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1.
Mol Psychiatry ; 23(4): 943-951, 2018 04.
Article in English | MEDLINE | ID: mdl-28373685

ABSTRACT

The notion that schizophrenia is a neurodevelopmental disorder in which neuropathologies evolve gradually over the developmental course indicates a potential therapeutic window during which pathophysiological processes may be modified to halt disease progression or reduce its severity. Here we used a neurodevelopmental maternal immune stimulation (MIS) rat model of schizophrenia to test whether early targeted modulatory intervention would affect schizophrenia's neurodevelopmental course. We applied deep brain stimulation (DBS) or sham stimulation to the medial prefrontal cortex (mPFC) of adolescent MIS rats and respective controls, and investigated its behavioral, biochemical, brain-structural and -metabolic effects in adulthood. We found that mPFC-DBS successfully prevented the emergence of deficits in sensorimotor gating, attentional selectivity and executive function in adulthood, as well as the enlargement of lateral ventricle volumes and mal-development of dopaminergic and serotonergic transmission. These data suggest that the mPFC may be a valuable target for effective preventive treatments. This may have significant translational value, suggesting that targeting the mPFC before the onset of psychosis via less invasive neuromodulation approaches may be a viable preventive strategy.


Subject(s)
Neurotransmitter Agents/metabolism , Schizophrenia/pathology , Animals , Behavior, Animal/physiology , Brain/growth & development , Brain/metabolism , Brain/pathology , Deep Brain Stimulation/methods , Deep Brain Stimulation/psychology , Disease Models, Animal , Dopamine/pharmacology , Male , Neurotransmitter Agents/pharmacology , Prefrontal Cortex/pathology , Psychotic Disorders/pathology , Rats , Rats, Wistar , Schizophrenia/metabolism , Schizophrenia/therapy , Sensory Gating/physiology
2.
Health Res Policy Syst ; 17(1): 47, 2019 May 02.
Article in English | MEDLINE | ID: mdl-31046786

ABSTRACT

BACKGROUND: The Platform for Innovation in Medical and Health Technologies (ITEMAS) is a network of 66 healthcare centres focused on fostering innovation in medical and health technologies as an essential tool for increasing the sustainability of the Spanish healthcare system. The present research is focused on defining a formal representation that details the most relevant concepts associated with the creation and adoption of innovative medical technology in the Spanish healthcare system. METHODS: The methodology applied is based on the methontology process, including peer-review identification and selection of concepts from the ITEMAS innovation indicators and innovation management system standards. This stage was followed by an iterative validation process. Concepts were then conceptualised, formalised and implemented in an ontology. RESULTS: The ontology defined describes how relationships between employees, organisations, projects and ideas can be applied to generate results that are transferrable to the market, general public and scientific forums. Overall, we identified 136 concepts, 138 object properties and 30 properties in a five-level hierarchy. The ontology was tested and validated as an appropriate framework for calculating the ITEMAS innovation indicators. CONCLUSIONS: The consensus concepts were expressed in the form of an ontology to be used as a single communication format between the members of the ITEMAS network. Healthcare centres can compare their innovation results and obtain a better understanding of their innovation context based on the reasoning techniques of artificial intelligence. As a result, they can benefit from advanced analytical capabilities to define the most appropriate innovation policies for each centre based on the common experience of the large number of healthcare centres involved. The results can be used to create a map of agents and knowledge to show capabilities, projects and services provided by each of the participating centres. The ontology could also be applied as an instrument to match needs with existing projects and capabilities from the community of organisations working in healthcare technology innovation.


Subject(s)
Biomedical Technology , Delivery of Health Care , Diffusion of Innovation , Health Facilities , Humans , Spain
3.
Psychol Med ; 47(14): 2472-2482, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28436341

ABSTRACT

BACKGROUND: Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions. METHODS: Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored. RESULTS: Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = -0.28, p = 0.041) and left posterior (r = -0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of 'autistic-like' symptoms (r = -0.30, p = 0.028). CONCLUSIONS: The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.


Subject(s)
Autism Spectrum Disorder/pathology , Cerebral Cortex/pathology , Magnetic Resonance Imaging/methods , Psychotic Disorders/pathology , Adolescent , Autism Spectrum Disorder/diagnostic imaging , Cerebral Cortex/diagnostic imaging , Child , Female , Humans , Male , Psychotic Disorders/diagnostic imaging
4.
J Imaging Inform Med ; 2024 Oct 14.
Article in English | MEDLINE | ID: mdl-39402356

ABSTRACT

Radiation dose and image quality in radiology are influenced by the X-ray prime factors: KVp, mAs, and source-detector distance. These parameters are set by the X-ray technician prior to the acquisition considering the radiographic position. A wrong setting of these parameters may result in exposure errors, forcing the test to be repeated with the increase of the radiation dose delivered to the patient. This work presents a novel approach based on deep learning that automatically estimates the radiographic position from a photograph captured prior to X-ray exposure, which can then be used to select the optimal prime factors. We created a database using 66 radiographic positions commonly used in clinical settings, prospectively obtained during 2022 from 75 volunteers in two different X-ray facilities. The architecture for radiographic position classification was a lightweight version of ConvNeXt trained with fine-tuning, discriminative learning rates, and a one-cycle policy scheduler. Our resulting model achieved an accuracy of 93.17% for radiographic position classification and increased to 95.58% when considering the correct selection of prime factors, since half of the errors involved positions with the same KVp and mAs values. Most errors occurred for radiographic positions with similar patient pose in the photograph. Results suggest the feasibility of the method to facilitate the acquisition workflow reducing the occurrence of exposure errors while preventing unnecessary radiation dose delivered to patients.

5.
Sci Rep ; 13(1): 8795, 2023 May 31.
Article in English | MEDLINE | ID: mdl-37258545

ABSTRACT

X-ray scatter in planar radiography degrades the contrast resolution of the image, thus reducing its diagnostic utility. Antiscatter grids partially block scattered photons at the cost of increasing the dose delivered by two- to four-fold and posing geometrical restrictions that hinder their use for other acquisition settings, such as portable radiography. The few software-based approaches investigated for planar radiography mainly estimate the scatter map from a low-frequency version of the image. We present a novel method for scatter correction in planar imaging based on direct patient measurements. Samples from the shadowed regions of an additional partially obstructed projection acquired with a beam stopper placed between the X-ray source and the patient are used to estimate the scatter map. Evaluation with simulated and real data showed an increase in contrast resolution for both lung and spine and recovery of ground truth values superior to those of three recently proposed methods. Our method avoids the biases of post-processing methods and yields results similar to those for an antiscatter grid while removing geometrical restrictions at around half the radiation dose. It can be used in unconventional imaging techniques, such as portable radiography, where training datasets needed for deep-learning approaches would be very difficult to obtain.

6.
Biomed Phys Eng Express ; 9(6)2023 Oct 16.
Article in English | MEDLINE | ID: mdl-37703847

ABSTRACT

Among other factors such as random, attenuation and scatter corrections, uniform spatial resolution is key to performing accurate quantitative studies in Positron emission tomography (PET). Particularly in preclinical PET studies involving simultaneous acquisition of multiple animals, the degradation of image resolution due to the depth of interaction (DOI) effect far from the center of the Field of View (FOV) becomes a significant concern. In this work, we incorporated a spatially-variant resolution model into a real time iterative reconstruction code to obtain accurate images of multi-animal acquisition. We estimated the spatially variant point spread function (SV-PSF) across the FOV using measurements and Monte Carlo (MC) simulations. The SV-PSF obtained was implemented in a GPU-based Ordered subset expectation maximization (OSEM) reconstruction code, which includes scatter, attenuation and random corrections. The method was evaluated with acquisitions from two preclinical PET/CT scanners of the SEDECAL Argus family: a Derenzo phantom placed 2 cm off center in the 4R-SuperArgus, and a multi-animal study with 4 mice in the 6R-SuperArgus. The SV-PSF reconstructions showed uniform spatial resolution without significant increase in reconstruction time, with superior image quality compared to the uniform PSF model.

7.
Eur Neuropsychopharmacol ; 69: 60-76, 2023 04.
Article in English | MEDLINE | ID: mdl-36780817

ABSTRACT

This study evaluates the long-term effects of a six and 14-week morphine withdrawal in rats pretreated with a cannabinoid agonist (CP-55,940, CP) during periadolescence. Wistar rats (33 males; 32 females) were treated with CP or its vehicle (VH) from postnatal day (PND) 28-38. At PND100, rats performed morphine self-administration (MSA, 15d/12 h/session). Eight groups were defined according to pretreatment (CP), treatment (morphine), and sex. Three [18F]FDG-PET brain images were acquired: after MSA, and after six and 14 weeks of withdrawal. PET data were analyzed with SPM12. Endocannabinoid (EC) markers were evaluated in frozen brain tissue at endpoint. Females showed a higher mean number of self-injections than males. A main Sex effect on global brain metabolism was found. FDG uptake in males was discrete, whereas females showed greater brain metabolism changes mainly in areas of the limbic system after morphine treatment. Moreover, the morphine-induced metabolic pattern in females was exacerbated when CP was previously present. In addition, the CP-Saline male group showed reduced CB1R, MAGL expression, and NAPE/FAAH ratio compared to the control group, and morphine was able to reverse CB1R and MAGL expression almost to control levels. In conclusion, females showed greater and longer-lasting metabolic changes after morphine withdrawal than males, indicating a higher vulnerability and a different sensitivity to morphine in subjects pre-exposed to CP. In contrast, males primarily showed changes in EC markers. Together, our results suggest that CP pre-exposure contributes to the modulation of brain metabolism and EC systems in a sex-dependent manner.


Subject(s)
Morphine , Substance Withdrawal Syndrome , Female , Rats , Animals , Male , Morphine/pharmacology , Cannabinoid Receptor Agonists/pharmacology , Rats, Wistar , Fluorodeoxyglucose F18 , Endocannabinoids , Neuroimaging , Glucose , Substance Withdrawal Syndrome/diagnostic imaging
8.
Rev Esp Cir Ortop Traumatol ; 67(4): 324-333, 2023.
Article in English, Spanish | MEDLINE | ID: mdl-36646252

ABSTRACT

AIM: Compare bone formation capacity in vivo of two types of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxyapatites and the other one on bioactive mesoporous glass. MATERIALS AND METHODS: Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite support, and with bioactive mesoporous glass support. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. RESULTS: In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than in the autograft group. CONCLUSION: Both supports seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.

9.
Rev Esp Cir Ortop Traumatol ; 67(4): T324-T333, 2023.
Article in English, Spanish | MEDLINE | ID: mdl-36940846

ABSTRACT

AIM: To compare the in vivo bone formation capacity of of biomaterials designed as bone substitutes with respect to iliac crest autograft, one based on carbonate hydroxiapatite and the other one on bioactive mesoporous glass. MATERIALS AND METHODS: Experimental study consisting on 14 adult female New Zeland rabbits where a critical defect was made in the rabbit radius bone. The sample was divided into four groups: defect without material, with iliac crest autograft, with carbonatehydroxyapatite scaffold, and with bioactive mesoporous glass scaffold. Serial X-ray studies were carried out at 2, 4, 6 and 12 weeks and a microCT study at euthanasia at 6 and 12 weeks. RESULTS: In the X-ray study, autograft group showed the highest bone formation scores. Both groups of biomaterials presented bone formation similar and greater than the defect without material, but always less than in the autograft group. The results of the microCT study showed the largest bone volume in the study area in the autograft group. The groups with bone substitutes presented greater bone volume than the group without material but always less than the autograft group. CONCLUSION: Both scaffolds seem to promote bone formation but are not capable of reproducing the characteristics of autograft. Due to their different macroscopic characteristics, each one could be suitable for a different type of defect.

10.
Microbiol Spectr ; 11(3): e0454022, 2023 06 15.
Article in English | MEDLINE | ID: mdl-37010409

ABSTRACT

Osteomyelitis is an infection of the bone, associated with an inflammatory process. Imaging plays an important role in establishing the diagnosis and the most appropriate patient management. However, data are lacking regarding the use of preclinical molecular imaging techniques to assess osteomyelitis progression in experimental models. This study aimed to compare structural and molecular imaging to assess disease progression in a mouse model of implant-related bone and joint infections caused by Staphylococcus aureus. In SWISS mice, the right femur was implanted with a resorbable filament impregnated with S. aureus (infected group, n = 10) or sterile culture medium (uninfected group, n = 6). Eight animals (5 infected, 3 uninfected) were analyzed with magnetic resonance imaging (MRI) at 1, 2, and 3 weeks postintervention, and 8 mice were analyzed with [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)-computed tomography (CT) at 48 h and at 1, 2, and 3 weeks postintervention. In infected animals, CT showed bone lesion progression, mainly in the distal epiphysis, although some uninfected animals presented evident bone sequestra at 3 weeks. MRI showed a lesion in the articular area that persisted for 3 weeks in infected animals. This lesion was smaller and less evident in the uninfected group. At 48 h postintervention, FDG-PET showed higher joint uptake in the infected group than in the uninfected group (P = 0.025). Over time, the difference between groups increased. These results indicate that FDG-PET imaging was much more sensitive than MRI and CT for differentiating between infection and inflammation at early stages. FDG-PET clearly distinguished between infection and postsurgical bone healing (in uninfected animals) from 48 h to 3 weeks after implantation. IMPORTANCE Our results encourage future investigations on the utility of the model for testing different therapeutic procedures for osteomyelitis.


Subject(s)
Osteomyelitis , Staphylococcal Infections , Animals , Mice , Positron Emission Tomography Computed Tomography , Fluorodeoxyglucose F18 , Staphylococcus aureus , Staphylococcal Infections/diagnostic imaging , Osteomyelitis/diagnostic imaging , Magnetic Resonance Imaging
11.
Radiologia ; 54(3): 208-20, 2012.
Article in Spanish | MEDLINE | ID: mdl-21924447

ABSTRACT

Perfusion MRI makes it possible to evaluate the cerebral microvasculature through changes in signal due to a tracer passing through blood vessels. The most commonly used technique is based on the magnetic susceptibility of gadolinium in T2*-weighted sequences, and the most commonly evaluated parameters are cerebral blood volume, cerebral blood flow, and mean transit time. Diverse technical aspects, like the sequence used, and the dose and speed of contrast material injection, must be taken into account in perfusion MRI studies. It is also essential to consider possible sources of error like contrast material leaks due to changes in the permeability of the blood-brain barrier. The most widely used clinical applications of perfusion MRI include the determination of the degree of aggressiveness of gliomas, the differentiation of some histological types of tumors or pseudotumors, and the evaluation of the penumbral area in acute ischemia.


Subject(s)
Brain Diseases/diagnosis , Cerebrovascular Circulation , Magnetic Resonance Angiography/methods , Artifacts , Humans
12.
Curr Eye Res ; 47(12): 1609-1614, 2022 12.
Article in English | MEDLINE | ID: mdl-36189946

ABSTRACT

Purpose: The purpose of this study was to describe the relationship between the outer retinal hyperreflective bands and visual acuity recovery after idiopathic epiretinal macular membrane (ERM) surgical removal.Methods: A prospective longitudinal non-comparative study was conducted that included a total of 68 patients with idiopathic ERM, who underwent consecutive 23 G pars plana vitrectomy (PPV) at San Juan University Hospital (Alicante, Spain) from January 2019 to January 2021. All patients underwent a complete preoperative standard ophthalmic examination, including measurement of best corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) examination. This protocol was repeated at 1 and 3 months after surgery.Results: Mean preoperative decimal BCVA was 0.30 ± 0.13 and disruption of the first, second, third and fourth outer retinal hyperreflective bands was observed by SD-OCT in 9 (27.9%), 27 (39.7%), 33 (48.5%) and 17 patients (25%), respectively. BCVA improved after ERM peeling at 1 and 3 months in all patients, regardless of the presence of disruption in any hyperreflective band. Significantly larger improvement of BCVA was found at 3 months after surgery in patients not showing disruption of hyperreflective bands 1 and 4 (p = 0.048 and 0.001, respectively).Conclusions: The integrity of the outer retinal hyperreflective bands by SD-OCT in patients with idiopathic ERM is a valuable tool to determine the visual prognosis of the surgical treatment of this condition. A successful recovery of hyperreflective bands 1 and 4 with ERM surgery may be a potential biomarker of the visual improvement achieved due to their important anatomical relation with cone photoreceptors at the foveal level.


Subject(s)
Epiretinal Membrane , Humans , Epiretinal Membrane/diagnosis , Epiretinal Membrane/surgery , Prospective Studies , Retrospective Studies , Vitrectomy/methods , Retina/diagnostic imaging , Tomography, Optical Coherence/methods
13.
Med Phys ; 38(11): 6275-84, 2011 Nov.
Article in English | MEDLINE | ID: mdl-22047393

ABSTRACT

PURPOSE: Standard image reconstruction methods for fluorescence Diffuse Optical Tomography (fDOT) generally make use of L2-regularization. A better choice is to replace the L2 by a total variation functional that effectively removes noise while preserving edges. Among the wide range of approaches available, the recently appeared Split Bregman method has been shown to be optimal and efficient. Furthermore, additional constraints can be easily included. We propose the use of the Split Bregman method to solve the image reconstruction problem for fDOT with a nonnegativity constraint that imposes the reconstructed concentration of fluorophore to be positive. METHODS: The proposed method is tested with simulated and experimental data, and results are compared with those yielded by an equivalent unconstrained optimization approach based on Gauss-Newton (GN) method, in which the negative part of the solution is projected to zero after each iteration. In addition, the method dependence on the parameters that weigh data fidelity and nonnegativity constraints is analyzed. RESULTS: Split Bregman yielded a reduction of the solution error norm and a better full width at tenth maximum for simulated data, and higher signal-to-noise ratio for experimental data. It is also shown that it led to an optimum solution independently of the data fidelity parameter, as long as the number of iterations is properly selected, and that there is a linear relation between the number of iterations and the inverse of the data fidelity parameter. CONCLUSIONS: Split Bregman allows the addition of a nonnegativity constraint leading to improve image quality.


Subject(s)
Tomography, Optical/methods , Image Processing, Computer-Assisted , Models, Theoretical , Phantoms, Imaging , Reproducibility of Results
14.
Retina ; 31(3): 475-81, 2011 Mar.
Article in English | MEDLINE | ID: mdl-20966825

ABSTRACT

PURPOSE: The purpose of this study was to evaluate whether combined customized photodynamic therapy (PDT) and bevacizumab in myopic choroidal neovascularization can improve vision and whether it is possible to decrease the frequency and number of intravitreal antiangiogenic injections. METHODS: A prospective, consecutive, noncomparative, interventional case series of 36 patients with myopic choroidal neovascularization, treated with an initial dose of PDT and intravitreal bevacizumab 48 hours to 60 hours afterward. Retreatments were carried out as required with monthly bevacizumab and PDT every 3 months if there were relapses. Follow-up lasted 1 year in all cases. RESULTS: The mean best-corrected visual acuity increased from 44 letters before the initial treatment to 59.5 letters at the 12-month follow-up (P < 0.01). Compared with initial vision, 94.5% of the eyes had the same or better vision and 5.5% lost fewer than 6 lines of vision. The mean number of PDT treatments was 1.1 per patient, and the mean number of bevacizumab injections was 1.5 per patient. Only 1 initial treatment with PDT + bevacizumab was necessary in 28 cases (77.8%). CONCLUSION: Combined personalized PDT + bevacizumab therapy makes it possible to obtain visual results similar to those obtained in monotherapy studies but with fewer intravitreal injections. It appears to be an interesting option for this type of patient.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Choroidal Neovascularization/drug therapy , Myopia, Degenerative/drug therapy , Photochemotherapy , Photosensitizing Agents/therapeutic use , Porphyrins/therapeutic use , Adult , Aged , Antibodies, Monoclonal, Humanized , Bevacizumab , Choroidal Neovascularization/diagnosis , Choroidal Neovascularization/physiopathology , Combined Modality Therapy , Female , Fluorescein Angiography , Follow-Up Studies , Humans , Intravitreal Injections , Male , Middle Aged , Myopia, Degenerative/diagnosis , Myopia, Degenerative/physiopathology , Prospective Studies , Retreatment , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Verteporfin , Visual Acuity/physiology , Young Adult
15.
Eur Neuropsychopharmacol ; 51: 1-6, 2021 10.
Article in English | MEDLINE | ID: mdl-34022746

ABSTRACT

Escitalopram is a selective serotonin reuptake inhibitor (SSRIs) antidepressant, drug that is currently used as first-line agents for the treatment of depression and it is also used in the treatment of other psychiatric disorders. The main goal of this study was to identify which brain areas are affected by escitalopram administration. This study was carried out on male Wistar rats that received escitalopram daily over 14 days and that were studied by 2-deoxy-2[18F]fluoro-D-glucose ([18F]FDG)-PET on the last day of treatment. Computed tomography (CT) images were acquired immediately before each PET scan and the main effects of drug administration were elucidated by Statistical Parametric Mapping. The results obtained indicated that repeated exposure to escitalopram increased metabolic activity in the retrosplenial and posterior cingulate cortices, while it decreased such activity in the ventral hippocampus, cerebellum, brainstem and midbrain regions, including the raphe nuclei and ventral tegmental area. Therefore, repeated exposure to escitalopram alters the activity of several brain areas closely related to the serotonergic system, and previously identified as key regions in the antidepressant effect induced by SSRIs. Furthermore, some of the changes found, such as the dampened metabolism in the ventral tegmental area, are similar to changes that have been described after treating with other fast-acting antidepressant approaches.


Subject(s)
Citalopram , Escitalopram , Animals , Antidepressive Agents/metabolism , Antidepressive Agents/pharmacology , Brain , Citalopram/metabolism , Citalopram/pharmacology , Glucose/metabolism , Humans , Male , Rats , Rats, Wistar , Selective Serotonin Reuptake Inhibitors/pharmacology
16.
Retina ; 30(8): 1190-6, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20539256

ABSTRACT

PURPOSE: The purposes of this study were to determine whether the association of photodynamic therapy (PDT) and intravitreal ranibizumab could improve vision in a group of patients with choroidal neovascularization secondary to age-related macular degeneration and whether it could reduce the number and frequency of intravitreal injections, thus minimizing adverse effects. METHODS: A nonrandomized, prospective, interventional study was conducted of a case series of 53 patients with sub- and juxtafoveal choroidal neovascularization secondary to age-related macular degeneration treated with a single initial dose of PDT and intravitreal ranibizumab. Retreatments were performed as required with monthly ranibizumab and PDT every 3 months if there were relapses. The retreatment criteria were based on visual acuity, optical coherence tomography, and fluorescein angiography. Follow-up lasted 12 months in all cases. RESULTS: The mean initial visual acuity was 40.6 letters versus 47.8 letters at the end of follow-up with a gain of 7.2 letters (P < 0.001). Moreover, 78.8% maintained or improved their initial vision, and 92.3% avoided moderate vision loss (>15 letters). A total of 65 PDT treatments (mean, 1.22 per patient) was performed and 126 doses of ranibizumab were injected (mean, 2.37 per patient). Only a single initial dose (PDT + ranibizumab) was required in 21 cases (39.6%). The central retinal thickness and choroidal neovascularization size decreased to 118 microm and 0.26 disk areas, respectively, from baseline to 12 months. CONCLUSION: Combined customized PDT + ranibizumab treatment can achieve visual results similar to those obtained with intravitreal monotherapy with the advantage of fewer intravitreous injections and reduced potential for adverse effects.


Subject(s)
Antibodies, Monoclonal/administration & dosage , Choroidal Neovascularization/drug therapy , Macular Degeneration/drug therapy , Photochemotherapy , Aged , Aged, 80 and over , Antibodies, Monoclonal, Humanized , Choroidal Neovascularization/etiology , Choroidal Neovascularization/physiopathology , Combined Modality Therapy , Exudates and Transudates , Female , Fluorescein Angiography , Follow-Up Studies , Humans , Macular Degeneration/complications , Macular Degeneration/physiopathology , Male , Prospective Studies , Ranibizumab , Retreatment , Tomography, Optical Coherence , Treatment Outcome , Visual Acuity/physiology
17.
Biomed Opt Express ; 11(10): 6038-6048, 2020 Oct 01.
Article in English | MEDLINE | ID: mdl-33150004

ABSTRACT

In the processes related to the development of cancer, there are different genetic and epigenetic events involved that result in structural changes of the affected cells. In the early stages of the disease, these changes occur at the nanoscale, remaining undetectable by conventional light microscopy, due to diffraction-limited resolution (∼250 - 550 nm). In this sense, a technique termed partial wave spectroscopy (PWS) allows the detection of these nanostructural changes by measuring a statistical parameter called disorder strength (L d ). PWS uses a combination of a tunable filter and a camera to acquire the backscattering spectra for each pixel on the image. In this paper, we study and validate the possibility of obtaining a qualitative measurement of the disorder using the spectrum of the averaged spatial information. Instead of using spatial information and measuring sequentially spectral ranges, we measure the backscattered signal gathered by an optical fiber by means of a spectrograph. This will allow this method to be applied in systems where it is not possible to acquire a complete high resolution image for many spectral bands, while significantly enhancing speed.

18.
J Am Soc Echocardiogr ; 33(3): 389-398, 2020 03.
Article in English | MEDLINE | ID: mdl-31813676

ABSTRACT

BACKGROUND: Cardioembolic stroke is a major source of mortality and disability worldwide. The authors hypothesized that quantitative characterization of intracardiac blood stasis may be useful to determine cardioembolic risk in order to personalize anticoagulation therapy. The aim of this study was to assess the relationship between image-based metrics of blood stasis in the left ventricle and brain microembolism, a surrogate marker of cardiac embolism, in a controlled animal experimental model of acute myocardial infarction (AMI). METHODS: Intraventricular blood stasis maps were derived from conventional color Doppler echocardiography in 10 pigs during anterior AMI induced by sequential ligation of the mid and proximal left anterior descending coronary artery (AMI-1 and AMI-2 phases). From these maps, indices of global and local blood stasis were calculated, such as the average residence time and the size and ratio of contact with the endocardium of blood regions with long residence times. The incidence of brain microemboli (high-intensity transient signals [HITS]) was monitored using carotid Doppler ultrasound. RESULTS: HITS were detected in 0%, 50%, and 90% of the animals at baseline and during AMI-1 and AMI-2 phases, respectively. The average residence time of blood in the left ventricle increased in parallel. The residence time performed well to predict microemboli (C-index = 0.89, 95% CI, 0.75-1.00) and closely correlated with the number of HITS (R = 0.87, P < .001). Multivariate and mediation analyses demonstrated that the number of HITS during AMI phases was best explained by stasis. Among conventional echocardiographic variables, only apical wall motion score weakly correlated with the number of HITS (R = 0.3, P = .04). Mural thrombosis in the left ventricle was ruled out in all animals. CONCLUSIONS: The degree of stasis of blood in the left ventricle caused by AMI is closely related to the incidence of brain microembolism. Therefore, stasis imaging is a promising tool for a patient-specific assessment of cardioembolic risk.


Subject(s)
Heart Diseases , Myocardial Infarction , Animals , Echocardiography , Endocardium , Heart Ventricles/diagnostic imaging , Myocardial Infarction/complications , Myocardial Infarction/diagnosis , Swine
19.
Mol Imaging Biol ; 11(2): 94-9, 2009.
Article in English | MEDLINE | ID: mdl-19037612

ABSTRACT

PURPOSE: This study was designed to assess changes in brain glucose metabolism in rats after visual stimulation. MATERIALS AND METHODS: We sought to determine whether visual activation in the rat brain could be detected using a small-animal positron emission tomography (PET) scanner and 2-deoxy-2-[(18)F]fluoro-D: -glucose (FDG). Eleven rats were divided into two groups: (a) five animals exposed to ambient light and (b) six animals stimulated by stroboscopic light (10 Hz) with one eye covered. Rats were injected with FDG and, after 45 min of visual stimulation, were sacrificed and scanned for 90 min in a dedicated PET tomograph. Images were reconstructed by a three-dimensional ordered subset expectation maximization algorithm (1.8 mm full width at half maximum). A region-of-interest (ROI) analysis was performed on 14 brain structures drawn on coronal sections. Statistical parametric mapping (SPM) adapted for small animals was also carried out. Additionally, the brains of three rats were sliced into 20-microm sections for autoradiography. RESULTS: Analysis of ROI data revealed significant differences between groups in the right superior colliculus, right thalamus, and brainstem (p < or = 0.05). SPM detected the same areas as the ROI approach. Autoradiographs confirmed the existence of hyperactivation in the left superior colliculus and auditory cortex. CONCLUSIONS: To our knowledge, this is the first report that uses FDG-PET and SPM analysis to show changes in rat brain glucose metabolism after a visual stimulus.


Subject(s)
Brain Mapping/methods , Brain/diagnostic imaging , Brain/metabolism , Glucose/metabolism , Photic Stimulation , Vision, Ocular , Analysis of Variance , Animals , Autoradiography , Female , Fluorodeoxyglucose F18/metabolism , Lighting , Positron-Emission Tomography , Rats , Rats, Wistar , Statistics, Nonparametric
20.
Med Phys ; 36(5): 1663-71, 2009 May.
Article in English | MEDLINE | ID: mdl-19544783

ABSTRACT

Low-pass filtering of sinograms in the radial direction is the most common practice to limit noise amplification in filtered back projection (FBP) reconstruction of positron emission tomography studies. Other filtering strategies have been proposed to prevent the loss in resolution due to low-pass radial filters, although results have been diverse. Using the well-known properties of the Fourier transform of a sinogram, the authors defined a binary mask that matches the expected shape of the support region in the Fourier domain of the sinogram ("bow tie"). This mask was smoothed by a convolution with a ten-point Gaussian kernel which not only avoids ringing but also introduces a pre-emphasis at low frequencies. A new filtering scheme for FBP is proposed, comprising this smoothed bow-tie filter combined with a standard radial filter and an axial filter. The authors compared the performance of the bow-tie filtering scheme with that of other previously reported methods: Standard radial filtering, angular filtering, and stackgram-domain filtering. All the quantitative data in the comparisons refer to a baseline reconstruction using a ramp filter only. When using the smallest size of the Gaussian kernel in the stackgram domain, the authors achieved a noise reduction of 33% at the cost of degrading radial and tangential resolutions (14.5% and 16%, respectively, for cubic interpolation). To reduce the noise by 30%, the angular filter produced a larger degradation of contrast (3%) and tangential resolution (46% at 10 mm from the center of the field of view) and showed noticeable artifacts in the form of circular blurring dependent on the distance to the center of the field of view. For a similar noise reduction (33%), the proposed bow-tie filtering scheme yielded optimum results in resolution (gain in radial resolution of 10%) and contrast (1% increase) when compared with any of the other filters alone. Experiments with rodent images showed noticeable image quality enhancement when using the proposed bow-tie filtering scheme.


Subject(s)
Algorithms , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Positron-Emission Tomography/methods , Animals , Mice , Phantoms, Imaging , Positron-Emission Tomography/instrumentation , Rats , Reproducibility of Results , Sensitivity and Specificity
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