Selective Angiographic Flat Detector Computer Tomography Blood Volume Imaging in Pre-Operative Vascular Mapping and Embolization of Hypervascular Intracranial Tumors-Preliminary Clinical Experience.

Pre-operative embolization of hypervascular intracranial tumors can be performed to reduce bleeding complications during resection. Accurate vascular mapping of the tumor is necessary for both the correct indication setting for embolization and for the evaluation of the performed embolization. We prospectively examined the role of whole brain and selective parenchymal blood volume (PBV) flat detector computer tomography perfusion (FD CTP) imaging in pre-operative angiographic mapping and embolization of patients with hypervascular intracranial tumors. Whole brain FD CTP imaging with a contrast injection from the aortic root and selective contrast injection in the dural feeding arteries was performed in five patients referred for tumor resection. Regional relative PBV values were obtained pre- and post-embolization. Total tumor volumes with selective external carotid artery (ECA) supply volumes and post-embolization devascularized tumor volumes were determined as well. In all patients, including four females and one male, with a mean age of 54.2 years (range 44-64 years), the PBV scans were performed without adverse events. The average ECA supply was 54% (range 31.5-91%). The mean embolized tumor volume was 56.5% (range 25-94%). Relative PBV values decreased from 5.75 ± 1.55 before embolization to 2.43 ± 1.70 post-embolization. In one patient, embolization was not performed because of being considered not beneficial for the resection. Angiographic FD CTP imaging of the brain tumor allows 3D identification and quantification of individual tumor feeder arteries. Furthermore, the technique enables monitoring of the efficacy of pre-operative endovascular tumor embolization.

Vessel territory mapping after cerebral revascularization surgery using selective angiographic flat detector perfusion imaging.

The technical feasibility and diagnostic potential of angiographic flat-detector perfusion imaging technique, combining digital subtraction angiography with a flat-detector computed tomography steady-state perfusion imaging, was explored in patients treated with direct or indirect revascularization surgery. This short communication is about an imaging modality with great potential for evaluation, comparison and grading of vascular perfusion territory areas and anatomical location selectively perfused by direct and indirect cerebral bypasses.

Molecular detection of infection homogeneity and impact of miltefosine treatment in a Syrian golden hamster model of Leishmania donovani and L. infantum visceral leishmaniasis.

Control of visceral leishmaniasis caused by Leishmania infantum and Leishmania donovani primarily relies on chemotherapy using an increasingly compromised repertoire of antileishmanial compounds. For evaluation of novel drugs, the Syrian golden hamster is considered as a clinically relevant laboratory model. In this study, two molecular parasite detection assays were developed targeting cathepsin-like cysteine protease B (CPB) DNA and 18S rRNA to achieve absolute amastigote quantification in the major target organs liver and spleen. Both quantitative PCR (qPCR) techniques showed excellent agreement with a strong correlation with the conventional microscopic reading of Giemsa-stained tissue smears. Using multiple single tissue pieces and all three detection methods, we confirmed homogeneity of infection in liver and spleen and the robustness of extrapolating whole organ burdens from a small single tissue piece. Comparison of pre- and post-treatment burdens in infected hamsters using the three detection methods consistently revealed a stronger parasite reduction in the spleen compared to the liver, indicating an organ-dependent clearance efficacy for miltefosine. In conclusion, this study in the hamster demonstrated high homogeneity of infection in liver and spleen and advocates the use of molecular detection methods for assessment of low (post-treatment) tissue burdens.