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1.
Langenbecks Arch Surg ; 409(1): 92, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38467934

RESUMO

BACKGROUND: Posthepatectomy liver failure (PHLF) remains a life-threatening complication after hepatectomy. To reduce PHLF, a preoperative assessment of liver function is indispensable. For this purpose, 99mTc-mebrofenin hepatobiliary scintigraphy with SPECT (MSPECT) can be used. The aim of the current study was to evaluate the predictive value of MSPECT for PHLF in patients with non-colorectal liver tumors (NCRLT) compared to patients with colorectal liver metastasis (CRLM) undergoing extended liver resection. METHODS: We included all patients undergoing extended liver resections via two-stage procedures between January 2019 and December 2021 at the University Medical Center Hamburg-Eppendorf, Germany. All patients received a preoperative MSPECT. RESULTS: Twenty patients were included. In every fourth patient, PHLF was observed. Four patients had PHLF grade C. There were no differences between patients with CRLM and NCRLT regarding PHLF rate and future liver remnant (FLR) volume. Patients with CRLM had higher mebrofenin uptake in the FLR compared to those with NCRLT (2.49%/min/m2 vs. 1.51%/min/m2; p = 0.004). CONCLUSION: Mebrofenin uptake in patients with NCRLT was lower compared to those patients with CRLM. However, there was no difference in the PHLF rate and FLR volume. Cut-off values for the mebrofenin uptake might need adjustments for different surgical indications, surgical procedures, and underlying diseases.


Assuntos
Compostos de Anilina , Neoplasias Colorretais , Glicina , Falência Hepática , Neoplasias Hepáticas , Humanos , Compostos Radiofarmacêuticos , Fígado/diagnóstico por imagem , Fígado/cirurgia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Hepatectomia/efeitos adversos , Falência Hepática/etiologia , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/complicações , Estudos Retrospectivos , Complicações Pós-Operatórias
2.
Phys Med Biol ; 65(16): 165015, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32369781

RESUMO

There is a tradeoff between spatial resolution and count sensitivity in SPECT with conventional collimators. Multi-pinhole (MPH) collimator technology has potential for concurrent improvement of resolution and sensitivity in clinical SPECT of 'small' organs. This study evaluated a novel MPH collimator specifically designed for dopamine transporter (DAT) SPECT with a triple-head SPECT camera. Count sensitivity was measured with a 99mTc point source placed on the lattice points of a 1 cm grid covering the whole field-of-view (FOV). Spatial resolution was assessed with a Derenzo type hot rod phantom. An anthropomorphic striatum phantom was scanned with total activity representative of a typical patient scan and different striatum-to-background activity concentration ratios. Recovery of striatum-to-background contrast was assessed by the contrast-recovery-coefficient. Measurements were repeated with double-head SPECT with fan-beam or low-energy-high-resolution-high-sensitivity (LEHRHS) collimators. A patient referred to DAT SPECT because of suspicion of Parkinson's disease was scanned with both LEHRHS and MPH collimators after a single tracer injection. The axial MPH sensitivity profile was approximately symmetrical around its peak, although it was shifted 7 cm towards the patient to simplify positioning. Peak sensitivity of the triple-head MPH system in the center of the FOV was 620 cps MBq-1 compared to 225 cps MBq-1 for the double-head fan-beam system. Sensitivity of the MPH system decreased towards the edges of the FOV. The full width of the sensitivity profile at 200 cps MBq-1 was 21 cm transaxially and 11 cm axially. In MPH SPECT of the Derenzo phantom all rods with ≥ 5 mm diameter were clearly visible. MPH SPECT improved striatal contrast recovery by ≥ 20% compared to fan-beam SPECT. The patient scan demonstrated good image quality of MPH SPECT with almost PET-like delineation of putamen and caudate nucleus. SPECT with dedicated MPH collimators provides considerable improvement of the resolution-sensitivity tradeoff in DAT SPECT compared to SPECT with fan-beam or LEHRHS collimators.


Assuntos
Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Tomografia Computadorizada de Emissão de Fóton Único/instrumentação , Humanos , Neostriado/metabolismo , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/metabolismo , Imagens de Fantasmas
3.
Mol Imaging Biol ; 19(3): 437-445, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27743210

RESUMO

PURPOSE: The purpose of this study was to assess the value of the spatial heterogeneity of somatostatin receptor (SSR) volume, quantified as asphericity (ASP), and to predict response to peptide receptor radionuclide therapy (PRRT) in patients with metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). PROCEDURES: From June 2011 to May 2013, patients suffering from GEP-NEN who underwent pretherapeutic [111In-DTPA0]octreotide scintigraphy (Octreoscan®) prior to [177Lu-DOTA0-Tyr3]octreotate ([177Lu]DOTATATE)-PRRT were enrolled in this retrospective evaluation. SSR expression in 20 NEN patients was qualitatively and quantitatively assessed using the Krenning score, the metastasis to liver uptake ratio (M/L ratio), and ASP at baseline. Response to PRRT was evaluated based on lesions, which were classified as responding lesions (RL) and non-responding lesions (NRL) after 4- and 12-month follow-ups. The values of the Krenning score, M/L ratio, and ASP for response prediction were compared by using the Mann-Whitney U test, Kruskal-Wallis test, and receiver operating characteristic (ROC) curves. RESULTS: Seventy-seven metastases (liver, n = 40; lymph node, n = 24; bone, n = 11; pancreas, n = 2) showed SSR expression. A higher ASP level was significantly associated with poorer response at both time points. ROC analyses revealed the highest area under the curve (AUC) for discrimination between RL and NRL for ASP after 4 months (AUC 0.97; p = 0.019) and after 12 months (AUC 0.96; p < 0.001), followed by the Krenning score (AUC 0.74; p = 0.082 and AUC 0.85; p < 0.001, respectively) and M/L ratio (AUC 0.77; p = 0.107 and AUC 0.82; p < 0.001). The optimal cutoff value for ASP was 5.12 % (sensitivity, 90 %; specificity, 93 %). CONCLUSION: Asphericity of SSR-expressing lesions in pretherapeutic single-photon emission computed tomography with integrated computed tomography (SPECT/CT) is a promising parameter for predicting response to PRRT in gastroenteropancreatic neuroendocrine neoplasms.


Assuntos
Tumores Neuroendócrinos/tratamento farmacológico , Octreotida/análogos & derivados , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/tratamento farmacológico , Ácido Pentético/análogos & derivados , Compostos Radiofarmacêuticos/uso terapêutico , Receptores de Peptídeos/uso terapêutico , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Octreotida/química , Ácido Pentético/química , Curva ROC , Resultado do Tratamento
4.
Nuklearmedizin ; 53(6): 234-41, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25209576

RESUMO

UNLABELLED: Semi-quantitative characterization of dopamine transporter availability from single photon emission computed tomography (SPECT) with 123I-ioflupane (FP-CIT) is based on uptake ratios relative to a reference region. The aim of this study was to evaluate the whole brain as reference region for semi-quantitative analysis of FP-CIT SPECT. The rationale was that this might reduce statistical noise associated with the estimation of non-displaceable FP-CIT uptake. PATIENTS, METHODS: 150 FP-CIT SPECTs were categorized as neurodegenerative or non-neurodegenerative by an expert. Semi-quantitative analysis of specific binding ratios (SBR) was performed with a custom-made tool based on the Statistical Parametric Mapping software package using predefined regions of interest (ROIs) in the anatomical space of the Montreal Neurological Institute. The following reference regions were compared: predefined ROIs for frontal and occipital lobe and whole brain (without striata, thalamus and brainstem). Tracer uptake in the reference region was characterized by the mean, median or 75th percentile of its voxel intensities. The area (AUC) under the receiver operating characteristic curve was used as performance measure. RESULTS: The highest AUC of 0.973 was achieved by the SBR of the putamen with the 75th percentile in the whole brain as reference. The lowest AUC for the putamen SBR of 0.937 was obtained with the mean in the frontal lobe as reference. CONCLUSION: We recommend the 75th percentile in the whole brain as reference for semi-quantitative analysis in FP-CIT SPECT. This combination provided the best agreement of the semi-quantitative analysis with visual evaluation of the SPECT images by an expert and, therefore, is appropriate to support less experienced physicians.


Assuntos
Encéfalo/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Doenças Neurodegenerativas/metabolismo , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tropanos/farmacocinética , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Encéfalo/diagnóstico por imagem , Simulação por Computador , Diagnóstico Diferencial , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Pessoa de Meia-Idade , Modelos Biológicos , Imagem Molecular/métodos , Doenças Neurodegenerativas/diagnóstico por imagem , Compostos Radiofarmacêuticos/farmacocinética , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Distribuição Tecidual
5.
Strahlenther Onkol ; 190(6): 575-81, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24535649

RESUMO

BACKGROUND AND PURPOSE: The aim of this pilot study was (1) to evaluate the combination of [(18)F]fluorodeoxyglucose (FDG) and [(15)O]water for detection of flow-metabolism mismatch in advanced cervical carcinomas, i.e., increased glycolysis at low blood flow, as a possible parameter for prediction of response to treatment, and (2) to propose a method for automated quantification of its spatial extent. PATIENTS AND METHODS: The study retrospectively included 10 women with advanced cervical carcinoma in whom PET with both FDG and [(15)O]water had been performed prior to therapy. The metabolically active tumor volume was delineated automatically in the FDG images. For computation of the regional blood flow in the tumor, a recovery corrected image-derived arterial input function was used. A tumor voxel was classified as mismatched when the voxel SUV of FDG was larger than the median tumor SUV and the voxel perfusion (K1) was smaller than the median perfusion. The absolute mismatch volume (aMMV) was defined as the volume of all mismatched voxels in ml, and the relative mismatch volume (rMMV) as the ratio of the aMMV to the metabolic tumor volume in percent. RESULTS: The tumors were quite heterogeneous with respect to both FDG uptake and perfusion. The aMMV clustered into 2 groups: "large aMMV" ≥ 10 ml in 40 % of patients and "small aMMV" ≤ 5 ml in 60 % of patients. The rMMV ranged from 12.7-24.9 %. There was no correlation between rMMV and metabolic tumor volume. There was a tendency (p = 0.126) for an association between rMMV and histological grading, rMMV being about 20 % higher in G3 than in G2 tumors. rMMV did not correlate with SUV or perfusion. CONCLUSION: These results suggest that combined PET with FDG and [(15)O]water allows detection and quantitative characterization of flow-metabolism mismatch in advanced cervical carcinomas.


Assuntos
Glicemia/metabolismo , Fluordesoxiglucose F18 , Processamento de Imagem Assistida por Computador/métodos , Radioisótopos de Oxigênio , Imagem de Perfusão/métodos , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Neoplasias do Colo do Útero/irrigação sanguínea , Adulto , Idoso , Colo do Útero/irrigação sanguínea , Colo do Útero/patologia , Quimiorradioterapia , Progressão da Doença , Feminino , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Projetos Piloto , Fluxo Sanguíneo Regional/fisiologia , Estudos Retrospectivos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia
6.
J Phys Condens Matter ; 24(23): 235401, 2012 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-22569003

RESUMO

We have studied the temperature and size dependence of the G and 2D phonon modes in graphene. It is shown that in a graphene monolayer the phonon energy decreases whereas the phonon damping increases with increasing temperature. The electron-phonon interaction leads to hardening whereas the fourth-order anharmonic phonon-phonon processes lead to softening of the phonon energy with increasing temperature. We have shown that the electron-phonon interaction plays an important role also by the dispersion dependence of the phonon G mode, by the observation of the Kohn anomaly. The G mode frequency decreases and damping increases, whereas the 2D phonon frequency and damping increase with increasing layer number. The temperature and size effects of the 2D mode are much stronger than those of the G mode.

7.
Artigo em Inglês | MEDLINE | ID: mdl-21269874

RESUMO

To understand the mechanism of the photoprotective and antioxidative functions of carotenoids, it is essential to have a profound knowledge of their excited electronic and vibronic states. In the present study we investigate the most powerful antioxidants: ß-carotene and lutein by means of resonance Raman spectroscopy. The aim was to study in detail their Raman spectra in solution at room temperature and their changes as a function of temperature. To measure the spectra in their natural environment pyridine has been used as a solvent. It has been chosen because of its polarizability (n=1.5092) which is close to that of membrane lipids and proteins. The temperature dependence of the most intensive ν(1) band in the range from 77 K to 295 K at 514.5 nm excitation has been obtained. It was found that in pyridine the CC stretching frequency, its intensity, line shape, and line width are very sensitive to the temperature (the sensitivity being different for the two studied carotenoids). The observed linear temperature dependence of the CC stretching frequency is explained by a mechanism involving changes of the vibronic coupling and the extent of π-electron delocalization. The different behavior of the temperature-induced broadening of the ν(1) band and its intensity for the two studied carotenoids can be associated with the different nature of their solid matrices: glassy for ß-carotene and crystalline-like for lutein, owing to their different chemical structures.


Assuntos
Carotenoides/química , Análise Espectral Raman/métodos , Temperatura , Luteína/análise , Estrutura Molecular , beta Caroteno/análise
8.
Nuklearmedizin ; 50(2): 83-92, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21165536

RESUMO

OBJECTIVES: We developed and tested a software tool for computer-assisted analysis of FDG-PET/CT in cancer therapy monitoring. The tool provides automatic semi-quantitative analysis of a baseline scan together with up to two follow-up scans (standardized uptake values, glycolytic volume). The tool also supports visual analysis by local spatial registration which allows display of tumor lesions with the same orientation in all scans. The tool's stability and accuracy was tested at typical everyday image quality. PATIENTS, METHODS: Ten unselected cancer patients in whom three FDG PET/CT scans had been performed were included. A total of 18 lesions were analyzed. RESULTS: Automatic lesion tracking worked properly in all lesions but one. In this lesion local coregistration had to be adjusted manually which, however, is easily performed with the tool. Semi-automatic lesion segmentation and fully automatic semi-quantitative analysis worked properly in all cases. Computer-assisted analysis was significantly less time consuming than manual analysis. CONCLUSIONS: The novel software tool appears useful for analysis of FDG-PET/CT in cancer therapy monitoring in clinical routine patient care.


Assuntos
Fluordesoxiglucose F18 , Interpretação de Imagem Assistida por Computador/métodos , Armazenamento e Recuperação da Informação/métodos , Neoplasias/diagnóstico , Neoplasias/terapia , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Algoritmos , Inteligência Artificial , Feminino , Seguimentos , Humanos , Aumento da Imagem/métodos , Masculino , Pessoa de Meia-Idade , Reconhecimento Automatizado de Padrão/métodos , Prognóstico , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resultado do Tratamento
9.
Nuklearmedizin ; 49(4): 139-47, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20502846

RESUMO

AIM: Both IBZM SPECT and FDG PET may be used for differentiation between Parkinson's disease (PD) and atypical neurodegenerative parkinsonian syndromes (APS). However, there are only very limited data of both modalities in the same subjects. The present study compared both modalities with respect to inter-rater agreement in 30 patients with neurodegenerative parkinsonian syndromes (PS) confirmed by FP-CIT SPECT. METHODS: IBZM SPECT and FDG PET were categorized as PD or APS by visual inspection of standardized report pages and statistical parametric maps (SPMs). Categorization was performed independently by five readers. Inter-rater agreement was quantified using Cohen's kappa kappa. RESULTS: IBZM SPECT resulted in PD and APS in 11 and 19 cases, respectively (majoritarian categorization). Inter-rater agreement was kappa=0.64+/-0.10. FDG PET resulted in PD and APS in 12 and 18 cases, respectively (majoritarian categorization). Inter-rater agreement was kappa=0.68+/-0.07. Majoritarian diagnosis disagreed between IBZM SPECT and FDG PET in 13 cases (43%). Semi-quantitative analysis of IBZM SPECT using the striatum-to-reference distribution volume ratio was in good agreement with visual categorization (area under ROC curve 0.92). CONCLUSION: In neurodegenerative PS, inter-rater agreement of visual analysis is substantial in both IBZM SPECT and FDG PET. Furthermore, (I) visual analysis of IBZM SPECT is reliable if adequate standardized image display is used, (II) visual analysis of FDG SPMs allows unique categorization as either PD or APS in most subjects, and (III) IBZM SPECT and FDG PET are discordant in a significant fraction of cases.


Assuntos
Fluordesoxiglucose F18 , Transtornos Parkinsonianos/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Benzamidas , Diagnóstico Diferencial , Antagonistas de Dopamina , Humanos , Variações Dependentes do Observador , Seleção de Pacientes , Pirrolidinas , Reprodutibilidade dos Testes
10.
Nuklearmedizin ; 48(1): 44-54, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19212611

RESUMO

AIM: FDG PET in hyperglycaemic subjects often suffers from limited statistical image quality, which may hamper visual and quantitative evaluation. In our study the following insulin bolus protocol is proposed for acute correction of hyperglycaemia (>7.0 mmol/l) in brain FDG PET. (i) Intravenous bolus injection of short-acting insulin, one I.E. for each 0.6 mmol/l blood glucose above 7.0. (ii) If 20 min after insulin administration plasma glucose is

Assuntos
Encéfalo/diagnóstico por imagem , Fluordesoxiglucose F18/farmacocinética , Hiperglicemia/tratamento farmacológico , Insulina/uso terapêutico , Tomografia por Emissão de Pósitrons , Encéfalo/metabolismo , Simulação por Computador , Humanos , Hiperinsulinismo/diagnóstico por imagem , Hiperinsulinismo/metabolismo , Hipoglicemiantes/uso terapêutico , Cinética , Radiografia , Radioisótopos/farmacocinética
11.
J Phys Condens Matter ; 21(3): 036002, 2009 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-21817285

RESUMO

The phonon properties of multiferroic BiFeO(3) (BFO) nanoparticles are studied using a Green's function technique on the basis of the Heisenberg and the transverse Ising models, taking into account anharmonic spin-phonon and phonon-phonon interaction terms. The phonon spectrum is obtained for different exchange, magnetoelectric, and spin-phonon interaction constants. The influence of temperature, surface and size effects on the phonon energy and damping is discussed. The phonon energy and damping in BFO nanoparticles are greater in comparison to those in bulk BFO. The strong spin-phonon interactions lead to anomalies in the phonon spectrum around the magnetic and ferroelectric phase transitions. The influence of an applied magnetic field is studied, too. The predictions are consistent with experimental results.

13.
J Phys Condens Matter ; 19(40): 406235, 2007 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-22049133

RESUMO

The influence of size, anisotropy and doping effects on the hysteresis loop of ferromagnetic nanoparticles is studied, based on the modified Heisenberg model. A Green's function technique in real space allows the calculation of the dependence of the magnetization on the temperature, magnetic field, anisotropy, defects and particle size. It is demonstrated that the coercive field H(c) is very sensitive to the surface single-ion anisotropy, and to the exchange interaction constant on the surface J(s) and in the defect shells J(d). With respect to the strong surface single-site anisotropy D(s), we observe at small particle size, N = 4 shells, a maximum in the size dependence of the coercive field, whereas for the small surface anisotropy there is no maximum. Taking into account that J can be different in the defect shells compared to the case without defects, we have obtained for the first time that the coercive field H(c), the permanent magnetization M(r) and the Curie temperature T(C) can increase or decrease for different kinds of doping ions. The dependence on the particle size is discussed, too. The results are in accordance with the experimental data.

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