic referencing, CT coregistration provides superior quantification of radiotracer uptake based on the attenuation correction capabilities of CT. Useful applications of SPECT/CT have been identified not only in oncology but also in other specialties such as orthopedics and cardiology. This book covers the full spectrum of clinical applications of SPECT/CT in diagnosis and therapy planning of benign and malignant diseases. Opening chapters discuss the technology and physics of SPECT/CT and its use for dosimetry. The role of SPECT/CT in the imaging of a range of pathologic conditions is then addressed in detail. Applications covered include, among others, imaging of the thyroid, bone, and lungs, imaging of neuroendocrine tumors, cardiac scintigraphy, and sentinel node scintigraphy. Individual chapters are also devoted to therapy planning in selective internal radiation therapy of liver tumors and bremsstrahlung SPECT/CT. Readers will find this book to be an essential and up-to-date source of information on this invaluable hybrid imaging technique.

  4. Comparison of the 68Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT in the Evaluation of Suspected Primary Pheochromocytomas and Paragangliomas.

    Science.gov (United States)

    Jing, Hongli; Li, Fang; Wang, Ling; Wang, Zhenghua; Li, Wei; Huo, Li; Zhang, Jingjing

    2017-07-01

    Anatomical imaging modalities including CT and MRI are the mainstay of evaluation of primary pheochromocytoma or paraganglioma. However, nuclear medicine imaging is frequently necessary to determine the nature of the lesions. The purpose of this investigation is to assess which commonly used nuclear medicine modality might have a better diagnostic value in this clinical setting. Eight patients who had been suspected of having either primary pheochromocytoma or primary paraganglioma and 1 patient with known pheochromocytoma were included in the analysis. Among the 8 patients without known diagnosis, 7 had been suggested by anatomical imaging modalities, whereas one of them presented with initial negative anatomical imaging interpretation. All of 9 patients underwent Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT for further evaluation. The imaging findings were compared with postsurgical pathology and follow-up. Both Ga-DOTATATA PET/CT and MIBG SPECT/CT accurately identified 9 primary tumors, whereas FDG PET/CT showed increased activity in 8 of 9 primary tumors. Both Ga-DOTATATA and FDG PET/CT are able to detect associated extra-adrenal lesions not shown on MIBG study in patients with multiple endocrine neoplasia syndrome. Ga-DOTATATA PET/CT could be the nuclear medicine imaging choice to evaluate suspected primary pheochromocytoma or paraganglioma, especially in the situation of multiple endocrine neoplasia syndrome.

  5. Reduction of radiation dose by using digital luminescence radiography compared to conventional screen film system with grid cassette; Reduktion der Strahlendosis mittels Speicherfolienradiographie im Vergleich zum konventionellen Film-Folien-System mit Rasterkassette am Schaedelphantom

    Energy Technology Data Exchange (ETDEWEB)

    Heyne, J.P.; Merbold, H.; Neumann, R.; Freesmeyer, M.; Jonetz-Mentzel, L.; Kaiser, W.A. [Friedrich-Schiller-Univ. Jena, Inst. fuer Diagnostische und Interventionelle Radiologie (Germany); Sehner, J. [AGFA-Deutschland, Vertriebsgesellschaft (Germany)

    1999-07-01

    mittels RK und digital (ADC-70, Agfa) a.p. geroentgt. Bei konstanter Spannung wurde das mAs-Produkt stufenweise gesenkt und dabei die Eintrittsdosis mittels Halbleiterdetektor des Dosimax (Wellhoefer) ermittelt. 5 Untersucher beurteilten die Aufnahmen nach charakteristischen Bildmerkmalen, kritischen Strukturen, Ortsaufloesung und Bildkontrast. Ergebnisse: Die Eintrittsdosis betrug bei 73 kV/22 mAs konventionell (Rasterkassette) 0,432 mGy und digital 0,435 mGy. Bis zu einer durchschnittlichen Dosis von 71% (0,308 mGy; SD 0,050) waren die Aufnahmen sehr gut und bis zu einer durchschnittlichen Dosis von 31% (0,136 mGy; SD 0,065) ausreichend beurteilbar. Die erkennbaren Linienpaare/mm auf dem Bleistrichraster reduzierten sich dabei untersucherabhaengig bis zu 2 Stufen. Der Bildkontrast war sehr gut bis ausreichend. Die Akzeptanz der nachverarbeiteten Aufnahmen war individuell verschieden und erbrachte nur in hoeheren Dosisbereichen eine verbesserte Beurteilbarkeit der Knochenstrukturen und des Kontrastes. Schlussfolgerung: Fuer die ausreichende Beurteilbarkeit einer moeglichen Fraktur/der Nasennebenhoehlen/zur Vermessung kann die Dosis auf mindestens 56% (Durchmesser 31%; SD 14,9%)/40% (Durchmesser 27%; SD 9,3%)/18% (Durchmesser 14%; SD 4,4%) gesenkt werden. Mittels digitaler Radiografie wird damit bei 73 kV ein fragestellungsbezogenes mAs-Produkt moeglich und angegeben, so z.B. zum Frakturausschluss 73 kV/12,5 mAs und zur Schaedelvermessung 73 kV/4 mAs. (orig.)

  6. CT findings of infant epilepsy

    International Nuclear Information System (INIS)

    Hojoh, Hiroatsu; Kataoka, Kenkichi; Nakagawa, Yoshihiro; Nakano, Shozo; Tomita, Yutaka.

    1982-01-01

    CT diagnosis of infantile epilepsy was evaluated. High incidence of abnormal CT findings in infantile spasms and Lennox-Gastaut syndrome was same as in other reports. Comparison between CT findings and neurological complications and that between CT findings and electroencephalogram findings revealed a stronger relationship existing in the former. This suggested that CT is more useful as a measure to detect underlying diseases which are due to organic change of the brain to cause epilepsy, rather than as that to disclose epileptic primary lesions of functional change. (Ueda, J.)

  7. CT of thymoma

    International Nuclear Information System (INIS)

    Sone, Shusuke; Higashihara, Tokuro; Morimoto, Shizuo; Ikezoe, Junpei; Arisawa, Jun

    1982-01-01

    Based on 17 patients with thymoma (8 with myasthenia gravis and 9 free from it); 1. The effectiveness of CT, conventional radiography and pneumomediastinography in the detection of thymomas was determined and the results compared. 2. The CT findings of thymomas were discussed and the CT features which seemed to suggest malignant thymomas were evaluated. The results were as follows: 1. Of the 17 cases with thymomas, 13 were diagnosed from p-a films, 13 from lateral films, and 16 from CT. Of the 16 thymomas, 14 were diagnosed from lateral tomography. Mass densities were shown in all 15 cases in which pneumomediastinography were performed. 2. Benign thymomas showed round or oval smoothly marginated mass. The fatty plane between the mass and the mediastinal structures was nicely preserved. 3. Malignant thymoma frequently showed a plaque-like mass with more or less irregular or lobulated contoures with obliteration of the fatty planes of the cardiovascular structures. Tumor calcification was shown in 4 of 10 malignant thymomas. 4. Slight tumor invasion to the mediastinal pleura and lung was difficult to predict from the CT images. (author)

  8. F-FDG PET/CT (PET/CT) influences management in patients with known or suspected pancreatic cancer

    International Nuclear Information System (INIS)

    Barber, Thomas W.; Kalff, Victor; Cherk, Martin H.; Yap, Kenneth SK.; Evans, Peter; Kelly, Michael J.

    2009-01-01

    Full text: Objective: To assess the impact on clinical management of PET/CT in patients with known or suspected pancreatic cancer. Methods: Between April 2006 and September 2008,25 PET/CT scans were performed using a dedicated PET/CT (22 scans) or a coincidence hybrid PET/CT camera (3 scans) in 23 patients with known or suspected pancreatic cancer. 17 scans were performed for initial evaluation and 8 for restaging of disease. The pre-PET/CT management plan and for intent were prospectively recorded in all cases. The post-PET/CT management plan was determined from the medical record and for discussions with treating clinicians. The impact of PET/CT on management was classified as High, Medium, Low or None, defined using ANZAPNM PET data collection project criteria. Follow-up was used to reconcile any discordance between PET/CT and conventional imaging. Results: Overall, PET/CT management impact was classified as high (n equal 7), medium (n equal 4), low (n equal 10) or none (n equal 4). Impact was either high or medium in l l/25 patients (44%) (95% confidence interval; 24 - 64%). Impact was high in 4/17 patients imaged for initial evaluation, predominantly by clarifying equivocal lesions on conventional imaging. In restaged patients, PET/CT impact was high in 3/8, and it correctly modified disease extent in 5/8. In the 16 discordant studies, PET/CT assessment was correct in 10, conventional imaging in 4 and there was insufficient information in 2. Conclusion: PET/CT has high or medium management impact in 44% of patients imaged for known or suspected pancreatic cancer, more commonly during restaging. Discordant PET/CT results were usually correct.

  9. SedCT: MATLAB™ tools for standardized and quantitative processing of sediment core computed tomography (CT) data collected using a medical CT scanner

    Science.gov (United States)

    Reilly, B. T.; Stoner, J. S.; Wiest, J.

    2017-08-01

    Computed tomography (CT) of sediment cores allows for high-resolution images, three-dimensional volumes, and down core profiles. These quantitative data are generated through the attenuation of X-rays, which are sensitive to sediment density and atomic number, and are stored in pixels as relative gray scale values or Hounsfield units (HU). We present a suite of MATLAB™ tools specifically designed for routine sediment core analysis as a means to standardize and better quantify the products of CT data collected on medical CT scanners. SedCT uses a graphical interface to process Digital Imaging and Communications in Medicine (DICOM) files, stitch overlapping scanned intervals, and create down core HU profiles in a manner robust to normal coring imperfections. Utilizing a random sampling technique, SedCT reduces data size and allows for quick processing on typical laptop computers. SedCTimage uses a graphical interface to create quality tiff files of CT slices that are scaled to a user-defined HU range, preserving the quantitative nature of CT images and easily allowing for comparison between sediment cores with different HU means and variance. These tools are presented along with examples from lacustrine and marine sediment cores to highlight the robustness and quantitative nature of this method.

  10. MRI of the hyaline knee joint cartilage. Animal experimental and clinical studies; MRT des hyalinen Kniegelenkknorpels. Tierexperimentelle und klinische Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik; Prescher, A. [Technische Hochschule Aachen (Germany). Inst. fuer Anatomie; Nolte-Ernsting, C. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik; Buehne, M. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik; Scherer, K. [Technische Hochschule Aachen (Germany). Inst. fuer Versuchstierkunde; Kuepper, W. [Technische Hochschule Aachen (Germany). Inst. fuer Versuchstierkunde; Guenther, R.W. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik

    1994-02-01

    The value of MR imaging for the detection of hyaline cartilage lesions using 2-D spin-echo and 3-D gradient-echo imaging was evaluated in an animal experiment in 10 dogs and in a clinical study in 30 patients. MR imaging findings were compared with histopathological and arthroscopy findings, respectively. Using MRI neither grade I nor grade II hyaline cartilage lesions were detectable. In the animal experiments 77% of grade III lesions and all the grade IV lesions were seen. However, in the clinical study only about the half of grade III and IV lesions were detected. 3-D gradient-echo MR imaging was superior to 2-D spin-echo imaging (p<0.001), while 3-D FLASH and 3-D FISP did not differ significantly in the detection rate (p<0.34). 3-D gradient-echo MR imaging seems to be the best method for the delineation of high grade cartilage lesions. However, early stages of cartilage degeneration are invisible even with this imaging modality. (orig.) [Deutsch] Die Wertigkeit der MRT in der Erfassung von Knorpellaesionen mit 2-D-Spin-Echo- und 3-D-Grafienten-Echo-Sequenzen wurde in einer tierexperimentellen Untersuchung an 10 Hunden sowie in einer klinischen Studie an 30 Patienten ueberprueft. Die kernspintomographischen Ergebnisse wurden mit dem pathologisch-anatomischen Befund bzw. der Arthroskopie verglichen. MR-tomographisch konnten weder Grad-I- noch Grad-II-Knorpellaesionen erfasst werden. Die Erkennbarkeitsrate der Grad-III- und -IV-Laesionen lag fuer die tierexperimentellen Untersuchungen bei 77 bzw. 100%, waehrend klinisch nur etwa 50% dieser Veraenderungen erkannt werden konnten. Dabei waren die 3-D-Gradienten-Echo-Sequenzen den 2-D-Spin-Echo-Sequenzen signifikant ueberlegen (p<0,001), waehrend sich die 3-D-Gradienten-Echo-Sequenzen FISP und FLASH nicht voneinander unterschieden (p<0,34). Derzeit muessen die 3-D-Gradienten-Echo-Sequenzen als die beste Methode zur Erfassung hoehergradiger Knorpellaesionen angesehen werden. Fruehe Stadien der Knorpelschaedigung sind

  11. CT in normal pressure hydrocephalus. Correlation between CT and clinical response to shunting

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, K.; Nogaki, H.; Noda, M.; Kusunoki, T.; Tamaki, N. (Kobe Univ. (Japan). School of Medicine)

    1981-02-01

    CT scans were obtained on 33 patients (age 73y. to 31y.) with the diagnosis of normal pressure hydrocephalus. In each case, the diagnosis was made on the basis of the symptoms, CT and cisternographic findings. Underlying diseases of normal pressure hydrocephalus are ruptured aneurysms (21 cases), arteriovenous malformations (2 cases), head trauma (1 case), cerebrovascular accidents (1 case) and idiopathie (8 cases). Sixteen of 33 patients showed marked improvement, five, moderate or minimal improvement, and twelve, no change. The results were compared with CT findings and clinical response to shunting. CT findings were classified into five types, bases on the degree of periventricular hypodensity (P.V.H.), the extent of brain damage by underlying diseases, and the degree of cortical atrophy. In 17 cases of type (I), CT shows the presence of P.V.H. with or without minimal frontal lobe damage and no cortical atrophy. The good surgical improvements were achieved in all cases of type (I) by shunting. In 4 cases of type (II), CT shows the presence of P.V.H. and severe brain damage without cortical atrophy. The fair clinical improvements were achieved in 2 cases (50%) by shunting. In one case of type (III), CT shows the absence of P.V.H. without brain damage nor cortical atrophy. No clinical improvement was obtained by shunting in this type. In 9 cases of type (IV) with mild cortical atrophy, the fair clinical improvement was achieved in two cases (22%) and no improvement in 7 cases. In 2 cases of type (V) with moderate or marked cortical atrophy, no clinical improvement was obtained by shunting. In conclusion, it appeared from the present study that there was a good correlation between the result of shunting and the type of CT, and clinical response to shunting operation might be predicted by classification of CT findings.

  12. Estimation of skull table thickness with clinical CT and validation with microCT.

    Science.gov (United States)

    Lillie, Elizabeth M; Urban, Jillian E; Weaver, Ashley A; Powers, Alexander K; Stitzel, Joel D

    2015-01-01

    Brain injuries resulting from motor vehicle crashes (MVC) are extremely common yet the details of the mechanism of injury remain to be well characterized. Skull deformation is believed to be a contributing factor to some types of traumatic brain injury (TBI). Understanding biomechanical contributors to skull deformation would provide further insight into the mechanism of head injury resulting from blunt trauma. In particular, skull thickness is thought be a very important factor governing deformation of the skull and its propensity for fracture. Current computed tomography (CT) technology is limited in its ability to accurately measure cortical thickness using standard techniques. A method to evaluate cortical thickness using cortical density measured from CT data has been developed previously. This effort validates this technique for measurement of skull table thickness in clinical head CT scans using two postmortem human specimens. Bone samples were harvested from the skulls of two cadavers and scanned with microCT to evaluate the accuracy of the estimated cortical thickness measured from clinical CT. Clinical scans were collected at 0.488 and 0.625 mm in plane resolution with 0.625 mm thickness. The overall cortical thickness error was determined to be 0.078 ± 0.58 mm for cortical samples thinner than 4 mm. It was determined that 91.3% of these differences fell within the scanner resolution. Color maps of clinical CT thickness estimations are comparable to color maps of microCT thickness measurements, indicating good quantitative agreement. These data confirm that the cortical density algorithm successfully estimates skull table thickness from clinical CT scans. The application of this technique to clinical CT scans enables evaluation of cortical thickness in population-based studies. © 2014 Anatomical Society.

  13. CT-based virtual tracheobronchoscopy in children - comparison with axial CT and multiplanar reconstruction: preliminary results

    International Nuclear Information System (INIS)

    Sorantin, Erich; Lindbichler, Franz; Eber, Ernst; Schimpl, Guenther

    2002-01-01

    Background: 3D post-processing of spiral-CT (S-CT) data using perspective projection allows the generation of virtual views similar to endoscopy. Objective: To evaluate whether simultaneous reading of axial S-CT, multiplanar reconstruction (MPR) and virtual tracheobronchoscopy (VTB) is more precise and accurate than reading of axial S-CT and MPR alone in paediatric patients. Materials and methods: S-CT studies of 15 symptomatic and 4 normal patients were investigated. Two radiologists independently read two sets of images for airway abnormalities: first axial CT and MPR, followed by axial CT, MPR and VTB. A final decision was later made by consensus. All results were compared to fibre-optic bronchoscopy (FTB). Interobserver agreement was used as an indicator of precision for the display technique used. Results: At reading of axial S-CT and MPR an interobserver agreement of 89.5% (κ=0.776, P<0.00103) was found. Based on the consensus decision, a diagnostic accuracy of 89.5% at a sensitivity 86.6% and specificity of 100% (κ=0.776, 95% CI 0.491-1.062, P<0.00103) was achieved. At reporting on axial S-CT, MPR and VTB, all cases were classified correctly by both readers, indicating 100% accuracy, interobserver agreement, sensitivity and specificity (κ=1.00, 95% CI 1.0-1.0, P<0.000258). Conclusions: The simultaneous display of axial S-CT, MPR and VTB raises the precision, accuracy and sensitivity of radiological reports. (orig.)

  14. Acute chest pain: a purely clinical problem or a question for radiology; Der akute Thoraxschmerz, ein rein klinisches Problem oder radiologische Fragestellung

    Energy Technology Data Exchange (ETDEWEB)

    Loewe, C. [Medizinische Universitaet Wien, Klinische Abteilung fuer Kardiovaskulaere und Interventionelle Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2008-05-15

    Acute chest pain represents a very common clinical occurrence and at the same time poses a severe diagnostic dilemma. It can be due to an acute life-threatening event such as acute cardiac infarct, or a relatively harmless condition of pain and illness (e.g. vertebrogenic pain) under the main symptom category of acute chest pain. This often unclear symptomatic, behind which there can always be a life-threatening disease leads to an exaggerated grouping of patients into emergency cases and to an increased number of inpatients for observation. The diagnosis of acute coronary syndrome with no initial ECG changes typical for ischemia is especially problematic. The availability of modern multidetector computed tomography is becoming increasingly more important for radiologists in the diagnosis and clarification of acute chest pain. In this article the clinical difficulties and radiology options for the diagnosis of patients with acute chest pain will be presented and possible future algorithms for diagnosis will be discussed. (orig.) [German] Der akute Thoraxschmerz repraesentiert ein sehr haeufiges klinisches Beschwerdebild und gleichzeitig ein grosses diagnostisches Dilemma, koennen sich doch sowohl lebensbedrohliche akute Ereignisse (wie der akute Herzinfarkt) als auch mehr oder weniger harmlose Schmerzzustaende und Erkrankungen (wie vertebrogene Schmerzen) unter dem Leitsymptom 'akuter Thoraxschmerz' praesentieren. Diese oft nicht eindeutige Symptomatik, hinter der immer auch ein lebensbedrohliches Krankheitsbild stecken kann, fuehrt zu einer Uebertriagierung der Patienten in Notaufnahmen und zu einer grossen Anzahl an stationaeren 'Absicherungsaufnahmen'. Besonders die Diagnose eines akuten Koronarsyndroms (AKS) bei initial fehlenden ischaemietypischen EKG-Veraenderungen stellt eine spezielle Problematik dar. Durch die Verfuegbarkeit moderner ultraschneller Multidetektorcomputertomographen (MDCT) spielt der Radiologe in der Diagnostik und

  15. CT of splenic trauma

    International Nuclear Information System (INIS)

    Griffiths, B.G.; Federle, M.P.; Minagi, H.; Jeffrey, R.B.

    1986-01-01

    Fifty-five consecutive cases of surgically proved splenic injuries were evaluated by CT. CT correctly identified 54 splenic injuries, with one false-negative and three false-positive studies. In the single false-negative study and in two of the three false-positive studies, CT correctly indicated the presence of a large hemoperitoneum and other abdominal visceral lacerations and so correctly indicated the need for surgery. Of the 55 proved cases of splenic injury, CT revealed hemoperitoneum in 54 (99%), perisplenic clot in 47 (85%), splenic laceration in 39 (71%), and subcapsular hematoma in 13 (24%). Perisplenic clot can be distinguished from lysed blood in the peritoneal cavity and is a sensitive and specific sign of splenic trauma, even in the absence of visible splenic laceration. The authors conclude that CT is highly reliable means of evaluating splenic trauma

  16. Gerbstoffe aus Potentilla officinalis wirken entzündungshemmend im UV-Erythem-Test und bei Anwendung auf atopischer Haut.

    Science.gov (United States)

    Hoffmann, Julia; Wölfle, Ute; Schempp, Christoph M; Casetti, Federica

    2016-09-01

    Das Rhizom von Potentilla officinalis (PO) ist reich an Gerbstoffen und wird traditionell zur äußerlichen Behandlung von Entzündungen der Haut und der Schleimhäute verwendet. Ziel der vorliegenden Arbeit war die Bestätigung der antiinflammatorischen Eigenschaften von PO mittels eines UV-Erythem-Tests und einer klinischen Anwendungsstudie bei atopischer Haut. Die antiinflammatorische Wirkung eines PO-Extrakts (standardisiert auf 2 % Trockensubstanz) wurde in einer prospektiven, randomisierten, placebokontrollierten Doppelblindstudie mit 40 gesunden Erwachsenen im UV-Erythem-Test im Vergleich zu 1 % Hydrocortisonacetat untersucht. Im Rahmen einer prospektiven nicht kontrollierten Studie wurde die Wirkung und Verträglichkeit der 2 % PO-Creme an zwölf Erwachsenen und zwölf Kindern mit atopischer Haut nach Anwendung über zwei Wochen in einem definierten Testareal anhand eines Teil-SCORAD untersucht. Zusätzlich wurde die Beeinflussung der Hautrötung im Testareal photometrisch gemessen. Im UV-Erythem-Test zeigte die PO-Creme eine signifikante Reduktion des Erythemindex im Vergleich zum Vehikel. Die antiinflammatorische Wirkung des Verums entsprach der der 1 % Hydrocortisonacetat-Creme. Die klinische Studie bei Atopikern zeigte eine signifikante Abnahme des Teil-SCORAD und des Erythems im Testareal. Es wurden keine Unverträglichkeitsreaktionen beobachtet. PO als 2%ige Zubereitung besitzt entzündungshemmende Eigenschaften und ist wirksam und gut verträglich auf atopischer Haut. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  17. Evaluation of pre and post-operative spinal plain CT and CT-myelography

    International Nuclear Information System (INIS)

    Nagase, Joji; Inoue, Shunichi; Miyasaka, Hitoshi; Kamata, Sakae; Shinohara, Hiroyasu.

    1983-01-01

    Confirmation of the level of scan slices is essential for the CT diagnosis of spinal and spinal-cord diseases. Pre- and postoperative comparison should be made on the same level. For reading of plain CT and CTM, window levels should be identical pre- and postoperatively. Both methods demonstrated the spinal canal, morphology of the spinal cord, and three-Fdimensional pathologic pictures inside and outside the spinal cord. Preoperative CT contributed useful information on the pathologic conditions and selection of surgical procedures and routes. Postoperative plain CT confirmed surgical results, and CTM revealed the spinal cord and the subarachnoid space, as well as the range and degree of decompression from the spinal cord. (Chiba, N.)

  18. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow new CT scanners to obtain multiple slices in a single rotation. These scanners, called "multislice CT" or "multidetector CT," ...

  19. SPECT/CT and pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Jann [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); The Faroese National Hospital, Department of Medicine, Torshavn (Faroe Islands); Gutte, Henrik [Copenhagen University Hospital, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen (Denmark); Herlev Hospital, Copenhagen University Hospital, Department of Radiology, Copenhagen (Denmark); University of Copenhagen, Cluster for Molecular Imaging, Faculty of Health Sciences, Copenhagen (Denmark)

    2014-05-15

    Acute pulmonary embolism (PE) is diagnosed either by ventilation/perfusion (V/P) scintigraphy or pulmonary CT angiography (CTPA). In recent years both techniques have improved. Many nuclear medicine centres have adopted the single photon emission CT (SPECT) technique as opposed to the planar technique for diagnosing PE. SPECT has been shown to have fewer indeterminate results and a higher diagnostic value. The latest improvement is the combination of a low-dose CT scan with a V/P SPECT scan in a hybrid tomograph. In a study comparing CTPA, planar scintigraphy and SPECT alone, SPECT/CT had the best diagnostic accuracy for PE. In addition, recent developments in the CTPA technique have made it possible to image the pulmonary arteries of the lungs in one breath-hold. This development is based on the change from a single-detector to multidetector CT technology with an increase in volume coverage per rotation and faster rotation. Furthermore, the dual energy CT technique is a promising modality that can provide functional imaging in combination with anatomical information. Newer high-end CT scanners and SPECT systems are able to visualize smaller subsegmental emboli. However, consensus is lacking regarding the clinical impact and treatment. In the present review, SPECT and SPECT in combination with low-dose CT, CTPA and dual energy CT are discussed in the context of diagnosing PE. (orig.)

  20. Variation in quantitative CT air trapping in heavy smokers on repeat CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Mets, Onno M.; Gietema, Hester A.; Jong, Pim A. de [University Medical Center Utrecht, Radiology, Heidelberglaan 100, Postbus 85500, Utrecht (Netherlands); Isgum, Ivana; Mol, Christian P. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Zanen, Pieter [University Medical Center Utrecht, Pulmonology, Utrecht (Netherlands); Prokop, Mathias [Radboud University Nijmegen Medical Centre, Radiology, Nijmegen (Netherlands); University Medical Center Utrecht, Radiology, Heidelberglaan 100, Postbus 85500, Utrecht (Netherlands)

    2012-12-15

    To determine the variation in quantitative computed tomography (CT) measures of air trapping in low-dose chest CTs of heavy smokers. We analysed 45 subjects from a lung cancer screening trial, examined by CT twice within 3 months. Inspiratory and expiratory low-dose CT was obtained using breath hold instructions. CT air trapping was defined as the percentage of voxels in expiratory CT with an attenuation below -856 HU (EXP{sub -856}) and the expiratory to inspiratory ratio of mean lung density (E/I-ratio{sub MLD}). Variation was determined using limits of agreement, defined as 1.96 times the standard deviation of the mean difference. The effect of both lung volume correction and breath hold reproducibility was determined. The limits of agreement for uncorrected CT air trapping measurements were -15.0 to 11.7 % (EXP{sub -856}) and -9.8 to 8.0 % (E/I-ratio{sub MLD}). Good breath hold reproducibility significantly narrowed the limits for EXP{sub -856} (-10.7 to 7.5 %, P = 0.002), but not for E/I-ratio{sub MLD} (-9.2 to 7.9 %, P = 0.75). Statistical lung volume correction did not improve the limits for EXP{sub -856} (-12.5 to 8.8 %, P = 0.12) and E/I-ratio{sub MLD} (-7.5 to 5.8 %, P = 0.17). Quantitative air trapping measures on low-dose CT of heavy smokers show considerable variation on repeat CT examinations, regardless of lung volume correction or reproducible breath holds. (orig.)

  1. Clinical values of CT and dynamic CT in brain infarction

    International Nuclear Information System (INIS)

    Lim, Soo Il; Jang, Do; Seo, Eun Joo; Sohn, Myung Hee; Choi, Ki Chul

    1985-01-01

    With the advent of faster scan time and new computer program, a scanning technique called 'dynamic computed tomography' has become possible. Dynamic computed tomography consisted of performing multiple rapid sequence scans after injection of contrast material. The authors have evaluated the clinical usefulness of computed tomography and dynamic computed tomography of 93 patients with brain infarction and/or ischemia during the period of 17 months from April 1983 to August 1984 in Department of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The age distribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59 years (40.9%). 2. The sites of brain infarction were cerebral lobes (63 cases,68), basal ganglia (15 cases, 16.1%) and multiple sites (6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. The contrast enhancement of acute infarction was noted in 14 cases (17.5%) which occurred commonly between 3 days and 2 weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a. Depression of slow wash-in phase was 20 cases (59%). b. Lower peak concentration was 17 cases (50%). c. Lower and delayed peak concentration was 7 cases (21%). d. No definite peak concentration was 6 cases (18%). First three patterns of time-density curve were thought as relatively characteristic curve of brain infarction and/or ischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings as hypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entity of dynamic CT scan were as follows; a. large artery thrombotic infarction were 23 cases (58%). b. lacnar infarction were 6 cases (15%). c. ischemia were 5 cases (13%). d. normal were 5 cases (13%). In six cases of lacunar infarction which was double hypodensity on pre-and postcontrast CT

  2. Clinical values of CT and dynamic CT in brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Soo Il; Jang, Do; Seo, Eun Joo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University College of Medicine, Jeonju (Korea, Republic of)

    1985-04-15

    With the advent of faster scan time and new computer program, a scanning technique called 'dynamic computed tomography' has become possible. Dynamic computed tomography consisted of performing multiple rapid sequence scans after injection of contrast material. The authors have evaluated the clinical usefulness of computed tomography and dynamic computed tomography of 93 patients with brain infarction and/or ischemia during the period of 17 months from April 1983 to August 1984 in Department of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The age distribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59 years (40.9%). 2. The sites of brain infarction were cerebral lobes (63 cases,68), basal ganglia (15 cases, 16.1%) and multiple sites (6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. The contrast enhancement of acute infarction was noted in 14 cases (17.5%) which occurred commonly between 3 days and 2 weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a. Depression of slow wash-in phase was 20 cases (59%). b. Lower peak concentration was 17 cases (50%). c. Lower and delayed peak concentration was 7 cases (21%). d. No definite peak concentration was 6 cases (18%). First three patterns of time-density curve were thought as relatively characteristic curve of brain infarction and/or ischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings as hypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entity of dynamic CT scan were as follows; a. large artery thrombotic infarction were 23 cases (58%). b. lacnar infarction were 6 cases (15%). c. ischemia were 5 cases (13%). d. normal were 5 cases (13%). In six cases of lacunar infarction which was double hypodensity on pre

  3. CT findings at lupus mesenteric vasculitis

    International Nuclear Information System (INIS)

    Ko, S.F.; Lee, T.Y.; Cheng, T.T.; Ng, S.H.; Lai, H.M.; Cheng, Y.F.; Tsai, C.C.

    1997-01-01

    Purpose: To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity. Methods: Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided. Results: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesentric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n=11), ascites with slightly increased peritoneal enhancement (n=11), small bowel wall thickening (n=10) with double halo or target sign (n=8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings. Conclusion: CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved. (orig.)

  4. CT findings at lupus mesenteric vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Ko, S.F. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Lee, T.Y. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Cheng, T.T. [Chang Gung Medical College and Memorial Hospital, Dept. of Rheumatology, Kaohsiung Hsien (Taiwan); Ng, S.H. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Lai, H.M. [Chang Gung Medical College and Memorial Hospital, Dept. of Rheumatology, Kaohsiung Hsien (Taiwan); Cheng, Y.F. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Tsai, C.C. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan)

    1997-01-01

    Purpose: To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity. Methods: Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided. Results: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesentric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n=11), ascites with slightly increased peritoneal enhancement (n=11), small bowel wall thickening (n=10) with double halo or target sign (n=8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings. Conclusion: CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved. (orig.).

  5. The impact of the PET/CT in comparison with the same day contrast enhanced CT in breast cancer management

    International Nuclear Information System (INIS)

    Piperkova, E.; Raphael, B.; Altinyay, M.; Castellon, I.; Libes, R.; Abdel-Dayem, H.

    2006-01-01

    Full text: The aim of this study is to evaluate the impact of 18F-fluorodeoxyglucose FDG positron emission tomography with fused computerized tomography (PET/CT) in comparison with the same day contrast enhanced CT (CE-CT) in the breast cancer (BC) management. 68 studies in 48 BC patients, 8 for initial and 60 for restaging disease, after surgery, radiation/chemotherapy, for radiation therapy planning or evaluating treatment response were included. All patients underwent whole body PET/CT for diagnostic purposes followed by CE-CT diagnostic scans of selected body regions. PET/CT was performed approximately 90 minutes following 10-15 mCi of 18F-FDG on a GE Discovery PET/CT system. CT part acquired with low dose X-ray for localization and attenuation correction. The CE-CT was performed according to departmental protocol. Out of a total of 235 lesions in 68 PET/CT and CE-CT studies, 189 were concordant between PET/CT and CE-CT. However, there were 46 discordant lesions, which were verified by either follow-up or biopsy. PET/CT correctly identified 25 (True Positive-TP). CE-CT identified 2 TP lesions missed by PET/CT (False negative): one liver metastasis with necrosis, which is a known non-avid FDG, the other was a missed abdominal metastatic node, which did not change staging or treatment. PET/CT incorrectly identified 2 lesions (False Positive) while CE-CT incorrectly identified 17 FP. For evaluating treatment response in 40 follow up studies PET/CT reported complete response in 15, partial response in 11, stable disease in 2, progression in 5, and free of disease following surgery - in 7. The CE-CT described progression of the disease in 1 PET/CT true negative study and no progression in 2 TP PET/CT studies. In this study, PET/CT played more important role than CECT scans alone and provided an impact on the management of BC patients

  6. CT, MRI, and FDG PET/CT findings of sinonasal sarcoma: Differentiation from squamous cell carcinoma

    International Nuclear Information System (INIS)

    Kim, Jin Ho; Yoon, Dae Young; Baek, Sora; Park, Min Woo; Kwon, Kee Hwan; Rho, Young Soo

    2016-01-01

    To evaluate computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) findings for the differentiation of sinonasal sarcoma from squamous cell carcinoma (SCC). We retrospectively reviewed CT, MRI, and FDG PET/CT results in 20 patients with pathologically proven sinonasal sarcoma (n = 7) and SCC (n = 13). Imaging characteristics of tumors, such as the shape, size, margin, MRI signal intensity, pattern of enhancement, local tumor invasion, and maximum standardized uptake value (SUVmax) were analyzed and compared between sarcoma and SCC. The SUVmax of sarcomas (7.4 ± 2.1) was significantly lower than the SUVmax of the SCCs (14.3 ± 4.5) (p = 0.0013). However, no significant difference in the shape, size, margin, MRI signal intensity, pattern of enhancement, and local tumor invasion was observed between sarcoma and SCC. Although CT and MR imaging features are nonspecific, FDG PET/CT is useful in distinguishing between sinonasal sarcoma and SCC based on the SUVmax value

  7. CT, MRI, and FDG PET/CT findings of sinonasal sarcoma: Differentiation from squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Ho; Yoon, Dae Young; Baek, Sora; Park, Min Woo; Kwon, Kee Hwan; Rho, Young Soo [Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    To evaluate computed tomography (CT), magnetic resonance imaging (MRI), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT) findings for the differentiation of sinonasal sarcoma from squamous cell carcinoma (SCC). We retrospectively reviewed CT, MRI, and FDG PET/CT results in 20 patients with pathologically proven sinonasal sarcoma (n = 7) and SCC (n = 13). Imaging characteristics of tumors, such as the shape, size, margin, MRI signal intensity, pattern of enhancement, local tumor invasion, and maximum standardized uptake value (SUVmax) were analyzed and compared between sarcoma and SCC. The SUVmax of sarcomas (7.4 ± 2.1) was significantly lower than the SUVmax of the SCCs (14.3 ± 4.5) (p = 0.0013). However, no significant difference in the shape, size, margin, MRI signal intensity, pattern of enhancement, and local tumor invasion was observed between sarcoma and SCC. Although CT and MR imaging features are nonspecific, FDG PET/CT is useful in distinguishing between sinonasal sarcoma and SCC based on the SUVmax value.

  8. CT of hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, H; Tanaka, T; Sai, H; Kawamoto, S; Morimoto, K [Osaka Univ. (Japan). Faculty of Medicine

    1982-06-01

    CT was investigated in 125 cases of hepatocelluar carcinoma and 47 cases of metastatic hepatic neoplasm. The entire contour of each tumor was traced and the average CT value in the tumor was estimated. As a result, the CT value for hepatocellular carcinoma tended to be higher on plain CT and also after contrast enhancement. The CT findings seen frequently were as follows: capsule in 76 cases (60.8%) and septum in 67 cases (53.6%); tumor thrombus in portal vein in 39 cases (31.2%) and that in inferior vena cava in 3 cases (2.4%); localized enlargement of hepatic bile duct in 24 cases (19.2%). These findings were rarely seen in the cases of metastatic hepatic neoplasm. As a relatively outstanding feature of hepatic metastases, a double contour, like concentric circles or contour lines, with a relatively large inner circle or contour line, was found in 21 cases (44.7%). By paying attention to the change of CT value on contrast enhancement and the characteristic image of each case, hepatocellular carcinoma could be differentiated from metastatic hepatic neoplasm with high probability.

  9. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    It has been said that chronic subdural hematoma cannot be diagnosed by CT. In our cases, CT was used, and the results were described. According to the density of the picture, CT findings of chronic subdural hematoma could be classified into 3 types, those of higher density than that of the cerebral paranchyma, those of isodensity, and those of lower density than that of the cerebral parenchyma. The difference among them appeared to be due to variation in the fluid in hematoma, especially that in hemoglobin concentration. Chronic subdural hematoma was found in 27 of 388 cases of head trauma in which CT was undertaken in our department of surgery for last 2 years. It is difficult to differenciate this disease from subdural edema or subarachnoideal retention of the cerebrospinal fluid. In many cases, use of contrast medium added no change to the CT picture. Cerebral angiography is necessary for definite diagnosis of the disease. Chronic subdural hematoma gives more varieties of findings than other intracranial hematomas. However, if the film is very carefully read, CT is still useful for diagnosing this disease in spite of initially remarked difficulties. (Ueda, J.)

  10. Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model.

    Science.gov (United States)

    Rosow, David E; Sahani, Dushyant; Strobel, Oliver; Kalva, Sanjeeva; Mino-Kenudson, Mari; Holalkere, Nagaraj S; Alsfasser, Guido; Saini, Sanjay; Lee, Susanna I; Mueller, Peter R; Fernández-del Castillo, Carlos; Warshaw, Andrew L; Thayer, Sarah P

    2005-12-01

    Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly facilitates the use of CT angiography (CTA) in the clinical setting. We sought to determine whether M.D.CT-CTA could accurately demonstrate vascular anatomy and capture the earliest stages of mesenteric ischemia in a porcine model. Pigs underwent embolization of branches of the superior mesenteric artery, then imaging by M.D.CT-CTA with three-dimensional reconstruction protocols. After scanning, diseased bowel segments were surgically resected and pathologically examined. Multidetector row CT and CT angiography reliably defined normal and occluded mesenteric vessels in the pig. It detected early changes of ischemia including poor arterial enhancement and venous dilatation, which were seen in all ischemic animals. The radiographic findings--compared with pathologic diagnoses-- predicted ischemia, with a positive predictive value of 92%. These results indicate that M.D.CT-CTA holds great promise for the early detection necessary for successful treatment of acute mesenteric ischemia.

  11. CT-guided stereotactic neurosurgery

    International Nuclear Information System (INIS)

    Takizawa, Takaaki; Sato, Shoju; Matsumoto, Akira; Sano, Akira; Takahashi, Kazunori; Murakami, Yuji; Ohta, Kosuke

    1985-01-01

    Brown-Roberts-Wells stereotactic instruments were used for CT guided stereotactic surgery in 54 cases (65 operations). Stereotactic biopsy was done in 9 cases and successive regional chemotherapy was done in 3 cases. Stereotactic drainage was done in 2 cases of bacterial abcess, 3 cases of cystic neoplasm and 33 cases (43 operations) of intracerebral hematoma. CT guided stereotactic procedure was valuable for the correct cannulation to the center of the cavity. We tried to utilize CT image for the selection of targets for stereotactic functional neurosurgical procedures in 6 cases. In the cases of thalamotomy, the information derived from CT made the operation safer than that by contrast ventriculography alone. In all cases of electrode implantation for deep brain stimulation, accurate and precise electrode placement was achieved from CT images alone. This rapid and easy surgical technique was useful also for poor risk patients. (author)

  12. Thyroid lymphography-computed tomography (TLG-CT)

    International Nuclear Information System (INIS)

    Matsuyama, Koukichi

    1992-01-01

    There are several useful diagnostic examinations for thyroid disease. The diagnostic value of CT in thyroid disease is still controvertial, although CT has become a routine clinical examination, since the plain CT does not always identify tumors accurately. In this paper, we introduce for the first time thyroid lymphography-computed tomography (TLG-CT) which may improve the diagnostic value of CT. The technique combines CT with thyroid lymphography. We performed TLG-CT in 92 patients with various thyroid diseases and 20 normal controls and classified the radiological features into the following 6 types: entire (normal thyroid); moth-eaten (Hashimoto's thyroiditis); defect (follicular adenoma and adenomatous goiter); lobate (papillary carcinoma); localized (various thyroid diseases); and extrathyroid defect (parathyroid tumor). In addition, we examined the relationship between TLG-CT type and the macroscopic appearance of the cut surface of the thyroid and lymph node metastasis in 20 patients with papillary carcinoma. The results suggest that papillary TLG-CT type carcinomas have a high incidence of lymph node metastasis. Our preliminary results suggest that TLG-CT is a potentially valuable diagnostic tool in the detection of thyroid disease and the assessment of the pathologic diagnosis as well as lymph node metastasis. (author)

  13. [Accurate 3D free-form registration between fan-beam CT and cone-beam CT].

    Science.gov (United States)

    Liang, Yueqiang; Xu, Hongbing; Li, Baosheng; Li, Hongsheng; Yang, Fujun

    2012-06-01

    Because the X-ray scatters, the CT numbers in cone-beam CT cannot exactly correspond to the electron densities. This, therefore, results in registration error when the intensity-based registration algorithm is used to register planning fan-beam CT and cone-beam CT. In order to reduce the registration error, we have developed an accurate gradient-based registration algorithm. The gradient-based deformable registration problem is described as a minimization of energy functional. Through the calculus of variations and Gauss-Seidel finite difference method, we derived the iterative formula of the deformable registration. The algorithm was implemented by GPU through OpenCL framework, with which the registration time was greatly reduced. Our experimental results showed that the proposed gradient-based registration algorithm could register more accurately the clinical cone-beam CT and fan-beam CT images compared with the intensity-based algorithm. The GPU-accelerated algorithm meets the real-time requirement in the online adaptive radiotherapy.

  14. CT scanning in pediatric head trauma: correlation of clinical features with CT scan diagnosis

    International Nuclear Information System (INIS)

    Arkoncel, Mary Ann P.; Posadas, Ma. Belen A.

    1997-01-01

    A retrospective review was conducted on 205 cases of pediatric head trauma for which cranial computed tomography scans were done at the Makati Medical Center, to determine which clinical features might positively predict an abnormality on CT scan. The clinical findings of loss of consciousness, GCS < 12, vomiting headache, seizures, and focal abnormalities on Neurologic Examination were significantly associated with abnormal findings on CT scan. However, a significant discrepancy does exist as to how accurately clinical findings do in fact predict normal and abnormal CT scan findings. Such a discrepancy allows us to conclude that a more liberal use of CT Scanning in cases of pediatric head trauma must be stressed to insure proper diagnosis. This study shows that when a patient presents with the aforementioned positive signs and symptoms, or with a focal neurologic deficit, or in combination, a 60-100 % positive prediction of abnormal CT Scan can be made. However, prediction of normal CT Scan is only 0-40%. (Author)

  15. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... or nurse at the time of the CT examination. If your child has a known contrast material ... be given to your child for the CT examination. top of page What does the CT equipment ...

  16. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  17. CT diagnosis of acute spinal injury

    International Nuclear Information System (INIS)

    Ohhama, Mitsuru; Niimiya, Hikosuke; Kimura, Ko; Yamazaki, Gyoji; Nasu, Yoshiro; Shioya, Akihide

    1982-01-01

    CT pictures of 22 acute spinal injuries with damage of the spinal cord were evaluated. In the cases of spinal cord damage with bone injury, changes in the vertebral canal were fully observed by CT. In some of spinal cord damages without bone injury, narrowing of the vertebral canal was demonstrated by CT combined with CT myelography and reconstruction. Evaluation of CT number showed a high density area in damaged spinal cord in some cases. CT was thus considered to be useful as an adjunct diagnostic aid. (Ueda, J.)

  18. Positron emission tomography/computed tomography (PET/CT) and CT for N staging of non-small cell lung cancer.

    Science.gov (United States)

    Vegar Zubović, Sandra; Kristić, Spomenka; Hadžihasanović, Besima

    2017-08-01

    Aim The aim of this study is to investigate the possibilities of non-invasive diagnostic imaging methods, positron emission tomography/computed tomography (PET/CT) and CT, in clinical N staging of non-small cell lung cancer (NSCLC). Methods Retrospective clinical study included 50 patients with diagnosed NSCLC who have undergone PET/CT for the purpose of disease staging. The International association for the study of lung cancer (IASLC) nodal mapping system was used for analysis of nodal disease. Data regarding CT N-staging and PET/CT Nstaging were recorded. Two methods were compared using χ2 test and Spearman rank correlation coefficient. Results Statistical analysis showed that although there were some differences in determining the N stage between CT and PET/CT, these methods were in significant correlation. CT and PET/CT findings established the same N stage in 74% of the patients. In five patients based on PET/CT findings the staging was changed from operable to inoperable, while in four patients staging was changed from inoperable to operable. Conclusion PET/CT and CT are noninvasive methods that can be reliably used for N staging of NSCLC. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  19. Flat-detector computed tomography (FD-CT)

    International Nuclear Information System (INIS)

    Kalender, Willi A.; Kyriakou, Yiannis

    2007-01-01

    Flat-panel detectors or, synonymously, flat detectors (FDs) have been developed for use in radiography and fluoroscopy with the defined goal to replace standard X-ray film, film-screen combinations and image intensifiers by an advanced sensor system. FD technology in comparison to X-ray film and image intensifiers offers higher dynamic range, dose reduction, fast digital readout and the possibility for dynamic acquisitions of image series, yet keeping to a compact design. It appeared logical to employ FD designs also for computed tomography (CT) imaging. Respective efforts date back a few years only, but FD-CT has meanwhile become widely accepted for interventional and intra-operative imaging using C-arm systems. FD-CT provides a very efficient way of combining two-dimensional (2D) radiographic or fluoroscopic and 3D CT imaging. In addition, FD technology made its way into a number of dedicated CT scanner developments, such as scanners for the maxillo-facial region or for micro-CT applications. This review focuses on technical and performance issues of FD technology and its full range of applications for CT imaging. A comparison with standard clinical CT is of primary interest. It reveals that FD-CT provides higher spatial resolution, but encompasses a number of disadvantages, such as lower dose efficiency, smaller field of view and lower temporal resolution. FD-CT is not aimed at challenging standard clinical CT as regards to the typical diagnostic examinations; but it has already proven unique for a number of dedicated CT applications, offering distinct practical advantages, above all the availability of immediate CT imaging in the interventional suite or the operating room. (orig.)

  20. Incidental findings of the kidneys, adrenal glands, adnexa uteri, gastrointestinal tract, mesentery and lymph nodes. Assessment and management recommendations; Zufallsbefunde von Niere, Nebenniere, Adnexen, Gastrointestinaltrakt, Mesenterium und Lymphknoten. Bewertung und Managementempfehlung

    Energy Technology Data Exchange (ETDEWEB)

    Scharitzer, M.; Tamandl, D.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

    2017-04-15

    Besides the upper abdominal parenchymal organs, the increasing application of cross-sectional imaging has also led to a rising number of incidental findings in the kidneys, adrenal glands, adnexa uteri, the gastrointestinal tract, mesentery and abdominal lymph nodes. Abdominal computed tomography investigations often show unexpected findings without any correlating symptoms. The growing clinical relevance is due to the large number of incidental findings as well as an increasing awareness of ethical and socioeconomic factors. When interpreting radiological findings not only morphological criteria but also individual risk factors of the patient and the clinical context are of great importance. The aims of this article are the description and evaluation of frequent incidental findings detected by computed tomography and to provide information about management recommendations. (orig.) [German] Neben den parenchymatoesen Oberbauchorganen hat der zunehmende Einsatz von Schnittbildverfahren zu einer vermehrten Anzahl von Zufallsbefunden der Nieren, Nebennieren, Adnexe, des Gastrointestinaltrakts, Mesenteriums und der intraabdominellen Lymphknoten gefuehrt. Abdominelle CT-Untersuchungen zeigen haeufig unerwartete Befunde ohne korrelierende Symptomatik. Die steigende klinische Relevanz ist einerseits auf die Zunahme inzidenteller Pathologien und andererseits auf ein wachsendes Bewusstsein ethischer und soziooekonomischer Faktoren zurueckzufuehren. Bei der radiologischen Interpretation sind neben morphologischen Kriterien sowohl die Einbeziehung der individuellen Risikofaktoren des Patienten als auch der klinische Gesamtkontext von grosser Bedeutung. Das Ziel dieses Artikels ist eine Beschreibung und Bewertung der in der Computertomographie detektierten genannten Zufallsbefunde sowie weiterer Managementempfehlungen. (orig.)

  1. Imaging and PET - PET/CT imaging

    International Nuclear Information System (INIS)

    Von Schulthess, G.K.; Hany, Th.F.

    2008-01-01

    PET/CT has grown because the lack of anatomic landmarks in PET makes 'hardware-fusion' to anatomic cross-sectional data extremely useful. Addition of CT to PET improves specificity, but also sensitivity, and adding PET to CT adds sensitivity and specificity in tumor imaging. The synergistic advantage of adding CT is that the attenuation correction needed for PET data can also be derived from the CT data. This makes PET-CT 25-30% faster than PET alone, leading to higher patient throughput and a more comfortable examination for patients typically lasting 20 minutes or less. FDG-PET-CT appears to provide relevant information in the staging and therapy monitoring of many tumors, such as lung carcinoma, colorectal cancer, lymphoma, gynaecological cancers, melanoma and many others, with the notable exception of prostatic cancer. for this cancer, choline derivatives may possibly become useful radiopharmaceuticals. The published literature on the applications of FDG-PET-CT in oncology is still limited but several designed studies have demonstrated the benefits of PET-CT. (authors)

  2. CT of abdominal abscesses

    International Nuclear Information System (INIS)

    Korobkin, M.T.

    1987-01-01

    The imaging search for a suspected abdominal abscess is common in hospitalized patients, especially after recent abdominal surgery. This paper examines the role of CT in the detection, localization, and treatment of abdominal abscess. The accuracy, limitations, and technical aspects of CT in this clinical setting are discussed. The diagnosis of an abscess is based on the demonstration of a circumscribed abnormal fluid collection. Although percutaneous aspiration with gram stain and culture is usually indicated to differentiate abscess from other fluid collections, the CT-based detection of extraluminal gas bubbles makes the diagnosis of an abscess highly likely. CT is compared with conventional radiographic studies, US, and radio-nuclide imaging. Specific CT and clinical features of abscesses in the following sites are emphasized: subphrenic space, liver, pancreas, kidneys, psoas muscle, appendix, and colonic diverticula. Most abdominal abscesses can be successfully treated with percutaneous drainage techniques. The techniques, results, and limitations of percutaneous abscess drainage are reviewed

  3. CT of tracheal agenesis

    International Nuclear Information System (INIS)

    Strouse, Peter J.; Hernandez, Ramiro J.; Newman, Beverley

    2006-01-01

    Tracheal agenesis is a rare and usually lethal anomaly. In the past, opaque contrast medium was injected via the esophagus to demonstrate the anatomy. To demonstrate the utility of helical and multidetector CT in delineating the aberrant anatomy in newborns with tracheal agenesis. Four newborns with tracheal agenesis were identified from three institutions. Imaging studies and medical records were reviewed. Each child was imaged with chest radiography. One child was imaged on a single-detector helical CT scanner and the other three on multidetector scanners. Helical and multidetector CT with 2D and 3D reconstructions clearly delineated the aberrant tracheobronchial and esophageal anatomy in each infant. Minimum intensity projection reformatted CT images were particularly helpful. One infant each had type I and type II tracheal agenesis. Two infants had type III tracheal agenesis. All four infants died. CT is a useful tool for delineating the aberrant anatomy of newborns with tracheal agenesis and thus helps in making rational clinical decisions. (orig.)

  4. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    In our cases of acute and subacute subdural hematoma, the use of CT was evaluated. In our department of surgery, acute subdural hematoma was found in 46 of 388 patients of head trauma who underwent CT. Acute subdural hematoma, like epidural hematoma was usually visualized as a high-density area along the cranial inner table, and this was easily differenciated from epidural hematoma because of difference in shape from the other. The picture of acute subdural hematoma was occasionally confused with that of intracerebral hematoma or cerebral contusion. Single use of CT does not differenciate subacute subdural hematoma from chronic subdural hematoma. However, CT usually visualized acute hematoma as a high-density area, showing the extent of hematoma. Comparison of the thickness of hematoma with the axis deviation of the median part such as the 3rd cerebral ventricle suggested severity of cerebral edema. CT also revealed bilateral or multiple lesions of cerebral contusion or intracerebral hematoma. (Ueda, J.)

  5. CT of laryngeal trauma

    International Nuclear Information System (INIS)

    Jeffrey, R.B.

    1986-01-01

    Computed tomography has made a significant contribution to the radiologic assessment of the injured larynx. CT is an accurate, noninvasive modality that can rapidly diagnose both soft tissue and cartilaginous injuries. CT of the larynx involves a minimal degree of patient manipulation and discomfort and can be performed in conjunction with CT evaluation of intracranial or facial injuries. Conventional radiologic studies (anteroposterior and lateral soft tissue films of the neck, tomograms, or xerograms) are capable of demonstrating some cartilaginous fractures but are of limited value in defining the extent of soft tissue injury. In the acute trauma setting, laryngography is often technically difficult to perform because of patient discomfort and inability to cooperate. Although the overall experience is somewhat limited, CT appears to overcome many of the limitations of these conventional radiologic methods. The following is a discussion of the role of CT scanning in evaluating injuries to the larynx and cervical soft tissues

  6. Congenital bronchopulmonary malformation: CT histopathological correlation.

    Science.gov (United States)

    Kyncl, Martin; Koci, Martin; Ptackova, Lea; Hornofova, Ludmila; Ondrej, Fabian; Snajdauf, Jiri; Pychova, Marcela

    2016-12-01

    This study evaluated the accuracy of postnatal computed tomography (CT) imaging in the identification of congenital bronchopulmonary malformation (BPM) in comparison with histopathological analysis. CT scans of prenatally diagnosed BPMs from 24 patients with available histology were analysed retrospectively. The CT images were reviewed blinded to histological findings by two radiologists. Specific diagnosis was assigned based on predetermined criteria. The accuracy of CT was evaluated. The agreement rate in CT diagnosis between two radiologists was 100%. In 75% the lesions were located in the lower lobes. An overlap of 71% in CT and histopathological diagnoses was reached. The least matching diagnosis was type 2 CPAM. Contrast enhanced chest CT is very accurate in characterizing the BPM spectrum and provides important information on lesion type and structure.

  7. Experimental determination of the electronic properties of application-relevant interfaces of organic semiconductors by means of photoelectron spectroscopy; Experimentelle Bestimmung der elektronischen Eigenschaften anwendungsrelevanter Grenzflaechen organischer Halbleiter mittels Photoelektronenspektroskopie

    Energy Technology Data Exchange (ETDEWEB)

    Grobosch, Mandy

    2009-07-01

    This thesis under the titel Experimental Determination of the Electronic Properties of Application-relevant Interfaces of Organic Semiconductors by means of Photoelectron Spectroscopy was drawn up at the Leibniz Institute for Solid-State and Materials Research (IFW) Dresden at the Institute for Solid-State Research (IFF) under the maintenance of Prof. Dr. B. Buechner. To the scientific study hereby came two types of application-relevant interfaces. On the one hand the influence of the electrode preparation under normal conditions by means of ex-situ purification procedures in comparison to in-situ prepared contacts on the electronic behaviour of the organic semiconductor sexithiophene on interfaces to metallic substrates was studied. As substrate materials hereby the metals silver, palladium, gold, and platinum came to application. In a second study the interfaces of the organic semiconductors sexithiophene and copper(II)-phthalocyanine in contact to thin films of the transition-metal oxide La{sub 0.7}Sr{sub 0.3}MnO{sub 3} were studied. Also here a comparing study for ex-situ and in-situ purificated La{sub 0.7}Sr{sub 0.3}MnO{sub 3} contacts was performed. The films applied for this were fabricated in the IWF Dresden at the Institute for Metallic Materials (IMW). Also in the framework of these studies the influence of oxygen on the electronic and chemical behaviour on the interfaces held the spotlight. [German] Diese Dissertation unter dem Titel Experimentelle Bestimmung der elektronischen Eigenschaften anwendungsrelevanter Grenzflaechen organischer Halbleiter mittels Photoelektronenspektroskopie wurde am Leibniz Institut fuer Festkoerper- und Werkstoffforschung (IFW) Dresden am Institut fuer Festkoerperforschung (IFF) unter der Betreuung von Prof. Dr. B. Buechner angefertigt. Zur wissenschaftlichen Untersuchung kamen hierbei zwei Typen anwendungsrelevanter Grenzflaechen. Zum einem wurde der Einfluss einer Elektrodenpraeparation unter Normalbedingungen mittels ex

  8. CT findings of inoperable lung carcinoma

    International Nuclear Information System (INIS)

    Gay, S.B.; Black, W.C.

    1987-01-01

    CT is useful in the evaluation of patients with newly diagnosed or highly suspected lung cancer. The principal role of CT is to screen those patients with metastatic disease beyond the hili from an attempt at curative thoracotomy. While CT is regarded as very sensitive, it is not considered highly specific, and thus a surgical procedure is usually recommended for definitive diagnosis of most ''positive'' CT findings. However, the authors demonstrate a few characteristic CT findings that are highly predictive of unresectable metastatic disease. These CT findings include massive mediastinal lymphadenopathy, diffuse mediastinal infiltration, pericardial involvement, vascular encasement, and advanced chest wall invasion

  9. Thyroid lymphography-computed tomography (TLG-CT)

    Energy Technology Data Exchange (ETDEWEB)

    Matsuyama, Koukichi (Kansai Medical Univ., Moriguchi, Osaka (Japan))

    1992-10-01

    There are several useful diagnostic examinations for thyroid disease. The diagnostic value of CT in thyroid disease is still controvertial, although CT has become a routine clinical examination, since the plain CT does not always identify tumors accurately. In this paper, we introduce for the first time thyroid lymphography-computed tomography (TLG-CT) which may improve the diagnostic value of CT. The technique combines CT with thyroid lymphography. We performed TLG-CT in 92 patients with various thyroid diseases and 20 normal controls and classified the radiological features into the following 6 types: entire (normal thyroid); moth-eaten (Hashimoto's thyroiditis); defect (follicular adenoma and adenomatous goiter); lobate (papillary carcinoma); localized (various thyroid diseases); and extrathyroid defect (parathyroid tumor). In addition, we examined the relationship between TLG-CT type and the macroscopic appearance of the cut surface of the thyroid and lymph node metastasis in 20 patients with papillary carcinoma. The results suggest that papillary TLG-CT type carcinomas have a high incidence of lymph node metastasis. Our preliminary results suggest that TLG-CT is a potentially valuable diagnostic tool in the detection of thyroid disease and the assessment of the pathologic diagnosis as well as lymph node metastasis. (author).

  10. CT diagnosis of hepatoma

    Energy Technology Data Exchange (ETDEWEB)

    Itai, Yuji [Tokyo Univ. (Japan). Faculty of Medicine

    1982-04-01

    In hepatocellular carcinoma, present status of CT diagnosis was discussed. Hepatocellular carcinoma is sometimes imaged in same concentration as that of surrounding tissues, and the detection rate ranged from 79 to 94%. The rate of differential diagnosis between primary and metastatic carcinoma was only 83% (includes 22% of false diagnosis) using contrast enhancement. The rates of detection of hepatocellular carcinoma and metastatic one were also only 87% and 75%, respectively, even by the combined use of arterial infusion CT and dynamic CT. However, the CT images is reproducible, and is supplemented by the information of US. Thus, the combination of these methods is useful in diagnosing the presence, extension, and nature of liver carcinoma.

  11. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... What is Children's CT? What are some common uses of the procedure? How should we prepare for the CT scan? What does the CT equipment look like? How does the procedure work? How is the procedure performed? What will my ...

  12. The role of CT in diagnosing small hepatic tumors; Usefulness of table incremental dynamic CT (ICT)

    Energy Technology Data Exchange (ETDEWEB)

    Usuki, Noriaki; Daikokuya, Hideo; Fukuda, Haruyuki; Saiwai, Shigeo; Nakajima, Hideyuki; Miyamoto, Takeshi; Kudo, Masatoshi (Kobe General Hospital, Hyogo (Japan))

    1992-11-01

    Twenty-seven cases of small hepatic tumors were examined by MRI and CT (ICT). MRI was more sensitive than plain and contrast CT. But ICT could detect more small lesions than MRI. CT is not more superior modality than MRI untill ICT is performed. It is concluded ICT should be done when diagnosing small hepatic tumors by CT. (author).

  13. CT of diffuse pulmonary diseases

    International Nuclear Information System (INIS)

    Itoh, Harumi; Murata, Kiyoshi; Todo, Giro

    1987-01-01

    While the theory of chest radiographic interpretation in diagnosing diffuse pulmonary diseases has not yet been established, X-ray computed tomography (CT), having intrinsic high contrast resolution and improved spatial resolution, has proved to offer important imformation concerning the location and invasion of diffuse pulmonary lesions. This study related to CT-pathologic correlation, focusing on perivascular interstitial space and secondary pulmonary lobule at macroscopic levels. The perivascular interstitial space was thickened as a result of the infiltration of cancer, granulomas, and inflammatory cells. This finding appeared as irregular contour of the blood vessel on CT. Centrilobular nodules were distributed at the tip of the bronchus or pulmonary artery on CT. The distance from the terminal and respiratory bronchioles to the lobular border was 2 to 3 mm. Lobular lesions were delineated as clear margin on CT. Contribution of these CT features to chest radiographic interpretation must await further studies. (Namekawa, K.)

  14. A simulation study on proton computed tomography (CT) stopping power accuracy using dual energy CT scans as benchmark

    DEFF Research Database (Denmark)

    Hansen, David Christoffer; Seco, Joao; Sørensen, Thomas Sangild

    2015-01-01

    Background. Accurate stopping power estimation is crucial for treatment planning in proton therapy, and the uncertainties in stopping power are currently the largest contributor to the employed dose margins. Dual energy x-ray computed tomography (CT) (clinically available) and proton CT (in...... development) have both been proposed as methods for obtaining patient stopping power maps. The purpose of this work was to assess the accuracy of proton CT using dual energy CT scans of phantoms to establish reference accuracy levels. Material and methods. A CT calibration phantom and an abdomen cross section...... phantom containing inserts were scanned with dual energy and single energy CT with a state-of-the-art dual energy CT scanner. Proton CT scans were simulated using Monte Carlo methods. The simulations followed the setup used in current prototype proton CT scanners and included realistic modeling...

  15. A simulation study on proton computed tomography (CT) stopping power accuracy using dual energy CT scans as benchmark.

    Science.gov (United States)

    Hansen, David C; Seco, Joao; Sørensen, Thomas Sangild; Petersen, Jørgen Breede Baltzer; Wildberger, Joachim E; Verhaegen, Frank; Landry, Guillaume

    2015-01-01

    Accurate stopping power estimation is crucial for treatment planning in proton therapy, and the uncertainties in stopping power are currently the largest contributor to the employed dose margins. Dual energy x-ray computed tomography (CT) (clinically available) and proton CT (in development) have both been proposed as methods for obtaining patient stopping power maps. The purpose of this work was to assess the accuracy of proton CT using dual energy CT scans of phantoms to establish reference accuracy levels. A CT calibration phantom and an abdomen cross section phantom containing inserts were scanned with dual energy and single energy CT with a state-of-the-art dual energy CT scanner. Proton CT scans were simulated using Monte Carlo methods. The simulations followed the setup used in current prototype proton CT scanners and included realistic modeling of detectors and the corresponding noise characteristics. Stopping power maps were calculated for all three scans, and compared with the ground truth stopping power from the phantoms. Proton CT gave slightly better stopping power estimates than the dual energy CT method, with root mean square errors of 0.2% and 0.5% (for each phantom) compared to 0.5% and 0.9%. Single energy CT root mean square errors were 2.7% and 1.6%. Maximal errors for proton, dual energy and single energy CT were 0.51%, 1.7% and 7.4%, respectively. Better stopping power estimates could significantly reduce the range errors in proton therapy, but requires a large improvement in current methods which may be achievable with proton CT.

  16. Acute pancreatitis: clinical vs. CT findings

    International Nuclear Information System (INIS)

    Hill, M.C.; Barkin, J.; Isikoff, M.B.; Silver stein, W.; Kalser, M.

    1982-01-01

    In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptons. This was especialy true of phlegmonous pancreatitis, where the CT findings could persist for months

  17. Multidetector CT of the colon

    International Nuclear Information System (INIS)

    Luboldt, W.; Hoepffner, N.; Holzer, K.

    2003-01-01

    Multidetector technology, enabling faster imaging, higher spatial resolution and reduction in radiation dose, increases the role of CT in colonic diagnostic. The higher spatial resolution in the z-direction also changes the way to analyze the images. Instead of reading axial sections, now the colon can be systematically assessed in 3D by scrolling through multiplanar reconstructions or in CT colonography by virtual endoscopy. With ongoing improvements in computer-aided diagnosis CT colonography becomes an alternative to fiberoptic colonocopy for screening (http://www.multiorganscreening.org). In this article we propose a CT examination protocol for the colon, describe the typical imaging findings of different colonic diseases, and summarize the current status of CT colonography. (orig.)

  18. CT examination of the kidneys

    International Nuclear Information System (INIS)

    Handa, Youji; Ishida, Ken; Arita, Takeshi; Ishine, Kenji; Tezen, Takashi; Ohta, Nobuhiro

    1985-01-01

    Plain CT scanning of the kidney was performed in 16 patients with renal failure whose basic renal disorder had been not necessarily known beforehand. The findings of the CT examination were composed of renal atrophy of various degree (12 cases), cystic lesions (8 cases), polycystic renal disease (one case), nephrosclerosis (2 cases), hydronephrosis (2 cases), ureter and renal stones (one case), and normal CT profile (2 cases). Being based on these CT findings and other clinical informations, basic renal disorders could be either presumed or confirmed. It was concluded that plain CT scanning of the kidney was useful to decide a method of treatment and to estimate prognosis in patients with renal failure. (author)

  19. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT ...

  20. Do SNOMED CT Relationships Qualify?

    NARCIS (Netherlands)

    Cornet, Ronald

    2008-01-01

    An important feature of SNOMED CT is post-coordination, which is enabled as SNOMED CT specifies refinability of target concepts of relationships. In this paper the use of refinable relationships in SNOMED CT is analysed, and the interplay between refinable and defining relationships. Refinability is

  1. CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: Accuracy, complications and radiation dose

    International Nuclear Information System (INIS)

    Prosch, Helmut; Stadler, Alfred; Schilling, Matthias; Bürklin, Sandra; Eisenhuber, Edith; Schober, Ewald; Mostbeck, Gerhard

    2012-01-01

    Background: The aim of this retrospective study was to compare the diagnostic accuracy, the frequency of complications, the duration of the interventions and the radiation doses of CT fluoroscopy (CTF) guided biopsies of lung lesions with those of multislice CT (MS-CT) biopsy mode-guided biopsies. Methods: Data and images from 124 consecutive patients undergoing CTF-guided lung biopsy (group A) and 132 MS-CT-biopsy mode-guided lung biopsy (group B) were reviewed. CTF-guided biopsies were performed on a Siemens Emotion 6 CT scanner with intermittent or continuous CT-fluoroscopy, MS-CT biopsy mode-guided biopsies were performed on a Siemens Emotion 16 CT scanner. All biopsies were performed with a coaxial needle technique. Results: The two groups (A vs. B) did not differ significantly regarding sensitivity (95.5% vs. 95.9%), specificity (96.7% vs. 95.5%), negative predictive value (87.9% vs. 84%) or positive predictive value (98.8% vs. 98.9%). Pneumothorax was observed in 30.0% and 32.5% of the patients, respectively. Chest tube placement was necessary in 4% (group A) and 13% (group B) of the patients. The duration of the intervention was significantly longer in group A (median 37 min vs. 32 min, p = 0.04). The mean CT dose index (CTDI) was 422 in group A and 36.3 in group B (p < 0.001). Conclusion: Compared to CTF-guided biopsies, chest biopsies using the MS-CT biopsy mode show dramatically lower CTDI levels. Although the diagnostic yield of the procedures do not differ significantly, biopsies using the MS-CT-biopsy mode have a three-fold higher rate of chest tube placement.

  2. {sup 18}F-FDG PET/CT and contrast-enhanced CT findings of pulmonary cryptococcosis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Si-yun, E-mail: wang_shuxia@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Chen, Gang, E-mail: cgggh@outlook.com [Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Luo, Dong-lan, E-mail: 695532870@qq.com [Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Shao, Dan, E-mail: shaodan501@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Liu, En-tao, E-mail: GDGH2015@gmail.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Sun, Taotao, E-mail: sunmoodsdaisy@bjmu.edu.cn [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Wang, Shu-Xia, E-mail: wsyggh@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China)

    2017-04-15

    Purpose: Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules in non-AIDS patients. This study reports the {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG PET/CT) and contrast-enhanced CT (CE-CT) findings of 42 patients with pulmonary cryptococcosis. Materials and methods: A retrospective review of the {sup 18}F-FDG PET/CT and CE-CT findings of 42 patients with histologically proven pulmonary cryptococcosis was conducted. All patients underwent PET/CT and CE-CT in the same session. The CT diagnosis was based on the location, morphological features, and enhancement of lesions. The PET/CT findings were recorded, and clinical data and surgical and histopathological findings were collected. Results: The results of the PET scans revealed that 37 (88%) of 42 patients showed higher FDG uptake, and 5 (12%) patients demonstrated lower FDG uptake than the mediastinal blood pool. The maximum standardized uptake value (SUV) of pulmonary cryptococcosis ranged from 1.4 to 13.0 (average: 5.7 ± 3.3, median 4.9). A single nodular pattern was the most prevalent pattern observed and was found in 29 (69%) patients. This pattern was followed by scattered nodular (n = 4, 10%), clustered nodular (n = 3, 7%), mass-like (n = 3, 7%), and bronchopneumonic (n = 3, 7%) patterns. The most frequent pattern of immunocompetent patients was the single nodular pattern (29 of 33, 88%). Immunocompromised patients most frequently pattern exhibited mass-like (3 of 9, 33%) and bronchopneumonic (3 of 9, 33%) patterns. Conclusion: Pulmonary cryptococcosis most commonly appears as single nodules in immunocompetent patients. Mass-like and bronchopneumonic patterns were common in immunocompromised patients. In 88% of patients, lung lesions showed high FDG uptake, thus mimicking a possible malignant condition.

  3. PET with coincidence gamma cameras - clinical benefit from the radiooncologists' point of view; PET mit Koinzidenz-Gammakameras - klinischer Nutzen aus der Sicht des Radioonkologen

    Energy Technology Data Exchange (ETDEWEB)

    Richter, E; Feyerabend, T; Stallmann, C; Lauer, I; Baehre, M [Universitaetsklinikum Luebeck (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

    2001-11-01

    Positron emission tomography with FDG (FDG-PET) is a new technique, which displays the cellular metabolic activity. Since tumors exhibit an increased metabolic activity when compared to normal tissue, this imaging modality has a particularly high importance. FDG-PET is not only useful for localizing and staging of malignant tumors, but also to evaluate therapy response. In this context, PET is superior to morphologically orientated modalities, because therapeutically induced changes in glucose metabolism precede morphologic alterations. Numerous studies indicate, that PET will play an important role in radiooncology concerning therapy planning and monitoring the effects of therapy during and after treatment. Further clinical studies are necessary to evaluate the information provided by FDG-PET more precisely. Coincidence gamma cameras with adequate imaging characteristics will gain enhanced importance to meet these increasing demands. (orig.) [German] Die Positronenemissionstomographie mit FDG (FDG-PET) ist ein neues Verfahren, das die Stoffwechselaktivitaet von Zellen bildlich wiedergibt. Da Tumorgewebe im Vergleich zu normalem Gewebe einen erhoehten Stoffwechsel aufweist, hat dieses Untersuchungsverfahren in der Onkologie einen besonders hohen Stellenwert. Neben der Lokalisations- und Ausbreitungsdiagnostik eignet sich die FDG-PET zur Erfolgsbeurteilung. Die PET ist hierin den anderen morphologischen Verfahren ueberlegen, da die Veraenderungen des Glukosemetabolismus durch therapeutische Massnahmen morphologischen Veraenderungen vorausgehen. Zahlreiche Untersuchungen lassen erkennen, dass die PET fuer die Radioonkologie einen wichtigen Stellenwert einnehmen wird. Dies betrifft die Bestrahlungsplanung und das Therapiemonitoring waehrend und nach einer Behandlung. Weitere klinische Studien sind notwendig, um die Aussagekraft der FDG-PET besser zu evaluieren. Den Koinzidenz-Gammakameras mit adaequaten Bildgebungseigenschaften kommt eine zunehmende Bedeutung zu, um

  4. Dose performance and image quality: Dual source CT versus single source CT in cardiac CT angiography

    International Nuclear Information System (INIS)

    Wang Min; Qi Hengtao; Wang Ximing; Wang Tao; Chen, Jiu-Hong; Liu Cheng

    2009-01-01

    Objective: To evaluate dose performance and image quality of 64-slice dual source CT (DSCT) in comparison to 64-slice single source CT (SSCT) in cardiac CT angiography (CTA). Methods: 100 patients examined by DSCT and 60 patients scanned by SSCT were included in this study. Objective indices such as image noise, contrast-to-noise ratio and signal-to-noise ratio were analyzed. Subjective image quality was assessed by two cardiovascular radiologists in consensus using a four-point scale (1 = excellent to 4 = not acceptable). Estimation of effective dose was performed on the basis of dose length product (DLP). Results: At low heart rates ( 0.05), but, at high heart rates (>70 bpm), DSCT provided robust image quality (P 70 bpm), DSCT is able to provide robust diagnostic image quality at doses far below that of SSCT.

  5. Early small-bowel ischemia: dual-energy CT improves conspicuity compared with conventional CT in a swine model.

    Science.gov (United States)

    Potretzke, Theodora A; Brace, Christopher L; Lubner, Meghan G; Sampson, Lisa A; Willey, Bridgett J; Lee, Fred T

    2015-04-01

    To compare dual-energy computed tomography (CT) with conventional CT for the detection of small-bowel ischemia in an experimental animal model. The study was approved by the animal care and use committee and was performed in accordance with the Guide for Care and Use of Laboratory Animals issued by the National Research Council. Ischemic bowel segments (n = 8) were created in swine (n = 4) by means of surgical occlusion of distal mesenteric arteries and veins. Contrast material-enhanced dual-energy CT and conventional single-energy CT (120 kVp) sequences were performed during the portal venous phase with a single-source fast-switching dual-energy CT scanner. Attenuation values and contrast-to-noise ratios of ischemic and perfused segments on iodine material-density, monospectral dual-energy CT (51 keV, 65 keV, and 70 keV), and conventional 120-kVp CT images were compared. Linear mixed-effects models were used for comparisons. The attenuation difference between ischemic and perfused segments was significantly greater on dual-energy 51-keV CT images than on conventional 120-kVp CT images (mean difference, 91.7 HU vs 47.6 HU; P conventional CT by increasing attenuation differences between ischemic and perfused segments on low-kiloelectron volt and iodine material density images. © RSNA, 2014.

  6. Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

    Science.gov (United States)

    Noh, Tae June; Lee, Chang Hoon; Kang, Young Ae; Kwon, Sung-Youn; Yoon, Ho-Il; Kim, Tae Jung; Lee, Kyung Won; Lee, Jae Ho

    2009-01-01

    Background/Aims This study examined the correlation between pneumothorax detected by immediate post-transthoracic needle aspiration-biopsy (TTNB) chest computed tomography (CT) and overt pneumothorax detected by chest PA, and investigated factors that might influence the correlation. Methods Adult patients who had undergone CT-guided TTNB for lung lesions from May 2003 to June 2007 at Seoul National University Bundang Hospital were included. Immediate post-TTNB CT and chest PA follow-up at 4 and 16 hours after CT-guided TTNB were performed in 934 patients. Results Pneumothorax detected by immediate chest CT (CT-pneumothorax) was found in 237 (25%) and overt pneumothorax was detected by chest PA follow-up in 92 (38.8%) of the 237 patients. However, overt pneumothorax was found in 18 (2.6%) of the 697 patients without CT-pneumothorax. The width and depth of CT-pneumothorax were predictive risk factors for overt pneumothorax. Conclusions CT-pneumothorax is very sensitive for predicting overt pneumothorax, and the width and depth on CT-pneumothorax are reliable risk factors for predicting overt pneumothorax. PMID:19949733

  7. Dynamic CT of the renal parenchyma

    International Nuclear Information System (INIS)

    Ohyama, Yukio; Imanishi, Yoshimasa; Ishikawa, Tohru; Fujii, Masamichi; Uji, Teruyuki

    1985-01-01

    Normal renal dynamic CT findings of 57 cases were analysed in termes of sequential change of renal parenchymal CT image. Cortex, outer medulla and inner medulla were delineated and their sequential CT image was well correlated with the anatomicophysiological character of the kidney. Dynamic CT of 32 abnormal cases showed abnormal sequential CT findings explaining the mechanism of the abnormalities. Especially, delayed enhancement of renal cortex was noted in 17 of 19 kidneys with arterial obstruction and delayed enhancement of renal medulla in 22 of 25 cases with renal dysfunction. Compaired with excretory urography in 11 cases with renal dysfunction, advantage of dynamic CT were noted. (author)

  8. Opportunities for new CT contrast agents to maximize the diagnostic potential of emerging spectral CT technologies.

    Science.gov (United States)

    Yeh, Benjamin M; FitzGerald, Paul F; Edic, Peter M; Lambert, Jack W; Colborn, Robert E; Marino, Michael E; Evans, Paul M; Roberts, Jeannette C; Wang, Zhen J; Wong, Margaret J; Bonitatibus, Peter J

    2017-04-01

    The introduction of spectral CT imaging in the form of fast clinical dual-energy CT enabled contrast material to be differentiated from other radiodense materials, improved lesion detection in contrast-enhanced scans, and changed the way that existing iodine and barium contrast materials are used in clinical practice. More profoundly, spectral CT can differentiate between individual contrast materials that have different reporter elements such that high-resolution CT imaging of multiple contrast agents can be obtained in a single pass of the CT scanner. These spectral CT capabilities would be even more impactful with the development of contrast materials designed to complement the existing clinical iodine- and barium-based agents. New biocompatible high-atomic number contrast materials with different biodistribution and X-ray attenuation properties than existing agents will expand the diagnostic power of spectral CT imaging without penalties in radiation dose or scan time. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    International Nuclear Information System (INIS)

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan

    2012-01-01

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED adj ). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED adj between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED adj that differed by up to 44% from effective dose estimates that were not

  10. CT diagnostic significance of tuboovarian abscess

    International Nuclear Information System (INIS)

    Du Tieqiao; Dong Jie; Xu Quanying; An Haiqin; Sang Chunyu

    2006-01-01

    Objective: To analyze computed tomographic (CT) imaging features of tuboovarian abscess as well as to discuss CT diagnostic significance. Methods: Ten patients with tuboovarian abscess were performed CT enhancing scans. Results: Ten patients manifested thick-walled, cystic-solid complex adnexal mass and indistinct margins on CT imaging. Internal thick septations and layered enhancement of the mass border on CT contrast images were common. Associated findings of CT included thickening of' the uterosacral ligaments in 9 of 10 patients, increased attenuation of the presacral and perirectal fat secondary to edema in 9 patients, serpiginous structure corresponding to a dilated, pus-filled fallopian tube in 6 patients and fluid-filled within uterine cavity in 4 patients. On CT scans, the inflammatory infiltration of adnexal abscesses involved pelvic structure included adhesion with borders of uterus in 9 patients, adhesion with rectal or sigmoid in 4 patients and pelvic wall or bowel loop in 3 patients. Two cases with peritoneal thicken showed ascites on CT images and right adnexal tuboovarian abscess in 2 patients were associated with appendicitis. Conclusion: CT can reveal pelvic adjacent organs involvement or adhesion and inflammatory infihration of pelvic floor soft-tissues or fascial planes except showing cystic solid complex mass of adnexal location so that indicating characteristics and the extent of the suspected pelvic inflammatory diseases. CT can be valuable in difficult cases of gynecologic infective diseases. (authors)

  11. Correlation of CT perfusion and CT volumetry in patients with Alzheimers disease

    International Nuclear Information System (INIS)

    Czarnecka, A.; Zimny, A.; Sasiadek, M.

    2010-01-01

    Background: Both brain atrophy and decrease of perfusion are observed in dementive diseases. The aim of the study was to correlate the results of brain perfusion CT (pCT) and CT volumetry in patients with Alzheimers disease (AD). Material/Methods: Forty-eight patients with AD (mean age of 71.3 years) underwent brain pCT and CT volumetry. The pCT was performed at the level of basal ganglia after the injection of contrast medium (50 ml, 4 ml/sec.) with serial scanning (delay 7 sec, 50 scans, 1 scan/sec). Volumetric measurements were carried out on the basis of source images, with the use of a dedicated CT software combined with manual outlining of the regions of interest in extracerebral and intraventricular CSF spaces. Perfusion parameters of the cerebral blood flow (CBF) and cerebral blood volume (CBV) from the grey matter of frontal and temporal as well as basal ganglia were compared statistically with the volumetric measurements of frontal and temporal cortical atrophy as well as subcortical atrophy. Results: A statistically significant positive correlation was found between the values of CBF and CBV in the basal ganglia and the volumes of the lateral and third ventricles. The comparison of CBF and CBV results with the volumetric measurements in the areas of the frontal and temporal lobes showed mostly negative correlations, but none of them was of statistical significance. Conclusions: In patients with AD, the degree of cortical atrophy is not correlated with the decrease of perfusion in the grey matter and subcortical atrophy is not correlated with the decrease of perfusion in the basal ganglia region. It suggests that functional and structural changes in AD are not related to each other. (authors)

  12. Adjuvant hysterectomy after radiochemotherapy for locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hass, Peter [Universitaetsklinikum Magdeburg, Department of Radiation Oncology, Magdeburg (Germany); Eggemann, Holm; Costa, Serban Dan; Ignatov, Atanas [Otto-von-Guericke University, Department of Obstetrics and Gynecology, Magdeburg (Germany)

    2017-12-15

    Standardverfahren zu vergleichen. Patienten mit Zervixkarzinom im FIGO-Stadium III wurden mit EBRT/cCT behandelt und dann in zwei Gruppen unterteilt: Gruppe 1 wurde weiter mit der standardmaessigen intrakavitaeren/interstitiellen Brachytherapie behandelt, Gruppe 2 unterzog sich einer AH. Von 881 Frauen mit Zervixkarzinom waren 246 fuer die Analyse geeignet: 161 erhielten eine iBT und 87 eine AH. Das mediane Follow-up der Studie betrug 53 Monate. Die klinischen und pathologischen Eigenschaften waren in den zwei Gruppen gut ausgewogen. Nach EBRT/cCT wurde eine klinische Komplettremission bei 121 (48,8 %) von 246 Patienten beobachtet. In Gruppe 1 wurde bei 81 (50,3 %) von 161 Patientinnen eine klinische Komplettremission beobachtet. Sechs Wochen nach EBRT/cCT hatten 40 (64,0 %) von 87 Patienten in der AH-Gruppe eine pathologische Komplettremission. Intra- und postoperative Komplikationen wurden in 10 (11,5 %) der 87 Faelle beobachtet. Die Rate der lokoregionaeren Rezidive und Metastasen war in den beiden Gruppen aehnlich. Das progressionsfreie Ueberleben (PFS) und das krankheitspezifische Gesamtueberleben (DOS) fuer diese Patienten waren in den beiden Gruppen aehnlich. Interessanterweise waren das PFS und das DOS fuer die Patienten mit Resttumor durch die AH signifikant verlaengert. Die AH koennte das Ueberleben von Patienten mit Residualtumor nach RCT verbessern und ist durch eine geringe Komplikationsrate gekennzeichnet. (orig.)

  13. Brain tumor and CT, 1. Relationship between the consistency of a brain tumor and the CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, N.; Katada, K.; Shinomiya, Y.; Sano, H.; Kanno, T. (Fujita Gakuen Univ., School of Medicine, Toyoake, Aichi (Japan))

    1981-08-01

    It is very important for a neurosurgeon to know the consistency of a brain tumor preoperatively, since the information is of much use in indicating the likely difficulty of the operation, which operative tools should be selected, the amount of bleeding to be expected from the tumor, and so on. The authors, therefore, tried to evaluate the consistency of brain tumors preoperatively. Twenty-seven cases in which the margin of the tumor was made clear with a homogeneous stain were studied concerning the relationship between the tumor consistency and the CT findings. The results are as follows: 1) A higher CT number on a plain CT indicated a harder consistency of the tumor. 2) A lesser contrast index (CT number on enhancement CT/CT number on plain CT) showed a harder consistency of the tumor.

  14. CT evaluation of acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Piazza, P; Girelli, G; Coran, F; Lutman, M

    1986-01-01

    The paper deals with sixteen cases of acetabular fractures studied with CT. After a short description of the normal CT findings, the different kind of fractures are reported. The usefulness of CT examination in evaluating acetabular fractures and their complications is confirmed both in conservative treatment and surgical approach.

  15. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... Stroke Brain Tumors Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - ...

  16. Intensity-modulated whole abdomen irradiation following adjuvant carboplatin/taxane chemotherapy for FIGO stage III ovarian cancer. Four-year outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Rochet, Nathalie; Lindel, Katja; Katayama, Sonja; Schubert, Kai; Herfarth, Klaus; Harms, Wolfgang; Debus, Juergen [Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg (Germany); University of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Schneeweiss, Andreas [University of Heidelberg, Nationales Centrum fuer Tumorerkrankungen (NCT), Heidelberg (Germany); Sohn, Christoph [University of Heidelberg, Department of Gynecology, Heidelberg (Germany)

    2015-07-15

    ;'intensity-modulated whole-abdominal irradiation'', IM-WAI) nach adjuvanter Chemotherapie beim Ovarialkarzinom im Stadium FIGO III prospektiv untersucht. Zwischen 2006 und 2009 wurden 16 Patientinnen mit optimal reseziertem Ovarialkarzinom im Stadium FIGO III mittels konsolidierender IM-WAI nach 6 Zyklen adjuvanter Carboplatin-/Taxane-Chemotherapie behandelt. Die ersten 10 Patientinnen wurden im Rahmen einer prospektiven Phase-I-Studie behandelt, danach wurden 6 Patientinnen analog zu dem Studienprotokoll behandelt. Bestrahlt wurde bis zu einer Gesamtdosis von 30 Gy in 1,5 Gy Fraktionen mittels ''step-and-shoot'' (n = 3) oder helikaler Tomotherapietechnik (n = 13). Das Zielvolumen umfasste die gesamte Peritonealhoehle, die Zwerchfellkuppeln, die Leberkapsel und die paraaortalen und pelvinen Lymphabflusswege. Risikoorgane waren die Nieren, das Leberparenchym, Herz und Knochen. Das mediane Follow-up betrug 44 Monate (Spanne 19,2-67,2 Monate). Unter Bestrahlung traten keine CTC-Grad-IV-Toxizitaeten auf und es fanden keine toxizitaetsbedingten Unterbrechungen statt. Beobachtete Grad-III-Akuttoxizitaeten waren Diarrhoe (25 %), Leukopenie (19 %), Uebelkeit/Erbrechen (6 %) und Thrombozytopenie (6 %). Insgesamt erlitten 6 Patientinnen einen Darmverschluss im spaeteren Verlauf (37 %). Die Ursachen dafuer waren postoperative Briden (19 %) und Peritonealkarzinose (19 %). Das mediane rezidivfreie Ueberleben (RFS) betrug 27,6 Monate (95 %-KI 24-44 Monate) und das mediane Gesamtueberleben betrug 42,1 Monate (95 %-KI 17-68 Monate). Die Peritonealhoehle war die haeufigste Rezidivstelle. Die konsolidierende IM-WAI ist machbar und klinisch gut vertraeglich. Die Daten zum RFS sind vielversprechend und rechtfertigen die Einleitung weiterer klinischer Studien. (orig.)

  17. SU-E-T-70: Commissioning a Multislice CT Scanner for X-Ray CT Polymer Gel Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Johnston, H [University of Victoria, Victoria, BC (Australia); UT Southwestern Medical Center, Dallas, TX (United States); Hilts, M [University of Victoria, Victoria, BC (Australia); BC Cancer Agency, Kelowna, BC (Australia); Jirasek, A [University of Victoria, Victoria, BC (Australia)

    2014-06-01

    Purpose: To commission a multislice computed tomography (CT) scanner for fast and reliable readout of radiation therapy (RT) dose distributions using CT polymer gel dosimetry (PGD). Methods: Commissioning was performed for a 16-slice CT scanner using images acquired through a 1L cylinder filled with water. Additional images were collected using a single slice machine for comparison purposes. The variability in CT number associated with the anode heel effect was evaluated and used to define a new slice-by-slice background image subtraction technique. Image quality was assessed for the multislice system by comparing image noise and uniformity to that of the single slice machine. The consistency in CT number across slices acquired simultaneously using the multislice detector array was also evaluated. Finally, the variability in CT number due to increasing x-ray tube load was measured for the multislice scanner and compared to the tube load effects observed on the single slice machine. Results: Slice-by-slice background subtraction effectively removes the variability in CT number across images acquired simultaneously using the multislice scanner and is the recommended background subtraction method when using a multislice CT system. Image quality for the multislice machine was found to be comparable to that of the single slice scanner. Further study showed CT number was consistent across image slices acquired simultaneously using the multislice detector array for each detector configuration of the slice thickness examined. In addition, the multislice system was found to eliminate variations in CT number due to increasing x-ray tube load and reduce scanning time by a factor of 4 when compared to imaging a large volume using a single slice scanner. Conclusion: A multislice CT scanner has been commissioning for CT PGD, allowing images of an entire dose distribution to be acquired in a matter of minutes. Funding support provided by the Natural Sciences and Engineering

  18. Results and complications of CT-guided biopsy with CT fluoroscopy

    International Nuclear Information System (INIS)

    Saika, Yoshinori; Ogura, Yasuharu; Doi, Kenji; Misaki, Toshimasa; Shimizu, Masashi; Narabayashi, Isamu

    2002-01-01

    We studied the results and complications of CT-guided biopsy with CT fluoroscopy performed 66 lesions in 64 patients from March 1999 to February 2001. In addition to the conventional procedure of CT-guided biopsy, we use CT fluoroscopy for confirmation of the location of the tip of the biopsy needle and the accurate contact, in some cases, at the time of puncturing. Examination results showed malignancy in 36 lesions and benign findings in 30 lesions. The sensitivity was 85.7%, specificity was 100.0%, and accuracy was 90.9%. Pneumothorax occurred in 20 out of 64 patients (31.3%). In a study on 26 small lesions (≤2 cm) in 25 patients, the sensitivity was 81.8%, specificity was 100.0%, accuracy was 92.3%. Pneumothorax occurred in 12 out of 25 patients (48.0%), more frequently than in patients with large lesions. In a study on 6 false negative cases, they tended to be intrapulmonary on location, small in diameter, and far from the skin puncture point. Examination results were satisfactory, especially in terms of accuracy in small lesions (≤2 cm). However, when the lesions were small, pneumothorax occurred frequently (48.0%). (author)

  19. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... vessels. CT examinations are fast and simple; in emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives. CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. CT is less sensitive to patient movement ...

  20. CT diagnosis of cystic ovarian lesions

    International Nuclear Information System (INIS)

    Iio, Kazuto; Shinmura, Ryoji; Arima, Naomi; Yamada, Eiichiro; Ohkubo, Koichi; Nagata, Yukihiro

    1985-01-01

    CT was undertaken and CT numbers were measured in 47 patients with cystic ovarian lesions. CT features particularly for chocolate cyst revealed the uniform thickness of the whole cystic wall, findings suggesting adhesion to the surrounding organs, circular or oval shape, and higher CT numbers within the cyst than those in the other cystic ovarian lesions. However, because these features are not always observed in cases of chocolate cyst, one should not rely solely on CT findings in the diagnosis of chocolate cyst. (Namekawa, K.)

  1. Dynamic CT of hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, Nobuyuki; Shirato, Hiroki; Shinohara, Masahiro; Miyasaka, Kazuo; Morita, Yutaka; Irie, Goro

    1983-03-01

    We performed dynamic CT in 30 cases of hepatocellular carcinoma, and concluded as below. Detecting the stain in the early phase of the dynamic series, it is possible to make a diagnosis of hepatocellular carcinoma. The dynamic CT is effective in a case of small hepatocellular carcinoma in which it is difficult to gain an accurate diagnosis in the routine CT study. The dynamic CT is also effective in the differential diagnosis of hepatic lesions, as other hepatic lesions such as hemangioma and metastatic liver cancer show different patterns compared with hepatocellular carcinoma.

  2. (18)F-FDG PET-CT simulation for non-small-cell lung cancer: effect in patients already staged by PET-CT.

    Science.gov (United States)

    Hanna, Gerard G; McAleese, Jonathan; Carson, Kathryn J; Stewart, David P; Cosgrove, Vivian P; Eakin, Ruth L; Zatari, Ashraf; Lynch, Tom; Jarritt, Peter H; Young, V A Linda; O'Sullivan, Joe M; Hounsell, Alan R

    2010-05-01

    Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV(CT) to GTV(FUSED) was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

  3. 18F-FDG PET-CT Simulation for Non-Small-Cell Lung Cancer: Effect in Patients Already Staged by PET-CT

    International Nuclear Information System (INIS)

    Hanna, Gerard G.; McAleese, Jonathan; Carson, Kathryn J.; Stewart, David P.; Cosgrove, Vivian P.; Eakin, Ruth L.; Zatari, Ashraf; Lynch, Tom; Jarritt, Peter H.; Young, V.A. Linda D.C.R.; O'Sullivan, Joe M.

    2010-01-01

    Purpose: Positron emission tomography (PET), in addition to computed tomography (CT), has an effect in target volume definition for radical radiotherapy (RT) for non-small-cell lung cancer (NSCLC). In previously PET-CT staged patients with NSCLC, we assessed the effect of using an additional planning PET-CT scan for gross tumor volume (GTV) definition. Methods and Materials: A total of 28 patients with Stage IA-IIIB NSCLC were enrolled. All patients had undergone staging PET-CT to ensure suitability for radical RT. Of the 28 patients, 14 received induction chemotherapy. In place of a RT planning CT scan, patients underwent scanning on a PET-CT scanner. In a virtual planning study, four oncologists independently delineated the GTV on the CT scan alone and then on the PET-CT scan. Intraobserver and interobserver variability were assessed using the concordance index (CI), and the results were compared using the Wilcoxon signed ranks test. Results: PET-CT improved the CI between observers when defining the GTV using the PET-CT images compared with using CT alone for matched cases (median CI, 0.57 for CT and 0.64 for PET-CT, p = .032). The median of the mean percentage of volume change from GTV CT to GTV FUSED was -5.21% for the induction chemotherapy group and 18.88% for the RT-alone group. Using the Mann-Whitney U test, this was significantly different (p = .001). Conclusion: PET-CT RT planning scan, in addition to a staging PET-CT scan, reduces interobserver variability in GTV definition for NSCLC. The GTV size with PET-CT compared with CT in the RT-alone group increased and was reduced in the induction chemotherapy group.

  4. Cardiac cone-beam CT

    International Nuclear Information System (INIS)

    Manzke, Robert

    2005-01-01

    This doctoral thesis addresses imaging of the heart with retrospectively gated helical cone-beam computed tomography (CT). A thorough review of the CT reconstruction literature is presented in combination with a historic overview of cardiac CT imaging and a brief introduction to other cardiac imaging modalities. The thesis includes a comprehensive chapter about the theory of CT reconstruction, familiarizing the reader with the problem of cone-beam reconstruction. The anatomic and dynamic properties of the heart are outlined and techniques to derive the gating information are reviewed. With the extended cardiac reconstruction (ECR) framework, a new approach is presented for the heart-rate-adaptive gated helical cardiac cone-beam CT reconstruction. Reconstruction assessment criteria such as the temporal resolution, the homogeneity in terms of the cardiac phase, and the smoothness at cycle-to-cycle transitions are developed. Several reconstruction optimization approaches are described: An approach for the heart-rate-adaptive optimization of the temporal resolution is presented. Streak artifacts at cycle-to-cycle transitions can be minimized by using an improved cardiac weighting scheme. The optimal quiescent cardiac phase for the reconstruction can be determined automatically with the motion map technique. Results for all optimization procedures applied to ECR are presented and discussed based on patient and phantom data. The ECR algorithm is analyzed for larger detector arrays of future cone-beam systems throughout an extensive simulation study based on a four-dimensional cardiac CT phantom. The results of the scientific work are summarized and an outlook proposing future directions is given. The presented thesis is available for public download at www.cardiac-ct.net

  5. How to choose PET-CT or CT in the diagnosis and staging of lung cancer. Practical experience in China

    International Nuclear Information System (INIS)

    Jiang, T.; Tao, X.; Liu, H.; Liu, S.; Zheng, X.

    2010-01-01

    How to use CT and PET-CT rationally to raise diagnosis, staging and prognostic assessment of lung cancer to a higher level at the best cost-effect ratio is a subject that Chinese clinicians and radiologists should face conscientiously. We review the rational application of CT and PET-CT in four aspects of lung cancer, including screening and detection, morphologic evaluation, haemodynamic or metabolic feature evaluation, and follow-up, staging and prognostic evaluation. As PET-CT is only available in class III-A hospitals today, CT is the most popular equipment in China. PET-CT is more valuable only in cases where CT presentation of lung cancer is atypical or difficult to determine, or in cases where the diagnosis of lung cancer has been initially confirmed, for which clinical staging and decision concerning on therapeutic regimens are needed. We also recommend the current strategies of CT and PET-CT managing of SPN in China. (orig.)

  6. CT number of the fatty liver

    International Nuclear Information System (INIS)

    Maeda, Hiroko; Kawai, Takeshi; Kanasaki, Yoshiki; Akagi, Hiroaki

    1981-01-01

    This report is studied on CT number and CT images of the eight cases with fatty liver. Five of these cases showed the reversal of densities of the liver and vessels. In these cases, the diagnoses of the fatty liver were easible. In other cases, the diagnoses were possible only by comparison of the CT number of the liver and spleen because the CT number of normal liver were higher than those of the spleen. In the results which we examined the correlation of the CT number and specific gravities of the blood, normal saline, distilled water, mayonnaise, eatable iol, ethyl alcohol and lard, we observed the linear relationship between CT number and specific gravities. And so, we think that the diagnosis of the fatty liver and the degree of fatty infiltration can be guessed by the CT number of the liver and spleen. (author)

  7. CT of Mirizzi syndrome

    International Nuclear Information System (INIS)

    Yamamoto, Shinichiro; Fukushima, Keisuke; Ishihara, Kenji; Hirano, Yutaka; Sano, Kaizo

    1983-01-01

    PTC or ERCP findings of four cases of Mirizzi syndrome were demonstrated. They consisted of a smooth stricture of the common hepatic duct, curved impressions of the duct and dilatation of proximal biliary radicles. CT could visualize the impacted stone in the neck of the gallbladder, dilatation of proximal common hepatic and intrahepatic duct. Absence of the dilatation of distal common bile duct could also be confirmed by CT, thus the diagnosis of Mirizzi syndrome might be possible by CT. (author)

  8. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... multislice CT" or "multidetector CT," allow thinner slices to be obtained, resulting in more detail of the body, in a shorter period of time. Modern CT scanners are so fast that they can scan through large sections of the body in just a few seconds. Such speed is beneficial for ...

  9. Normal CT anatomy of the spine

    International Nuclear Information System (INIS)

    Quiroga, O.; Matozzi, F.; Beranger, M.; Nazarian, S.; Salamon, G.; Gambarelli, J.

    1982-01-01

    To analyse the anatomo-radiological correlation of the spine and spinal cord, 22 formalized, frozen anatomical specimens corresponding to different regions of the spinal column (8 cervical, 5 dorsal, and 9 lumbar) were studied by CT scans on axial, sagittal and coronal planes and by contact radiography after they were cut into anatomical slices in order to clarify the normal CT anatomy of the spinal column. The results obtained from CT patient scans, performed exclusively on the axial plane, were compared with those obtained from the anatomical specimens (both CT and contrast radiography). High resolution CT programs were used, enabling us to obtain better individualization of the normal structures contained in the spinal column. Direct sagittal and coronal sections were performed on the specimens in order to get further anatomo-radiological information. Enhanced CT studies of the specimens were also available because of the air already present in the subarachnoid spaces. Excellent visualization was obtained of bone structures, soft tissue and the spinal cord. High CT resolution of the spine appeares to be an excellent neuroradiological procedure to study the spine and spinal cord. A metrizamide CT scan is, however, necessary when a normal unenhanced CT scan is insufficient for diagnosis and when the spinal cord is not clearly visible, as often happens at the cervical level. Clinical findings are certainly very useful to ascertain the exact CT level and to limit the radiation exposure. (orig.)

  10. Diagnosis of gastric cancers by CT

    International Nuclear Information System (INIS)

    Zhu Jianbing; Gong Jianping; Huan Jian

    1999-01-01

    Forty two cases of gastric cancers were reviewed. The cancer had been examined by CT and was confirmed by operation and pathology. The diagnostic results of gastric cancers obtained by CT were compared with that from GI and fibro-gastroscopy examination. The results showed that the preparation of gastrointestinal tract before CT examination was important in the CT diagnosis of gastric cancer. CT in diagnosis of focus of gastric cancer and organ invasion is better than Gl and Fibro-gastroscopy and accuracy in diagnosis of gastric cancers is near to that of GI examination

  11. Effective radiation dose from semicoronal CT of the sacroiliac joints in comparison with axial CT and conventional radiography

    Energy Technology Data Exchange (ETDEWEB)

    Jurik, Anne Grethe; Boecker Puhakka, Katriina [Department of Radiology R, Aarhus University Hospital, Aarhus Kommunehospital, Noerrebrogade 44, 8000 Aarhus C (Denmark); Hansen, Jolanta [Department of Medical Physics, Aarhus University Hospital, Aarhus Kommunehospital, Noerrebrogade 44, 8000 Aarhus C (Denmark)

    2002-11-01

    The aim of this study was to evaluate the radiation dose given by semicoronal CT of the sacroiliac joints (SIJs) in comparison with axial CT and conventional radiography. The total effective radiation doses given by serial contiguous semicoronal and axial CT, using 5-mm slices, 120 kV and 330 mAs, were determined by measurement of organ doses using an anthropomorphic Rando Alderson phantom paced with thermoluminescence dosimeters. The doses given by conventional antero-posterior (AP) and oblique projections of the SIJs were determined similarly. In a female the total effective dose by semicoronal CT was found to be more than six times lower than by axial CT and 2.5 times lower than the dose use to obtain a conventional AP radiograph, the values being 102, 678, and 255 {mu}Sv, respectively. The effective dose by semicoronal CT was only a little higher than the dose given to obtain two oblique radiographs. In a male with lead protection of the gonads the dose by semicoronal CT was four times lower than by axial CT, but higher than by conventional radiography. In conclusion, the effective dose by semicoronal CT of the SIJs is lower than by axial CT, and in females a semicoronal CT implies a lower effective radiation dose that used to obtain an AP radiograph. (orig.)

  12. Pulmonary langerhans cell histiocytosis in adults: high-resolution CT - pathology comparisons and evolutional changes at CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo Jin; Lee, Ho Yun; Kim, Tae Sung [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Samsung Medical Center, Department of Radiology, Seoul (Korea, Republic of); Johkoh, Takeshi [Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Department of Radiology, Hyoko (Japan); Tomiyama, Noriyuki [Osaka University Graduate School of Medicine, Department of Radiology, Osaka (Japan); Han, Joungho [Sungkyunkwan University School of Medicine, Department of Pathology, Samsung Medical Center, Seoul (Korea, Republic of)

    2011-07-15

    To compare high-resolution (HR) CT and histopathological findings and to evaluate serial CT findings in pulmonary Langerhans cell histiocytosis (PLCH). We reviewed CT of lung lesions in 27 adults (M:F = 20:7, mean age, 41 {+-} 12.3 years) with PLCH. After evaluating lung abnormalities including nodules, micronodules, thick-walled, thin-walled, and bizarre-shaped cysts and reticulation, observers compared CT findings obtained at lung biopsy sites with histopathological findings. The final CT was compared with the initial CT to determine disease extent changes. The most frequently observed patterns of lung abnormalities were micronodules (n = 24, 89%), thick-walled (n = 22, 82%), and thin-walled (n = 22, 82%) cysts. Even thin-walled and bizarre cysts harboured active inflammatory Langerhans cell sheets and eosinophils in their walls. In thin-walled cysts, we noted pericystic inflammatory cell infiltrations along the alveolar walls, as well as pericystic emphysema. Thin-walled or bizarre cysts demonstrated a tendency to coalesce with surrounding cysts via their cystic wall destruction. Fourteen (52%) patients showed improvement and nine (33%) showed progressing disease. More than half of patients with pulmonary PLCH show improvement at follow-up CT. Even thin-walled cysts harbour active inflammatory cells on histopathology and exhibit improvement at follow-up CT. (orig.)

  13. CT in normal pressure hydrocephalus

    International Nuclear Information System (INIS)

    Fujita, Katsuzo; Nogaki, Hidekazu; Noda, Masaya; Kusunoki, Tadaki; Tamaki, Norihiko

    1981-01-01

    CT scans were obtained on 33 patients (age 73y. to 31y.) with the diagnosis of normal pressure hydrocephalus. In each case, the diagnosis was made on the basis of the symptoms, CT and cisternographic findings. Underlying diseases of normal pressure hydrocephalus are ruptured aneurysms (21 cases), arteriovenous malformations (2 cases), head trauma (1 case), cerebrovascular accidents (1 case) and idiopathie (8 cases). Sixteen of 33 patients showed marked improvement, five, moderate or minimal improvement, and twelve, no change. The results were compared with CT findings and clinical response to shunting. CT findings were classified into five types, bases on the degree of periventricular hypodensity (P.V.H.), the extent of brain damage by underlying diseases, and the degree of cortical atrophy. In 17 cases of type (I), CT shows the presence of P.V.H. with or without minimal frontal lobe damage and no cortical atrophy. The good surgical improvements were achieved in all cases of type (I) by shunting. In 4 cases of type (II), CT shows the presence of P.V.H. and severe brain damage without cortical atrophy. The fair clinical improvements were achieved in 2 cases (50%) by shunting. In one case of type (III), CT shows the absence of P.V.H. without brain damage nor cortical atrophy. No clinical improvement was obtained by shunting in this type. In 9 cases of type (IV) with mild cortical atrophy, the fair clinical improvement was achieved in two cases (22%) and no improvement in 7 cases. In 2 cases of type (V) with moderate or marked cortical atrophy, no clinical improvement was obtained by shunting. In conclusion, it appeared from the present study that there was a good correlation between the result of shunting and the type of CT, and clinical response to shunting operation might be predicted by classification of CT findings. (author)

  14. CT manifestation of peritoneal metastasis

    International Nuclear Information System (INIS)

    Cha, Soon Joo; Kang, Eun Young; Suh, Won Hyuck

    1989-01-01

    Peritoneal metastasis is frequent mode of dissemination of intraabdominal malignancies. Radiologic diagnosis of peritoneal metastasis has relied on indirect evidence on a barium UGI series and small bowel examination. With the advent of CT scanning, CT is capable of direct imaging of peritoneum. The sensitivity of CT in detecting peritoneal metastasis and CT manifestation of peritoneal metastatic lesions had reported occasionally, but rarely in Korea. So, authors illustrated the CT manifestation of peritoneal metastatic lesions in 32 cases of macroscopically proven cases in laparoscopy or laparotomy in Korea University Hae Wha Hospital during recent 4 years. The results are as follows. 1. Of total 32 cases, 18 cases were male and 14 cases were female. Age incidence was the most common in 6th decade. 2. The most common type of malignancy that cause peritoneal metastasis was the stomach cancer and next common type of malignancies were pancreas cancer in men and ovarian cancer in women. 3. Of total 32 cases of peritoneal metastasis which was confirmed by laparoscopy or laparotomy macroscopically, 23 cases (72%) were detected peritoneal thickening and/or omental pathology by CT, and the remaining 9 cases (28%) were not detected by CT. 4. Ascites was present in 19 cases (59%). 5. Parietal peritoneal thickening was present in 16 cases (50%) by CT and sheetlike pattern was the most common findings. The patterns of peritoneal thickening was relatively nonspecific and was not correlated with primary tumor type. 6. Tumor involvement of greater omentum by CT was present in 19 cases (59%). There were 7 cases of smudged appearance pattern, 6 cases of nodular pattern, 6 cases of omental cake pattern and no cystic mass pattern. The patterns of omental pathology was relatively nonspecific and was nor correlated with primary tumor type

  15. Helical CT defecography

    International Nuclear Information System (INIS)

    Ferrando, R.; Fiorini, G.; Beghello, A.; Cicio, G.R.; Derchi, L.E.; Consigliere, M.; Resasco, M.; Tornago, S.

    1999-01-01

    The purpose of this work is to investigate the possible role of Helical CT defecography in pelvic floor disorders by comparing the results of the investigations with those of conventional defecography. The series analyzed consisted of 90 patients, namely 62 women and 28 men, ranging in age 24-82 years. They were all submitted to conventional defecography, and 18 questionable cases were also studied with Helical CT defecography. The conventional examination was performed during the 4 standard phases of resting, squeezing, Valsalva and straining; it is used a remote-control unit. The parameters for Helical CT defecography were: 5 mm beam collimation, pitch 2, 120 KV, 250 m As and 18-20 degrees gantry inclination to acquire coronal images of the pelvic floor. The rectal ampulla was distended with a bolus of 300 mL nonionic iodinated contrast agent (dilution: 3g/cc). The patient wore a napkin and was seated on the table, except for those who could not hold the position and were thus examined supine. Twenty-second helical scans were performed at rest and during evacuation; multiplanar reconstructions were obtained especially on the sagittal plane for comparison with conventional defecographic images. Coronal Helical CT defecography images permitted to map the perineal floor muscles, while sagittal reconstructions provided information on the ampulla and the levator ani. To conclude, Helical CT defecography performed well in study of pelvic floor disorders and can follow conventional defecography especially in questionable cases [it

  16. Helical CT imaging of clinically suspected appendicitis: Correlation of CT and histological findings

    International Nuclear Information System (INIS)

    Wong, S.K.; Chan, L.P.; Yeo, A.

    2002-01-01

    PURPOSE: The diagnosis of appendicitis is traditionally made on the basis of clinical findings supported by laboratory results. The aim of our study was to determine the accuracy and feasibility of using a relatively new technique of computed tomography (CT) using only colonic contrast medium. MATERIALS AND METHODS: A total of 50 patients clinically diagnosed as having appendicitis were prospectively examined before surgery with thin-collimation helical CT from the L3 level to the acetabular roof with only rectally administered colon contrast medium. The hard copy CT images were reviewed jointly by two radiologists and a consensus was reached for each patient. The results were then compared with the surgical and histological findings at appendicectomy. RESULTS: There were 35 true-positives, one false-positive, 12 true-negatives and two false-negatives for CT. This yielded an accuracy of 94%, sensitivity of 95%, specificity of 92%, positive predictive value of 97% and negative predictive value of 86%. The appendix was identified in 45 patients (90%) and obscured by an inflammatory mass in the remaining five. An alternative diagnosis was found in 10 of 12 normal CT examinations (83%). CONCLUSION: Helical CT with rectal contrast medium is a quick, well tolerated and accurate test to diagnose appendicitis. It can offer alternative, possibly non-surgical diagnosis in patients who would otherwise have undergone laparotomy. Wong, S.K. et al. (2002)

  17. CT and MRT in mediastinal and hilar masses. CT und MRT bei mediastinalen und hilaeren Raumforderungen

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, L.; Kramer, J.; Stiglbauer, R.; Wimberger, D.; Imhof, H. (Vienna Univ. (Austria). Klinik fuer Radiodiagnostik Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)); Metz, V. (Vienna Univ. (Austria). 2. Chirurgische Klinik)

    1990-11-01

    Thirty-eight patients with mediastinal and/or hilar masses were imaged by computed tomography (CT) and magnetic resonance imaging (MRI). Results were analyzed retrospectively regarding the ability to demonstrate the masses, their number, size, definition, location and tissue characteristics. CT and MRI showed equivalent results in 32 cases; additional information was obtained in two patients by CT, in four patients by MRI. In view of the specific advantages and limitations of both CT and MRI we believed that in patients with mediastinal and/or hilar masses, contrast enhanced CT remains the procedure of choice after performing plain chest radiographs; in certain cases MRI will prove useful for further evaluation. (orig.).

  18. CT diagnosis of rectal cancer

    International Nuclear Information System (INIS)

    Kanda, Hiroshi; Hachisuka, Kitao; Yamaguchi, Akihiro

    1986-01-01

    Preoperative diagnosis of the depth of invasion and lymph node metastasis of rectal cancer were studied using the findings of computed tomography (CT). Of one hundred and four cases operated on for rectal cancer over a period of 32 months, thirty five cases were examined by CT with the use of olive oil enema and contrast enhancement using a 60 % Conray drip infusion with reference to the histological findings. For direct invasion into the wall, the diagnoses by CT were coincident with microscopic findings in 75 % of cancers of the rectosigmoid, in 75 % of the upper rectum and in 84 % of the lower rectum. Of all cases, 28 (80 %) were diagnosed correctly. As to local lymph node metastasis, 74 % of all diagnoses by CT corresponded with the histological diagnosis. Moreover, seventeen cases were evaluated for lateral lymph node metastasis, and the diagnostic accuracy by CT was 88 %. In conclusion, preoperative CT evaluation of the extension into the rectal wall and lymph node metastasis in rectal cancer was considesed useful. (author)

  19. CT features of appendiceal mucocele

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Won Jong; Byun, Jae Young; Jung, Jung Im; Lee, Hae Gyu; Park, Young Ha; Shin, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-10-15

    To evaluate the usefulness of CT features of appendiceal mucocele in the diagnosis and evaluation of complications. We retrospectively reviewed CT findings and compared with operative findings in 7 cases of pathologically proven appendiceal mucocele. CT findings such as location and extent of the lesion, tissue density, thickness or calcification of the wall, presence of adjacent inflammatory infiltration, and visualization of normal vermiform appendix were analyzed. Appendiceal mucocele was found as homogeneous low density cystic mass adjacent to the cecum, which has no surrounding inflammatory infiltration except in one case of perforation and one case of intussusception. Mean CT number measured in 4 cases was 21 Hounsfield unit. Thin curvilinear calcifications were noted along the cystic wall in 2 cases. Normal vermiform appendix couldn't be demonstrated in all cases. Appendiceal mucocele is characterized by homogeneously low density and thin walled cystic tumor adjacent to cecum without surrounding inflammatory infiltration, and absence of normal vermiform appendix on CT. Therefore, CT is valuable in preventing operative complications of appendiceal mucocele.

  20. PET/CT. Dose-escalated image fusion?

    International Nuclear Information System (INIS)

    Brix, G.; Beyer, T.

    2005-01-01

    Clinical studies demonstrate a gain in diagnostic accuracy by employing combined PET/CT instead of separate CT and PET imaging. However, whole-body PET/CT examinations result in a comparatively high radiation burden to patients and thus require a proper justification and optimization to avoid repeated exposure or over-exposure of patients. This review article summarizes relevant data concerning radiation exposure of patients resulting from the different components of a combined PET/CT examination and presents different imaging strategies that can help to balance the diagnostic needs and the radiation protection requirements. In addition various dose reduction measures are discussed, some of which can be adopted from CT practice, while others mandate modifications to the existing hard- and software of PET/CT systems. (orig.)

  1. Optical-CT scanning of polymer gels

    Energy Technology Data Exchange (ETDEWEB)

    Oldham, M [Radiation Oncology Physics, Duke University Medical Center, Duke University, NC (United States)

    2004-01-01

    The application of optical-CT scanning to achieve accurate high-resolution 3D dosimetry is a subject of current interest. The purpose of this paper is to provide a brief overview of past research and achievements in optical-CT polymer gel dosimetry, and to review current issues and challenges. The origins of optical-CT imaging of light-scattering polymer gels are reviewed. Techniques to characterize and optimize optical-CT performance are presented. Particular attention is given to studies of artifacts in optical-CT imaging, an important area that has not been well studied to date. The technique of optical-CT simulation by Monte-Carlo modeling is introduced as a tool to explore such artifacts. New simulation studies are presented and compared with experimental data.

  2. Optical-CT scanning of polymer gels

    International Nuclear Information System (INIS)

    Oldham, M

    2004-01-01

    The application of optical-CT scanning to achieve accurate high-resolution 3D dosimetry is a subject of current interest. The purpose of this paper is to provide a brief overview of past research and achievements in optical-CT polymer gel dosimetry, and to review current issues and challenges. The origins of optical-CT imaging of light-scattering polymer gels are reviewed. Techniques to characterize and optimize optical-CT performance are presented. Particular attention is given to studies of artifacts in optical-CT imaging, an important area that has not been well studied to date. The technique of optical-CT simulation by Monte-Carlo modeling is introduced as a tool to explore such artifacts. New simulation studies are presented and compared with experimental data

  3. Three-dimensional-CT imaging of colorectal disease with thin collimation helical CT scanning

    International Nuclear Information System (INIS)

    Ogura, Toshihiro; Koizumi, Koichi; Sakai, Tatsuya; Kai, Shunkichi; Takatsu, Kazuaki; Maruyama, Masakazu

    1998-01-01

    We have conducted research on three-dimensional (3D)-CT-colonoscopy with thin collimation helical CT scanning over the past three years. This has lately become a subject of special interest. 3D-CT-colonoscopy has three kinds of visualizing methods depending on the threshold setting of CT values. The first one is the virtual endoscopy method which is displayed in a similar fashion to colonoscopic images. The second one is the air image method using the air in the digestive tract as a contrast medium. The third one is the pseudo-tract method which has characteristics of both virtual endoscopy and the air image method and visualizes in a shape of the digestive tract. The image visualized by 3D-CT-colonoscopy is similar to that of conventional colonoscopy and barium enema study, which is obtained with minimal invasion to patients. Obvious advanced carcinomas were easily visualized, and even a small flat polyp measuring 5 mm in size, was able to be observed retrospectively. The characteristics of our method are that we can easily make an examination in a short time and with little dependence on expert technique. Also patients have little discomfort compared to that experienced during colonoscopy and barium enema study. Important features are as follows; long calculation time, insufficient air insufflation, fecal material in the patient''s bowel, whole abdominal scan, and spatial resolution. In the near future, a multislice CT scanner system will have ability to overcome these problems. Therefore, 3D-CT-colonoscopy might be applied in the future for first line examination as a mass screening for colorectal carcinoma. (author)

  4. 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.)

  5. 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.)

  6. Development of ''Eminence STARGATE'' PET/CT system

    International Nuclear Information System (INIS)

    Okazaki, Masato; Inoue, Yoshihiro; Amano, Masaharu

    2009-01-01

    A PET/CT system, the combination of a PET (Positron Emission Tomography) system with an X-ray CT system, has been widely used in recent years. Our newly developed ''Eminence STARGATE'' PET/CT system allows the PET gantry and the X-ray CT gantry to move independently. This advantage provides high flexibility for PET examination and X-ray CT examination and also eases a patient's psychological anxiety about closed spaces. The system has a 16-slice X-ray CT scanner. (author)

  7. CT findings in epileptic children

    International Nuclear Information System (INIS)

    Koide, Nobuo; Kimura, Shigeru; Watanabe, Jun; Haneda, Satoshi; Takebe, Yukinao

    1981-01-01

    CT findings in 43 children with generalized seizures (grand mal seizures) (GM group) and in 50 children with partial seizures (P group), classified according to clinical seizure type, were studied. 1) CT abnormalities were demonstrated in 19% (8/43) in GM group and in 40% (20/50) in P group, including localized CT abnormalities in 9.3% (4/43) and in 34% (17/50) respectively. CT abnormalities were found more frequently in cases with abnormal past histories and/or mental defects (MD) than in those without them. 2) In P group, localized CT abnormalities and generalized brain atrophy were observed in 13 and 7 cases respectively. In 40 cases with focal epileptic discharges (FED) in EEG, localized CT abnormalities were demonstrated in 23% (9/40). The sites of localized CT abnormalities corresponded in 73% (11/15) to the sites of focal suppression in EEG (i.e., slowing, low amplitude and lazy pattern) regardless of FED. 3) The bicaudate cerebro-ventricular index (B-CVI) in 19 cases in the normal control group over 2 years of age was 10.0 +- 1.2 (mean +- SD). Ventricular narrowing (VN), with B-CVI less than 8.2 (mean - 1.5 SD), was observed in 5, 17 and 27% in control, GM and P groups respectively, indicating more frequently in epileptic children than in normal controls. Seizures were well controlled in 85% (11/13) in VN group and in 70% (26/36) in normal ventricular group. Brain atrophy in CT findings to inspection was ascertained in all cases by measuring B-CVI. (author)

  8. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    International Nuclear Information System (INIS)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee

    2016-01-01

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone

  9. The diagnostic utility of ultrasonography, CT and PET/CT for the preoperative evaluation of cervical lymph node metastasis inpapillary thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim Young Sang; Lee, Tae Hyun; Park, Dong Hee [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2016-08-15

    To compare the diagnostic utility of ultrasonography (US), CT and positron emission tomography/CT (PET/CT) in the preoperative evaluation of cervical lymph node metastasis in patients with papillary thyroid carcinoma. The study population consisted of 300 patients with pathologically diagnosed papillary thyroid carcinoma after thyroidectomy and neck dissection. Preoperative US, CT, and PET/CT findings were compared with pathologic outcomes after thyroidectomy and neck dissection. Sensitivity in detecting central lymph node metastasis (US 29.9%, CT 27.9%, PET/CT 18.8%) was lower than that for lateral lymph node metastasis (US 56.3%, CT 66.2%, PET/CT 43.7%). Specificity in detecting central lymph node metastasis (US 80.6%, CT 77.7%, PET/CT 83.0%) was lower than that for lateral lymph node metastasis (US 96.8%, CT 80.6%, PET/CT 95.2%). The combination of US and CT had higher specificity (77.3%) and higher sensitivity (33.1%) than US alone. PET/CT has no significant additional benefit over the combination of US and CT. In preoperative evaluations of neck lymph node metastasis, US and CT and PET/CT are more useful in lateral lymph node areas than in central lymph node areas. The combination of US and CT has higher sensitivity than US alone.

  10. Classical patterns of interstitial lung diseases; Klassische Muster der interstitiellen Lungenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Mueller-Mang, C. [Institut fuer CT und MRT, Gaenserndorf (Austria); Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria)

    2014-12-15

    High resolution computed tomography (HRCT) is the most important non-invasive tool in the diagnostics and follow-up of patients with interstitial lung disease (ILD). A systematic review of the HRCT patterns of ILD was carried out and the most relevant differential diagnoses are discussed in order to provide a road map for the general radiologist to successfully navigate the complex field of ILD. Using HRCT four basic patterns of ILD can be identified: linear and reticular patterns, the nodular pattern, the high attenuation and low attenuation patterns. These patterns can be further differentiated according to their localization within the secondary pulmonary lobule (SPL), e.g. centrilobular or perilymphatic and their distribution within the lungs (e.g. upper or lower lobe predominance). Relevant clinical data, such as smoking history and course of the disease provide useful additional information in the diagnosis of ILD. On the basis of the pattern and anatomical distribution on HRCT, an accurate diagnosis can be achieved in some cases of ILD; however, due to morphological and clinical overlap the final diagnosis of many ILDs requires close cooperation between clinicians, radiologists and pathologists. (orig.) [German] Die hochaufloesende CT (High-resolution[HR]-CT) ist das wichtigste nichtinvasive Verfahren zur Identifikation und Verlaufsbeurteilung von Patienten mit interstitiellen Lungenerkrankungen (''interstitial lung diseases'', ILD). Systematische Darstellung der HRCT-Muster interstitieller Lungenerkrankungen und Diskussion der relevanten Differenzialdiagnosen, um dem Radiologen eine erfolgreiche Analyse der komplexen CT-Morphologie der ILD zu ermoeglichen. Mit der HRCT koennen 4 Grundmuster interstitieller Grunderkrankungen identifiziert werden: das retikulaere und lineare Muster, das nodulaere Muster, das Muster mit erhoehter Lungendichte und das Muster mit verminderter Lungendichte. Diese Muster koennen anhand ihrer Lage im sekundaeren

  11. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    Energy Technology Data Exchange (ETDEWEB)

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan [Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States) and Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Department of Physics, Duke University, Durham, North Carolina 27710 (United States); and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States)

    2012-11-15

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED{sub adj}). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED{sub adj} between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED{sub adj} that differed by up to 44% from effective dose

  12. CT cystography

    International Nuclear Information System (INIS)

    Tsili, A.

    2012-01-01

    Full text: Cancer of the urinary bladder is one of the commonest urothelial neoplasms. Conventional cystoscopy remains the mainstay in the diagnosis of urinary bladder carcinomas. But it is an invasive and uncomfortable procedure, associated with complications. Computed tomographic (CT) virtual cystoscopy has been proposed as an alternative imaging modality with potential advantages in the detection of urinary bladder neoplasms and good patient acceptance. It is a minimally invasive technique, allowing imaging of the urinary bladder in multiple planes and a 360 0 view. CT cystoscopy provides information about the location, size and morphologic features of urinary bladder lesions, indicating appropriate areas for biopsy. It can be performed in cases in which conventional cystoscopy is not feasible, such as in the presence of urethral strictures, marked prostatic hypertrophy or active bleeding, and in cases in which cystoscopic findings are inconclusive. The technique can be used to evaluate areas of the urinary bladder difficult to evaluate with cystoscopy, such as the anterior bladder neck and narrowmouthed diverticula. Finally, virtual cystoscopy provides both intraluminal and extraluminal pathologic changes, so intravesical disease and exrtavesical extension can be evaluated in the same study. One of the limitations of this technique is the difficulty to demonstrate small-sized lesions. The introduction of multi-detector row CT (MDCT) scanners was a major technological advancement because among other things it substantially improves z-axis resolution by reducing section collimation and allowing the detection of very small lesions. The near isotropic or isotropic pixels achieved with a multidetector CT scanner, enable the creation of multiplanar reformatted images with a resolution very close to that of the axial images and three-dimensional (3D) renderings of outstanding quality. Transverse, multiplanar reformations and virtual endoscopic images are complementary

  13. FDG-PET/CT in oncology. German guideline

    International Nuclear Information System (INIS)

    Krause, B.J.; Beyer, T.; Bockisch, A.; Delbeke, D.; Kotzerke, J.; Minkov, V.; Reiser, M.; Willich, N.

    2007-01-01

    FDG-PET/CT examinations combine metabolic and morphologic imaging within an integrated procedure. Over the past decade PET/CT imaging has gained wide clinical acceptance in the field of oncology. This FDG-PET/CT guideline focuses on indications, data acquisition and processing as well as documentation of FDG-PET/CT examinations in oncologic patients within a clinical and social context specific to Germany. Background information and definitions are followed by examples of clinical and research applications of FDG-PET/CT. Furthermore, protocols for CT scanning (low dose and contrast-enhanced CT) and PET emission imaging are discussed. Documentation and reporting of examinations are specified. Image interpretation criteria and sources of errors are discussed. Quality control for FDG and PET/CT-systems, qualification requirements of personnel as well as legal aspects are presented. (orig.)

  14. Abdominal and Pelvic CT

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  15. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... the scanning. Any motion, whether breathing or body movements, can lead to artifacts on the images. This ... clinical problems. CT is less sensitive to patient movement than MRI. CT can be performed if you ...

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  18. Computed Tomography (CT) -- Head

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  1. Abdominal and Pelvic CT

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  2. Abdominal and Pelvic CT

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  3. Computed Tomography (CT) -- Head

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  5. Computed Tomography (CT) -- Head

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    Full Text Available ... cavities (ventricles) in patients with hydrocephalus . diseases or malformations of the skull. CT scanning is also performed ... biopsy ) from the brain. assess aneurysms or arteriovenous malformations through a technique called CT angiography. For more ...

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  11. Abdominal and Pelvic CT

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  12. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  13. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... can be performed if you have an implanted medical device of any kind, unlike MRI. CT imaging ...

  14. Abdominal and Pelvic CT

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... can be performed if you have an implanted medical device of any kind, unlike MRI. CT imaging ...

  15. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of ...

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  17. Computed Tomography (CT) -- Head

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  19. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces ... particularly the lungs, abdomen, pelvis and bones. A diagnosis determined by CT scanning may eliminate the need ...

  20. Computed Tomography (CT) -- Head

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    Full Text Available ... as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces ... medical device of any kind, unlike MRI. A diagnosis determined by CT scanning may eliminate the need ...

  1. Abdominal and Pelvic CT

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    Full Text Available ... CT scanning. top of page Additional Information and Resources RTAnswers.org: Radiation Therapy for Bladder Cancer Radiation ... Image Gallery Patient undergoing computed tomography (CT) scan View full size with caption Pediatric Content Some imaging ...

  2. Abdominal and Pelvic CT

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  3. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When ... actual CT scanning is performed. Depending on the type of CT scan, the machine may make several ...

  4. Computed Tomography (CT) -- Head

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  5. Computed Tomography (CT) -- Head

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits CT scanning is painless, noninvasive and accurate. ... CT scans should have no immediate side effects. Risks There is always a slight chance of cancer ...

  6. Abdominal and Pelvic CT

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits Viewing a CT scan, an experienced radiologist ... CT scans should have no immediate side effects. Risks There is always a slight chance of cancer ...

  7. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... top of page What are the benefits vs. risks? Benefits A CT scan is one of the ... CT scans should have no immediate side effects. Risks There is always a slight chance of cancer ...

  8. Computed Tomography (CT) -- Head

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    Full Text Available ... scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, ... membranes covering the brain. top of page Additional Information and Resources RTAnswers.org Radiation Therapy for Brain ...

  9. Computed Tomography (CT) -- Sinuses

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  10. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... air-filled spaces within the bones of the face surrounding the nasal cavity. CT scanning is painless, ... and blood vessels. A CT scan of the face produces images that also show a patient's paranasal ...

  11. Computed Tomography (CT) -- Head

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... Then, the table will move slowly through the machine as the actual CT scanning is performed. Depending ...

  12. Abdominal and Pelvic CT

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    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... Then, the table will move slowly through the machine as the actual CT scanning is performed. Depending ...

  13. Computed Tomography (CT) -- Sinuses

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  14. Computed Tomography (CT) -- Sinuses

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    Full Text Available ... CT scanner is typically a large, box-like machine with a hole, or short tunnel, in the ... Then, the table will move slowly through the machine as the actual CT scanning is performed. Depending ...

  15. Computed Tomography (CT) -- Head

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    Full Text Available ... CT scanner is typically a large, box-like machine with a hole, or short tunnel, in the ... Then, the table will move slowly through the machine as the actual CT scanning is performed. Depending ...

  16. Abdominal and Pelvic CT

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    Full Text Available ... CT scanner is typically a large, box-like machine with a hole, or short tunnel, in the ... Then, the table will move slowly through the machine as the actual CT scanning is performed. Depending ...

  17. Imaging of female pelvic malignancies regarding MRI, CT, and PET/CT. Pt. 2

    International Nuclear Information System (INIS)

    Alt, Celine D.; Kauczor, Hans-Ulrich; Hallscheidt, Peter; Brocker, Kerstin A.; Eichbaum, Michael; Sohn, Christof; Arnegger, Florian U.

    2011-01-01

    To compose diagnostic standard operating procedures for both clinical and imaging assessment for vulvar and vaginal cancer, for vaginal sarcoma, and for ovarian cancer. The literature was reviewed for diagnosing the above mentioned malignancies in the female pelvis. Special focus herein lies in tumor representation in MRI, followed by the evaluation of CT and PET/CT for this topic. MRI is a useful additional diagnostic complement but by no means replaces established methods of gynecologic diagnostics and ultrasound. In fact, MRI is only implemented in the guidelines for vulvar cancer. According to the current literature, CT is still the cross-sectional imaging modality of choice for evaluating ovarian cancer. PET/CT appears to have advantages for staging and follow-up in sarcomas and cancers of the ovaries. (orig.)

  18. FDG PET/CT Is Superior to Enhanced CT in Detecting Recurrent Subcentimeter Lesions in the Abdominopelvic Cavity in Colorectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai Jeon; Kim, Yu Kyeong; Kim, Sang Eun [Seoul National Univ. Bundang Hospital, Seoul (Korea, Republic of); Lee, Jong Jin [Asan Medical Center, Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2011-06-15

    This study aims to compare the performance of contrast enhanced computed tomography (CeCT) and 18 F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting small tumor implants and metastatic lymph nodes (LNs) in the abdominopelvic cavity in patients with colorectal cancer. We enrolled 16 patients who were clinically suspected of experiencing a recurrences (6 male, 10 female; mean age 61{+-}14 years). All subjects underwent CeCT and PET/CT, and the performance of these methods was compared with regard to detecting recurrences. The final diagnosis of a recurrence was made clinically. CeCT identified 38 lesions in 12 patients, all of which were detected by PET/CT. PET/CT found 27 additional lesions in 8 patients, comprising 9 seeding nodules (2 in the right upper quadrant of the abdomen and 7 in the pelvic cavity) and 18 LNs (2 celiac, 2 paraaortic, 2 hepatic hilar, 11 common iliac, 1 external iliac). Most additional lesions were located in the pelvic cavity (approximately 78% of seeding nodules that were detected solely by PET/CT was significantly higher compared with the CeCT and PET/CT confirmed nodules (5.5{+-}4.2 vs. 2.9{+-}2.5, p=0.03). The seeding nodules that were detected only by PET/CT were significantly smaller than the CeCT and PET/CT confirmed nodules (long axis:1.0{+-}0.3cm vs. 2.0{+-}1.1cm, p=0.001; short axis: 0.8{+-}0.3cm vs. 1.7{+-}0.9cm, p=0.001). Similarly, PET/CT only detected LNs were significantly smaller than CeCT and PET/CT identified LNs (0.7{+-}0.1cm vs. 2.3{+-}1.2cm, p<0.0001). PET/CT is superior to CeCT in detecting seeding nodules and metastatic LNs in patients with recurrent colorectal cancer. Specifically, PET/CT detects subcentimeter lesions in anatomically deformed pelvic cavities.

  19. Dynamic CT of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Fujita, Nobuyuki; Shirato, Hiroki; Shinohara, Masahiro; Miyasaka, Kazuo; Morita, Yutaka; Irie, Goro

    1983-01-01

    We performed dynamic CT in 30 cases of hepatocellular carcinoma, and concluded as below. 1 Decting the stain in the early phase of the dynamic series, it is possible to make a diagnosis of hepatocellular carcinoma. 2 The dinamic CT is effective in a case of small hepatocellular carcinoma in which it is difficult to gain an accurate diagnosis in the routine CT study. 3 The dynamic CT is also effective in the differential diagnosis of hepatic lesions, as other hepatic lesions such as hemangioma and metastatic liver cancer show different patterns compared with hepatocellular carcinoma. (author)

  20. The role of F-18 FDG-PET for 3-D radiation treatment planning of non-small cell lung cancer - first results of a prospective study; Einsatz der F-18-FDG-PET in der 3-D-Bestrahlungsplanung des nichtkleinzelligen Bronchialkarzinoms: erste Ergebnisse einer prospektiven Studie

    Energy Technology Data Exchange (ETDEWEB)

    Schmuecking, M.; Baum, R.P.; Przetak, C.; Niesen, A. [Zentralklinik Bad Berka (Germany). Klinik fuer Nuklearmedizin/PET-Zentrum; Lopatta, E.C.; Wendt, T.G. [Jena Univ. (Germany). Klinik fuer Radiologie, Abt. Strahlentherapie; Plichta, K.; Leonhardi, J. [Zentralklinik Bad Berka (Germany). Inst. fuer Bildgebende Diagnostik

    2001-04-01

    Spiral-CT- und eine F-18-FDG-PET-Untersuchung innerhalb von 10 Tagen. Die PET-Daten wurden iterativ rekonstruiert, anschliessend erfolgte die Bildfusion mit den CT-Daten. Zunaechst wurden Zielvolumina und die Volumina der Risikoorgane (Lunge, Herz, Rueckenmark) basierend auf CT-Daten generiert. Anschliessend wurden erneut die Zielvolumina, basierend auf den PET-Daten errechnet. Fuer jedes Zielvolumen wurden Bestrahlungsplaene erstellt und Dosis-Volumen-Histogramme (DVH) berechnet. Durch die Integration der metabolischen PET-Zusatzinformation in die 3-D-Bestrahlungsplanung, konnten kleinere Zielvolumina bei 25 von 27 Patienten generiert werden (im Mittel um 12%, Spannbreite von 3% bis 21%). Die auf PET-Daten basierenden DVH zeigten eine Dosisreduktion an den Risikoorganen, V{sub Lunge} (20 Gy) konnte im Mittel um 10% (Spannbreite 5% bis 17%) reduziert werden. Bei 2 Patienten war das auf der PET basierende Zielvolumen groesser, als das auf der CT basierende Volumen, da im PET Lymphknotenmetastasen detektiert wurden, die im CT morphologisch unauffaellig erschienen (Groesse<10 mm). Die F-18-FDG-PET liefert nuetzliche Zusatzinformationen zu den morphologisch-anatomisch orientierten bildgeben Verfahren und ermoeglicht eine exaktere Lokalisation von Lymphknotenmetastasen und eine genauere Bestimmung der Primaertumorausdehnung. Bedingt durch kleinere Zielvolumina, konnte bei 93% der Patienten die Strahlentherapie mit kleineren, toxizitaetsaermeren Volumina durchgefuehrt werden. Andererseits ist eine komplette Tumorerfassung mit hoeherer Genauigkeit moeglich, sodass wahrscheinlich eine bessere Tumorkontrolle resultiert. Durch den Einsatz der FDG-PET in der 3-D-Bestrahlungsplanung koennte moeglicherweise die therapeutische Breite der Radiotherapie erhoeht werden. Um dies zu sichern, sind weitere Untersuchungen notwendig. (orig.)

  1. SPECT/CT workflow and imaging protocols

    Energy Technology Data Exchange (ETDEWEB)

    Beckers, Catherine [University Hospital of Liege, Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, Liege (Belgium); Hustinx, Roland [University Hospital of Liege, Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, Liege (Belgium); Domaine Universitaire du Sart Tilman, Service de Medecine Nucleaire et Imagerie Oncologique, CHU de Liege, Liege (Belgium)

    2014-05-15

    Introducing a hybrid imaging method such as single photon emission computed tomography (SPECT)/CT greatly alters the routine in the nuclear medicine department. It requires designing new workflow processes and the revision of original scheduling process and imaging protocols. In addition, the imaging protocol should be adapted for each individual patient, so that performing CT is fully justified and the CT procedure is fully tailored to address the clinical issue. Such refinements often occur before the procedure is started but may be required at some intermediate stage of the procedure. Furthermore, SPECT/CT leads in many instances to a new partnership with the radiology department. This article presents practical advice and highlights the key clinical elements which need to be considered to help understand the workflow process of SPECT/CT and optimise imaging protocols. The workflow process using SPECT/CT is complex in particular because of its bimodal character, the large spectrum of stakeholders, the multiplicity of their activities at various time points and the need for real-time decision-making. With help from analytical tools developed for quality assessment, the workflow process using SPECT/CT may be separated into related, but independent steps, each with its specific human and material resources to use as inputs or outputs. This helps identify factors that could contribute to failure in routine clinical practice. At each step of the process, practical aspects to optimise imaging procedure and protocols are developed. A decision-making algorithm for justifying each CT indication as well as the appropriateness of each CT protocol is the cornerstone of routine clinical practice using SPECT/CT. In conclusion, implementing hybrid SPECT/CT imaging requires new ways of working. It is highly rewarding from a clinical perspective, but it also proves to be a daily challenge in terms of management. (orig.)

  2. SPECT/CT workflow and imaging protocols

    International Nuclear Information System (INIS)

    Beckers, Catherine; Hustinx, Roland

    2014-01-01

    Introducing a hybrid imaging method such as single photon emission computed tomography (SPECT)/CT greatly alters the routine in the nuclear medicine department. It requires designing new workflow processes and the revision of original scheduling process and imaging protocols. In addition, the imaging protocol should be adapted for each individual patient, so that performing CT is fully justified and the CT procedure is fully tailored to address the clinical issue. Such refinements often occur before the procedure is started but may be required at some intermediate stage of the procedure. Furthermore, SPECT/CT leads in many instances to a new partnership with the radiology department. This article presents practical advice and highlights the key clinical elements which need to be considered to help understand the workflow process of SPECT/CT and optimise imaging protocols. The workflow process using SPECT/CT is complex in particular because of its bimodal character, the large spectrum of stakeholders, the multiplicity of their activities at various time points and the need for real-time decision-making. With help from analytical tools developed for quality assessment, the workflow process using SPECT/CT may be separated into related, but independent steps, each with its specific human and material resources to use as inputs or outputs. This helps identify factors that could contribute to failure in routine clinical practice. At each step of the process, practical aspects to optimise imaging procedure and protocols are developed. A decision-making algorithm for justifying each CT indication as well as the appropriateness of each CT protocol is the cornerstone of routine clinical practice using SPECT/CT. In conclusion, implementing hybrid SPECT/CT imaging requires new ways of working. It is highly rewarding from a clinical perspective, but it also proves to be a daily challenge in terms of management. (orig.)

  3. Skeletal scintigraphy and SPECT/CT in orthopedic imaging; Knochenszintigrafie und SPECT/CT bei orthopaedischen Fragestellungen

    Energy Technology Data Exchange (ETDEWEB)

    Klaeser, B.; Walter, M.; Krause, T. [Inselspital Bern (Switzerland). Universitaetsklinik fuer Nuklearmedizin

    2011-03-15

    Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

  4. The stylohyoid chain: CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uysal Ramadan, Selma, E-mail: uysalselma@yahoo.co [Department of Radiology, Ankara Training and Research Hospital, Ankara 06590 (Turkey); Goekharman, Dilek, E-mail: gokharman@ttnet.net.t [Department of Radiology, Ankara Training and Research Hospital, Ankara 06590 (Turkey); Kosar, Pinar, E-mail: pkosar@hotmail.co [Department of Radiology, Ankara Training and Research Hospital, Ankara 06590 (Turkey); Kacar, Mahmut, E-mail: mkacar1961@gamil.co [Department of Radiology, Ankara Training and Research Hospital, Ankara 06590 (Turkey); Kosar, Ugur, E-mail: ugurkosar@hotmail.co [Department of Radiology, Ankara Training and Research Hospital, Ankara 06590 (Turkey)

    2010-09-15

    We aimed in this report to discuss the embryology, anatomy, theories of ossification and symptoms, clinical presentation, and diagnosis of the stylohyoid chain (SHC) variations, together with the role of radiographs, computed tomography (CT) and three-dimensional (3D)-CT in showing these variations. Because CT/3D-CT additionally facilitates visualization of the entire SHC with different axes, it is the most valuable method for establishing the relationship between the SHC and the surrounding tissue. SHC variation can be discovered during CT performed for indications other than ossified SHC. It is important to diagnose whether or not the SHC is ossified, since one of the treatment procedures in ossified SHC is total excision. If the clinician and radiologist are aware of these variations observed in the SHC, patients with vague symptoms may be spared unnecessary investigations and may be properly diagnosed earlier.

  5. Choline-PET/CT for imaging prostate cancer; Cholin-PET/CT zur Bildgebung des Prostatakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Krause, Bernd Joachim [Klinik- und Poliklinik fuer Nuklearmedizin, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany); Treiber, U.; Schwarzenboeck, S.; Souvatzoglou, M. [Klinik fuer Urologie, Klinikum rechts der Isar, Technische Univ. Muenchen (Germany)

    2010-09-15

    PET and PET/CT using [{sup 11}C]- and [{sup 18}F]-labelled choline derivatives are increasingly being used for imaging of prostate cancer. The value of PET and PET/CT with [{sup 11}C]- and [{sup 18}F]-labelled choline derivates in biochemical recurrence of prostate cancer has been examined in many studies and demonstrates an increasing importance. Primary prostate cancer can be detected with moderate sensitivity using PET and PET/CT using [{sup 11}C]- and [{sup 18}F]-labelled choline derivatives - the differentiation between benign prostatic hyperplasia, prostatitis or high-grade intraepithelial neoplasia (HGPIN) is not always possible. At the present time [{sup 11}C]choline PET/CT is not recommended in the primary setting but may be utilized in clinically suspected prostate cancer with repeatedly negative prostate biopsies, in preparation of a focused re-biopsy. Promising results have been obtained for the use of PET and PET/CT with [{sup 11}C]- and [{sup 18}F]-labelled choline derivates in patients with biochemical recurrence. The detection rate of choline PET and PET/CT for local, regional, and distant recurrence in patients with a biochemical recurrence shows a linear correlation with PSA values at the time of imaging and reaches about 75% in patients with PSA > 3 ng/mL. At PSA values below 1 ng/mL, the recurrence can be diagnosed with choline PET/CT in approximately 1/3 of the patients. PET and PET/CT with [{sup 11}C]- and [{sup 18}F]choline derivates can be helpful for choosing a therapeutic strategy in the sense of an individualized treatment: since an early diagnosis of recurrence is crucial to the choice of optimal treatment. The localization of the site of recurrence - local recurrence, lymph node metastasis or systemic dissemination - has important influence on the therapy regimen. (orig.)

  6. Construction of a voxel model from CT images with density derived from CT numbers

    International Nuclear Information System (INIS)

    Cheng Mengyun; Zeng Qin; Cao Ruifen; Li Gui; Zheng Huaqing; Huang Shanqing; Song Gang; Wu Yican

    2010-01-01

    The voxel models representing human anatomy have been developed to calculate dose distribution in human body, while the density is the most important physical property of voxel model. Traditionally, when creating the Monte Carlo input files, the average tissue parameters recommended in ICRP report were used to assign each voxel in the existing voxel models. However, as each tissue consists of many voxels in which voxels are different in their densities, the method of assigning average tissue parameters doesn't take account of the voxel's discrepancy, and can't represent human anatomy faithfully. To represent human anatomy more faithfully, a method was implemented to assign each voxel, the density of which was derived from CT number. In order to compare with the traditional method, we have constructed two models from a same cadaver specimen date set. A CT-based pelvic voxel model called Pelvis-CT model, was constructed, the densities of which were derived from the CT numbers. A color photograph-based pelvic voxel model called Pelvis-Photo model, was also constructed, the densities of which were taken from ICRP Publication. The CT images and color photographs were obtained from the same female cadaver specimen. The Pelvis-CT and Pelvis-Photo models were ported into Monte Carlo code MCNP to calculate the conversion coefficients from kerma free-in-air to absorbed dose for external monoenergetic photon beams with energies of 0.1, 1 and 10 MeV under anterior-posterior (AP) geometries. The results were compared with those of given in ICRP74. Differences of up to 50% were observed between conversion coefficients of Pelvis-CT and Pelvis-Photo models, moreover the discrepancies decreased for the photon beams with higher energies. The overall trend of conversion coefficients of the Pelvis-CT model were agreed well with that of ICRP74 data. (author)

  7. Construction of a voxel model from CT images with density derived from CT numbers

    International Nuclear Information System (INIS)

    Cheng Mengyun; Zeng Qin; Cao Ruifen; Li Gui; Zheng Huaqing; Huang Shanqing; Song Gang; Wu Yican

    2011-01-01

    The voxel models representing human anatomy have been developed to calculate dose distribution in human body, while the density and elemental composition are the most important physical properties of voxel model. Usually, when creating the Monte Carlo input files, the average tissue densities recommended in ICRP Publication were used to assign each voxel in the existing voxel models. As each tissue consists of many voxels with different densities, the conventional method of average tissue densities failed to take account of the voxel's discrepancy, and therefore could not represent human anatomy faithfully. To represent human anatomy more faithfully, a method was implemented to assign each voxel, the densities of which were derived from CT number. In order to compare with the traditional method, we constructed two models from the cadaver specimen dataset. A CT-based pelvic voxel model called Pelvis-CT model was constructed, the densities of which were derived from the CT numbers. A color photograph-based pelvic voxel model called Pelvis-Photo model was also constructed, the densities of which were taken from ICRP Publication. The CT images and the color photographs were obtained from the same female cadaver specimen. The Pelvis-CT and Pelvis-Photo models were both ported into Monte Carlo code MCNP to calculate the conversion coefficients from kerma free-in-air to absorbed dose for external monoenergetic photon beams with energies of 0.1, 1 and 10 MeV under anterior-posterior (AP) geometry. The results were compared with those of given in ICRP Publication 74. Differences of up to 50% were observed between conversion coefficients of Pelvis-CT and Pelvis- Photo models, moreover the discrepancies decreased for the photon beams with higher energies. The overall trend of conversion coefficients of the Pelvis-CT model agreed well with that of ICRP Publication 74 data. (author)

  8. Correlative Imaging in a Patient with Cystic Thymoma: CT, MR and PET/CT Comparison

    International Nuclear Information System (INIS)

    Romeo, Valeria; Esposito, Alfredo; Maurea, Simone; Camera, Luigi; Mainenti, Pier Paolo; Palmieri, Giovannella; Buonerba, Carlo; Salvatore, Marco

    2015-01-01

    Cystic thymoma is a rare variant of thymic neoplasm characterized by almost complete cystic degeneration with mixed internal structure. We describe a case of a 60 year-old woman with a cystic thymoma studied with advanced tomographic imaging stydies. CT, MRI and PET/CT with 18 F-FDG were performed; volumetric CT and MRI images provided better anatomic evaluation for pre-operative assessment, while PET/CT was helpful for lesion characterization based on 18 F-FDG uptake. Although imaging studies are mandatory for pre-operative evaluation of cystic thymoma, final diagnosis still remains surgical. A 60-year-old woman with recent chest pain and no history of previous disease was admitted to our departement to investigate the result of a previous chest X-ray that showed bilateral mediastinal enlargement; for this purpose, enhanced chest CT scan was performed using a 64-rows scanner (Toshiba, Aquilion 64, Japan) before and after intravenous bolus administration of iodinated non ionic contrast agent; CT images demonstrated the presence of a large mediastinal mass (11×8 cm) located in the anterior mediastinum who extended from the anonymous vein to the cardio-phrenic space, compressing the left atrium and causing medium lobe atelectasis; bilateral pleural effusion was also present. In conclusion, correlative imaging plays a foundamental role for the diagnostic evaluation of patient with cystic thymoma. In particular, volumetric CT and MRI studies can provide better anatomic informations regarding internal structure and local tumor spread for pre-operative assessment. Conversely, metabolic imaging using 18 F-FDG PET/CT is helpful for lesion characterization differentiating benign from malignant lesion on the basis of intense tracer uptake. The role of PET/MRI is still under investigation. However, final diagnosis still remains surgical even though imaging studies are mandatory for pre-operative patient management

  9. CT appearance of splenosis

    Energy Technology Data Exchange (ETDEWEB)

    Mendelson, D.S.; Cohen, B.A.; Armas, R.R.

    1982-12-01

    Splenosis is an unusual complication of splenic trauma. The computed tomographic (CT) appearance of splenosis is described. One should consider this diagnosis when faced with a history of splenic trauma and multiple round or oval masses at CT.

  10. CT appearance of splenosis

    International Nuclear Information System (INIS)

    Mendelson, D.S.; Cohen, B.A.; Armas, R.R.

    1982-01-01

    Splenosis is an unusual complication of splenic trauma. The computed tomographic (CT) appearance of splenosis is described. One should consider this diagnosis when faced with a history of splenic trauma and multiple round or oval masses at CT

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT ... CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide greater detail ...

  12. CT images of gossypiboma

    International Nuclear Information System (INIS)

    Jeon, Hae Jeong; Lim, Jong Nam; Choi, Young Chil; Park, Jeong Hee

    1994-01-01

    Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. We experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had medical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment

  13. CT images of gossypiboma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Lim, Jong Nam; Choi, Young Chil; Park, Jeong Hee [College of Medicine, Kon-Kuk University, Seoul (Korea, Republic of)

    1994-04-15

    Surgical sponges retained after laparotomy can cause serious problem if they were not be identified in early state. In these circumstances abdominal CT yields the accurate diagnostic images. The purpose of this report is to present highly indicative findings permitting correct preoperative diagnosis of the gossypiboma. We experienced three cases in which CT showed the images sufficiently characteristic to suggest the correct preoperative diagnosis. We evaluated retrospectively the radiological images of gossypiboma confirmed by operation. Three patients were admitted due to palpable masses. Two female patients had medical histories of cesarean sections and a male patient had been operated due to malignant fibrous histiocytoma, previously. Abdominal CT scan of one case revealed huge ovoid hypodense mass with enhanced peripheral rim. Calcific spots and whirl-like stripes were noted within the lesion. Towel was found in pathologic specimen. CT images of two patients showed well-encapsulated, mixed fluid and soft tissue density mass with several gas bubbles. Surgical sponges were found within abscesses. The authors conclude that these characteristic CT findings and careful histories of surgery are very useful for correct pre-operative diagnosis and permit the guideline for the optimal plan of the surgical treatment.

  14. Perforated appendicitis: accuracy of CT diagnosis and correlation of CT findings with the length of hospital

    International Nuclear Information System (INIS)

    Siddiqui, H.A.; Afzal, S.

    2007-01-01

    To determine the sensitivity and specificity of CT findings in the differentiation of perforated from nonperforated appendicitis and correlate CT diagnosis with the length of hospital stay. The study included 70 patients who presented with right lower quadrant abdominal pain and underwent preoperative CT scan followed by appendectomy. Patients were divided into two groups of having perforated and nonperforated appendicitis on the basis of CT scan findings. The surgical and pathological reports combined were considered the reference standard for the diagnosis of perforated appendicitis. Various CT scan findings and average duration of hospital stay in days was compared by t-test. Twenty-six (37%) of 70 patients had perforated appendicitis. It was correctly identified on pre-operative CT scan in 18 patients. There were 18 true positive diagnoses, 43 true negative diagnoses, 1 false positive diagnosis and 8 false negative diagnoses which yielded a sensitivity of 69%, specificity of 97%, positive predictive value of 94% and negative predictive value of 84%. Mean length of hospital stay in perforated group was 6.3 days and 2.9 days in nonperforated group. Severe periappendiceal inflammation, periappendiceal and or abdominopelvic fluid and abscess were significantly associated with perforated appendicitis and with a significant longer hospital stay (p <.001). CT scan is 69% sensitive and 97% specific for the diagnosis of perforated appendicitis and constellation of CT findings can be used to select patients with perforated appendicitis for initial non-operative management. Presence of CT signs of significant appendiceal inflammation is independent predictor of longer hospital stay. (author)

  15. Dental CT: examination technique, radiation load and anatomy; Dental-CT: Untersuchungstechnik, Strahlenbelastung und Anatomie

    Energy Technology Data Exchange (ETDEWEB)

    Lenglinger, F.X.; Muhr, T. [AKH Wels (Austria). Inst. fuer Radiologie; Krennmair, G. [Praxis fuer Zahn-, Mund- und Kieferheilkunde und Implantologie, Marchtrenk (Austria)

    1999-12-01

    Traditionally oral surgeons and dentists have evaluated the jaws using intraoral films and panoramic radiographs. The involvement of radiologists has been limited. In the past few years dedicated CT-software-programs developed to evaluate dental implant patients have provided a new look at the jaws. The complex anatomy is described and identified on human skulls and on axial, panoramic, and cross-sectional images. With this anatomic description Dental-CT-scans are used to demonstrate the anatomy of maxilla and the mandible. An overview of the technique of Dental-CT is provided, furthermore the radiation dose of different organs is explained. Suggestions to reduce these doses by simple modifications of the recommended protocols are given. (orig.) [German] Die Einfuehrung im Bereich der Computertomographiesoftware (Dental-CT) ermoeglicht dem Radiologen zusaetzlich zu den ueblichen, von den Zahnaerzten durchgefuehrten Roentgenuntersuchungen eine ueberlagerungs- und verzerrungsfreie Darstellung des Ober- und Unterkiefers. In der Implantologie ist mit dieser Darstellung eine exakte Planung moeglich. Weiterhin haben sich Duennschicht-CT-Untersuchungen auch bei der Abklaerung von Zysten, Tumoren, Frakturen, tiefen Parodontitiden und retinierten Zaehnen bewaehrt. In dieser Zeit wird ein Ueberblick ueber die Anatomie, die Untersuchungstechnik des Dental-CT und die auftretende Strahlenbelastung gegeben. Basierend auf rezente Literaturangaben kann eine Reduktion der absorbierten Dosis bei gleichbleibender Bildqualitaet durch einfache Protokollmodifikationen erzielt werden. (orig.)

  16. Monte Carlo dose calibration in CT scanner

    International Nuclear Information System (INIS)

    Yadav, Poonam; Ramasubramanian, V.; Subbaiah, K.V.; Thayalan, K.

    2008-01-01

    Computed Tomography (CT) scanner is a high radiation imaging modality compared to radiography. The dose from a CT examination can vary greatly depending on the particular CT scanner used, the area of the body examined, and the operating parameters of the scan. CT is a major contributor to collective effective dose in diagnostic radiology. Apart from the clinical benefits, the widespread use of multislice scanner is increasing radiation level to patient in comparison with conventional CT scanner. So, it becomes necessary to increase awareness about the CT scanner. (author)

  17. {sup 18}F-FDG PET/CT imaging versus dynamic contrast-enhanced CT for staging and prognosis of inflammatory breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Champion, Laurence; Edeline, Veronique; Giraudet, Anne-Laure; Wartski, Myriam [Service de Medecine Nucleaire, Saint-Cloud (France); Lerebours, Florence [Service d' Oncologie Medicale, Saint-Cloud (France); Cherel, Pascal [Institut Curie, Hopital Rene Huguenin, Service de Radiologie, Saint-Cloud (France); Bellet, Dominique [Service de Medecine Nucleaire, Saint-Cloud (France); Universite Paris Descartes, Pharmacologie Chimique et Genetique and Imagerie, Inserm U1022 CNRS UMR 8151, Faculte des sciences pharmaceutiques et biologiques, Paris (France); Alberini, Jean-Louis [Service de Medecine Nucleaire, Saint-Cloud (France); Universite Versailles Saint-Quentin, Faculte de medecine, Saint-Quentin-en-Yvelines (France)

    2013-08-15

    Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer with a poor prognosis. Locoregional staging is based on dynamic contrast-enhanced (DCE) CT or MRI. The aim of this study was to compare the performances of FDG PET/CT and DCE CT in locoregional staging of IBC and to assess their respective prognostic values. The study group comprised 50 women (median age: 51 {+-} 11 years) followed in our institution for IBC who underwent FDG PET/CT and DCE CT scans (median interval 5 {+-} 9 days). CT enhancement parameters were net maximal enhancement, net early enhancement and perfusion. The PET/CT scans showed intense FDG uptake in all primary tumours. Concordance rate between PET/CT and DCE CT for breast tumour localization was 92 %. No significant correlation was found between SUVmax and CT enhancement parameters in primary tumours (p > 0.6). PET/CT and DCE CT results were poorly correlated for skin infiltration (kappa = 0.19). Ipsilateral foci of increased axillary FDG uptake were found in 47 patients (median SUV: 7.9 {+-} 5.4), whereas enlarged axillary lymph nodes were observed on DCE CT in 43 patients. Results for axillary node involvement were fairly well correlated (kappa = 0.55). Nineteen patients (38 %) were found to be metastatic on PET/CT scan with a significant shorter progression-free survival than patients without distant lesions (p = 0.01). In the primary tumour, no statistically significant difference was observed between high and moderate tumour FDG uptake on survival, using an SUVmax cut-off of 5 (p = 0.7 and 0.9), or between high and low tumour enhancement on DCE CT (p > 0.8). FDG PET/CT imaging provided additional information concerning locoregional involvement to that provided by DCE CT on and allowed detection of distant metastases in the same whole-body procedure. Tumour FDG uptake or CT enhancement parameters were not correlated and were not found to have any prognostic value. (orig.)

  18. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... over time. top of page What are the benefits vs. risks? Benefits CT scanning is painless, noninvasive and accurate. A ... bear denotes child-specific content. Related Articles and Media Radiation Dose in X-Ray and CT Exams ...

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... over time. top of page What are the benefits vs. risks? Benefits A CT scan is one of the safest ... scanning is painless, noninvasive and accurate. A major advantage of CT is its ability to image bone, ...

  20. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... over time. top of page What are the benefits vs. risks? Benefits Viewing a CT scan, an experienced radiologist can ... scanning is painless, noninvasive and accurate. A major advantage of CT is its ability to image bone, ...

  1. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional ... advantage of CT is its ability to image bone, soft tissue and blood vessels all at the same time. ...

  2. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional ... advantage of CT is its ability to image bone, soft tissue and blood vessels all at the same time. ...

  3. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... CD or DVD. CT images of internal organs, bones, soft tissue and blood vessels provide greater detail than traditional ... advantage of CT is its ability to image bone, soft tissue and blood vessels all at the same time. ...

  4. Interobserver Delineation variation using CT versus combined CT + MRI in intensity- modulated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Vaerenbergh, K. van; Vakaet, L.; Bral, S.; Claus, F.; Neve, W.J. de; Meerleer, G.O. de

    2005-01-01

    Purpose: to quantify interobserver variation of prostate and seminal vesicle delineations using CT only versus CT + MRI in consensus reading with a radiologist. Material and methods: the prostate and seminal vesicles of 13 patients treated with intensity-modulated radiotherapy for prostatic adenocarcinoma were retrospectively delineated by three radiation oncologists on CT only and on CT + MRI in consensus reading with a radiologist. The volumes and margin positions were calculated and intermodality and interobserver variations were assessed for the clinical target volume (CTV), seminal vesicles, prostate and three prostatic subdivisions (apical, middle and basal third). Results: using CT + MRI as compared to CT alone, the mean CTV, prostate and seminal vesicle volumes significantly decreased by 6.54%, 5.21% and 10.47%, respectively. More importantly, their standard deviations significantly decreased by 63.06%, 62.65% and 44.83%, respectively. The highest level of variation was found at the prostatic apex, followed by the prostatic base and seminal vesicles. Conclusion: addition of MRI to CT in consensus reading with a radiologist results in a moderate decrease of the CTV, but an important decrease of the interobserver delineation variation, especially at the prostatic apex. (orig.)

  5. Comparative analysis of multi-slice spiral CT and positron emission tomography-CT in evaluation of axillary lymph nodes in breast cancer patients

    International Nuclear Information System (INIS)

    Sun Xianchang; Zhang Ruyi; Liu Qingwei; Zhao Suhong; Zu Degui; Li Xin

    2008-01-01

    Objective: To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients. Methods: Forty patients with pathologically proven breast cancer underwent contrast-enhanced spiral CT of the breast and axilla, 13 of them also underwent PET-CT examination. One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT, while 57 lymph nodes were found in the 13 patients through PET-CT. Three radiologists rated the lymph nodes found in CT images on a five-point scale. If the score was equal to or greater than 3, it was defined as positive (metastatic), otherwise negative. Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images. The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results. The relative value of CT and PET-CT was analyzed. Exact probability statistics were employed. Results: One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT, 91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT, 99 were positive and 59 were negative pathologicall. A total of 57 lymph nodes were found by PET-CT. Thirty-nine of them were defined as positive and 18 as negative. Among the lymph nodes found in PET-CT, 39 were positive and 18 were negative pathologically. The sensitivity, specificity, accuracy, positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%, 94.91%, 91.14%, 96.70%, and 83.58%, respectively. The sensitivity, specificity, accuracy, positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%, 94.44%, 96.49%, 97.44%, and 94.44%, respectively. PET-CT had no significant difference with spiral CT in sensitivity, accuracy, positive and negative predictive values for detection

  6. CT scan findings of fungal pneumonia; Diagnose der Pilzpneumonie in der Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Heckmann, M.; Uder, M.; Bautz, W.; Heinrich, M. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Diagnostische Radiologie

    2008-07-01

    The importance of fungal infection of the lung in immunocompromised patients has increased substantially during the last decades. Numerically the most patients are those with neutropenia, e.g. patients with malignancies or solid organ and stem cell transplantation, chemotherapy, corticosteroid use and HIV infection. Although fungal infections can occur in immunocompetent patients, their frequency in this population is rare. The clinical symptoms such as fever accompanied with non-productive cough are unspecific. In some patients progression to hypoxemia and dyspnea may occur rapidly. In spite of improved antifungal therapy morbidity and mortality of these infections are still high. Therefore an early and non-invasive diagnosis is very important. That is why CT and even better High-Resolution-CT (HR-CT) is a very important modality in examining immunocompromised patients with a probability of fungal infection. CT is everywhere available and, as a non-invasive method, able to give the relevant diagnose efficiently. This paper should give an overview about the radiologic findings and possible differential diagnosis of diverse pulmonary fungal infections in CT. Pneumonias caused by Aspergillus, Cryptococcus, Candida, Histoplasma, Mucor and Geotrichum capitatum are illustrated. (orig.)

  7. CT findings of the thymus

    International Nuclear Information System (INIS)

    Kang, Eun Young; Kim, Yun Hwan; Seol, Hae Young; Chung, Woun Kyun; Suh, Won Hyuck

    1987-01-01

    In 14 cases of normal and abnormal thymus proved surgically and histopathologically in korea University Hae Wha Hospital during recent 6 years, the clinical and CT findings were analyzed. 1. Of 14 cases, 2 cases were normal thymus, 5 cases were thymic hyperplasia, 4 cases were benign thymoma, 2 case were malignant thymoma and 1 case was thymic cyst. 2. Of 14 cases, 10 cases were associated with myasthenia gravis, and 7 of these 10 cases were 3rd to 5th decades females. Among 10 cases with myasthenia gravis. 5 cases were thymic hyperplasia, 1 case was benign thymoma, 2 cases were malignant thymoma, and 2 cases were normal thymus. 3. All 5 thymic hyperplasia were associated with myasthenia gravis. CT findings of thymic hyperplasia were normal in 4 cases and increased lobe thickness in 1 case. 4. Of 4 cases of benign thymoma, only 1 case was associated with myasthenia gravis, and all 4 cases were positive findings in CT scan. CT findings of benign thymoma were round or oval soft tissue mass in anterior mediastinum, and 1 case had punctuate calcifications. 5. Of 2 cases of malignant thymoma, all 2 cases were associated with myasthenia gravis and positive findings in CT scan. CT findings of malignant thymoma were anterior mediastinal soft tissue mass with obliteration of the normal fat planes surrounding great vessels. SVC compression, and pleural tumor implants. 6. CT yielded significant diagnostic information of differential diagnosis between thymoma and thymoma hyperplasia in myasthenia gravis patients. Also CT was highly sensitive test in detection of thymoma and determined the extent and invasiveness of thymoma.

  8. CT findings of the thymus

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Young; Kim, Yun Hwan; Seol, Hae Young; Chung, Woun Kyun; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1987-02-15

    In 14 cases of normal and abnormal thymus proved surgically and histopathologically in korea University Hae Wha Hospital during recent 6 years, the clinical and CT findings were analyzed. 1. Of 14 cases, 2 cases were normal thymus, 5 cases were thymic hyperplasia, 4 cases were benign thymoma, 2 case were malignant thymoma and 1 case was thymic cyst. 2. Of 14 cases, 10 cases were associated with myasthenia gravis, and 7 of these 10 cases were 3rd to 5th decades females. Among 10 cases with myasthenia gravis. 5 cases were thymic hyperplasia, 1 case was benign thymoma, 2 cases were malignant thymoma, and 2 cases were normal thymus. 3. All 5 thymic hyperplasia were associated with myasthenia gravis. CT findings of thymic hyperplasia were normal in 4 cases and increased lobe thickness in 1 case. 4. Of 4 cases of benign thymoma, only 1 case was associated with myasthenia gravis, and all 4 cases were positive findings in CT scan. CT findings of benign thymoma were round or oval soft tissue mass in anterior mediastinum, and 1 case had punctuate calcifications. 5. Of 2 cases of malignant thymoma, all 2 cases were associated with myasthenia gravis and positive findings in CT scan. CT findings of malignant thymoma were anterior mediastinal soft tissue mass with obliteration of the normal fat planes surrounding great vessels. SVC compression, and pleural tumor implants. 6. CT yielded significant diagnostic information of differential diagnosis between thymoma and thymoma hyperplasia in myasthenia gravis patients. Also CT was highly sensitive test in detection of thymoma and determined the extent and invasiveness of thymoma.

  9. Quantitative dual energy CT measurements in rabbit VX2 liver tumors: Comparison to perfusion CT measurements and histopathological findings

    International Nuclear Information System (INIS)

    Zhang, Long Jiang; Wu, Shengyong; Wang, Mei; Lu, Li; Chen, Bo; Jin, Lixin; Wang, Jiandong; Larson, Andrew C.; Lu, Guang Ming

    2012-01-01

    Purpose: To evaluate the correlation between quantitative dual energy CT and perfusion CT measurements in rabbit VX2 liver tumors. Materials and methods: This study was approved by the institutional animal care and use committee at our institution. Nine rabbits with VX2 liver tumors underwent contrast-enhanced dual energy CT and perfusion CT. CT attenuation for the tumors and normal liver parenchyma and tumor-to-liver ratio were obtained at the 140 kVp, 80 kVp, average weighted images and dual energy CT iodine maps. Quantitative parameters for the viable tumor and adjacent liver were measured with perfusion CT. The correlation between the enhancement values of the tumor in iodine maps and perfusion CT parameters of each tumor was analyzed. Radiation dose from dual energy CT and perfusion CT was measured. Results: Enhancement values for the tumor were higher than that for normal liver parenchyma at the hepatic arterial phase (P < 0.05). The highest tumor-to-liver ratio was obtained in hepatic arterial phase iodine map. Hepatic blood flow of the tumor was higher than that for adjacent liver (P < 0.05). Enhancement values of hepatic tumors in the iodine maps positively correlated with permeability of capillary vessel surface (r = 0.913, P < 0.001), hepatic blood flow (r = 0.512, P = 0.010), and hepatic blood volume (r = 0.464, P = 0.022) at the hepatic arterial phases. The effective radiation dose from perfusion CT was higher than that from DECT (P < 0.001). Conclusions: The enhancement values for viable tumor tissues measured in iodine maps were well correlated to perfusion CT measurements in rabbit VX2 liver tumors. Compared with perfusion CT, dual energy CT of the liver required a lower radiation dose.

  10. 3D CT versus axial helical CT versus conventional tomography in the classification of acetabular fractures: A ROC analysis

    International Nuclear Information System (INIS)

    Kickuth, Ralph; Laufer, Ulf; Hartung, Guido; Gruening, Christian; Stueckle, Christoph; Kirchner, Johannes

    2002-01-01

    AIM: To assess the diagnostic power of three-dimensional computed tomography (3D CT), axial helical computed tomography (CT) and conventional tomography in the classification of acetabular fractures by interdisciplinary review. MATERIALS AND METHODS: Receiver operating characteristics (ROCs) were assessed for two radiologists and two surgeons blinded to the presence of acetabular fractures in an animal model (a total of 62 porcine hips, 40 of them with artificial acetabular fractures). Main target parameter was the diagnostic accuracy in the classification of the artificial fractures following Judet et al. RESULTS: ROC analysis for radiologists showed A z values of 0·83 for 3D CT, 0·81 for axial helical CT, and 0·78 for conventional tomography; differences between the three techniques were not significant (P = 0·46-0·73). A z values for the surgeons were 0·87 for 3D CT, 0·68 for axial helical CT, and 0·60 for conventional tomography; 3D CT was significantly better than axial helical CT (P = 0·01) and conventional tomography (P = 0·001). The differences between axial helical CT and conventional tomography were not significant (P = 0·37). CONCLUSION: Acetabular fractures are best classified by 3D CT, followed by axial helical CT and conventional tomography when assessed by surgeons. 3D CT did not provide any additional significant benefit in the classification performed by radiologists. Kickuth, R. et al. (2002)

  11. Cardiac pathologies incidentally detected with non-gated chest CT; Inzidentelle Pathologien des Herzens im Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, Axel; Kroepil, P.; Lanzman, R.S.; Moedder, U. [Inst. fuer Radiologie, Universitaetsklinikum Duesseldorf, Heinrich-Heine-Univ. (Germany); Choy, G.; Abbara, S. [Cardiovascular Imaging Section, Massachusetts General Hospital, Harvard Medical School (United States)

    2009-12-15

    Cardiac imaging using electrocardiogram-gated multi-detector computed tomography (MDCT) permits noninvasive diagnosis of congenital and acquired cardiac pathologies and has thus become increasingly important in the last years. Several studies investigated the incidence and relevance of incidental extracardiac structures within the lungs, mediastinum, chest wall, and abdomen with gated coronary CT. This resulted in the general acceptance of the review of extracardiac structures as a routine component of coronary CT interpretation. On the other hand radiologists tend to neglect pericardial and cardiac pathologies in non-gated chest CT, which is primarily performed for the evaluation of the respiratory system or for tumor staging. Since the introduction of multi-detector spiral CT technology, the incidental detection of cardiac and pericardial findings has become possible using non-gated chest CT. This article reviews the imaging appearances and differential diagnostic considerations of incidental cardiac entities that may be encountered in non-gated chest CT. (orig.)

  12. Multislice CT imaging of pulmonary embolism

    International Nuclear Information System (INIS)

    Schoepf, J.U.; Kessler, M.A.; Rieger, C.T.; Herzog, P.; Wiesgigl, S.; Becker, C.R.; Exarhos, D.N.; Reiser, M.F.

    2001-01-01

    In recent years CT has been established as the method of choice for the diagnosis of central pulmonary embolism (PE) to the level of the segmental arteries. The key advantage of CT over competing modalities is the reliable detection of relevant alternative or additional disease causing the patient's symptoms. Although the clinical relevance of isolated peripheral emboli remains unclear, the alleged poor sensitivity of CT for the detection of such small clots has to date prevented the acceptance of CT as the gold standard for diagnosing PE. With the advent of multislice CT we can now cover the entire chest of a patient with 1-mm slices within one breath-hold. In comparison with thicker sections, the detection rate of subsegmental emboli can be significantly increased with 1-mm slices. In addition, the interobserver correlation which can be achieved with 1-mm sections by far exceeds the reproducibility of competing modalities. Meanwhile use of multislice CT for a combined diagnosis of PE and deep venous thrombosis with the same modality appears to be clinically accepted. In the vast majority of patients who receive a combined thoracic and venous multislice CT examination the scan either confirms the suspected diagnosis or reveals relevant alternative or additional disease. The therapeutic regimen is usually chosen based on the functional effect of embolic vascular occlusion. With the advent of fast CT scanning techniques, also functional parameters of lung perfusion can be non-invasively assessed by CT imaging. These advantages let multislice CT appear as an attractive modality for a non-invasive, fast, accurate, and comprehensive diagnosis of PE, its causes, effects, and differential diagnoses. (orig.)

  13. PET/CT imaging in head and neck tumors

    International Nuclear Information System (INIS)

    Roedel, R.; Palmedo, H.; Reichmann, K.; Reinhardt, M.J.; Biersack, H.J.; Straehler-Pohl, H.J.; Jaeger, U.

    2004-01-01

    To evaluate the usefulness of combined PET/CT examinations for detection of malignant tumors and their metastases in head and neck oncology. 51 patients received whole body scans on a dual modality PET/CT system. CT was performed without i.v. contrast. The results were compared concerning the diagnostic impact of native CT scan on FDG-PET images and the additional value of fused imaging. From 153 lesions were 97 classified as malignant on CT and 136 on FDG/PET images, as suspicious for malignancy in 33 on CT and 7 on FDG-PET and as benign in 23 on CT and 10 on FDG-PET. With combined PET/CT all primary and recurrent tumors could be found, the detection rate in patients with unknown primary tumors was 45%. Compared to PET or CT alone the sensitivity, specifity and accuracy could be significantly improved by means of combined PET/CT. Fused PET/CT imaging with [F18]-FDG and native CT-scanning enables accurate diagnosis in 93% of lesions and 90% of patients with head and neck oncology. (orig.) [de

  14. CT findings in neonatal hypothermia

    International Nuclear Information System (INIS)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y.; Hershkowitz, E.; Berenstein, T.; Sofer, S.; Maor, E.

    1998-01-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.)

  15. Radiation exposure in CT-guided interventions

    Energy Technology Data Exchange (ETDEWEB)

    Kloeckner, Roman, E-mail: Roman.Kloeckner@unimedizin-mainz.de [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany); Santos, Daniel Pinto dos; Schneider, Jens [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany); Kara, Levent [Department of Radiology, Inselspital Bern, Freiburgstraße 18, 3010 Bern (Switzerland); Dueber, Christoph; Pitton, Michael B. [Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz (Germany)

    2013-12-01

    Purpose: To investigate radiation exposure in computed tomography (CT)-guided interventions, to establish reference levels for exposure, and to discuss strategies for dose reduction. Materials and methods: We analyzed 1576 consecutive CT-guided procedures in 1284 patients performed over 4.5 years, including drainage placements; biopsies of different organs; radiofrequency and microwave ablations (RFA/MWA) of liver, bone, and lung tumors; pain blockages, and vertebroplasties. Data were analyzed with respect to scanner settings, overall radiation doses, and individual doses of planning CT series, CT intervention, and control CT series. Results: Eighy-five percent of the total radiation dose was applied during the pre- and post-interventional CT series, leaving only 15% applied by the CT-guided intervention itself. Single slice acquisition was associated with lower doses than continuous CT-fluoroscopy (37 mGy cm vs. 153 mGy cm, p < 0.001). The third quartile of radiation doses varied considerably for different interventions. The highest doses were observed in complex interventions like RFA/MWA of the liver, followed by vertebroplasty and RFA/MWA of the lung. Conclusions: This paper suggests preliminary reference levels for various intervention types and discusses strategies for dose reduction. A multicenter registry of radiation exposure including a broader spectrum of scanners and intervention types is needed to develop definitive reference levels.

  16. CT findings in Reye syndrome

    International Nuclear Information System (INIS)

    Lee, Kil Woo; Lim, Hyo Keun; Choo, In Wook; Bae, Sang Hoon

    1990-01-01

    We present here the CT findings in 10 patients with Reye syndrome. Acute findings is diffuse cerebral swelling with or without parenchymal low density. The cerebral swelling gradually changed to atrophy. The parenchymal low density predisposes in Lt temporoparietal area. Contrast enhanced CT scan showed no additional finding, except 1 case. The hemorrhagic infarction which has not been reported previously was seen in 1 case and resulted in the most prominent sequela. The sequelae were developed in all atrophic cases. So, the brain CT may be useful in monitoring cerebral swelling, determining treatment plan in acute stage, and in presenting prognosis and sequelae on fellow up CT

  17. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... can help plan the safest and most effective surgery. CT of the sinuses is now widely available and is performed in a relatively short time, especially when compared to magnetic resonance imaging (MRI). CT scanning is painless, noninvasive and ...

  18. Coronary CT angiography: Diagnostic value and clinical challenges.

    Science.gov (United States)

    Sabarudin, Akmal; Sun, Zhonghua

    2013-12-26

    Coronary computed tomography (CT) angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography. Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320- slice CT scanners. Despite the promising diagnostic value, coronary CT angiography is still limited in some areas, such as inferior temporal resolution, motion-related artifacts and high false positive results due to severe calcification. The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners. Prognostic value of coronary CT angiography in coronary artery disease is also discussed, while limitations and challenges of coronary CT angiography are highlighted.

  19. Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

    Science.gov (United States)

    Wu, T.-H.; Liang, C.-H.; Wu, J.-K.; Lien, C.-Y.; Yang, B.-H.; Huang, Y.-H.; Lee, J. J. S.

    2009-07-01

    Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18F-fluorodeoxyglucose (18F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

  20. Integration of PET-CT and cone-beam CT for image-guided radiotherapy with high image quality and registration accuracy

    International Nuclear Information System (INIS)

    Wu, T-H; Liang, C-H; Wu, J-K; Lien, C-Y; Yang, B-H; Lee, J J S; Huang, Y-H

    2009-01-01

    Hybrid positron emission tomography-computed tomography (PET-CT) system enhances better differentiation of tissue uptake of 18 F-fluorodeoxyglucose ( 18 F-FDG) and provides much more diagnostic value in the non-small-cell lung cancer and nasopharyngeal carcinoma (NPC). In PET-CT, high quality CT images not only offer diagnostic value on anatomic delineation of the tissues but also shorten the acquisition time for attenuation correction (AC) compared with PET-alone imaging. The linear accelerators equipped with the X-ray cone-beam computed tomography (CBCT) imaging system for image-guided radiotherapy (IGRT) provides excellent verification on position setup error. The purposes of our study were to optimize the CT acquisition protocols of PET-CT and to integrate the PET-CT and CBCT for IGRT. The CT imaging parameters were modified in PET-CT for increasing the image quality in order to enhance the diagnostic value on tumour delineation. Reproducibility and registration accuracy via bone co-registration algorithm between the PET-CT and CBCT were evaluated by using a head phantom to simulate a head and neck treatment condition. Dose measurement in computed tomography dose index (CTDI) was also estimated. Optimization of the CT acquisition protocols of PET-CT was feasible in this study. Co-registration accuracy between CBCT and PET-CT on axial and helical modes was in the range of 1.06 to 2.08 and 0.99 to 2.05 mm, respectively. In our result, it revealed that the accuracy of the co-registration with CBCT on helical mode was more accurate than that on axial mode. Radiation doses in CTDI were 4.76 to 18.5 mGy and 4.83 to 18.79 mGy on axial and helical modes, respectively. Registration between PET-CT and CBCT is a state-of-the-art registration technology which could provide much information on diagnosis and accurate tumour contouring on radiotherapy while implementing radiotherapy procedures. This novelty technology of PET-CT and cone-beam CT integration for IGRT may have a

  1. Percutaneous CT-guided high-dose brachytherapy (CT-HDRBT) ablation of primary and metastatic lung tumors in nonsurgical candidates; Perkutane CT-gesteuerte Hochdosis-Brachytherapie (CT-HDRBT) von primaeren und metastatischen Lungentumoren in nicht chirurgischen Kandidaten

    Energy Technology Data Exchange (ETDEWEB)

    Collettini, F.; Schnapauff, D.; Poellinger, A.; Denecke, T.; Banzer, J.; Golenia, M.J.; Gebauer, B. [Charite - Universitatesmedizin Berlin (Germany). Inst. fuer Radiologie; Wust, P. [Charite - Universitatesmedizin Berlin (Germany). Klinik fuer Strahlentherapie

    2012-04-15

    To evaluate the safety and efficacy of CT-guided high-dose brachytherapy (CT-HDRBT) ablation of primary and metastatic lung tumors. Between November 2007 and May 2010, all consecutive patients with primary or metastatic lung tumors, unsuitable for surgery, were treated with CT-HDRBT. Imaging follow-up after treatment was performed with contrast-enhanced CT at 6 weeks, 3 months and every 6 months after the procedure. The endpoints of the study were local tumor control and time to progression. The Kaplan-Meier method was used to estimate survival functions and local tumor progression rates. 34 procedures were carried out on 33 lesions in 22 patients. The mean diameter of the tumors was 33.3 mm (SD = 20.4). The first contrast-enhanced CT showed that complete ablation was achieved in all lesions. The mean minimal tumor enclosing dose was 18.9 Gy (SD = 2). Three patients developed a pneumothorax after the procedure. The mean follow-up time was 13.7 (3 - 29) months. 2 of 32 lesions (6.25 %) developed a local tumor progression. 8 patients (36.3 %) developed a distant tumor progression. After 17.7 months, 13 patients were alive and 9 patients had died. CT-HDRBT ablation is a safe and attractive treatment option for patients with lung malignancies and allows targeted destruction of tumor tissue with simultaneous preservation of important lung structures. Furthermore, CT-HDRBT is independent of the size of the lesion and its location within the lung parenchyma. (orig.)

  2. Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts

    International Nuclear Information System (INIS)

    Lee, Chang Hyun; Im, Jung Gi; Goo, Jin Mo; Lee, Hyun Ju; Hong, Sung Tae; Shen, Cheng Hua; Chung, Doo Hyun; Son, Kyu Ri; Chang, Jung Min; Eo, Hong

    2007-01-01

    To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. The initial findings were pleural effusion and/or subpleural groundglass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus

  3. Clinical application of CT and CT-guided percutaneous transthoracic needle biopsy in patients with indeterminate pulmonary nodules

    Energy Technology Data Exchange (ETDEWEB)

    Cardoso, Luciana Vargas; Souza Júnior, Arthur Soares, E-mail: fabianonatividade@terra.com.br [Rio Preto-Ultra-X Radiological Diagnosis Institute, São José do Rio Preto, SP (Brazil)

    2014-07-15

    Objective: To investigate the clinical application of CT and CT-guided percutaneous transthoracic needle biopsy (CT-PTNB) in patients with indeterminate pulmonary nodules (IPNs). Methods: We retrospectively studied 113 patients with PNs undergoing CT and CT-PTNB. Variables such as gender, age at diagnosis, smoking status, CT findings, and CT-PTNB techniques were analyzed. Data analysis was performed with the Student's t-test for independent samples the chi-square test, and normal approximation test for comparison of two proportions. Results: Of the 113 patients studied, 68 (60.2%) were male and 78 (69%) were smokers. The diameter of malignant lesions ranged from 2.6 cm to 10.0 cm. Most of the IPNs (85%) were located in the peripheral region. The biopsied IPNs were found to be malignant in 88 patients (77.8%) and benign in 25 (22.2%). Adenocarcinoma was the most common malignant tumor, affecting older patients. The IPN diameter was significantly greater in patients with malignant PNs than in those with benign IPNs (p < 0.001). Having regular contour correlated significantly with an IPN being benign (p = 0.022), whereas spiculated IPNs and bosselated IPNs were more often malignant (in 50.7% and 28.7%, respectively). Homogeneous attenuation and necrosis were more common in patients with malignant lesions (51.9% and 26.9%, respectively). Conclusions: In our sample, CT and CT-PTNB were useful in distinguishing between malignant and benign IPNs. Advanced age and smoking were significantly associated with malignancy. Certain CT findings related to IPNs (larger diameter, spiculated borders, homogeneous attenuation, and necrosis) were associated with malignancy. (author)

  4. Detectability index of differential phase contrast CT compared with conventional CT: a preliminary channelized Hotelling observer study

    Science.gov (United States)

    Tang, Xiangyang; Yang, Yi; Tang, Shaojie

    2013-03-01

    Under the framework of model observer with signal and background exactly known (SKE/BKE), we investigate the detectability of differential phase contrast CT compared with that of the conventional attenuation-based CT. Using the channelized Hotelling observer and the radially symmetric difference-of-Gaussians channel template , we investigate the detectability index and its variation over the dimension of object and detector cells. The preliminary data show that the differential phase contrast CT outperforms the conventional attenuation-based CT significantly in the detectability index while both the object to be detected and the cell of detector used for data acquisition are relatively small. However, the differential phase contrast CT's dominance in the detectability index diminishes with increasing dimension of either object or detector cell, and virtually disappears while the dimension of object or detector cell approaches a threshold, respectively. It is hoped that the preliminary data reported in this paper may provide insightful understanding of the differential phase contrast CT's characteristic in the detectability index and its comparison with that of the conventional attenuation-based CT.

  5. Computed Tomography (CT) -- Head

    Medline Plus

    Full Text Available ... images or pictures of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted ... of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT ...

  6. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... images or pictures of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted ... of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT ...

  7. Abdominal and Pelvic CT

    Medline Plus

    Full Text Available ... images or pictures of the inside of the body. The cross-sectional images generated during a CT scan can be reformatted ... of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT ...

  8. CT urography and hematuria

    DEFF Research Database (Denmark)

    Bretlau, Thomas; Hansen, Rasmus H; Thomsen, Henrik S

    2015-01-01

    BACKGROUND: Computed tomography (CT) urography is now used in the work-up of patients with hematuria. The dose of contrast medium and radiation varies considerably between the different CT protocols. PURPOSE: To study the disease prevalence in a consecutive group of patients with hematuria...

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page How should ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of the sinuses is now widely available ...

  10. Dual energy cardiac CT.

    Science.gov (United States)

    Carrascosa, Patricia; Deviggiano, Alejandro; Rodriguez-Granillo, Gastón

    2017-06-01

    Conventional single energy CT suffers from technical limitations related to the polychromatic nature of X-rays. Dual energy cardiac CT (DECT) shows promise to attenuate and even overcome some of these limitations, and might broaden the scope of patients eligible for cardiac CT towards the inclusion of higher risk patients. This might be achieved as a result of both safety (contrast reduction) and physiopathological (myocardial perfusion and characterization) issues. In this article, we will review the main clinical cardiac applications of DECT, that can be summarized in two core aspects: coronary artery evaluation, and myocardial evaluation.

  11. CT diagnosis in diseases of the breast

    International Nuclear Information System (INIS)

    Han Hongbin; Xie Jingxia

    1998-01-01

    Purpose: To study the CT signs of breast diseases, and discuss the value of CT in the diagnosis of breast cancer and the axillary lymph node (LN) metastases. Materials and methods: Fifty three cases were reported, including breast cancer 30 cases and benign diseases 23 cases. CT were performed in all patients, 44 also had mammography examination. Results: (1) The CT appearance of breast cancer: round or irregular mass, spiculate border, duct retraction, involved Cooper's ligament, deformed adipose space etc. Benign hyperplasia: Irregular mass and symmetrical thickening of breast glands. Cystic hyperplasia: typically multiple, round, liquid-density mass. (2) CT was comparable to mammography in terms of differential diagnosis, however with breast mass located near the axilla or for evaluation of the thoracic wall. CT was superior to mammography. CT was also helpful in detecting LN metastases. Conclusion: CT is valuable in detecting and differentiating breast diseases as well as in the diagnosis of LN metastases

  12. Oncologic PET/CT: current status and controversies

    International Nuclear Information System (INIS)

    Siegel, B.A.; Dehdashti, F.

    2005-01-01

    The introduction of integrated PET/CT has dramatically increased the worldwide rate of growth for PET, predominantly for oncologic imaging with the glucose analog 18 F-fluorodeoxyglucose (FDG). A rapidly expanding body of literature demonstrates that the use FDG-PET/CT and the resultant ability to interpret coregistered and fused PET and CT images lead to improved observer confidence and improved diagnostic performance by comparison with PET alone, CT alone, and visually correlated PET and CT. The value of PET/CT is likely to be even greater with new PET radiopharmaceuticals under development, many of which produce PET images with even fewer anatomical landmarks than FDG images. PET/CT is also likely to lead to the resurrection of 18 F-fluoride as a principal agent for radionuclide bone imaging. There are a number of controversies related to PET/CT, including minimum training and experience requirements for interpreting physicians and defining new models for technical and professional reimbursement. (orig.)

  13. The sensitivity of computed tomography (CT) scans in detecting trauma: are CT scans reliable enough for courtroom testimony?

    Science.gov (United States)

    Molina, D Kimberley; Nichols, Joanna J; Dimaio, Vincent J M

    2007-09-01

    Rapid and accurate recognition of traumatic injuries is extremely important in emergency room and surgical settings. Emergency departments depend on computed tomography (CT) scans to provide rapid, accurate injury assessment. We conducted an analysis of all traumatic deaths autopsied at the Bexar County Medical Examiner's Office in which perimortem medical imaging (CT scan) was performed to assess the reliability of the CT scan in detecting trauma with sufficient accuracy for courtroom testimony. Cases were included in the study if an autopsy was conducted, a CT scan was performed within 24 hours before death, and there was no surgical intervention. Analysis was performed to assess the correlation between the autopsy and CT scan results. Sensitivity, specificity, positive predictive value, and negative predictive value were defined for the CT scan based on the autopsy results. The sensitivity of the CT scan ranged from 0% for cerebral lacerations, cervical vertebral body fractures, cardiac injury, and hollow viscus injury to 75% for liver injury. This study reveals that CT scans are an inadequate detection tool for forensic pathologists, where a definitive diagnosis is required, because they have a low level of accuracy in detecting traumatic injuries. CT scans may be adequate for clinicians in the emergency room setting, but are inadequate for courtroom testimony. If the evidence of trauma is based solely on CT scan reports, there is a high possibility of erroneous accusations, indictments, and convictions.

  14. CT findings in neonatal hypothermia

    Energy Technology Data Exchange (ETDEWEB)

    Schulman, H.; Laufer, L.; Berginer, J.; Hertzanu, Y. [Department of Radiology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 151, Beer-Sheva 84101 (Israel); Hershkowitz, E.; Berenstein, T.; Sofer, S. [Pediatric Intensive Care Unit, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel); Maor, E. [Department of Pathology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

    1998-06-01

    Background. Newborn infants are particularly prone to hypothermia, a condition with a high mortality. Objective. To study the CT brain patterns in infants with hypothermia and neurological symptoms. Materials and methods. We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. Results. Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the `reversal sign`. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. Conclusions. The `reversal sign` has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause. (orig.) With 6 figs., 1 tab., 13 refs.

  15. Anatomy and function: PET-CT.

    Science.gov (United States)

    Kajander, Sami; Saraste, Antti; Ukkonen, Heikki; Knuuti, Juhani

    2010-05-01

    CT coronary angiography and perfusion PET form an attractive combination to study coronary artery lesions and their consequences in patients with coronary artery disease. Whereas CT provides non-invasive assessment of coronary lumen and wall, PET perfusion is a reliable method for the evaluation of myocardial flow. CT, although very capable of ruling out significant coronary artery disease, is less than satisfactory in assessing the actual significance of the detected lesions. PET imaging, despite its excellent sensitivity, fails to describe the exact anatomy of the epicardial vessels. By fusing image data from these two modalities, lesions can be accurately correlated with their physiological or anatomical counterparts. Hybrid PET-CT devices, now in wide clinical use, allow such fusion in a one-stop-shop study. Although still seeking its place in clinical scenarios, growing evidence suggests that hybrid PET-CT imaging of coronary anatomy and myocardial perfusion can accurately - and non-invasively - assess the existence and degree of coronary artery disease.

  16. Complicated pleural tuberculosis in children: CT evaluation

    International Nuclear Information System (INIS)

    Moon, W.K.; Kim, W.S.; Kim, I.O.; Im, J.G.; Kim, J.H.; Yeon, K.M.; Han, M.C.

    1999-01-01

    Purpose. To describe the CT features of complicated pleural tuberculosis in children and to define the use of CT in children with pleural tuberculosis. Materials and methods. The CT findings in 11 children with complicated pleural tuberculosis were retrospectively analysed. CT was performed to evaluate persistent pleural thickening (n = 6) or a mass-like lesion (n = 5) detected on plain radiographs. Chest radiographs and medical records were reviewed to determine whether additional information provided by CT had altered clinical management. Results. On CT, more than one location was involved in five patients (45 %) and in two patients (18 %) the entire pleural spaces were involved. Pleural thickening was seen in all 11 patients and enhancement after administration of contrast medium occurred in ten patients (91 %). Low-density fluid collections were seen in nine patients (82 %) and in two, CT revealed fluid collections within calcified pleural lesions. In five patients with mass-like lesions on plain radiographs, CT showed a low-density pleural mass with peripheral enhancement in four and a calcified pleural mass with fluid collection in one. CT demonstrated parenchymal abnormalities on the same side as pleural lesions in all 11 patients and hilar or mediastinal adenopathy in four. Four patients (36 %) underwent surgery because of fluid within a calcified fibrothorax (n = 3) and chest wall tuberculosis (n = 1) that were seen only on CT. Conclusions. The CT features of complicated pleural tuberculosis in children were pleural thickening, enhancement and fluid collection with associated parenchymal abnormalities and lymphadenopathy. In the evaluation of children with pleural tuberculosis, CT can be useful for demonstrating fluid within a calcified fibrothorax or chest wall involvement, which usually requires surgical intervention. (orig.)

  17. Clinical application of helical CT colonography

    International Nuclear Information System (INIS)

    Zeng Huiliang; Zhu Xinjin; Liang Rujian; Liang Jianhao; Ou Weiqian; Wen Haomao

    2009-01-01

    Objective: To investigate the clinical value of 16-slice helical CT colonography in the diagnosis of colon tumor and polypus. Methods: 16-slice helical CT volumetric scanning was performed in 18 patients with colonic disease, including colonic tumor (n=16) and colonic polypus (n=2). 3D images, virtual endoscopy and multiplanar reformation were obtained in the AW4.1 workstation. CT appearances were compared with operation and fiberoptic colonoscopy. Results: Satisfied results were achieved from 18 patients, no difference found in results between CT colonography and operation in 16 patients with colonic tumor. Conclusion: 16-slice helical CT colonography is of great value in preoperative staging of colonic tumor and have a high value in clinical application. (authors)

  18. CT diagnosis of retroperitoneal gigantic liposarcoma

    International Nuclear Information System (INIS)

    Fang Wei; Zheng Zhaohua; Liao Zuyuan; Hu Yinsong

    2009-01-01

    Objective: To analyze CT manifestation of retroperitoneal gigantic liposaxcoma and to improve the image understanding. Methods: Five cases of retroperitoneal gigantic liposarcoma confirmed by surgery and pathology in our hospital were collected. Plain and enhanced CT scan were performed. Results: Of five cases, one was substantive, two was pseudocyst and two was mixed tumor. Several patterns of enhancement such as strip, floccule, irregular patchy or nodular enhancement were revealed inside the lesions on enhanced CT scan. And strip-form of high density enhancement was a typical type. Conclusion: CT examination could determine the tumor's location, size and density, together with the relationship to adjacent organizations CT scan is an important method in diagnosing retroperitoneal gigantic liposarcoma. (authors)

  19. Trapping volumetric measurement by multidetector CT in chronic obstructive pulmonary disease: Effect of CT threshold

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiaohua; Yuan, Huishu [Department of Radiology, Peking University Third Hospital, Beijing 100191 (China); Duan, Jianghui [Medical School, Peking University, Beijing 100191 (China); Du, Yipeng; Shen, Ning; He, Bei [Department of Respiration Internal Medicine, Peking University Third Hospital, Beijing 100191 (China)

    2013-08-15

    Purpose: The purpose of this study was to evaluate the effect of various computed tomography (CT) thresholds on trapping volumetric measurements by multidetector CT in chronic obstructive pulmonary disease (COPD).Methods: Twenty-three COPD patients were scanned with a 64-slice CT scanner in both the inspiratory and expiratory phase. CT thresholds of −950 Hu in inspiration and −950 to −890 Hu in expiration were used, after which trapping volumetric measurements were made using computer software. Trapping volume percentage (Vtrap%) under the different CT thresholds in the expiratory phase and below −950 Hu in the inspiratory phase was compared and correlated with lung function.Results: Mean Vtrap% was similar under −930 Hu in the expiratory phase and below −950 Hu in the inspiratory phase, being 13.18 ± 9.66 and 13.95 ± 6.72 (both lungs), respectively; this difference was not significant (P= 0.240). Vtrap% under −950 Hu in the inspiratory phase and below the −950 to −890 Hu threshold in the expiratory phase was moderately negatively correlated with the ratio of forced expiratory volume in one second to forced vital capacity and the measured value of forced expiratory volume in one second as a percentage of the predicted value.Conclusions: Trapping volumetric measurement with multidetector CT is a promising method for the quantification of COPD. It is important to know the effect of various CT thresholds on trapping volumetric measurements.

  20. The effect of iodine uptake on radiation dose absorbed by patient tissues in contrast enhanced CT imaging. Implications for CT dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Perisinakis, Kostas; Damilakis, John [University of Crete, Department of Medical Physics, Medical School, Heraklion, Crete (Greece); University Hospital of Heraklion, Department of Medical Physics, Heraklion, Crete (Greece); Tzedakis, Antonis; Papadakis, Antonios E. [University Hospital of Heraklion, Department of Medical Physics, Heraklion, Crete (Greece); Spanakis, Kostas [University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); Hatzidakis, Adam [University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); University of Crete, Department of Radiology, Medical School, Heraklion, Crete (Greece)

    2018-01-15

    To investigate the effect of iodine uptake on tissue/organ absorbed doses from CT exposure and its implications in CT dosimetry. The contrast-induced CT number increase of several radiosensitive tissues was retrospectively determined in 120 CT examinations involving both non-enhanced and contrast-enhanced CT imaging. CT images of a phantom containing aqueous solutions of varying iodine concentration were obtained. Plots of the CT number increase against iodine concentration were produced. The clinically occurring iodine tissue uptake was quantified by attributing recorded CT number increase to a certain concentration of aqueous iodine solution. Clinically occurring iodine uptake was represented in mathematical anthropomorphic phantoms. Standard 120 kV CT exposures were simulated using Monte Carlo methods and resulting organ doses were derived for non-enhanced and iodine contrast-enhanced CT imaging. The mean iodine uptake range during contrast-enhanced CT imaging was found to be 0.02-0.46% w/w for the investigated tissues, while the maximum value recorded was 0.82% w/w. For the same CT exposure, iodinated tissues were found to receive higher radiation dose than non-iodinated tissues, with dose increase exceeding 100% for tissues with high iodine uptake. Administration of iodinated contrast medium considerably increases radiation dose to tissues from CT exposure. (orig.)

  1. CT of pleural abnormalities

    International Nuclear Information System (INIS)

    Webb, W.R.

    1995-01-01

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.)

  2. CT of pleural abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Webb, W R [California Univ., San Francisco, CA (United States). Dept. of Radiology

    1996-12-31

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.).

  3. Multiplanar CT of the spine

    International Nuclear Information System (INIS)

    Rothman, S.L.G.; Glenn, W.V. Jr.

    1986-01-01

    This is an illustrated text on computed tomography (CT) of the lumbar spine with an emphasis on the role and value of multiplanar imaging for helping determine diagnoses. The book has adequate discussion of scanning techniques for the different regions, interpretations of various abnormalities, degenerative disk disease, and different diagnoses. There is a 50-page chapter on detailed sectional anatomy of the spine and useful chapters on the postoperative spine and the planning and performing of spinal surgery with CT multiplanar reconstruction. There are comprehensive chapters on spinal tumors and trauma. The final two chapters of the book are devoted to CT image processing using digital networks and CT applications of medical computer graphics

  4. Left-right subtraction of brain CT

    International Nuclear Information System (INIS)

    Ishiguchi, Tsuneo; Sakuma, Sadayuki

    1986-01-01

    A new image-processing method to obtain a left-right subtraction image of CT was designed for the automated detection of abnormalities in brain CT. An original CT image was divided in two by a centerline. Then the right half of the image was subtracted from the left half by calculating the absorption value of the pixels on the symmetrical positions against the centerline. The mean and the standard deviation of the absorption value of the pixels in the subtraction image were used as parameters for analysis, and the detectability of abnormal CT findings was evaluated in 100 cases - 50 cases each with normal and abnormal CT. The presence of abnormalities could be diagnosed with a sensitivity of 86 %, a specificity of 90 %, and an overall accuracy of 88 % when the borderline of these parameters between normal and abnormal CT was set at the mean + 2SD in the normal group. As a further analysis, the CT image was subdivided into several areas from a functional or anatomical viewpoint, such as cerebral vascular territories, and the left-right subtraction image of each area was obtained. The possibilities of diagnosing the location of an abnormality and of detecting smaller lesions with this method were shown. Left-right subtraction was considered to be a useful method for the detection of asymmetric abnormalities in the automated diagnosis of brain CT. (author)

  5. Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won [Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of); Park, Seong Jin [Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Department of Radiology, Seoul (Korea, Republic of)

    2012-06-15

    To identify CT features that discriminate individuals with and without acute appendicitis in patients with equivocal CT findings, and to assess whether knowledge of these findings improves diagnostic accuracy. 53 patients that underwent appendectomy with an indeterminate preoperative CT interpretation were selected and allocated to an acute appendicitis group or a non-appendicitis group. The 53 CT examinations were reviewed by two radiologists in consensus to identify CT findings that could aid in the discrimination of those with and without appendicitis. In addition, two additional radiologists were then requested to evaluate independently the 53 CT examinations using a 4-point scale, both before and after being informed of the potentially discriminating criteria. CT findings found to be significantly different in the two groups were; the presence of appendiceal wall enhancement, intraluminal air in appendix, a coexistent inflammatory lesion, and appendiceal wall thickening (P < 0.05). Areas under the curves of reviewers 1 and 2 significantly increased from 0.516 and 0.706 to 0.677 and 0.841, respectively, when reviewers were told which CT variables were significant (P = 0.0193 and P = 0.0397, respectively). Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. circle Numerous patients with clinically equivocal appendicitis do not have acute appendicitis circle Computed tomography (CT) helps to reduce the negative appendectomy rate circle CT is not always infallible and may also demonstrate indeterminate findings circle However knowledge of significant CT variables can further reduce negative appendectomy rate circle An equivocal CT interpretation of appendicitis should be reassessed with this knowledge. (orig.)

  6. Reassessment of CT images to improve diagnostic accuracy in patients with suspected acute appendicitis and an equivocal preoperative CT interpretation

    International Nuclear Information System (INIS)

    Kim, Hyun Cheol; Yang, Dal Mo; Kim, Sang Won; Park, Seong Jin

    2012-01-01

    To identify CT features that discriminate individuals with and without acute appendicitis in patients with equivocal CT findings, and to assess whether knowledge of these findings improves diagnostic accuracy. 53 patients that underwent appendectomy with an indeterminate preoperative CT interpretation were selected and allocated to an acute appendicitis group or a non-appendicitis group. The 53 CT examinations were reviewed by two radiologists in consensus to identify CT findings that could aid in the discrimination of those with and without appendicitis. In addition, two additional radiologists were then requested to evaluate independently the 53 CT examinations using a 4-point scale, both before and after being informed of the potentially discriminating criteria. CT findings found to be significantly different in the two groups were; the presence of appendiceal wall enhancement, intraluminal air in appendix, a coexistent inflammatory lesion, and appendiceal wall thickening (P < 0.05). Areas under the curves of reviewers 1 and 2 significantly increased from 0.516 and 0.706 to 0.677 and 0.841, respectively, when reviewers were told which CT variables were significant (P = 0.0193 and P = 0.0397, respectively). Knowledge of the identified CT findings was found to improve diagnostic accuracy for acute appendicitis in patients with equivocal CT findings. circle Numerous patients with clinically equivocal appendicitis do not have acute appendicitis circle Computed tomography (CT) helps to reduce the negative appendectomy rate circle CT is not always infallible and may also demonstrate indeterminate findings circle However knowledge of significant CT variables can further reduce negative appendectomy rate circle An equivocal CT interpretation of appendicitis should be reassessed with this knowledge. (orig.)

  7. Spect-CT and PET: CT in the management of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Khan, Shoukat H.

    2007-01-01

    Full text: With the advancement and evolution in medical technology notably imaging there has been a sea change in the overall management strategy of most of the cancers of human body. The present day functional, imaging with PET and MRI enables us to pick up a tumour at its cellular stage. Molecular imaging and nanotechnology have further added to this expanding armamentarium of cancer imaging and treatment. Thyroid cancer is one such cancer where the cutting edge biotechnology has dramatically changed the management profile of a disease. Thyroid cancer can safely be classified as one of the cancers which if optimally managed is curable. Hybrid and fusion imaging like SPECT-CT and PET-CT with their superior sensitivity and specificity have greatly improved the accuracy of disease detection and reduced drastically the false positive disease sites. Disease not detected by conventional planar imaging can now be detected and also anatomically localized using hybrid imaging modalities of SPECT-CT and PET-CT. An accurate detection and precise localization improves image interpretation and a treatment optimization in the curable cancer of thyroid

  8. Comparison of CT and integrated PET-CT based radiation therapy planning in patients with malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Pehlivan, Berrin; Topkan, Erkan; Onal, Cem; Nursal, Gul Nihal; Yuksel, Oznur; Dolek, Yemliha; Yavuz, Melek Nur; Yavuz, Ali Aydin

    2009-01-01

    When combined with adequate tumoricidal doses, accurate target volume delineation remains to be the one of the most important predictive factors for radiotherapy (RT) success in locally advanced or medically inoperable malignant pleural mesothelioma (MPM) patients. Recently, 18-fluorodeoxyglucose positron emission tomography (PET) has demonstrated significant improvements in diagnosis and accurate staging of MPM. However, role of additional PET data has not been studied in RT planning (RTP) of patients with inoperable MPM or in those who refuse surgery. Therefore, we planned to compare CT with co-registered PET-CT as the basis for delineating target volumes in these patients group. Retrospectively, the CT and co-registered PET-CT data of 13 patients with histologically proven MPM were utilized to delineate target volumes separately. For each patient, target volumes (gross tumor volume [GTV], clinical target volume [CTV], and planning target volume [PTV]) were defined using the CT and PET-CT fusion data sets. The PTV was measured in two ways: PTV1 was CTV plus a 1-cm margin, and PTV2 was GTV plus a 1-cm margin. We analyzed differences in target volumes. In 12 of 13 patients, compared to CT-based delineation, PET-CT-based delineation resulted in a statistically significant decrease in the mean GTV, CTV, PTV1, and PTV2. In these 12 patients, mean GTV decreased by 47.1% ± 28.4%, mean CTV decreased by 38.7% ± 24.7%, mean PTV1 decreased by 31.1% ± 23.1%, and mean PTV2 decreased by 40.0% ± 24.0%. In 4 of 13 patients, hilar lymph nodes were identified by PET-CT that was not identified by CT alone, changing the nodal status of tumor staging in those patients. This study demonstrated the usefulness of PET-CT-based target volume delineation in patients with MPM. Co-registration of PET and CT information reduces the likelihood of geographic misses, and additionally, significant reductions observed in target volumes may potentially allow escalation of RT dose beyond

  9. CT Diagnosis of Appendicitis

    Directory of Open Access Journals (Sweden)

    Christopher Libby

    2017-01-01

    Full Text Available History of present illness: A 19-year-old male with no previous medical history presented with 7/10 non-radiating, constant, sharp, periumbilical pain associated with nausea, and four episodes of vomiting. He was seen at urgent care where his labs showed a WBC of 16,000/mcL. He was subsequently sent to the emergency department (ED for concern of appendicitis. Of note, his pain worsened with bumps during the drive to the ED. After arriving to the ED the pain migrated to the right lower quadrant. Computed tomography (CT revealed acute appendicitis and the patient was admitted to the surgery service and taken to the operating room (OR for an appendectomy. Significant findings: The CT abdomen/pelvis with IV contrast shows a dilated appendix (see red outline with thickened, hyperenhancing wall (see blue outline best visualized in the axial and coronal planes. Discussion: Appendicitis is a common diagnosis in the emergency department in patients presenting with abdominal pain, occurring most frequently in young adults with a peak incidence in those aged 10-19.1 Failure to quickly diagnose acute appendicitis can result in perforation rates as high as 80 percent.2 While the diagnosis of appendicitis can be made clinically, CT is a non-invasive modality that improves the detection of appendicitis with sensitivities of 88–100%, specificities of 91–99%, positive predictive values of 92–98%, negative predictive values of 95–100%, and accuracies of 94–98%.3-8 The major advantage of CT over both clinical exam and ultrasound is the ability of the radiologist to exclude acute appendicitis if the appendix appears normal. However, CT carries the risks associated with ionizing radiation. While previously there was some debate on the best choice for type of CT scan and use of IV and oral contrast, recent studies have shown that CT abdomen/pelvis with IV contrast alone is sufficient for diagnosis of appendicitis.9, 10

  10. CT examinations in older patients

    International Nuclear Information System (INIS)

    Sciuk, J.; Peters, P.E.

    1989-01-01

    A total of 2,878 unselected subsequent CT examinations carried out in 1984 were analyzed retrospectively. All studies were performed in a university hospital with a centralized department of diagnostic radiology. Most of the patients investigated were hospitalized; there were only 12% outpatients. Of the patients studied 12.6% were older than 65 years and 20.5% older than 60; 17.7% were emergency cases and patients between 16 and 25 years of age represented the largest fraction. In all other age groups the relative distribution between emergency cases and regular studies revealed no significant differences. There was no statistically significant difference between the older age group (patients older than 65 years) and the total population of this study in almost all items investigated, i.e., no differences in CT examination time and no differences in preparation time (time between two CT studies). The rate of abdominal CT examinations was 7% higher in the older age group, while the relative distribution of all other CT examinations was again comparable to the total population under study. Thus, the expected increase in patients in the older age group does not measurably prolong the CT examination time. This statement applies to a major referral center with a high percentage of inpatients. (orig.) [de

  11. Overview of CT technologies for children

    Energy Technology Data Exchange (ETDEWEB)

    Frush, Donald P. [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC (United States)

    2014-10-15

    Many technical advances in CT have reduced radiation exposure in children and adults. These advances in technology should be used in conjunction with CT techniques such as appropriate patient preparation and intravenous contrast media administration to maximize dose management and image quality. This article summarizes current dose reduction technologies for pediatric CT, noting ranges of dose reduction as well as potential limitations. Discussion includes some of the elusive aspects of assessing image quality and the need for developing personalized CT. (orig.)

  12. Overview of CT technologies for children

    International Nuclear Information System (INIS)

    Frush, Donald P.

    2014-01-01

    Many technical advances in CT have reduced radiation exposure in children and adults. These advances in technology should be used in conjunction with CT techniques such as appropriate patient preparation and intravenous contrast media administration to maximize dose management and image quality. This article summarizes current dose reduction technologies for pediatric CT, noting ranges of dose reduction as well as potential limitations. Discussion includes some of the elusive aspects of assessing image quality and the need for developing personalized CT. (orig.)

  13. CT-diskography in patients with sciatica. Comparison with plain CT and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dullerud, R. [Ullevaal Univ. Hospital, Oslo (Norway). Section of Neuroradiology; Johansen, J.G. [Ullevaal Univ. Hospital, Oslo (Norway). Section of Neuroradiology

    1995-09-01

    The findings at CT-diskography (CT-D), including recording of the pain introduced at contrast injection, were compared with plain CT and MR imaging in 111 disks in 101 patients aged 18 to 68 years. Six disks which were normal at CT had normal CT-D and 5 of them had normal signal on MR imaging. The degree of annular degeneration and the depth of the annular tears were significantly associated with each other and with loss of disk height, but not with size or location of the hernias. Only the depth of the tears was significantly associated with loss of signal on MR. However, frequently complete annular tears and severe annular degeneration were seen in association with small bulges and hernias, even in disks with normal or slightly reduced signal on MR and with normal height. The type and intensity of the pain introduced were associated with each other and with the depth of the annular tears, but not with the degree of annular degeneration, size of the hernia or the MR signal intensity of the disks. Annular degeneration and tears on one hand, and the type and intensity of pain introduced on the other, see to be related rather than separate phenomena. (orig./MG).

  14. CT-diskography in patients with sciatica. Comparison with plain CT and MR imaging

    International Nuclear Information System (INIS)

    Dullerud, R.; Johansen, J.G.

    1995-01-01

    The findings at CT-diskography (CT-D), including recording of the pain introduced at contrast injection, were compared with plain CT and MR imaging in 111 disks in 101 patients aged 18 to 68 years. Six disks which were normal at CT had normal CT-D and 5 of them had normal signal on MR imaging. The degree of annular degeneration and the depth of the annular tears were significantly associated with each other and with loss of disk height, but not with size or location of the hernias. Only the depth of the tears was significantly associated with loss of signal on MR. However, frequently complete annular tears and severe annular degeneration were seen in association with small bulges and hernias, even in disks with normal or slightly reduced signal on MR and with normal height. The type and intensity of the pain introduced were associated with each other and with the depth of the annular tears, but not with the degree of annular degeneration, size of the hernia or the MR signal intensity of the disks. Annular degeneration and tears on one hand, and the type and intensity of pain introduced on the other, see to be related rather than separate phenomena. (orig./MG)

  15. PET/CT in malignant melanoma: contrast-enhanced CT versus plain low-dose CT

    International Nuclear Information System (INIS)

    Pfluger, Thomas; Schneider, Vera; Fougere, Christian la; Bartenstein, Peter; Weiss, Mayo; Melzer, Henriette Ingrid; Coppenrath, Eva; Berking, Carola

    2011-01-01

    The aim of this study was to evaluate the diagnostic value of contrast-enhanced CT (CECT) versus non-enhanced low-dose CT (NECT) in the staging of advanced malignant melanoma with 18 F-fluordeoxyglucose (FDG) positron emission tomography (PET)/CT. In total, 50 18 F-FDG PET/CT examinations were performed in 50 patients with metastasized melanoma. For attenuation correction, whole-body NECT was performed followed by diagnostic CECT with contrast agent. For the whole-body PET, 18 F-FDG was applied. Criteria for evaluation were signs of vital tumour tissue (extent of lesions, contrast enhancement, maximum standardized uptake value >2.5). Findings suspicious for melanoma were considered lesions. NECT, CECT and 18 F-FDG PET were evaluated separately, followed by combined analysis of PET/NECT and PET/CECT. Findings were verified histologically and/or by follow-up (>6 months). Overall, 232 lesions were analysed, and 151 proved to be metastases. The sensitivity of NECT, CECT, PET, PET/NECT and PET/CECT was 62, 85, 90, 97 and 100%, and specificity was 52, 63, 88, 93 and 93%, respectively. Compared to CECT, NECT obtained additional false-negative results: lymph node (n = 19) and liver/spleen metastases (n = 9). Misinterpreted physiological structures mainly caused additional false-positive findings (n = 17). In combined analysis of PET/NECT, six false-positive [other tumours (n = 2), inflammatory lymph nodes (n = 2), inflammatory lung lesion (n = 1), blood vessel (n = 1)] and five false-negative findings [liver (n = 3), spleen (n = 1), lymph node metastases (n = 1)] remained. On PET/CECT, six false-positive [inflammatory lymph nodes (n = 3), other tumours (n = 2), inflammatory lung lesion (n = 1)] and no false-negative findings occurred. However, additional false findings on PET/NECT (6 of 232) did not change staging compared to PET/CECT. Our results indicate that it is justified to perform PET/NECT instead of PET/CECT for melanoma staging. (orig.)

  16. Diagnostic performance of contrast enhanced CT and 18F-FDG PET/CT in suspicious recurrence of biliary tract cancer after curative resection

    International Nuclear Information System (INIS)

    Lee, Yun-Gyoo; Bang, Yung-Jue; Han, Sae-Won; Oh, Do-Youn; Chie, Eui Kyu; Jang, Jin-Young; Im, Seock-Ah; Kim, Tae-You; Kim, Sun-Whe; Ha, Sung Whan

    2011-01-01

    Because of the late clinical presentation of biliary tract cancer (BTC), only 10% of patients are eligible for curative surgery. Even among those patients who have undergone curative surgery, most patients develop recurrent cancer. This study is to determine the clinical role of 18 F-FDG PET/CT during post-operative surveillance of suspected recurrent BTC based on symptoms, laboratory findings and contrast-enhanced CT (ceCT) findings. We consecutively enrolled 50 patients with BTC who underwent curative surgery. An 18 F-FDG PET/CT was obtained for assessment of recurrence based on clinical suspicion during post-operative surveillance. The final confirmation of recurrence was determined pathologically or clinically. When a pathologic confirmation was impossible or inconclusive, a clinical confirmation was used by radiologic correlation with subsequent follow-up ceCT at a minimum of 3-month intervals. Diagnostic efficacy was evaluated by comparing the results of ceCT and 18 F-FDG PET/CT with the final diagnosis. Among the 50 patients, 34(68%) were confirmed to have a recurrence. PET/CT showed higher sensitivity (88% vs. 76%, p = 0.16) and accuracy (82% vs. 66%, p = 0.11) for recurrence compared to ceCT, even though the difference was not significant. The positive (86% vs. 74%, p = 0.72) and negative predictive values for recurrence (73% vs. 47%, p = 0.55) were not significantly different between PET/CT and ceCT. However, an additional PET/CT on ceCT significantly improved the sensitivity than did a ceCT alone (94% [32/34] for PET/CT on ceCT vs. 76% [26/34] for ceCT alone, p = 0.03) without increasing the specificity, positive predictive value, and negative predictive value. 18 F-FDG PET/CT alone is not more sensitive or specific than ceCT in the detection of recurrent BTC after curative surgery. These results do not reach statistical significance, probably due to the low number of patients. However, an additional 18 F-FDG PET/CT on ceCT significantly improves the

  17. Predicting tumor hypoxia in non-small cell lung cancer by combining CT, FDG PET and dynamic contrast-enhanced CT.

    Science.gov (United States)

    Even, Aniek J G; Reymen, Bart; La Fontaine, Matthew D; Das, Marco; Jochems, Arthur; Mottaghy, Felix M; Belderbos, José S A; De Ruysscher, Dirk; Lambin, Philippe; van Elmpt, Wouter

    2017-11-01

    Most solid tumors contain inadequately oxygenated (i.e., hypoxic) regions, which tend to be more aggressive and treatment resistant. Hypoxia PET allows visualization of hypoxia and may enable treatment adaptation. However, hypoxia PET imaging is expensive, time-consuming and not widely available. We aimed to predict hypoxia levels in non-small cell lung cancer (NSCLC) using more easily available imaging modalities: FDG-PET/CT and dynamic contrast-enhanced CT (DCE-CT). For 34 NSCLC patients, included in two clinical trials, hypoxia HX4-PET/CT, planning FDG-PET/CT and DCE-CT scans were acquired before radiotherapy. Scans were non-rigidly registered to the planning CT. Tumor blood flow (BF) and blood volume (BV) were calculated by kinetic analysis of DCE-CT images. Within the gross tumor volume, independent clusters, i.e., supervoxels, were created based on FDG-PET/CT. For each supervoxel, tumor-to-background ratios (TBR) were calculated (median SUV/aorta SUV mean ) for HX4-PET/CT and supervoxel features (median, SD, entropy) for the other modalities. Two random forest models (cross-validated: 10 folds, five repeats) were trained to predict the hypoxia TBR; one based on CT, FDG, BF and BV, and one with only CT and FDG features. Patients were split in a training (trial NCT01024829) and independent test set (trial NCT01210378). For each patient, predicted, and observed hypoxic volumes (HV) (TBR > 1.2) were compared. Fifteen patients (3291 supervoxels) were used for training and 19 patients (1502 supervoxels) for testing. The model with all features (RMSE training: 0.19 ± 0.01, test: 0.27) outperformed the model with only CT and FDG-PET features (RMSE training: 0.20 ± 0.01, test: 0.29). All tumors of the test set were correctly classified as normoxic or hypoxic (HV > 1 cm 3 ) by the best performing model. We created a data-driven methodology to predict hypoxia levels and hypoxia spatial patterns using CT, FDG-PET and DCE-CT features in NSCLC. The

  18. Virtual Non-Contrast CT Using Dual-Energy Spectral CT: Feasibility of Coronary Artery Calcium Scoring

    OpenAIRE

    Song, Inyoung; Yi, Jeong Geun; Park, Jeong Hee; Kim, Sung Mok; Lee, Kyung Soo; Chung, Myung Jin

    2016-01-01

    Objective To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. Materials and Methods This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated V...

  19. CT applications of medical computer graphics

    International Nuclear Information System (INIS)

    Rhodes, M.L.

    1985-01-01

    Few applications of computer graphics show as much promise and early success as that for CT. Unlike electron microscopy, ultrasound, business, military, and animation applications, CT image data are inherently digital. CT pictures can be processed directly by programs well established in the fields of computer graphics and digital image processing. Methods for reformatting digital pictures, enhancing structure shape, reducing image noise, and rendering three-dimensional (3D) scenes of anatomic structures have all become routine at many CT centers. In this chapter, the authors provide a brief introduction to computer graphics terms and techniques commonly applied to CT pictures and, when appropriate, to those showing promise for magnetic resonance images. Topics discussed here are image-processing options that are applied to digital images already constructed. In the final portion of this chapter techniques for ''slicing'' CT image data are presented, and geometric principles that describe the specification of oblique and curved images are outlined. Clinical examples are included

  20. CT images of infantile viral encephalitis

    International Nuclear Information System (INIS)

    Sugimoto, Tateo; Okazaki, Hitoshi; Woo, Man

    1985-01-01

    Cranial CT scanning was undertaken in 40 patients with infantile viral encephalitis seen from 1977 to 1983. According to the pathogenic viruses, abnormal CT findings were detected most frequently in cases of herpes simplex encephalitis (HSE), followed by non-eruptive viral encephalitis, measles encephalitis, and rubella encephalitis in that order, which coincided well with neurological prognosis. Although CT findings lay within a normal range in cases of measles encephalitis, except a case in which cerebral ventricle was slightly dilated, the degree of consciousness disturbance was unfavorable and it persisted long. This revealed that there is no distinct correlation between the degree of consciousness disturbance and CT findings. Normal CT findings were detected in 13% of patients aged less than 5 years and 76.5% of patients aged 5 years or more. In many patients who had an attack of viral encephalitis at the age of 5 years or more, epileptic seizures occurred frequently, even though CT findings were normal. (Namekawa, K.)

  1. MR and CT for malignant hypernephromas

    International Nuclear Information System (INIS)

    Uhlenbrock, D.; Fischer, C.; Ruehl, G.; Beyer, H.K.; Hummelsheim, P.; Bochum Univ.; Marienhospital, Herne; Bochum Univ.

    1987-01-01

    Forty patients with histologically confirmed hypernephromas were examined by MR and CT. As regards T-staging, MR had an accuracy of 97 % and CT of 91%; for N-staging, MR had an accuracy of 85% and CT of 91% and, with regard to infiltration of the renal vein, MR was correct in 88% of cases and CT in 81%. MR was most accurate in the pre-operative assessment of tumour spread, demonstrating caval involvement in 100% and lymph node metastases in 97%. On the other hand, infiltration of the renal pelvis could be assessed in only 65% of cases; in 27% the assessment was not possible and in 8% one could not be certain. CT proved to be at its best for staging of lymph nodes, but in 15% it was not possible to identify infiltration of the renal vein. MR was not greatly superior to CT in the preoperative diagnosis and staging of hypernephromas. (orig.) [de

  2. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma

    International Nuclear Information System (INIS)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T.; O'Brien, Maureen M.

    2018-01-01

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations. (orig.)

  3. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Qi, Zhihua; Gates, Erica L.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); O' Brien, Maureen M. [Cincinnati Children' s Hospital Medical Center, Division of Oncology, Cancer and Blood Disease Institute, Cincinnati, OH (United States)

    2018-02-15

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (P<0.0001). Average dose savings with the combined approach was 24.8±17.8% (2.60±2.51 mSv [range: 0.32-4.72 mSv]) of total CT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations. (orig.)

  4. Radiation dose reduction through combining positron emission tomography/computed tomography (PET/CT) and diagnostic CT in children and young adults with lymphoma.

    Science.gov (United States)

    Qi, Zhihua; Gates, Erica L; O'Brien, Maureen M; Trout, Andrew T

    2018-02-01

    Both [F-18]2-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) and diagnostic CT are at times required for lymphoma staging. This means some body segments are exposed twice to X-rays for generation of CT data (diagnostic CT + localization CT). To describe a combined PET/diagnostic CT approach that modulates CT tube current along the z-axis, providing diagnostic CT of some body segments and localization CT of the remaining body segments, thereby reducing patient radiation dose. We retrospectively compared total patient radiation dose between combined PET/diagnostic CT and separately acquired PET/CT and diagnostic CT exams. When available, we calculated effective doses for both approaches in the same patient; otherwise, we used data from patients of similar size. To confirm image quality, we compared image noise (Hounsfield unit [HU] standard deviation) as measured in the liver on both combined and separately acquired diagnostic CT images. We used t-tests for dose comparisons and two one-sided tests for image-quality equivalence testing. Mean total effective dose for the CT component of the combined and separately acquired diagnostic CT exams were 6.20±2.69 and 8.17±2.61 mSv, respectively (PCT effective dose. Image noise was not statistically significantly different between approaches (12.2±1.8 HU vs. 11.7±1.5 HU for the combined and separately acquired diagnostic CT images, respectively). A combined PET/diagnostic CT approach as described offers dose savings at similar image quality for children and young adults with lymphoma who have indications for both PET and diagnostic CT examinations.

  5. Panoramic three-dimensional CT imaging

    International Nuclear Information System (INIS)

    Kawamata, Akitoshi; Fujishita, Masami

    1998-01-01

    Panoramic radiography is a unique projection technique for producing a single image of both maxillary and mandibular arches and many other anatomical structures. To obtain a similar panoramic image without panoramic radiography system, a modified three-dimensional (3D) CT imaging technique was designed. A set of CT slice image data extending from the chin to the orbit was used for 3D reconstruction. The CT machine used in this study was the X-Vision (TOSHIBA, Japan). The helical scan technique was used. The slice thickness of reconstructed image was one or 1.5 mm. The occlusal plane or Frankfort horizontal (FH) plane was used as the reference line. The resultant slice image data was stored on a magnetic optical disk and then used to create panoramic 3D-CT images on a Macintosh computer systems (Power Macintosh 8600/250, Apple Computer Inc., USA). To create the panoramic 3D-CT image, the following procedure was designed: Design a curved panoramic 3D-CT imaging layer using the imaging layer and the movement of the x-ray beam in panoramic radiography system as a template; Cut this imaging layer from each slice image, then the trimmed image was transformed to a rectangular layer using the ''still image warping'' special effect in the Elastic Reality special effects system (Elastic Reality Inc., USA); Create panoramic 3D-CT image using the Voxel View (Vital Images Inc., USA) rendering system and volume rendering technique. Although the image quality was primitive, a panoramic view of maxillofacial region was obtained by this technique. (author)

  6. Use of the CT component of PET-CT to improve PET-MR registration: demonstration in soft-tissue sarcoma

    International Nuclear Information System (INIS)

    Somer, Edward J; Benatar, Nigel A; O'Doherty, Michael J; Smith, Mike A; Marsden, Paul K

    2007-01-01

    We have investigated improvements to PET-MR image registration offered by PET-CT scanning. Ten subjects with suspected soft-tissue sarcomas were scanned with an in-line PET-CT and a clinical MR scanner. PET to CT, CT to MR and PET to MR image registrations were performed using a rigid-body external marker technique and rigid and non-rigid voxel-similarity algorithms. PET-MR registration was also performed using transformations derived from the registration of CT to MR. The external marker technique gave fiducial registration errors of 2.1 mm, 5.1 mm and 5.3 mm for PET-CT, PET-MR and CT-MR registration. Target registration errors were 3.9 mm, 9.0 mm and 9.3 mm, respectively. Voxel-based algorithms were evaluated by measuring the distance between corresponding fiducials after registration. Registration errors of 6.4 mm, 14.5 mm and 9.5 mm, respectively, for PET-CT, PET-MR and CT-MR were observed for rigid-body registration while non-rigid registration gave errors of 6.8 mm, 16.3 mm and 7.6 mm for the same modality combinations. The application of rigid and non-rigid CT to MR transformations to accompanying PET data gives significantly reduced PET-MR errors of 10.0 mm and 8.5 mm, respectively. Visual comparison by two independent observers confirmed the improvement over direct PET-MR registration. We conclude that PET-MR registration can be more accurately and reliably achieved using the hybrid technique described than through direct rigid-body registration of PET to MR

  7. Chest CT in children: anesthesia and atelectasis

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Gawande, Rakhee [Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Krane, Elliot J. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford, CA (United States); Holmes, Tyson H. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Psychiatry and Behavioral Sciences, Stanford, CA (United States); Robinson, Terry E. [Stanford University School of Medicine, Lucile Packard Children' s Hospital, Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary Biology, Stanford, CA (United States)

    2014-02-15

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  8. Chest CT in children: anesthesia and atelectasis

    International Nuclear Information System (INIS)

    Newman, Beverley; Gawande, Rakhee; Krane, Elliot J.; Holmes, Tyson H.; Robinson, Terry E.

    2014-01-01

    There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity. To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children. Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases. Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred. Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain

  9. Sacral-neuromodulation CT-guided

    International Nuclear Information System (INIS)

    Amoroso, Lamberto; Ricci, Stefano; Pelliccioni, Giuseppe; Scarpino, Osvaldo; Ghiselli, Roberto; Saba, Vittorio

    2005-01-01

    Purpose: Sacral neuromodulation is a new treatment for refractory voiding disorders such as urge incontinence, urinary retention, frequency-urgency syndromes and faecal incontinence. The current approach to sacral nerve stimulation consists of a two-stage procedure. The first is a PNE test (Percutaneous Nerve Evaluation) by a provisional electrically stimulated spinal needle, placed percutaneously in the S3 foramina for four of ten days. If successful, the second stage, permanent implantation, is carried out. The PNE test is performed under fluoroscopic control using the palpable bony sacral foramina as referral points. This technique can show some limitations, such as operator Rx exposure, poor visualization of sacral foramina because of bowel gas artefacts or sacral malformation. In order to reduce these inconveniences and to improve efficiency of the test we tried an alternative technique. The purpose of our study was to test the use of CT as an alternative technique in order to evaluate its advantages and possible routine use. Materials and methods: We tested 30 patients with the PNE test under CT guidance (16 males and 14 females) suffering from serious pelvic disorders and not responding to the normal therapeutic regime. Twenty-seven patient showed relative anatomical integrity of the pelvis and the sacrum, the remaining 3 patients presented morphological anormalities of the sacral foramina. With the patient in the prone position the sacral foramina were identified with CT volumetric scanning using a spiral CT scanner equipped with a second console for the three-dimensional reconstructions. Having identified the location of the S3 foramina, a sterile field was prepared and the spiral needle introduced checking correct positioning with a CT control scan. An electrode was inserted after having checked correct muscular contractile response and the precise position with a further CT scan. Results: Thirty patients were subjected to PNE under CT guidance for a

  10. CT numbers of liver and spleen in normal children

    International Nuclear Information System (INIS)

    Kim, Young Kim

    2002-01-01

    To determine the mean liver CT numbers, and differences between liver and spleen, and liver and back muscle CT numbers in normal children, and to correlate the findings with sex and age. One hundred and five normal children aged 2-14 years underwent pre-contrast CT scanning. Mean CT numbers of the liver, spleen, and back muscles were calculated, as well as the differences in CT numbers between the liver and spleen (liver-spleen CT numbers), and between the liver-back muscle CT numbers were 70.22±6.51 HU, 53.28±3.57 HU, 17.13±6.57 HU, and 11.88±5.94 HU, respectively. Mean liver CT numbers and the difference between liver and back muscle CT numbers were not different by age. By sex, all the CT numbers did not vary according to age. The sex of a subject did not affect the CT number. The children's mean liver CT number was 70.22±6.51 HU and the difference between liver and spleen CT numbers was 17.13±6.57 HU. Younger children had higher liver CT and liver-spleen CT numbers than older children. No CT numbers varied according to sex

  11. Is CT effective in diagnosing the acute appendicitis?: Focus on comparison of unenhanced CT with barium enema

    International Nuclear Information System (INIS)

    Choi, Seong Hee; Hahm, So Hee; Kang Jin Hwa; Moon, Jeong Hwa

    1994-01-01

    To evaluate the role of unenhanced CT in diagnosing the acute appendicitis. We retrospectively analyzed conventional contrast-enhanced abdominal CT scans of 197 normal patients and barium enemas of 26 out of the 197 patients. Additional unenhanced CT scans of right lower abdomen were performed on 30 patients who were suspected of having acute appendicitis; barium enema was performed in 26 patients. In the analysis of the conventional CT scans, we could detect 132 (67%) normal appendices. On barium enema of 26 out of 197 patients, abruptly narrowed appendix was visualized in 5 cases and luminal irregularity in 4 cases but all 26 cases showed normal appendix on CT. In the 30 cases of unenhanced CT, all appendices were visualized. Among 12 cases which were proved as acute appendicitis, barium enema was done in 10 cases; abruptly narrowed appendix was shown in 3 and luminal irregularity in 1. Among 18 cases which were diagnosed as normal appendix, nonvisualization of appendix was in 1 case, abruptly narrowed lumen in 3, and luminal irregularity in 9. Unenhanced CT in the area of the cecum may be an effective and safe diagnostic tool acute appendicitis

  12. Variation in the quality of CT images of the upper abdomen when CT automatic exposure control is employed

    International Nuclear Information System (INIS)

    Aizawa, Isao; Muramatsu, Yoshihisa; Nomura, Keiichi; Shimizu, Fuminori

    2010-01-01

    The aim of this study was to analyze the reason for variation of image quality in the upper abdomen CT with the use of CT-automatic exposure control (AEC). The CT investigated was 3D modulation in the 16 multi detector row CT (MDCT) and lung cancer screening CT (LSCT) phantom was used to simulate the patient. When there was a phase difference, an image noise increase of around 15% at the maximum was accepted. It is concluded that the major reason for variation in image quality is respiratory motion and the importance of respiration control must be recognized. (author)

  13. Multiphase contrast-enhanced CT with highly concentrated contrast agent can be used for PET attenuation correction in integrated PET/CT imaging

    International Nuclear Information System (INIS)

    Aschoff, Philip; Plathow, Christian; Lichy, Matthias P.; Claussen, Claus D.; Pfannenberg, Christina; Beyer, Thomas; Erb, Gunter; Oeksuez, Mehmet Oe.

    2012-01-01

    State-of-the-art positron emission tomography/computed tomography (PET/CT) systems incorporate multislice CT technology, thus facilitating the acquisition of multiphase, contrast-enhanced CT data as part of integrated PET/CT imaging protocols. We assess the influence of a highly concentrated iodinated contrast medium (CM) on quantification and image quality following CT-based attenuation correction (CT-AC) in PET/CT. Twenty-eight patients with suspected malignant liver lesions were enrolled prospectively. PET/CT was performed 60 min after injection of 400 MBq of 18 F-fluorodeoxyglucose (FDG) and following the biphasic administration of an intravenous CM (400 mg iodine/ml, Iomeron 400). PET images were reconstructed with CT-AC using any of four acquired CT image sets: non-enhanced, pre-contrast (n-PET), arterial phase (art-PET), portal venous phase (pv-PET) and late phase (late-PET). Normal tissue activity and liver lesions were assessed visually and quantitatively on each PET/CT image set. Visual assessment of PET following CT-AC revealed no noticeable difference in image appearance or quality when using any of the four CT data sets for CT-AC. A total of 44 PET-positive liver lesions was identified in 21 of 28 patients. There were no false-negative or false-positive lesions on PET. Mean standardized uptake values (SUV) in 36 evaluable lesions were: 5.5 (n-PET), 5.8 (art-PET), 5.8 (pv-PET) and 5.8 (late-PET), with the highest mean increase in mean SUV of 6%. Mean SUV changes in liver background increased by up to 10% from n-PET to pv-PET. Multiphase CT data acquired with the use of highly concentrated CM can be used for qualitative assessment of liver lesions in torso FDG PET/CT. The influence on quantification of FDG uptake is small and negligible for most clinical applications. (orig.)

  14. Predictors of pneumothorax after CT-guided transthoracic needle lung biopsy: the role of quantitative CT.

    Science.gov (United States)

    Chami, H A; Faraj, W; Yehia, Z A; Badour, S A; Sawan, P; Rebeiz, K; Safa, R; Saade, C; Ghandour, B; Shamseddine, A; Mukherji, D; Haydar, A A

    2015-12-01

    To evaluate the association of quantitative computed tomography (CT) measures of emphysema with the occurrence of pneumothorax after CT-guided needle lung biopsy (NLB) accounting for other risk factors. One hundred and sixty-three CT-guided NLBs performed between 2008 and 2013 with available complete chest CT within 30 days were reviewed for the occurrence of post-procedure pneumothorax. Percent emphysema was determined quantitatively as the percentage of lung voxels below -950 HU on chest CT images using automated software. Multivariable regression was used to assess the association of percent emphysema volume with the occurrence of post-procedure pneumothorax. The association of percent emphysema volume with the pneumothorax size and need for chest tube placement after NLB was also explored. Percent emphysema was significantly associated with the incidence of post-NLB pneumothorax (OR=1.10 95% confidence interval: 1.01-1.15; p=0.03) adjusting for lower-lobe lesion location, needle path length, lesion size, number of passes, and pleural needle trajectory angle. Percent emphysema was not associated with the size of the pneumothorax, nor the need for chest tube placement after NLB. Percent emphysema determined quantitatively from chest CT is a significant predictor of post-NLB pneumothorax. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. CT of chest trauma

    International Nuclear Information System (INIS)

    Goodman, P.C.

    1986-01-01

    There appears to be a limited role for computed tomography in the evaluation of chest trauma. The literature contains few papers specifically addressing the use of CT in the setting of chest trauma. Another series of articles relates anecdotal experiences in this regard. This paucity of reports attests to the remarkable amount of information present on conventional chest radiographs as well as the lack of clear indications for CT in the setting of chest trauma. In this chapter traumatic lesions of various areas of the thorax are discussed. The conventional radiographic findings are briefly described and the potential or proven application of CT is addressed

  16. CT pelvimetry. La scanopelvimetrie

    Energy Technology Data Exchange (ETDEWEB)

    Vicens, J.L.; Charles, G.; Le Berre, J.; Flageat, J. (Hopital d' Instruction des Armees Begin, 94 - Saint-Mande (FR))

    1989-01-01

    Pelvimetry aims at providing the obstetrician with information on the size and morphology of the female pelvis, thus enabling him to assess the obstetrical prognosis as accurately as possible. Computed tomography (CT) has several advantages, in particular the lower mother and fetus radiation dose. After a brief description of obstetrical anatomy, the usual CT exploration method is presented and its results are considered in terms of measurements, indices and morphological findings. If performed with a very strict exploration procedure, CT pelvimetry is a very reliable, fact and comfortable method of examination. All these advantages, combined with the minimized patient dose, should lead to an increasingly widespread use of this technique.

  17. PET/CT: underlying physics, instrumentation, and advances.

    Science.gov (United States)

    Torres Espallardo, I

    Since it was first introduced, the main goal of PET/CT has been to provide both PET and CT images with high clinical quality and to present them to radiologists and specialists in nuclear medicine as a fused, perfectly aligned image. The use of fused PET and CT images quickly became routine in clinical practice, showing the great potential of these hybrid scanners. Thanks to this success, manufacturers have gone beyond considering CT as a mere attenuation corrector for PET, concentrating instead on design high performance PET and CT scanners with more interesting features. Since the first commercial PET/CT scanner became available in 2001, both the PET component and the CT component have improved immensely. In the case of PET, faster scintillation crystals with high stopping power such as LYSO crystals have enabled more sensitive devices to be built, making it possible to reduce the number of undesired coincidence events and to use time of flight (TOF) techniques. All these advances have improved lesion detection, especially in situations with very noisy backgrounds. Iterative reconstruction methods, together with the corrections carried out during the reconstruction and the use of the point-spread function, have improved image quality. In parallel, CT instrumentation has also improved significantly, and 64- and 128-row detectors have been incorporated into the most modern PET/CT scanners. This makes it possible to obtain high quality diagnostic anatomic images in a few seconds that both enable the correction of PET attenuation and provide information for diagnosis. Furthermore, nowadays nearly all PET/CT scanners have a system that modulates the dose of radiation that the patient is exposed to in the CT study in function of the region scanned. This article reviews the underlying physics of PET and CT imaging separately, describes the changes in the instrumentation and standard protocols in a combined PET/CT system, and finally points out the most important

  18. Usefulness and limit of CT diagnosis on appendicitis

    International Nuclear Information System (INIS)

    Kuchiki, Megumi; Takanashi, Toshiyasu; Yamaguchi, Koichi.

    1997-01-01

    CT was performed in 104 patients with abdominal pain suspected appendicitis. CT showed positive finding (abnormal appendix, appendicolith, pericecal inflammatory change, fluid collection, LN swelling, abscess) and complication of appendicitis clearly. CT diagnosis showed high accuracy than clinical diagnosis. CT proved its usefulness especially only CT imaging showed the correct diagnosis. On the other hand, diverticulitis and terminal ileitis common diagnostic disease of appendicitis showed similar clinical appearance and CT image, caused to be difficult to diagnose correctly. In the cases showing similar image to appendicitis or atypical image, CT also proved its limit of the diagnosis on appendicitis. (author)

  19. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik; Molvin, Lior Z.; Wang, Jia

    2014-01-01

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  20. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Molvin, Lior Z. [Stanford Hospital and Clinics, Stanford, CA (United States); Wang, Jia [Stanford University, Environmental Health and Safety, Stanford, CA (United States)

    2014-10-15

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)