95 results on '"Diagnostic Imaging/methods"'
Search Results
2. Marked Concentric Myocardial Hypertrophy with Good Postoperative Evolution in a 4 Years Old Child
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Atik, Edmar, Leal, Gabriela Nunes, and Jatene, Marcelo B.
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Fatores de Risco ,Hypertrophy, Left Ventricular/surgery ,Diagnostic Imaging/methods ,Anormalidades Congênitas/cirurgia ,Risk Factors ,Hipertrofia Ventricular Esquerda/cirurgia ,Abnormalities Congenital/surgery ,Cardiomyopathy, Hypertrophic/surgery ,Cardiomiopatia Hipertrófica/cirurgia ,Morte Súbita Cardíaca ,Sudden Cardiac Death ,Diagnóstico por Imagem/métodos - Published
- 2023
Catalog
3. Brazilian Interventional Cardiology and Chronic Coronary Occlusions: Where Are We?
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Mariani Junior, José
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Coronary Angiography/methods ,Diagnostic Imaging/methods ,Ultrasonografia, Intervencional/métodos ,Coronary Occlusion/mortality ,Oclusão Coronária/mortalidade ,Oclusão Coronária/terapia ,Stents Farmacológicos ,Ultrasonography,Interventional/methods ,Angiografia Coronária/métodos ,Coronary Occlusion/therapy ,Drug-Eluting Stents ,Diagnóstico por Imagem/métodos - Published
- 2023
4. Predição de Obstrução Coronariana Significativa em População com Suspeita de Doença Coronariana e Ausência de Cálcio Coronariano: CORE-64 e CORE320
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Anderson C. Armstrong, Rodrigo Cerci, Matthew B. Matheson, Tiago Magalhães, Satoru Kishi, Jeff Brinker, Melvin E. Clouse, Carlos E. Rochitte, Christopher Cox, João A. C. Lima, and Armin Arbab-Zadeh
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Coronary Artery Disease/complications ,Chest Pain ,Escore de Cálcio ,Doença Arterial Coronariana/complicações ,Coronary Angiography ,Dor Torácica ,Diagnostic Imaging/methods ,X Ray Computed/methods ,Angiografia Coronária ,Cardiology and Cardiovascular Medicine ,Tomography ,Indice Calcio ,Tomografia Computadorizada por Raios X/métodos ,Diagnóstico por Imagem/métodos - Abstract
Resumo Fundamento A avaliação do Escore de Cálcio Coronariano (ECC) pode ser realizada por tomografia computadorizada sem contraste para prever eventos cardiovasculares, mas tem menor valor na estratificação de risco em pacientes sintomáticos. Objetivo Identificar e validar preditores de obstrução coronariana significativa (OCS) em pacientes sintomáticos sem calcificação da artéria coronária. Métodos Um total de 4258 participantes foram rastreados dos estudos CORE64 e CORE 320, nos quais foram avaliados pacientes encaminhados para angiografia invasiva, e do Quanta Registry que incluiu pacientes encaminhados para angiotomografia. Modelos de regressão logística avaliaram associações entre fatores de risco cardiovascular, ECC e OCS. Um nível de significância de 5% foi usado nas análises. Resultados Dos 509 participantes do estudo CORE, 117 (23%) apresentaram um ECC igual a zero; 13 (11%) pacientes sem cálcio coronariano apresentaram OCS. A ausência de cálcio coronariano correlacionou-se com idade mais jovem, sexo feminino, índice de massa corporal mais baixo, ausência de diabetes, e ausência de dislipidemia. O fato de ser fumante atual aumentou em 3,5 vezes a probabilidade de OCS e outros fatores de risco cardiovasculares não apresentaram associação significativa. Considerando os achados clínicos, um algoritmo para estratificar os pacientes com ECC igual a zero foi proposto, e tiveram desempenho limitado na coorte de validação (AUC 58; IC95% 43, 72). Conclusão Um perfil de risco cardiovascular mais baixo está associado a um ECC igual a zero em pacientes de alto risco. Tabagismo é o preditor mais forte de OCS em pacientes com ausência de cálcio coronariano. Abstract Background Coronary artery calcium (CAC) scanning can be performed using non-contrast computed tomography to predict cardiovascular events, but has less value for risk stratification in symptomatic patients. Objective To identify and validate predictors of significant coronary obstruction (SCO) in symptomatic patients without coronary artery calcification. Methods A total of 4,258 participants were screened from the CORE64 and CORE320 studies that enrolled patients referred for invasive angiography, and from the Quanta Registry that included patients referred for coronary computed tomography angiography (CTA). Logistic regression models evaluated associations between cardiovascular risk factors, CAC, and SCO. An algorithm to assess the risk of SCO was proposed for patients without CAC. Significance level of 5% was used in the analyses. Results Of the 509 participants of the CORE study, 117 (23%) had zero coronary calcium score; 13 (11%) patients without CAC had SCO. Zero calcium score was related to younger age, female gender, lower body mass index, no diabetes, and no dyslipidemia. Being a current smoker increased ~3.5 fold the probability of SCO and other CV risk factors were not significantly associated. Considering the clinical findings, an algorithm to further stratify zero calcium score patients was proposed and had a limited performance in the validation cohort (AUC 58; 95%CI 43, 72). Conclusion A lower cardiovascular risk profile is associated with zero calcium score in a setting of high-risk patients. Smoking is the strongest predictor of SCO in patients without CAC. more...
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- 2023
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5. Mecânica Ventricular Esquerda: Desvendando as Vias da Resposta Cardiovascular ao Exercício
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Eduardo M. Vilela and Ricardo Fontes-Carvalho
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Diagnostic Imaging/methods ,Ecocardiografia/métodos ,Coronary Artery Disease ,Echocardiography/methods ,Cardiology and Cardiovascular Medicine ,Doenças Cardiovasculares/prevenção e controle ,Cardiovascuar Diseases/prevention and control ,Doença Arterial Coronariana ,Diagnóstico por Imagem/métodos - Published
- 2023
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6. Coronary Tortuosity as a New Phenotype for Ischemia without Coronary Artery Disease
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Eltahlawi, Mohammad
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Coronary Artery Disease/complications ,Dislipidemias ,Diagnostic Imaging/methods ,Aterosclerose ,Risk Factors ,Calcium Metabolism Disorders/complications ,Myocardial Ischemia/complications ,Transtornos do Metabolismo do Cálcio/complicações, Fatores de Risco ,Atherosclerosis ,Doença da Artéria Coronariana/complicações ,Isquemia Miocárdica ,Diagnóstico por Imagem/métodos ,Dyslipidemias - Published
- 2022
7. High-Risk Cardiovascular Conditions in Sports-Related Sudden Death: Prevalence in 5,169 Schoolchildren Screened via Cardiac Magnetic Resonance.
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Angelini, Paolo, Cheong, Benjamin Y., Lenge De Rosen, Veronica V., Lopez, Alberto, Uribe, Carlo, Masso, Anthony H., Ali, Syed W., Davis, Barry R., Muthupillai, Raja, and Willerson, James T.
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CARDIAC magnetic resonance imaging , *CARDIAC arrest , *ELECTROCARDIOGRAPHY , *DILATED cardiomyopathy , *HYPERTROPHIC cardiomyopathy - Abstract
Improving preparticipation screening of candidates for sports necessitates establishing the prevalence of high-risk cardiovascular conditions (hr-CVC) that predispose young people to sudden cardiac death (SCD). Our accurate, novel protocol chiefly involved the use of cardiac magnetic resonance (CMR) to estimate this prevalence. Middle and high school students from a general United States population were screened by means of questionnaires, resting electrocardiograms, and CMR to determine the prevalence of 3 types of hr-CVC: electrocardiographic abnormalities, cardiomyopathies, and anomalous coronary artery origin from the opposite sinus with intramural coronary course (ACAOS-IM). We examined the range of normal left ventricular size and function in the main study cohort (schoolchildren 11–14 yr old). We defined diagnostic criteria for hr-CVC and compared the cardiac measurements of these younger participants with those of older children whom we examined (age, 15–18 yr). From 5,169 completed diagnostic studies (mean participant age, 13.06 ± 1.78 yr), CMR results revealed 76 previously undiagnosed cases of hr-CVC (1.47% of the total cohort): 11 of dilated cardiomyopathy (14.5%), 3 of nonobstructive hypertrophic cardiomyopathy (3.9%), 23 ACAOS-IM cases (30.3%; 6 left-ACAOS and 17 right-ACAOS), 4 Wolff-Parkinson-White patterns (5.3%), 34 prolonged QT intervals (44.7%), and 1 Brugada pattern (1.3%). Cardiomyopathies were significantly more prevalent in the older children. Of note, we identified 959 cases (18.5%) of left ventricular noncompaction. If our estimate is accurate, only 1.47% of school-age sports participants will need focused secondary evaluations; the rest can probably be reassured about their cardiac health after one 30-minute screening study. [ABSTRACT FROM AUTHOR] more...
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- 2018
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8. Management of Adults with Congenital Heart Disease
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Samarai, Daniel and Samarai, Daniel
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Adults with congenital heart disease (ACHD) are a completely new and rapidly growing specialty comprising patients who require specialist knowledge regarding their care and treatment. Challenges involve diagnostics and treatment as studies are scarce and include small and heterogenous study populations.The first aim with this thesis was to evaluate the relationship between the systemic right ventricular function determined by cardiac magnetic resonance (CMR) imaging, biomarkers, echocardiographic parameters, New York Heart Association class and performance on stress test.The second aim of this thesis was to evaluate anticoagulation treatment with vitamin K antagonists (VKA) in ACHD. This involved determining the quality of VKA therapy by evaluating time in therapeutic range (TTR) and variability of international normalised ratio of prothrombin time. Furthermore, studying the efficacy and safety of VKA and non-vitamin K oral antagonists (NOAC) in ACHD by evaluating the incidence of thromboembolism (TE), major bleeding and potential risk factors.Paper I A correlation was observed between the systemic ventricular function determined with CMR and echocardiographic ventricular global longitudinal strain in patients with systemic right ventricle.Paper II-III Anticoagulation with VKA was of high quality in ACHD in the South of Sweden. A low incidence of TE and major bleeding events was seen in ACHD patients with high quality VKA treatment. Younger age, female gender and cardiac failure were risk factors for poor anticoagulation and thus may be cause for cautiosness and when suitable, consideration of alternative non-VKA anticoagulants. History of TE was associated with complcations (TE and major bleeding).Paper IV In this retrospective study reports a single-center experience of NOAC use in ACHD patients we found no thromboembolic and one major bleeding events during a median duration of 17 months of therapy.In conclusion, right ventricular global longitudinal strain by ec more...
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- 2022
9. It is Time for Coronary Computed Tomography Angiography to be Incorporated into the SUS
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Poppi, Nilson Tavares
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Diagnostic Imaging/methods ,Angina Estável ,Doença da Artéria Coronariana ,Computed Tomography Angiography ,Cost-Benefit Analysis ,Unified Health System ,Análise Custo-Benefício ,Stable Angina ,Coronary Artery Disease ,Angiografia por Tomografia Computadorizada ,Sistema Único de Saúde (SUS ,Diagnóstico por Imagem/métodos - Published
- 2022
10. Anatomical-radiological correspondence of cineradiography :Practical guideness for students
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Suárez Velásquez, Andrea Marcela, Valcárcel García, Amalia, and Lozano Castillo, Javier Alfonso
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Materiales de Enseñanza ,Deglución ,Teaching Materials ,Cineradiography ,Didactics ,Cinedeglución ,Swallowing ,Didáctica ,Diagnostic Imaging/methods ,Videofluoroscopy ,611 - Anatomía humana, citología, histología [610 - Medicina y salud] ,Diagnóstico por Imagen/métodos ,Deglutition/physiology ,Cinerradiografía ,Anatomy ,Anatomía ,Deglución/fisiología - Abstract
ilustraciones, fotografías, gráficas, tablas La deglución es un proceso complejo que ha sido tema de interés en el ámbito clínico, la cinedeglución como examen diagnóstico ha sido el patrón de oro para su descripción y manejo. El reconocimiento de los elementos anatómicos que participan en el proceso de la deglución, es un factor fundamental para su interpretación. Las habilidades de observación y asociación deben ser desarrolladas durante la formación académica y perfeccionadas durante el ejercicio profesional. Por tal motivo, se realiza una guía práctica para estudiantes de fonoaudiología y especialidades médicas que se relacionen con la realización e interpretación del examen, a partir de la correspondencia de los elementos anatómicos ubicados en imágenes de cadáveres con imágenes radiológicas en reposo y en diferentes momentos de la deglución. Se tomaron imágenes de cadáveres del anfiteatro de la Facultad de Medicina de la Universidad Nacional de Colombia y registros de las historias clínicas de sujetos con diagnóstico de deglución normal del Hospital Universitario Nacional, en un periodo de un año, con edades entre 25 y 50 años indiferente del sexo. Se seleccionaron las imágenes, se ubicaron los elementos anatómicos en reposo y en tres momentos de la deglución orofaríngea. Con base en las imágenes se realizó la guía como herramienta didáctica interactiva donde se da a conocer la anatomía funcional de la deglución, se da información sobre el procedimiento para la realización del examen, se exponen las imágenes seleccionadas en correspondencia y por último se encuentra una evaluación. Se concluye que el conocimiento de la anatomía y la fisiología es la base fundamental para una interpretación diagnóstica precisa. (Texto tomado de la fuente). Swallowing is a complex procces that has been the subjet of interest for many professionals in the clinical practice. The cinerradiography is the gold standart for its diagnosis and managment. The anatomical elements identification that participate in the swallowing process is a fundamental factor for its interpretation. Observation and association skills must be developed during academical traninig and perfected whith de professional practice. For this reason, a practical guideness is made for students of speech and language patologist and medical specialization related with interpretation of exam, based on the correspondence of the anatomical elements identified in images of the cadavers with radiological images static and during swallowing. Cadavers images were taken from the amphitheater of de Faculty of Medicine of the Universidad Nacional de Colombia and medical records of subjects with a diagnosis of normal swallowing in the Hospital Universitario Nacional, in a period of one year, with ages between 25 and 50 years, indifferent to sex. Images were selected, anatomical elements were located at statical images and at three moments of oropharyngeal swallowing. Based on the images, the guide was made as an interactive didactic tool where the functional anatomy of swallowing is showed, information is given about the procedure for conducting the examination, the selected images are exposed in correspondence and finally a evaluation. It is concluded that the knowledge of anatomy and physiology is the fundamental basis for a accurate diagnostic interpretation. Incluye anexos Maestría Magíster en Morfología Humana Estudio descriptivo, observacional, retrospectivo Profundización more...
- Published
- 2021
11. Comparison of Commonly Carried Liquids Against Commercial Ultrasound Gel for Use in the Backcountry Setting.
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Wray JN, Soucy ZP, Daniel NJ, Weinberg NE, Krauthamer GM, Crockett SC, Pollack CC, and Storn JM
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- Humans, Ultrasonography methods, Gels, Point-of-Care Systems, Sunscreening Agents, Physicians
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Introduction: Point-of-care ultrasound (POCUS) is utilized in austere environments because it is lightweight, durable, battery powered, and portable. In austere settings, weight and space constraints are limitations to carrying dedicated ultrasound gel. Few studies have assessed commonly carried liquids as gel alternatives. The study objective was to assess the suitability of common food and personal care products as ultrasound coupling agents compared with that of commercial gel., Methods: A noninferiority study compared 9 products to commercial gel. Each substance was independently tested on 2 subjects by 2 sonographers covering 8 standardized ultrasound windows. Clips were recorded, blinded, and independently graded by 2 ultrasound fellowship-trained physicians on the ability to make clinical decisions and technical details, including contrast, resolution, and artifact. A 20% noninferiority margin was set, which correlates to levels considered to be of reliably sufficient quality by American College of Emergency Physicians' guidelines. The substances included water, soap, shampoo, olive oil, energy gel, maple syrup, hand sanitizer, sunscreen, and lotion., Results: A total of 300 of 318 (94%) clips met the primary endpoint of adequacy to make a clinical decision. All media, except sunscreen, were noninferior to commercial gel in the ability to make a clinical decision (α=0.05). In terms of secondary outcomes, resolution, artifact, and contrast, all substances were noninferior to commercial gel (α=0.05). The sonographers concluded that all gel alternatives' usability performed similarly to commercial gel, with the exception of energy gel., Conclusions: Of the 9 substances tested, 8 were noninferior to commercial gels for clinical decisions. Our study indicates that several POCUS gel substitutes are serviceable to produce clinically adequate images., (Copyright © 2022 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.) more...
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- 2023
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12. Imaging features of immunoglobulin G4-related disease.
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Dillon, Jonathan, Dart, Andrea, and Sutherland, Tom
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IMMUNOGLOBULIN G , *AUTOIMMUNE diseases , *PANCREATITIS , *ADRENOCORTICAL hormones , *RADIOLOGY , *DISEASES - Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition that was first recognised as a systemic disease in 2003, when patients with autoimmune pancreatitis were found to have extrapancreatic manifestations. Since 2003, IgG4-RD has been described in a diverse range of other organs including the biliary tree, orbits, lacrimal glands, salivary glands, lungs, kidneys, aorta, retroperitoneum, lymph nodes, pachymeninges, prostate and pituitary gland. The disease frequently occurs in the absence of pancreatic involvement. The imaging manifestations of IgG4-RD are broad and variable depending on the organ involved. The majority of individual organ appearances are non-specific and differentiation between IgG4-RD and potentially more serious conditions is not usually possible based on radiological findings in one organ alone. However, if there are simultaneous findings typical of IgG4-RD in multiple organs then this is a key diagnostic clue and IgG4-RD should be considered as one of the main differentials. This review article examines the spectrum of imaging appearances of IgG4-RD. Increased awareness of the spectrum of radiological appearances of IgG4-RD throughout the body and subsequent consideration of the condition may potentially avoid invasive treatment and lead to more prompt corticosteroid therapy. [ABSTRACT FROM AUTHOR] more...
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- 2016
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13. Giant Cardiac Lipoma: Refined Hypothesis Proposes Invagination from Extracardiac to Intracardiac Sites.
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Rainer, W. Gerald, Bailey, David J., and Hollis, Harris W.
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HEART tumors , *LIPOMA , *HEART physiology , *MOLECULAR genetics , *DIAGNOSIS - Abstract
Cardiac lipomas are rare and usually present as benign, encapsulated masses outside the heart; however, they can also be found within the atria. No single theory-including molecular genetic mutation-adequately explains why this occurs. Extensive career experience and broadened knowledge in embryology and cardiac physiology have helped us to develop a hypothesis based on invagination of extracardiac tumors. This report describes a vexing case of a giant right atrial lipoma, from 1985, in which the diagnosis was made incidentally during management of a patient's acute limb ischemia. In addition, we discuss the imaging and treatment of cardiac lipoma. [ABSTRACT FROM AUTHOR] more...
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- 2016
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14. Vascular Spectrum of Imaging Findings in COVID-19: Ischemic, Hemorrhagic, and Thromboembolic Complications
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Castro, Pedro Neves Paiva de, Chagas, Lucia Antunes, Wajnberg, Eduardo, Santos, Roberto, Cougo, Pedro, and Machado, Dequitier Carvalho
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Diagnostic Imaging/methods ,Thromboembolism/complications ,COVID-19/complications ,Hemorrhage ,Pneumonia ,Spectrum Analysis/methods - Abstract
Ischemic strokes secondary to occlusion of large vessels have been described in patients with COVID-19. Also, venous thrombosis and pulmonary thromboembolism have been related to the disease. Vascular occlusion may be associated with a prothrombotic state due to COVID-19-related coagulopathy and endotheliopathy. Intracranial hemorrhagic lesions can additionally be seen in these patients. The causative mechanism of hemorrhage could be associated with anticoagulant therapy or factors such as coagulopathy and endotheliopathy. We report on cases of ischemic, thrombotic, and hemorrhagic complications in six patients diagnosed with SARS-CoV-2 infection. Chest computed tomography (CT) showed typical SARS-CoV-2 pneumonia findings in all the cases, which were all confirmed by either serology or reverse transcription polymerase chain reaction (RT-PCR) tests. more...
- Published
- 2021
15. Evaluation of endothelial dysfunction in COVID-19 with flow-mediated dilatation
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Asli Kurtar Mansiroglu, Hande Seymen, Yilmaz Gunes, and Isa Sincer
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Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Brachial Artery ,Coronavirus disease 2019 (COVID-19) ,COVID-19/complicações ,Mialgia ,Dilatação do Fluxo Mediado ,Células Endoteliais/infecção ,Endotélio Vascular/lesões ,Endothelial, Cells/infection ,Echocardiography/methods ,Flow Dilatation ,Distúrbios do Paladar ,Ultrassonografia/métodos ,Diagnostic Imaging/methods ,Olfaction Disorders ,Taste Disorders ,Young Adult ,Internal medicine ,medicine ,Humans ,In patient ,Vascular Diseases ,Correlation test ,Endothelial dysfunction ,Inflammation ,Receiver operating characteristic ,business.industry ,Significant difference ,Healthy subjects ,COVID-19 ,Distúrbios do Olfato ,Ultrasonography/methods ,Myalgia ,medicine.disease ,Dilatation ,Vasodilation ,Ecocardiografia/métodos ,Endothelium Vascular/injuries ,COVID-19/complications ,Cardiology ,Female ,Endothelium, Vascular ,business ,Diagnóstico por Imagem/métodos ,Dilatation, Pathologic - Abstract
Resumo Fundamento: Sabe-se que a inflamação desempenha um papel crucial em muitas doenças, incluindo a COVID-19. Objetivo: Utilizando a dilatação fluxo-mediada (DFM), objetivou-se avaliar os efeitos da inflamação na função endotelial de pacientes com COVID-19. Métodos: Este estudo foi realizado com um total de 161 indivíduos, dos quais 80 foram diagnosticados com COVID-19 nos últimos seis meses (48 mulheres e 32 homens com idade média de 32,10±5,87 anos) e 81 eram controles saudáveis (45 mulheres e 36 homens com idade média de 30,51±7,33 anos). Os achados do ecocardiograma transtorácico e da DFM foram analisados em todos os indivíduos. Resultados com p more...
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- 2021
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16. Conservative Management of Cardiac Hemangioma for 11 Years.
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Gribaa, Rym, Slim, Mehdi, Neffati, Elyes, and Boughzela, Essia
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HEART tumors , *BENIGN tumors , *SURGICAL excision , *HEMANGIOMAS , *THERAPEUTICS - Abstract
Cardiac hemangiomas are benign tumors with an unpredictable natural history. Surgical resection is the treatment of choice; however, conservative management can be an alternative in some patients. We report a case of a left-sided cardiac hemangioma that we managed conservatively for 11 years without obvious major complications in the patient, an adult woman. [ABSTRACT FROM AUTHOR] more...
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- 2015
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17. Absence of Atherosclerosis in Chagas' Disease: The Role of Trypanosoma Cruzi Transialidase
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Higuchi, Maria de Lourdes
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Score Calcium ,Aterosclerose ,Computed Tomography Angiography ,Escore de Cálcio ,Atherosclerosis/physiopathology ,Trypanosoma cruzi ,Tomografia Computadorizada/métodos ,Artigo Original ,Doença de Chagas/fisiopatologia ,Minieditorial ,Aterosclerose/fisiopatologia ,Coronary Artery Disease ,Tomography, Computerized/methods ,Atherosclerosis ,Diagnostic Imaging/methods ,Tomografia Computadorizada Angiográfica ,Computed Tomography/methods ,Prevalence ,Humans ,Chagas Disease ,Original Article ,Short Editorial ,Chagas Disease/physiopathology ,Diagnóstico por Imagem/métodos ,Doença Arterial Coronariana - Abstract
Resumo Fundamento Em regiões endêmicas da doença de Chagas, por muitos anos, existe uma observação empírica recorrente de que a doença arterial coronariana (DAC) é incomum em pacientes com doença de Chagas. Estudos anteriores baseados em análise patológica ou angiografia coronária invasiva apresentam resultados controversos. Objetivo Investigar se a DAC é menos prevalente e menos grave em pacientes com doença de Chagas crônica em comparação a uma população pareada controle, com perfil de risco para DAC similar. Métodos Um total de 86 participantes, 43 pacientes com doença de Chagas crônica consecutivos e 43 indivíduos assintomáticos, sem qualquer história prévia de doença cardíaca ou doença DAC conhecida (grupo controle), foram incluídos no estudo. Pacientes e controles foram pareados quanto sexo, idade e escore de risco de Framingham. Todos os pacientes foram analisados quanto ao escore de cálcio coronário (ECC) e submetidos à angiotomografia coronária usando um tomógrafo de 320 detectores. O nível de significância estatística adotado foi de p < 0,05. Resultados O ECC foi significativamente mais baixo em pacientes com doença de Chagas em comparação aos controles (p 10 (OR: 0,11, IC95%: 0,01-0,87, p=0,04), e para a presença de estenose (OR: 0,06, IC95%: 0,01-0,47, p=0,001). O pareamento por escore de propensão também mostrou um efeito da doença de Chagas no ECC (-21,6 pontos no escore absoluto e 25% menos pacientes com ECC > 10; p=0,015). Conclusões A prevalência e a gravidade da DAC são mais baixas nos pacientes com doença de Chagas crônica em comparação a uma população pareada e perfil de risco para DAC similar. (Arq Bras Cardiol. 2020; 115(6):1051-1060) more...
- Published
- 2021
18. Intravenous Leiomyomatosis with Intracardiac Extension: Echocardiographic Study and Literature Review.
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Rongjuan Li, Yanguang Shen, Yan Sun, Chuanchen Zhang, Ya Yang, Jiao Yang, Ruijuan Su, and Bo Jiang
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UTERINE cancer , *ECHOCARDIOGRAPH research , *HYSTERECTOMY , *VENA cava inferior , *SURGICAL excision , *DIAGNOSIS , *TUMORS - Abstract
Uterine leiomyomatosis is a common disease in women; however, intravenous leiomyomatosis with intracaval and intracardiac tumor extension is rare. We sought to analyze the clinical and echocardiographic features of intracardiac leiomyomatosis. From January 2003 through July 2012, 7 women (age range, 24-59 yr) underwent surgical resection of histopathologically diagnosed intracardiac leiomyomas at our hospital. Most of the patients had histories of hysterectomy or uterine leiomyoma. We retrospectively analyzed their preoperative echocardiograms. We found that the tumors had no stalks, did not adhere to the wall of the right side of the heart, were highly mobile, and moved back and forth in the right atrium near the tricuspid orifice. All tumors originated from the inferior vena cava and had borders well demarcated from that structure's wall. Most of the masses extended into the inferior vena cava and right atrium through the right internal and common iliac veins. Computed tomograms revealed pelvic tumors and contiguous filling defects in 6 patients. When echocardiograms reveal a right-sided cardiac mass that originates from the inferior vena cava, particularly in women who have a history of hysterectomy or uterine leiomyoma, intracardiac leiomyomatosis should be suspected. If the mass has no stalk and freely moves within the inferior vena cava and right-sided cardiac chambers without attachment to the endothelial surface or endocardium, intracardiac leiomyomatosis should be diagnosed. We discuss our findings and briefly review the relevant medical literature. [ABSTRACT FROM AUTHOR] more...
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- 2014
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19. Intimal Sarcoma in the Aortic Arch Partially Obstructing the Aorta with Metastasis to the Brain.
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Mecklai, Alicia, Rosenzweig, Barry, Applebaum, Robert, Axel, Leon, Grossi, Eugene, Chan, Alexander, and Saric, Muhamed
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AORTA , *TUMORS , *BRAIN metastasis , *METASTASIS - Abstract
Primary tumors of the aorta are rare entities. We report the unusual manifestation of an aortic intimal sarcoma that presented as a brain metastasis in a 56-year-old, otherwise healthy woman. After the brain mass had been resected, multiple imaging methods revealed pseudocoarctation and the primary tumor in the aortic arch. To our knowledge, this is the first report of the diagnosis of an aortic intimal sarcoma with use of real-time, 3-dimensional transesophageal echocardiography. [ABSTRACT FROM AUTHOR] more...
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- 2014
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20. Diagnostic imaging in Crohn's disease: What is the new gold standard?
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Dambha, F. and Carroll, N.
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- 2014
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21. Imaging patients with stable chest pain special feature
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Edwin J R van Beek and Matthijs Oudkerk
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Diagnostic Imaging ,Heart Diseases/complications ,Chest Pain ,medicine.medical_specialty ,Heart Diseases ,business.industry ,MEDLINE ,Heart ,General Medicine ,Imaging patients with stable chest pain special feature: Editorial ,Chest pain ,Heart/diagnostic imaging ,Diagnostic Imaging/methods ,Feature (computer vision) ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,medicine.symptom ,business ,Chest Pain/diagnosis ,Introductory Journal Article - Published
- 2020
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22. Current landscape of Imaging and the potential role for Artificial intelligence in the management of COVID-19
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Omer A. Awan, Faiq Shaikh, M. Rizwan Sohail, Michael Brun Andersen, Olga Kubassova, Francisca Mulero, Sotirios Bisdas, Diana Dupont-Roettger, and Jamshid Dehmeshki
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Diagnostic Imaging ,Disease status ,Coronavirus disease 2019 (COVID-19) ,Radiography ,COVID-19/prevention & control ,artificial ,Early detection ,Computed tomography ,medical ,Article ,Diagnostic Imaging/methods ,Artificial Intelligence ,INFECTION ,Image Interpretation, Computer-Assisted ,Medical imaging ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,FDG-PET ,medicine.diagnostic_test ,SARS-CoV-2 ,business.industry ,Image Interpretation, Computer-Assisted/methods ,COVID-19 ,imaging ,intelligence ,Functional imaging ,Positron emission tomography ,Radiology Nuclear Medicine and imaging ,Artificial intelligence ,business - Abstract
The clinical management of COVID-19 is challenging. Medical imaging plays a critical role in the early detection, clinical monitoring and outcomes assessment of this disease. Chest x-ray radiography and computed tomography) are the standard imaging modalities used for the structural assessment of the disease status, while functional imaging (namely, positron emission tomography) has had limited application. Artificial intelligence can enhance the predictive power and utilization of these imaging approaches and new approaches focusing on detection, stratification and prognostication are showing encouraging results. We review the current landscape of these imaging modalities and artificial intelligence approaches as applied in COVID-19 management. more...
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- 2020
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23. Ausência de Aterosclerose na Doença de Chagas: O Papel da Transialidase do Trypanosoma Cruzi
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Maria de Lourdes Higuchi
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Diagnostic Imaging/methods ,Tomografia Computadorizada Angiográfica ,Atherosclerosis/physiopathology ,RC666-701 ,Computed Tomography/methods ,Doença de Chagas/fisiopatologia ,Diseases of the circulatory (Cardiovascular) system ,Aterosclerose/fisiopatologia ,Chagas Disease/physiopathology ,Diagnóstico por Imagem/métodos - Published
- 2021
24. Benign or Malignant Anomaly?
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Rosenthal, Robert L., Carrothers, Irene A., and Schussler, Jeffrey M.
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PATHOLOGICAL physiology , *TOMOGRAPHY , *ANGIOGRAPHY , *RADIOSCOPIC diagnosis ,CORONARY artery abnormalities - Abstract
Very high takeoff of the left main coronary artery in the absence of another coronary anomaly is a rare finding. The pathologic consequences of this anomaly are unclear, and the literature on this subject does not agree on whether the condition is dangerous. We present our findings in 2 patients who were discovered to have this anomaly upon noninvasive computed tomographic coronary angiography, and we discuss our analysis of the literature and our management of these patients. [ABSTRACT FROM AUTHOR] more...
- Published
- 2012
25. Hepatic Height on Coronal Computed Tomography Images Predicts Total Liver Volume in European Adults Without Liver Disease.
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Soyer, Philippe, Sirol, Marc, Dohan, Anthony, Gayat, Etienne, Placé, Vinciane, Hristova, Lora, Hamzi, Lounis, and Boudiaf, Mourad
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LIVER diseases , *TOMOGRAPHY , *IMAGE processing , *DIAGNOSTIC imaging , *MEDICAL statistics , *REGRESSION analysis , *EUROPEANS , *DISEASES - Abstract
Background: Hepatic volume measurement provides useful information in a large range of clinical situations. Aims: The goal of this study was to test the hypothesis that significant correlation exists between hepatic volume calculated using three-dimensional reconstruction of computed tomography (CT) data and hepatic height calculated using coronal reformation of CT images in European adult patients without liver disease. Methods: One hundred patients (50 men, 50 women; mean age, 47 years) without hepatic disease were included. Coronal and three-dimensional images of the liver were obtained using 64-section helical CT. Correlation between hepatic height and hepatic volume was searched for using the Pearson correlation test. Regression analysis was used to compare hepatic height and hepatic volume. Results: A strong and highly significant positive correlation was found between hepatic height and hepatic volume, with a correlation coefficient ( r) of 0.767 (95%CI 0.672-0.837; r = 0.588) ( P < 0.001). The equation of the correlation line was y = 11.764 x − 244 where y represents the hepatic volume in cm and x the hepatic height in mm. Conclusion: Hepatic height as obtained on coronal CT image is a simple and rapid measurement that allows predicting hepatic volume in European adult patients without liver disease. [ABSTRACT FROM AUTHOR] more...
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- 2012
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26. Micro-Ultrasonographic Imaging of Atherosclerotic Progression.
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Rong-Juan Li, Ya Yang, Yan-Hong Wang, Jin-Jie Xie, Li Song, Zheng Wang, Yao-Zhong Zhang, Yan-Wen Qin, Zhi-An Li, and Xiao-Shan Zhang
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ATHEROSCLEROSIS , *APOLIPOPROTEINS , *BLOOD lipoproteins , *C-reactive protein , *ACUTE phase proteins - Abstract
We studied prospectively whether atherosclerotic progression in apolipoprotein-E knock- out mice could be noninvasively and accurately measured by use of high-resolution ultra- sonographic biomicroscopy. We examined the correlation between the ultrasonographic characterization of ascending aortic atherosclerotic plaque and plasma C-reactive protein, interleukin-1, and interleukin-6 levels in these mice. In 4 age groups (8, 16, 24, and 32 wk) of 8 male knockout mice each (atherosclerotic groups) and age-matched male C57BL/6 mice (control groups), we used ultrasonographic biomicroscopy to measure maximal plaque thickness or intima-media thickness in the ascending aorta. We compared the findings with corresponding histologic measurements, and we measured plasma C-reactive protein, interleukin-1, and interleukin-6 levels in each group. Mean atherosclerotic thicknesses and C-reactive protein and interleukin levels were significantly higher in each atherosclerotic group than in the control groups (all P <0.05). Ultrasonographically measured atherosclerotic thickness correlated well with histologic measurements of the same vascular regions (r=0.81, P <0.001). C-reactive protein levels increased concomitantly with age in the knockout mice, and ultrasonographically measured atherosclerotic thickness correlated with those levels (r=0.626, P <0.001). However, there was no correlation between plasma interleukin levels and atherosclerotic severity as measured by ultrasonographic biomicroscopy. In the apolipoprotein-E knockout mice, we found that measurements of intima-media or maximal plaque thickness by ultrasonographic biomicroscopy noninvasively and accurately detected atherosclerotic progression, that plasma C-reactive protein levels correlated with atherosclerosis, and that elevated plasma C-reactive protein levels correlated with atherosclerotic severity. [ABSTRACT FROM AUTHOR] more...
- Published
- 2011
27. Symptomatic Anomalous Origination of the Left Coronary Artery from the Opposite Sinus of Valsalva.
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Angelini, Paolo, Walmsley, Robert P., Libreros, Andres, and Ott, David A.
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CORONARY arteries , *PARANASAL sinuses , *ULTRASONIC imaging , *CORONARY artery bypass , *AORTA - Abstract
Anomalous origination of a coronary artery can have serious, even fatal, consequences. Intravascular ultrasonography has recently provided new insights into anomalous coronary artery origination from the opposite sinus of Valsalva. On the basis of these insights, we describe 3 typical forms of this anomaly with left coronary artery involvement, including clinical presentations, diagnostic methods (particularly intravascular ultrasonography), and details of surgical treatment. In this case series, the left coronary artery originated from the noncoronary sinus in 1 patient and from the right sinus in another patient. In the 3rd patient, both the left and right coronary arteries originated from the ascending aorta above the sinotubular junction. Baseline areas of stenosis ranged from 48.6% to 70.1%. Intravascular ultrasonography was the only method that enabled us to clarify the mechanisms and the severity of the anomaly. Pharmacologic challenge was useful to predict worsening that might have occurred under physiologic conditions. We found that, in cases of symptomatic left anomalous coronary artery origination from the opposite sinus of Valsalva, the proximal segment of the left coronary artery consistently has 1) an intramural course inside the aortic wall; 2) hypoplasia, as determined by its circumference; and 3) a cross-sectional ovaloid deformity (lateral compression) with phasic and exercise-induced worsening of the deformity. With regard to surgical treatment, ostioplasty is preferable to coronary bypass. To establish sound guidelines for managing these anomalies, a larger series should be studied prospectively with quantitative parameters and long-term follow-up. [ABSTRACT FROM AUTHOR] more...
- Published
- 2006
28. Corneal differences between healthy and subclinical patients assessed using two diferente corneal tomographers
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Zhaoge Wang, Meilan Cai, Xiaotong Han, Ruifang Wang, Ruichun Ge, Yi Sun, Zhaoping Yang, Haixia Zhao, and Wenying Guan
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Adult ,Male ,medicine.medical_specialty ,Maximum curvature ,Keratoconus ,genetic structures ,Adolescent ,Cornea/diagnostic imaging ,Keratoconus/diagnosis ,Eye care ,Curvature ,Statistics, Nonparametric ,law.invention ,Radius of curvature (optics) ,Cornea ,Young Adult ,law ,Reference Values ,Ophthalmology ,Diagnóstico por imagem/mé todos ,medicine ,Humans ,Córnea/diagnóstico por imagem ,Prospective Studies ,Subclinical infection ,Keratometer ,medicine.diagnostic_test ,business.industry ,Corneal Topography ,Reproducibility of Results ,General Medicine ,RE1-994 ,medicine.disease ,Corneal topography ,Diagnostic imaging/methods ,eye diseases ,Case-Control Studies ,Topografia da córnea ,Estudo comparativo ,Female ,sense organs ,Comparative study ,Ceratocone/diagnóstico ,business - Abstract
Purpose: To analyze subclinical keratoconus topography indexes using Pentacam and Orbscan-II measurements to identify evidences for seeking sensitive indexes to screen and diagnose subclinical keratoconus. Methods: Fifty healthy participants (50 eyes) and 40 patients with subclinical keratoconus (40 eyes) were included. Seven common parameters including corneal thickness at the thinnest point; minimum curvature of the front surface (minimum simulated keratometry value, SimK’s Min); maximum curvature of the front surface (maximum simulated keratometry value, SimK’s Max); the frontal corneal surface best-fit spherical radius of the curvature; the back corneal surface best-fit spherical radius of curvature; the anterior corneal surface height (anterior Diff value); and the posterior corneal surface height (posterior Diff value) measured by Pentacam and Orbscan-II between normal and subclinical keratoconus eyes were compared. Results: Statistical differences between the healthy and subclinical keratoconus groups (p more...
- Published
- 2019
29. Diabetic calcaneal osteomyelitis
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Waibel, Felix W A, Uçkay, Ilker, Sairanen, Kati, Waibel, Lorenz, Berli, Martin C, Böni, Thomas, Gariani, Karim, Lipsky, Benjamin A, University of Zurich, and Uçkay, Ilker
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ddc:616 ,Male ,610 Medicine & health ,2725 Infectious Diseases ,Middle Aged ,Orthopedic Procedures/methods ,2726 Microbiology (medical) ,Bacterial Infections/diagnosis/microbiology ,Diabetic Foot/complications/diagnosis/epidemiology/therapy ,Anti-Bacterial Agents/therapeutic use ,Calcaneus ,Diagnostic Imaging/methods ,Osteomyelitis/diagnosis/epidemiology/etiology/therapy ,Treatment Outcome ,Humans ,Regression Analysis ,Female ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,Aged - Abstract
Diabetic foot infection (DFI), a multi-facetted disease requiring a multidisciplinary approach for successful treatment, mostly affects the forefoot. Calcaneal osteomyelitis (CO) is an uncommon presentation of DFI with a somewhat different epidemiology, clinical features, and approach to management. These patients, compared to those with non-calcaneal DFI, more often require special surgical techniques and off-loading approaches. In this narrative review targeted to non-surgical clinicians, we explore how CO differs from other types of DFI affecting other anatomical locations. Based on our review of the literature and personal experience, we also highlight important issues regarding the management of CO osteomyelitis, including the need for specialized surgical approaches. more...
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- 2019
30. The Human Brain Project—Synergy between neuroscience, computing, informatics, and brain-inspired technologies
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Egidio D'Angelo, Alain Destexhe, Alois Knoll, Viktor K. Jirsa, Katrin Amunts, Philippe Ryvlin, Jan G. Bjaalie, Cyriel M. A. Pennartz, Thomas Lippert, Institute of Neuroscience and Medicine [Jülich] (INM-1), Institut für Informatik (LRR-TUM), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Jülich Supercomputing Centre, Institute for Advanced Simulation, Swammerdam Institute for Life Sciences [Amsterdam, Pays-Bas], University of Amsterdam [Amsterdam] (UvA), Department of Clinical Neurosciences, Centre Hospitalo-Universitaire Vaudois (CHUV), Institut des Neurosciences Paris-Saclay (NeuroPSI), Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS), Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Mondino National Institute of Neurology Foundation, IRCCS - Pavia, Department of Brain and Behavioral Science, Unit of Neurophysiology, University of Oslo (UiO), Institute of Basic Medical Sciences [Oslo], Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), European Project: 720270,H2020 Pilier Excellent Science,H2020-Adhoc-2014-20,HBP SGA1(2016), European Project: 785907,H2020,HBP SGA2(2018), Cognitive and Systems Neuroscience (SILS, FNWI), PERIGNON, Alain, Human Brain Project Specific Grant Agreement 1 - HBP SGA1 - - H2020 Pilier Excellent Science2016-04-01 - 2018-03-31 - 720270 - VALID, and Human Brain Project Specific Grant Agreement 2 - HBP SGA2 - - H20202018-04-01 - 2020-03-31 - 785907 - VALID more...
- Subjects
0301 basic medicine ,Technology ,[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology ,[SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior ,Health informatics ,Database and Informatics Methods ,0302 clinical medicine ,Community Page ,Image Processing, Computer-Assisted ,Biology (General) ,Data Management ,[SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior ,General Neuroscience ,Brain ,[SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences ,Simulation and modeling ,3. Good health ,ddc ,General Agricultural and Biological Sciences ,Neural networks ,Diagnostic Imaging ,Computer and Information Sciences ,QH301-705.5 ,Brain research ,Cognitive neuroscience ,Biology ,Research and Analysis Methods ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Humans ,ddc:610 ,Brain/anatomy & histology ,Brain/diagnostic imaging ,Diagnostic Imaging/methods ,Image Processing, Computer-Assisted/methods ,Medical Informatics/methods ,Medical Informatics/trends ,Neurosciences/methods ,Neurosciences/trends ,Reproducibility of Results ,Technology/methods ,Technology/trends ,Metadata ,Computational neuroscience ,General Immunology and Microbiology ,business.industry ,Behavioral neuroscience ,[SDV.NEU.NB] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology ,Neurosciences ,Biology and Life Sciences ,Computational Biology ,Human Brain Project ,030104 developmental biology ,Informatics ,Cognitive Science ,business ,Neuroscience ,[SDV.NEU.SC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences ,030217 neurology & neurosurgery ,Medical Informatics - Abstract
The Human Brain Project (HBP) is a European flagship project with a 10-year horizon aiming to understand the human brain and to translate neuroscience knowledge into medicine and technology. To achieve such aims, the HBP explores the multilevel complexity of the brain in space and time; transfers the acquired knowledge to brain-derived applications in health, computing, and technology; and provides shared and open computing tools and data through the HBP European brain research infrastructure. We discuss how the HBP creates a transdisciplinary community of researchers united by the quest to understand the brain, with fascinating perspectives on societal benefits., This Community Page article presents the Human Brain Project; a European Flagship project with a ten-year horizon aiming to understand the human brain and translate neuroscience knowledge into medicine and technology. more...
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- 2019
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31. Imaging Methodology for Hip Preservation:Techniques, Parameters, and Thresholds
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Vasco V. Mascarenhas, Reto Sutter, João Novo, Anne Grethe Jurik, Niels Egund, Olufemi R. Ayeni, Miguel O. Castro, Sara Gonçalves, António Caetano, University of Zurich, and Mascarenhas, Vasco V
- Subjects
Diagnostic Imaging ,musculoskeletal diseases ,medicine.medical_specialty ,MEDLINE ,610 Medicine & health ,Osteoarthritis, Hip ,Arthroscopy ,Diagnostic Imaging/methods ,2732 Orthopedics and Sports Medicine ,Hip Joint/diagnostic imaging ,Femoracetabular Impingement ,medicine ,2741 Radiology, Nuclear Medicine and Imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Orthopedics and Sports Medicine ,Intensive care medicine ,Femoracetabular Impingement/diagnostic imaging ,Femoroacetabular impingement ,Hip surgery ,Surgical approach ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Review article ,Clinical diagnosis ,Hip Joint ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,Hip arthroscopy ,Osteoarthritis, Hip/diagnostic imaging ,business - Abstract
The concept of hip impingement and hip-preserving surgery has been appreciated in more detail since 2001 when a new surgical approach was reported and a hypothesis linking femoroacetabular impingement (FAI) with osteoarthritis was presented. Paralleling the introduction of hip arthroscopy, these events led to an increasing interest in the hip, and the number of publications has risen rapidly over the past 15 years, despite limited evidence levels and inconsistent methodology. Accordingly, etiology, diagnosis, prognosis, and the effects of treatment for FAI are still elusive due to a number of uncertainties and a lack of clear diagnostic criteria.Future research must focus on developing high-quality scientific studies, so thorough and reproducible methodology is needed. This review provides researchers, radiologists, and clinicians with a comprehensive approach to hip imaging with a focus on strategies to help guide the clinical diagnosis. Using evidence from current literature and knowledge from experienced clinicians, some of the imaging methodology challenges are deciphered. more...
- Published
- 2019
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32. Increased use of cross-sectional imaging for follow-up does not improve post-recurrence survival of surgically treated initially localized R.C.C.: results from a European multicenter database (R.E.C.U.R.)
- Author
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Axel Bex, Sergio Fernández-Pello, Thomas B. Lam, Paimaun Zakikhani, Alessandro Volpe, Serenella Monagas, Börje Ljungberg, Christian Beisland, Karim Bensalah, Thomas Powles, Samuel P Williams, Erik van Werkhoven, Grant D. Stewart, William Gietzmann, Richard P. Meijer, Lorenzo Marconi, Michael Staehler, Saeed Dabestani, and Eirikur Gudmundsson more...
- Subjects
Nephrology ,Male ,genetic structures ,Databases, Factual ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Diagnostic Imaging/methods ,Neoplasm Recurrence, Local/diagnostic imaging ,0302 clinical medicine ,Renal cell carcinoma ,Risk Factors ,follow-up ,Medicine ,Carcinoma, Renal Cell/diagnostic imaging ,imaging ,Middle Aged ,Prognosis ,Kidney Neoplasms ,Kidney Neoplasms/diagnostic imaging ,Multicenter Study ,Europe ,Survival Rate ,Female ,Diagnostic Imaging ,medicine.medical_specialty ,Local/diagnostic imaging ,overall survival ,Urology ,Cross-sectional imaging ,Renal Cell/diagnostic imaging ,Databases ,03 medical and health sciences ,Internal medicine ,Medical imaging ,Overall survival ,Journal Article ,Humans ,Survival rate ,Carcinoma, Renal Cell ,Factual ,Aged ,Retrospective Studies ,business.industry ,Carcinoma ,Retrospective cohort study ,medicine.disease ,Neoplasm Recurrence ,Multicenter study ,Neoplasm Recurrence, Local ,business ,Nuclear medicine ,Follow-Up Studies - Abstract
Objective: Modality and frequency of image-based renal cell carcinoma (R.C.C.) follow-up strategies are based on risk of recurrence. Using the R.E.C.U.R.-database, frequency of imaging was studied in regard to prognostic risk groups. Furthermore, it was investigated whether imaging modality utilized in contemporary follow-up were associated with outcome after detection of recurrence. Moreover, outcome was compared based on whether the assessment of potential curability was a pre-defined set of criteria’s (per-protocol) or stated by the investigator. Materials and methods: Consecutive non-metastatic R.C.C. patients (n = 1,612) treated with curative intent at 12 institutes across eight European countries between 2006 and 2011 were included. Leibovich or U.I.S.S. risk group, recurrence characteristics, imaging modality, frequency and survival were recorded. Primary endpoints were overall survival (O.S.) after detection of recurrence and frequency of features associated with favourable outcome (non-symptomatic recurrences and detection within the follow-up-programme). Results: Recurrence occurred in 336 patients. Within low, intermediate and high risk for recurrence groups, the frequency of follow-up imaging was highest in the early phase of follow-up and decreased significantly over time (p < 0.001). However, neither the image modality for detection nor ≥ 50% cross-sectional imaging during follow-up were associated with improved O.S. after recurrence. Differences between per protocol and investigator based assessment of curability did not translate into differences in O.S. Conclusions: As expected, the frequency of imaging was highest during early follow-up. Cross-sectional imaging use for detection of recurrences following surgery for localized R.C.C. did not improve O.S. post-recurrence. Prospective studies are needed to determine the value of imaging in follow-up. more...
- Published
- 2019
33. Anomalous Origin of the Left Main Coronary Artery from the Right Coronary Artery with a Preaortic Course.
- Author
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Yildiz, Omer, Ocal Karabay, Kanber, Akman, Canan, and Aytekin, Vedat
- Subjects
- *
ANGINA pectoris , *CORONARY arteries , *ULTRASONIC imaging , *VALSALVA'S maneuver , *PULMONARY artery catheters - Abstract
We report the case of a 51-year-old woman who presented with stable angina pectoris and Canadian Cardiovascular Society class II functional capacity. An electrocardiogram during a treadmill exercise test showed substantial ST-segment depression in the inferolateral leads. Coronary angiograms revealed an anomalous origin of the left main coronary artery from the opposite sinus of Valsalva and an interarterial course between the ascending aorta and pulmonary artery. Although this phenomenon is dangerous, the patient refused further examination. We discuss the diagnosis and treatment of patients who have an anomalous origin of a coronary artery from the opposite sinus of Valsalva. [ABSTRACT FROM AUTHOR] more...
- Published
- 2015
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34. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules - 2016 Update Appendix
- Author
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Gharib, Hossein, Papini, Enrico, Garber, Jeffrey R., Duick, Daniel S., Harrell, R. Mack, Hegedüs, Laszlo, Paschke, Ralf, Valcavi, Roberto, Vitti, Paolo, Balafouta, Sofia Tseleni, Baloch, Zubair, Crescenzi, Anna, Dralle, Henning, Frasoldati, Andrea, Gärtner, Roland, Guglielmi, Rinaldo, Mechanick, Jeffrey I., Reiners, Christoph, Szabolcs, Istvan, Zeiger, Martha A., and Zini, Michele more...
- Subjects
Diagnostic Imaging ,Thyroid nodules ,medicine.medical_specialty ,Biopsy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Biopsy, Fine-Needle ,Diagnostic Techniques, Endocrine/standards ,Levothyroxine ,030209 endocrinology & metabolism ,Malignancy ,Diagnostic Techniques, Endocrine ,Diagnostic Imaging/methods ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Female ,Humans ,Italy ,Pregnancy ,Thyroid Nodule ,United States ,Internal medicine ,medicine ,Suspicious for Malignancy ,medicine.diagnostic_test ,business.industry ,Thyroid ,Nodule (medicine) ,Thyroid Nodule/classification ,medicine.disease ,Diagnostic Techniques ,Diabetes and Metabolism ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Fine-Needle ,Radiology ,medicine.symptom ,Percutaneous ethanol injection ,Endocrine ,business ,Endocrinology/organization & administration ,medicine.drug - Abstract
Thyroid nodules are detected in up to 50 to 60% of healthy subjects. Most nodules do not cause clinically significant symptoms, and as a result, the main challenge in their management is to rule out malignancy, with ultrasonography (US) and fine-needle aspiration (FNA) biopsy serving as diagnostic cornerstones. The key issues discussed in these guidelines are as follows: (1) US-based categorization of the malignancy risk and indications for US-guided FNA (henceforth, FNA), (2) cytologic classification of FNA samples, (3) the roles of immunocytochemistry and molecular testing applied to thyroid FNA, (4) therapeutic options, and (5) follow-up strategy. Thyroid nodule management during pregnancy and in children are also addressed. On the basis of US features, thyroid nodules may be categorized into 3 groups: low-, intermediate-and high-malignancy risk. FNA should be considered for nodules ≤10 mm diameter only when suspicious US signs are present, while nodules ≤5 mm should be monitored rather than biopsied. A classification scheme of 5 categories (nondiagnostic, benign, indeterminate, suspicious for malignancy, or malignant) is recommended for the cytologic report. Indeterminate lesions are further subdivided into 2 subclasses to more accurately stratify the risk of malignancy. At present, no single cytochemical or genetic marker can definitely rule out malignancy in indeterminate nodules. Nevertheless, these tools should be considered together with clinical data, US signs, elastographic pattern, or results of other imaging techniques to improve the management of these lesions. Most thyroid nodules do not require any treatment, and levothyroxine (LT4) suppressive therapy is not recommended. Percutaneous ethanol injection (PEI) should be the first-line treatment option for relapsing, benign cystic lesions, while US-guided thermal ablation treatments may be considered for solid or mixed symptomatic benign thyroid nodules. Surgery remains the treatment of choice for malignant or suspicious nodules. The present document updates previous guidelines released in 2006 and 2010 by the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE) and Associazione Medici Endocrinologi (AME). more...
- Published
- 2016
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35. 18F-FDG, as a single imaging agent in assessing cancer, shows the ongoing biological phenomena in many domains
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Poul Flemming Høilund-Carlsen, Saeid Gholami, Thomas C. Kwee, Domenico Rubello, Thomas Werner, and Abass Alavi
- Subjects
Diagnostic Imaging ,medicine.medical_specialty ,Neoplasms/blood supply ,030218 nuclear medicine & medical imaging ,Diagnostic Imaging/methods ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Neoplasms ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Radioactive Tracers ,Cell Proliferation ,Neovascularization, Pathologic ,business.industry ,Cancer ,General Medicine ,medicine.disease ,Imaging agent ,Editorial ,Radiology Nuclear Medicine and imaging ,Positron-Emission Tomography ,030220 oncology & carcinogenesis ,business - Published
- 2016
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36. Radiation Therapy for Solitary Plasmacytoma and Multiple Myeloma:Guidelines From the International Lymphoma Radiation Oncology Group
- Author
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Tsang, Richard W, Campbell, Belinda A, Goda, Jayant S, Kelsey, Chris R, Kirova, Youlia M, Parikh, Rahul R, Ng, Andrea K, Ricardi, Umberto, Suh, Chang-Ok, Mauch, Peter M, Specht, Lena, Yahalom, Joachim, Tsang, Richard W, Campbell, Belinda A, Goda, Jayant S, Kelsey, Chris R, Kirova, Youlia M, Parikh, Rahul R, Ng, Andrea K, Ricardi, Umberto, Suh, Chang-Ok, Mauch, Peter M, Specht, Lena, and Yahalom, Joachim more...
- Abstract
PURPOSE: To develop guidelines for the work-up and radiation therapy (RT) management of patients with plasma cell neoplasms.METHODS AND MATERIALS: A literature review was conducted covering staging, work-up, and RT management of plasma cell neoplasms. Guidelines were developed through consensus by an international panel of radiation oncologists with expertise in these diseases, from the International Lymphoma Radiation Oncology Group. RT volume definitions are based on the International Commission on Radiation Units and Measurements.RESULTS: Plasma cell neoplasms account for approximately one-fifth of mature B-cell neoplasms in the United States. The majority (∼95%) are diagnosed as multiple myeloma, in which there has been tremendous progress in systemic therapy approaches with novel drugs over the last 2 decades, resulting in improvements in disease control and survival. In contrast, a small proportion of patients with plasma cell neoplasms present with a localized plasmacytoma in the bone, or in extramedullary (extraosseous) soft tissues, and definitive RT is the standard treatment. RT provides long-term local control in the solitary bone plasmacytomas and is potentially curative in the extramedullary cases. This guideline reviews the diagnostic work-up, principles, and indications for RT, target volume definition, treatment planning, and follow-up procedures for solitary plasmacytoma. Specifically, detailed recommendations for RT volumes and dose/fractionation are provided, illustrated with specific case scenarios. The role of palliative RT in multiple myeloma is also discussed.CONCLUSIONS: The International Lymphoma Radiation Oncology Group presents a standardized approach to the use and implementation of definitive RT in solitary plasmacytomas. The modern principles outlining the supportive role of palliative RT in multiple myeloma in an era of novel systemic therapies are also discussed. more...
- Published
- 2018
37. Inflammatory myofibroblastic tumor of the lung: a rare cause of atelectasis in children
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Alexandra Reverdin, Sylviane Hanquinet, Mehrak Anooshiravani, Amira Dhouib, and Constance Barrazzone
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Diagnostic Imaging ,Male ,medicine.medical_specialty ,Pathology ,Pulmonary Atelectasis ,Lung Neoplasms ,Atelectasis ,ddc:616.0757 ,Complete resection ,Diagnosis, Differential ,Diagnostic Imaging/methods ,Neoplasms, Muscle Tissue ,Pulmonary Atelectasis/diagnosis/etiology ,medicine ,Persistent cough ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Neuroradiology ,Lung Neoplasms/complications/diagnosis ,Lung ,business.industry ,Left main bronchus ,Histology ,Pneumonia ,respiratory system ,medicine.disease ,respiratory tract diseases ,medicine.anatomical_structure ,Pneumonia/diagnosis/etiology ,Neoplasms, Muscle Tissue/complications/diagnosis ,Pediatrics, Perinatology and Child Health ,Radiology ,business - Abstract
Although rare, inflammatory myofibroblastic tumor is the most common primary lung mass in children. We report the case of an 11-year-old boy investigated for persistent cough and dyspnea with complete left lung atelectasis mimicking pneumonia. CT and MRI showed an endobronchial mass of the left main bronchus. The boy underwent endoscopic resection of the tumor and histology was in favor of an inflammatory myofibroblastic tumor of the lung. This diagnosis should be suspected in children with recurrent pneumonia. The prognosis is good after complete resection. more...
- Published
- 2018
38. Decrease in Propagation of Interictal Epileptiform Activity After Introduction of Levetiracetam Visualized with Electric Source Imaging
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Goeran Lantz, Orvar Eeg-Olofsson, Christoph M. Michel, Pål G. Larsson, and Margitta Seeck
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Diagnostic Imaging ,Male ,medicine.medical_specialty ,Levetiracetam ,Time Factors ,Neurology ,Electroencephalography/methods ,Piracetam/*analogs & derivatives/therapeutic use ,Electroencephalography ,Brain mapping ,Diagnostic Imaging/methods ,Epilepsy ,Brain Mapping ,Neuroimaging ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Ictal ,Source imaging ,Child ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Piracetam ,ddc:616.8 ,Anticonvulsants/*therapeutic use ,Child, Preschool ,Anticonvulsants ,Female ,Neurology (clinical) ,Epilepsy/drug therapy/pathology/physiopathology ,Anatomy ,business ,Neuroscience ,medicine.drug - Abstract
Different neuroimaging techniques (fMRI, spectroscopy, PET) are being used to evaluate candidate drugs in pharmacological development. In patients with epilepsy fast propagation of the epileptiform activity between different brain areas occurs. Electric Source Imaging (ESI), in contrast to the aforementioned techniques, has a millisecond time resolution, allowing visualization of this fast propagation. The purpose of the current project was to use ESI to investigate whether introduction of an antiepileptic drug (levetiracetam, LEV) would change the propagation patterns of the interictal epileptiform activity. Thirty patients with epilepsy were subject to an EEG recording before (pre-LEV) and after (in-LEV) introduction of LEV. Interictal spikes with similar topographic distribution were averaged within each subject, and a distributed source model was used to localize the EEG sources of the epileptiform activity. The temporal development of the activity within 20 regions of interest (ROIs) was determined, and source propagation between different regions was compared between the pre-LEV and in-LEV recordings. Patients with epileptic seizures showed propagation in 22/24 identified spike types in the pre-LEV recordings. In the in-LEV recordings only 7/15 spike types showed propagation, and six of these seven propagating spikes were recorded in patients with poor effect of treatment. Also in patients without seizures LEV tended to suppress propagation. We conclude that the observed suppression of source propagation can be considered as an indicator of effective antiepileptic treatment. ESI might thus become a useful tool in the early clinical evaluation of new candidate drugs in pharmacological development. more...
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- 2018
39. Comparison of three commercially available radio frequency coils for human brain imaging at 3 Tesla
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Wietske van der Zwaag, Rolf Gruetter, Ralf Mekle, and Andreas Joosten
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Magnetic Resonance Imaging/instrumentation/methods ,Phased array ,TEM coil ,Radio Waves ,Physics::Medical Physics ,Nuclear magnetic resonance ,B-1 Field ,Image Processing, Computer-Assisted ,Human Head ,Spectroscopy ,Physics ,CIBM-AIT ,Brain Mapping ,Radiation ,Radiological and Ultrasound Technology ,Human head ,Phantoms, Imaging ,Brain ,Signal Processing, Computer-Assisted ,Magnetic Resonance Imaging ,Tem Volume Coil ,Diagnostic Imaging/instrumentation/methods ,Transverse plane ,RF-coil ,Homogeneity ,Radio frequency ,In-Vivo ,Artifacts ,Electromagnetic Phenomena ,Algorithms ,Diagnostic Imaging ,Biophysics ,Field strength ,Snr ,ddc:616.0757 ,Sensitivity and Specificity ,Flip angle ,Brain Mapping/methods ,Humans ,Radiology, Nuclear Medicine and imaging ,Brain/pathology ,high field MRI ,Surface Coil ,Nmr ,Electromagnetic coil ,Phased-Array ,Diagnostic Imaging/instrumentation ,Diagnostic Imaging/methods ,Magnetic Resonance Imaging/instrumentation ,Magnetic Resonance Imaging/methods ,Software ,Birdcage ,Radiofrequency coil - Abstract
OBJECTIVE: To evaluate a transverse electromagnetic (TEM), a circularly polarized (CP) (birdcage), and a 12-channel phased array head coil at the clinical field strength of B0 = 3T in terms of signal-to-noise ratio (SNR), signal homogeneity, and maps of the effective flip angle alpha. MATERIALS AND METHODS: SNR measurements were performed on low flip angle gradient echo images. In addition, flip angle maps were generated for alpha(nominal) = 30 degrees using the double angle method. These evaluation steps were performed on phantom and human brain data acquired with each coil. Moreover, the signal intensity variation was computed for phantom data using five different regions of interest. RESULTS: In terms of SNR, the TEM coil performs slightly better than the CP coil, but is second to the smaller 12-channel coil for human data. As expected, both the TEM and the CP coils show superior image intensity homogeneity than the 12-channel coil, and achieve larger mean effective flip angles than the combination of body and 12-channel coil with reduced radio frequency power deposition. CONCLUSION: At 3T the benefits of TEM coil design over conventional lumped element(s) coil design start to emerge, though the phased array coil retains an advantage with respect to SNR performance. more...
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- 2018
40. Benefits and Limitations of Multimodality Imaging in the Diagnosis of a Primary Cardiac Lymphoma.
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Nijjar, Prabhjot Singh, Masri, Sofia Carolina, Tamene, Ashenafi, Kassahun, Helina, Liao, Kenneth, and Valeti, Uma
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- *
HEART disease risk factors , *TUMOR risk factors , *LYMPHOMA risk factors , *HEART disease diagnosis , *POSITRON emission tomography - Abstract
Primary cardiac tumors are far rarer than tumors metastatic to the heart. Angiosarcoma is the primary cardiac neoplasm most frequently detected; lymphomas constitute only 1% of primary cardiac tumors. We present the case of a 55-year-old woman with a recently diagnosed intracardiac mass who was referred to our institution for consideration of urgent orthotopic heart transplantation. Initial images suggested an angiosarcoma; however, a biopsy specimen of the mass was diagnostic for diffuse large B-cell lymphoma. The patient underwent chemotherapy rather than surgery, and she was asymptomatic 34 months later. We use our patient's case to discuss the benefits and limitations of multiple imaging methods in the evaluation of cardiac masses. Certain features revealed by computed tomography, cardiac magnetic resonance, and positron emission tomography can suggest a diagnosis of angiosarcoma rather than lymphoma. Cardiac magnetic resonance and positron emission tomography enable reliable distinction between benign and malignant tumors; however, the characteristics of different malignant tumors can overlap. Despite the great usefulness of multiple imaging methods for timely diagnosis, defining the extent of spread and the hemodynamic impact, and monitoring responses to treatment, we think that biopsy analysis is still warranted in order to obtain a correct histologic diagnosis in cases of suspected malignant cardiac tumors. [ABSTRACT FROM AUTHOR] more...
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- 2014
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41. The value of PET/CT with FES or FDG tracers in metastatic breast cancer
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Rositsa G Koleva-Kolarova, Karin M. Vermeulen, A. W. J. M. Glaudemans, Talitha L Feenstra, Geke A. P. Hospers, Erik Buskens, Marcel J. W. Greuter, E.G.E. de Vries, M. van Kruchten, G. H. de Bock, E. F. J. de Vries, Methods in Medicines evaluation & Outcomes research (M2O), Translational Immunology Groningen (TRIGR), Molecular Neuroscience and Ageing Research (MOLAR), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), and Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) more...
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Cancer Research ,Cost effectiveness ,Biopsy ,Tomography, X-Ray Computed/methods ,Estrogen receptor ,costs ,Receptors, Estrogen/biosynthesis ,COST-EFFECTIVENESS ,Diagnostic Imaging/methods ,neoplasm metastasis ,cost analysis ,fluorodeoxyglucose F-18 ,Neoplasm Metastasis ,skin and connective tissue diseases ,Estradiol ,WOMEN ,Metastatic breast cancer ,Receptors, Estrogen ,Oncology ,Cost analysis ,fluorodeoxyglucose 18F ,Female ,Radiology ,Biopsy/economics ,medicine.medical_specialty ,diagnostic imaging ,Breast Neoplasms ,DIAGNOSIS ,Sensitivity and Specificity ,LIVER METASTASES ,LUNG-CANCER ,breast neoplasm ,Fluorodeoxyglucose F18 ,IMAGING BONE METASTASES ,mental disorders ,medicine ,Medical imaging ,Humans ,Computer Simulation ,Estrogen biosynthesis ,Lung cancer ,RECURRENCE ,TOMOGRAPHY/COMPUTED TOMOGRAPHY PET/CT ,Neoplasm Staging ,Breast Neoplasms/diagnostic imaging ,PET-CT ,business.industry ,Estradiol/analogs & derivatives ,Reproducibility of Results ,medicine.disease ,Positron-Emission Tomography/methods ,carbohydrates (lipids) ,ESTROGEN-RECEPTORS ,Positron-Emission Tomography ,Clinical Study ,fluorine radioisotopes ,Neoplasm Staging/methods ,Radiopharmaceuticals ,Tomography, X-Ray Computed ,Nuclear medicine ,business ,FOLLOW-UP - Abstract
Background: The aim of this study was to evaluate the effect on the number of performed biopsies and costs associated with implementing positron emission tomography (PET) and computed tomography (PET/CT) with 16 alpha-[F-18]fluoro-17 beta-oestradiol (FES) or 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) as an upfront imaging test for diagnosing metastatic breast cancer (MBC) in comparison with the standard work-up in oestrogen receptor-positive women with symptoms.Methods: A published computer simulation model was adapted and validated. Three follow-up strategies were evaluated in a simulated cohort of women with primary breast cancer over a 5-year-time horizon: (1) the standard work-up, (2) upfront FES-PET/CT and (3) upfront FDG-PET/CT. The main outcome was the number of avoided biopsies to assess MBC. The costs for all three strategies were calculated based on the number of imaging tests and biopsies. The incremental cost-effectiveness ratio (ICER) to avoid a biopsy was calculated only based on the costs of initial imaging and staging tests.Results: The FES-PET/CT strategy decreased the number of biopsies by 39 +/- 9%, while upfront FDG-PET/CT increased the number of biopsies by 38 +/- 15% when compared with the standard work-up. Both PET/CT strategies reduced the number of imaging tests and false positives when compared with the standard work-up. The number of false negatives decreased only in the FES-PET/CT strategy. The ICER in the FES-PET/CT strategy per avoided biopsy was 12.1 +/- 3.4 thousand Euro. In the FDG-PET/CT strategy, the costs were higher and there were no avoided biopsies as compared with the standard work-up, hence this was an inferior strategy in terms of cost effectiveness.Conclusions: The number of performed biopsies was lower in the FES-PET/CT strategy at an ICER of 12.1 +/- 3.4 thousand Euro per biopsy avoided, whereas the application of the FDG-PET/CT did not reduce the number of biopsies and was more expensive. Whether the FES-PET/CT strategy has additional benefits for patients in terms of therapy management has to be evaluated in clinical studies. more...
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- 2015
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42. Radiological assessment of irreducible posterolateral knee subluxation after dislocation due to interposition of the vastus medialis: a case report
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Jean-Damien Nicodeme, Christoph D. Becker, Sana Boudabbous, Emilie Paulin, and Daniel Arditi
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Diagnostic Imaging ,Male ,medicine.medical_specialty ,Knee Dislocation ,Vastus medialis ,medicine.medical_treatment ,Muscle, Skeletal/injuries/pathology/radiography ,Knee Injuries ,ddc:616.0757 ,Magnetic resonance angiography ,Diagnosis, Differential ,Diagnostic Imaging/methods ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Muscle, Skeletal ,Reduction (orthopedic surgery) ,Computed tomography angiography ,Subluxation ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Surgery ,Radiography ,Angiography ,Knee Dislocation/diagnosis/etiology ,Radiology ,Knee Injuries/complications/diagnosis ,business ,human activities - Abstract
Knee dislocation is a serious and relatively uncommon traumatism that every emergency room is supposed to diagnose and treat rapidly. Most of the time these dislocations reduce spontaneously or with closed reduction. If a subluxation persists, an incarceration of soft tissue in the joint must be suspected. Irreducible knee subluxations after dislocation are rare entities better described in the orthopaedic than in the radiological literature. However, the initial radiological assessment is an important tool to obtain the correct diagnosis, to detect neurovascular complications, and to plan the most suitable treatment. In cases of delayed diagnosis, the functional prognosis of the joint and even the limb may be seriously compromised primarily because of vascular lesions. Thereby, vascular imaging is essential in cases of dislocation of the knee, and we will discuss the role of angiography and the more recent use of computed tomography angiography or magnetic resonance angiography. Our patient presented with an irreducible knee subluxation due to interposition of the vastus medialis, and we will review the classical clinical presentation and 'do not miss' imaging findings on conventional radiography, computed tomography angiography, and magnetic resonance imaging. Finally, we will also report the classical imaging pathway indicated in knee dislocation, with a special emphasis on the irreducible form. more...
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- 2015
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43. Multispectral imaging for highly accurate analysis of tumour-infiltrating lymphocytes in primary melanoma
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Willeke A. M. Blokx, Stefania Di Blasio, I. Jolanda M. de Vries, J. Han van Krieken, Carl G. Figdor, Dagmar Verweij, and Angela Vasaturo
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0301 basic medicine ,Diagnostic Imaging ,Cell type ,Pathology ,medicine.medical_specialty ,Histology ,Melanoma/immunology ,Skin Neoplasms ,medicine.medical_treatment ,Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] ,Skin Neoplasms/immunology ,Biology ,Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9] ,Pathology and Forensic Medicine ,Melanin ,Lymphocytes, Tumor-Infiltrating/pathology ,03 medical and health sciences ,Diagnostic Imaging/methods ,0302 clinical medicine ,Lymphocytes, Tumor-Infiltrating ,Image Interpretation, Computer-Assisted ,medicine ,Computer-Assisted/methods ,Journal Article ,Humans ,Lymphocytes ,Image Interpretation ,Melanoma ,Microscopy ,Spectrum Analysis ,Image Interpretation, Computer-Assisted/methods ,Digital pathology ,General Medicine ,Immunotherapy ,medicine.disease ,3. Good health ,030104 developmental biology ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,Immunohistochemistry ,Tumor-Infiltrating/pathology ,Infiltration (medical) ,Spectrum Analysis/methods ,Microscopy/methods ,Algorithms - Abstract
Contains fulltext : 173035.pdf (Publisher’s version ) (Open Access) AIMS: The quality and quantity of the infiltration of immune cells into tumour tissues have substantial impacts on patients' clinical outcomes, and are associated with response to immunotherapy. Therefore, the precise analysis of tumour-infiltrating lymphocytes (TILs) is becoming an important additional pathological biomarker. Analysis of TILs is usually performed semiquantitatively by pathologists on haematoxylin and eosin-stained or immunostained tissue sections. However, automated quantification outperforms semiquantitative approaches, and is becoming the standard. Owing to the presence of melanin pigment, this approach is seriously hampered in melanoma, because the spectrum of melanin lies close to that of commonly used immunohistochemical stains. Aim of this study is to overcome the technical issues due to the presence of melanin for an automated and accurate quantification of TILs in melanoma. METHODS AND RESULTS: Here, we successfully applied a novel multispectral imaging (MSI) technique to enumerate T cells in human primary melanomas. This microscopy technique combines imaging with spectroscopy to obtain both quantitative expression data and the tissue distributions of different cellular markers. We demonstrate that MSI allows complete and accurate analysis of TILs, successfully avoiding the blurring of images by melanin pigments, in whole tissue slide primary melanoma lesions, which could otherwise not be accurately detected by conventional digital image methodologies. CONCLUSIONS: Our study highlights the potential of MSI for accurate assessment of immune cell infiltrates, including those in notoriously difficult tissues, such as pigmented melanomas. Quantification of tumour infiltration by different immune cell types is crucial in the search for new biomarkers to predict patient responses to immunotherapies. Our findings show that this innovative microscopy technique is an important extension of the armamentarium of pathologists. more...
- Published
- 2016
44. Hamartomatous polyps - a clinical and molecular genetic study
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Jelsig, Anne Marie
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Diagnostic Imaging/methods ,Phenotype ,Genotype ,Humans ,digestive system diseases ,Genetic Testing/methods ,Peutz-Jeghers Syndrome/diagnosis - Abstract
Hamartomatous polyps (HPs) in the gastrointestinal (GI) tract are rare compared to other types of GI polyps, yet they are the most common type of polyp in children. The symptoms are usually rectal bleeding, abdominal pain, obstipation, anaemia, and/or small bowel obstruction. The polyps are typically removed concurrently with endoscopy when located in the colon, rectum, or stomach, whereas polyps in the small bowel are removed during push-enteroscopy, device-assisted enteroscopy, or by surgery. HPs can be classified as juvenile polyps or Peutz-Jeghers polyps based on their histopathological appearance. Patients with one or a few juvenile polyps are usually not offered clinical follow-up as the polyp(s) are considered not to harbour any malignant potential. Nevertheless, it is important to note that juvenile polyps and HPs are also found in patients with hereditary hamartomatous polyposis syndromes (HPS). Patients with HPS have an increased risk of cancer, recurrences of polyps, and extraintestinal complications. The syndromes are important to diagnose, as patients should be offered surveillance from childhood or early adolescence. The syndromes include juvenile polyposis syndrome, Peutz-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing. Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps in the colon and rectum in Denmark in 1995-2014. Based on the Danish Pathology Data Bank we found that 1772 patients had 2108 JPs examined in the period, and we calculated the incidence of juvenile polyps to be between 1:45,000 and 1:65,000. The majority of patients with juvenile polyps were adults and 1% fulfilled to diagnostic criteria of JPS. The majority of patients had a single juvenile polyp. Paper II: In this paper we conducted a review of the HPS based on the current literature. Paper III: We investigated the hypothesis that patients with one or few HPs may have a HPS based on genetic screening. We de-signed a panel of 26 genes associated with HPS and used targeted next generation sequencing in 77 patients with mainly one juvenile polyp. We detected several germ line variants, among them three in ENG, two in BMPR1A, one in PTEN, and one in SMAD4. Although some of the detected variants have been reported previously none could be classified as definitely pathogenic or likely pathogenic according to our variant classification scheme and thus we concluded that genetic screening of patients with one or few JPs are not indicated. Paper IV: In Paper IV we investigated one of the ethical aspects of next generation sequencing: the issue whether research participants in NGS studies should be offered the possibility of not re-ceiving information on incidental genetic findings (the "opting out possibility"). We conducted semi-structures interviews in 127 research participants, and found that the majority (61%) wanted information on all incidentals findings, while 36% wanted information on actionable incidental findings. Only 3% did not want information on incidental findings at all. Paper V: In this paper we wanted to gather information on all Danish patients with Peutz-Jeghers syndrome in order to investigate the phenotype and genotype. Through Danish registers we detected 43 patients of which 14 had deceased. We calculated the prevalence of Peutz-Jeghers syndrome to be approximately one in 195,000 individuals. The median age at diagnosis was 29 years with obstruction of the small bowel as the most frequent presenting symptom. We noted 18 cancer occurrences in the population in both the GI tract and at extraintestinal sites, demonstrating that these patients are predisposed to cancer at various anatomical sites. The study also underlined the wide phenotypic expression of the syndrome. Paper VI: In the last paper we identified patients with juvenile polyposis syndrome, who carry a SMAD4 mutation, and described their genotype and phenotype. We especially investigated whether these patients have symptoms of both juvenile polyposis syndrome and hereditary hemorrhagic telangiectasia. We identified 14 Danish patients. Most of these had symptoms of both conditions and one had aortic root dilatation. Thus, this group of patients requires a multidisciplinary follow-up program. more...
- Published
- 2016
45. Is imaging relevant for treatment choice in early stage cervical uterine cancer?
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Christoph D. Becker, Alexandre Bodmer, Pierre Loubeyre, Manuela Undurraga, Osman Ratib, Isabelle Navarria, and Patrick Petignat
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Diagnostic Imaging ,medicine.medical_specialty ,Stromal cell ,Decision Making ,Uterine Cervical Neoplasms ,ddc:616.0757 ,Stromal Invasion ,Diagnostic Imaging/methods ,Uterine cancer ,medicine ,Humans ,Stage (cooking) ,Lymph node ,Early Detection of Cancer ,Neoplasm Staging ,Cervical cancer ,ddc:618 ,business.industry ,Gold standard (test) ,Uterine Cervical Neoplasms/pathology/therapy ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Oncology ,Lymphatic Metastasis ,Female ,Radiology ,Lymph ,Neoplasm Staging/methods ,business - Abstract
Background Improvement in the selection of patients with early cervical cancer eligible for different therapeutic options is expected from imaging. Objective We examined key tumoral features such as tumor diameter cut-off values of 2 cm or 4 cm in largest dimension, distance between tumor and internal os, outer third stromal cervical invasion, parametrial invasion and lymph node invasion. Search strategy We conducted a literature search to identify all relevant studies based on imaging that evaluated these parameters. Selection criteria Articles were only considered when data of imaging modalities were compared with histopathological findings of the surgical specimens, considered as the gold standard. Data collection and analysis We examined series that included more than 30 patients with primary untreated biopsy-confirmed cervical cancer. When numerous articles were obtained for one investigational modality, only series that included more than fifty patients were taken into account. Main results Data is lacking for the diagnostic value of imaging for assessing tumor diameter cut-off values of 2 cm or 4 cm, and distance between tumor and internal os. There is a high negative predictive value of MRI for complete stromal invasion. Accurate assessment of lymph node status in patients with early cervical cancer is still lacking. PET-CT role is promising, but the diagnostic value of normal-sized hypermetabolic lymph nodes needs further investigation. Conclusion Based on imaging, accurate selection of patients for treatment choice is still lacking in patients with early cervical cancer. more...
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- 2012
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46. Atherosclerosis screening by noninvasive imaging for cardiovascular prevention: a systematic review
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Reto Auer, Jacques Cornuz, Vanessa de Bosset Sulzer, Nicolas Rodondi, and William A. Ghali
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Diagnostic Imaging ,Noninvasive imaging ,medicine.medical_specialty ,Atherosclerosis/complications ,Atherosclerosis/diagnosis ,Cardiovascular Diseases/epidemiology ,Cardiovascular Diseases/prevention & control ,Clinical Trials as Topic/methods ,Diagnostic Imaging/methods ,Humans ,Mass Screening/methods ,Randomized Controlled Trials as Topic/methods ,Reviews ,030204 cardiovascular system & hematology ,Coronary disease ,03 medical and health sciences ,0302 clinical medicine ,Cardiovascular prevention ,Internal Medicine ,medicine ,Mass Screening ,030212 general & internal medicine ,Intensive care medicine ,Mass screening ,Randomized Controlled Trials as Topic ,Clinical Trials as Topic ,business.industry ,Atherosclerosis ,3. Good health ,Clinical trial ,Clinical Practice ,Cardiovascular Diseases ,Physical therapy ,Health behavior ,business ,Insurance coverage - Abstract
BACKGROUND: Noninvasive imaging of atherosclerosis is being increasingly used in clinical practice, with some experts recommending to screen all healthy adults for atherosclerosis and some jurisdictions mandating insurance coverage for atherosclerosis screening. Data on the impact of such screening have not been systematically synthesized. OBJECTIVES: We aimed to assess whether atherosclerosis screening improves cardiovascular risk factors (CVRF) and clinical outcomes. DESIGN: This study is a systematic review. DATA SOURCES: We searched MEDLINE and the Cochrane Clinical Trial Register without language restrictions. STUDY ELIGIBILITY CRITERIA: We included studies examining the impact of atherosclerosis screening with noninvasive imaging (e.g., carotid ultrasound, coronary calcification) on CVRF, cardiovascular events, or mortality in adults without cardiovascular disease. RESULTS: We identified four randomized controlled trials (RCT, n = 709) and eight non-randomized studies comparing participants with evidence of atherosclerosis on screening to those without (n = 2,994). In RCTs, atherosclerosis screening did not improve CVRF, but smoking cessation rates increased (18% vs. 6%, p = 0.03) in one RCT. Non-randomized studies found improvements in several intermediate outcomes, such as increased motivation to change lifestyle and increased perception of cardiovascular risk. However, such data were conflicting and limited by the lack of a randomized control group. No studies examined the impact of screening on cardiovascular events or mortality. Heterogeneity in screening methods and studied outcomes did not permit pooling of results. CONCLUSION: Available evidence about atherosclerosis screening is limited, with mixed results on CVRF control, increased smoking cessation in one RCT, and no data on cardiovascular events. Such screening should be validated by large clinical trials before widespread use more...
- Published
- 2012
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47. Multimodal image coregistration and inducible selective cell ablation to evaluate imaging ligands
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Laurent Vinet, Alvin C. Powers, Mohammad Sib Ansari, Pedro Luis Herrera, Chunhua Dai, Joseph A. Henske, Aramandla Radhika, Daniel Skovronsky, Ronald M. Baldwin, Hank F. Kung, Franz Hefti, Todd E. Peterson, Paolo Meda, Smaragda Lamprianou, and John Virostko more...
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Diagnostic Imaging ,Male ,Pathology ,medicine.medical_specialty ,Luminescence ,Insulin/metabolism ,Tomography, X-Ray Computed/methods ,Biology ,Ligands ,030218 nuclear medicine & medical imaging ,Diabetes Mellitus/metabolism ,Diagnostic Imaging/methods ,Islets of Langerhans ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Mice, Inbred NOD ,In vivo ,Insulin-Secreting Cells ,Diabetes Mellitus ,Medical imaging ,medicine ,Animals ,Humans ,Insulin ,Bioluminescence imaging ,ddc:576.5 ,Tissue Distribution ,Luciferase ,ddc:612 ,030304 developmental biology ,0303 health sciences ,Multidisciplinary ,Tomographic reconstruction ,medicine.diagnostic_test ,Biological Sciences ,Positron-Emission Tomography/methods ,Rats ,medicine.anatomical_structure ,Positron emission tomography ,Positron-Emission Tomography ,Insulin-Secreting Cells/pathology ,Biophysics ,Female ,Islets of Langerhans/metabolism ,Molecular imaging ,Tomography, X-Ray Computed ,Pancreas - Abstract
We combined multimodal imaging (bioluminescence, X-ray computed tomography, and PET), tomographic reconstruction of bioluminescent sources, and two unique, complementary models to evaluate three previously synthesized PET radiotracers thought to target pancreatic beta cells. The three radiotracers {[ 18 F]fluoropropyl-(+)-dihydrotetrabenazine ([ 18 F]FP-DTBZ), [ 18 F](+)-2-oxiranyl-3-isobutyl-9-(3-fluoropropoxy)-10-methoxy-2,3,4,6,7,11b-hexahydro-1H-pyrido[2,1-a]isoquinoline ( 18 F-AV-266), and (2 S ,3 R ,11b R )-9-(3-fluoropropoxy)-2-(hydroxymethyl)-3-isobutyl-10-methoxy-2,3,4,6,7,11b-hexahydro-1 H -pyrido[2,1- a ]isoquinolin-2-ol ( 18 F-AV-300)} bind vesicular monoamine transporter 2. Tomographic reconstruction of the bioluminescent signal in mice expressing luciferase only in pancreatic beta cells was used to delineate the pancreas and was coregistered with PET and X-ray computed tomography images. This strategy enabled unambiguous identification of the pancreas on PET images, permitting accurate quantification of the pancreatic PET signal. We show here that, after conditional, specific, and rapid mouse beta-cell ablation, beta-cell loss was detected by bioluminescence imaging but not by PET imaging, given that the pancreatic signal provided by three PET radiotracers was not altered. To determine whether these ligands bound human beta cells in vivo, we imaged mice transplanted with luciferase-expressing human islets. The human islets were imaged by bioluminescence but not with the PET ligands, indicating that these vesicular monoamine transporter 2-directed ligands did not specifically bind beta cells. These data demonstrate the utility of coregistered multimodal imaging as a platform for evaluation and validation of candidate ligands for imaging islets. more...
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- 2011
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48. Dynamic MR angiography (MRA) of spinal vascular diseases at 3T
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Maria Vargas, Zolt Kulcsár, Karl Lovblad, Magalie Viallon, D.A. Rüfenacht, Bénédict Rilliet, Duy Nguyen, and Enrico Tessitore
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Adult ,Diagnostic Imaging ,Male ,medicine.medical_specialty ,Contrast Media ,Spinal Cord/blood supply ,ddc:616.0757 ,Arteriovenous Malformations/diagnosis/*pathology ,Magnetic resonance angiography ,Arteriovenous Malformations ,Diagnostic Imaging/methods ,medicine ,Medical imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Central Nervous System Vascular Malformations/diagnosis/*pathology ,Aged ,Neuroradiology ,Aged, 80 and over ,Central Nervous System Vascular Malformations ,medicine.diagnostic_test ,business.industry ,Magnetic Resonance Angiography/*methods ,Interventional radiology ,Arteriovenous malformation ,Spine/*pathology ,General Medicine ,Middle Aged ,Spinal cord ,medicine.disease ,Spine ,ddc:616.8 ,medicine.anatomical_structure ,Spinal Cord ,Angiography ,Female ,Radiology ,Contrast Media/pharmacology ,business ,Magnetic Resonance Angiography ,Artery - Abstract
Spinal magnetic resonance angiography (MRA) is difficult to perform because of the size of the spinal cord vessels. High-field MR improves resolution and imaging speed. We examined 17 patients with spinal vascular diseases with dynamic contrast-enhanced three-dimensional MR sequences. In three patients, the artery of Adamkievicz could be seen; we could also detect all arteriovenous malformations and dural fistulas. MRA has the potential to replace diagnostic spinal angiography and the latter should be used only for therapeutic purposes. more...
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- 2010
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49. Enhancement patterns and signal-intensity characteristics of small hepatocellular carcinoma in cirrhosis: pathologic basis and diagnostic challenges
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Prodromos Hytiroglou, Osamu Matsui, and S. C. Efremidis
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Diagnostic Imaging ,medicine.medical_specialty ,Pathology ,Carcinoma, Hepatocellular ,Cirrhosis ,Fibrosis/*complications/*diagnosis ,Medical Oncology/methods ,Carcinoma, Hepatocellular/*complications/*diagnosis/pathology ,Tomography, X-Ray Computed/*methods ,Medical Oncology ,Models, Biological ,Sensitivity and Specificity ,Diagnosis, Differential ,Diagnostic Imaging/methods ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Neuroradiology ,medicine.diagnostic_test ,Liver Diseases/complications/pathology ,business.industry ,Liver Diseases ,Liver Neoplasms ,Hepatitis C/complications/pathology ,Magnetic resonance imaging ,General Medicine ,HCCS ,medicine.disease ,Fibrosis ,Hepatitis C ,Magnetic Resonance Imaging ,digestive system diseases ,Transplantation ,Hepatocellular carcinoma ,Liver Neoplasms/*complications/*diagnosis/pathology ,Radiology ,Differential diagnosis ,Tomography, X-Ray Computed ,business ,Magnetic Resonance Imaging/*methods - Abstract
Recent pathologic studies of hepatic resection and transplantation specimens have elucidated the morphologic features of the precancerous lesions and small hepatocellular carcinomas (HCCs) arising in cirrhotic livers. Small HCCs measuring less than 2 cm in diameter are of two types: vaguely nodular, well-differentiated tumors, also known as "early" HCCs, and distinctly nodular tumors, with histologic features of "classic" HCC. The precancerous lesions include dysplastic foci and dysplastic nodules. "Classic" small HCCs are supplied by nontriadal arteries, whereas early HCCs and dysplastic nodules may receive blood supply from both portal tracts and nontriadal arteries. The similarities in blood supply of these three types of nodular lesions result in significant overlap of findings on dynamic imaging. Nevertheless, small HCCs sometimes display characteristic radiologic features, such as "nodule-in-nodule" configuration and "corona enhancement" pattern. Moreover, various histologic features of these nodular lesions may also be related to a variety of signal intensities and attenuation coefficients, while the presence of cirrhosis is known to limit the sensitivity and specificity of any imaging modality, due to liver inhomogeneity. Because of these reasons, imaging findings of nodular lesions in cirrhotic livers are often inconclusive, emphasizing the need for a better understanding of these imaging features. European Radiology more...
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- 2007
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50. Two-photon lifetime imaging of fluorescent probes in intact blood vessels: A window to sub-cellular structural information and binding status
- Author
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Dick W. Slaaf, Kim Douma, Marc A. M. J. van Zandvoort, Lenneke Prinzen, Remco T. A. Megens, Sietze Reitsma, Ear, Nose and Throat, and AII - Inflammatory diseases
- Subjects
Diagnostic Imaging ,In situ ,Endothelial Cells/chemistry ,Fluorescent Dyes/analysis ,Cytoplasm ,Fluorescence-lifetime imaging microscopy ,Time Factors ,Histology ,Analytical chemistry ,Mitochondria/chemistry ,Biology ,Glycocalyx ,Fluorescence ,Diagnostic Imaging/methods ,Mice ,Two-photon excitation microscopy ,Lectins ,Microscopy ,Animals ,Carotid Arteries/chemistry ,Instrumentation ,Multiphoton ,Fluorescent Dyes ,Cell Nucleus ,Endothelial Cells ,Ligand (biochemistry) ,Photon counting ,Mitochondria ,Staining ,Glycocalyx/metabolism ,Medical Laboratory Technology ,Carotid Arteries ,Microscopy, Fluorescence, Multiphoton ,Biophysics ,Lectins/metabolism ,Blood Vessels ,Cell Nucleus/chemistry ,Anatomy ,Cytoplasm/chemistry ,Protein Binding - Abstract
Fluorescence lifetime imaging (FLIM) provides a complementary contrast mechanism to fluorescence intensity and ratio imaging in intact tissue. With FLIM the time-resolved decay in fluorescence intensity of (interacting) fluorophores can be quantified by means of time correlated single photon counting (TCSPC). Here we focus on fluorescence lifetime imaging in intact blood vessels. Requisites for imaging in intact tissue are good penetration depth and limited tissue damage. Therefore, in this pilot-study, we performed TCSPC-FLIM using two-photon laser scanning microscopy to determine, with sub-cellular resolution, the fluorescence lifetime of two fluorescent probes. First, we focused on the nucleic acid dye SYTO41 in the various compartments of cells in vitro and in situ in the wall of intact mouse carotid arteries. Second, it was assessed whether the interaction of the lectin WGA-FITC with the endothelial glycocalyx affects its fluorescence lifetime. Results showed comparable mono-exponential fluorescence lifetimes of SYTO41 in the nuclei of cells in vitro and in situ. The slightly shorter fluorescence lifetime observed in the cytoplasm allowed discrimination of the nuclei. SYTO41 displayed strong mitochondrial staining, as was verified by the mitochondrion-specific probe CMXRos. In addition, mitochondrial staining by SYTO41 was accompanied by a green shift in emission. In the mitochondrial region, SYTO41 showed a highly bi-exponential and relatively fast decay, with two distinct lifetime components. It is hypothesized that the fitted bi-exponential decay can either be contributed to (1) the mathematical approximation of the fluorescence intensity decay or (2) the presence of free and DNA-bound SYTO41 in the mitochondrial compartment, leading to two lifetime components. The fluorescence lifetime of WGA-FITC decreased by approximately 25% upon binding to the endothelial glycocalyx. From this study, we conclude that FLIM offers an additional contrast mechanism in imaging intact tissue and provides information on binding status between a probe and its ligand. more...
- Published
- 2007
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