PubMed Health⌕ Search

Biomedical subjects

C E Neumaier

Publications and source records attributed to C E Neumaier.

At least 19 recordsLinked to original sources

Magnetic resonance imaging at 1.5 T with immunospecific contrast agent in vitro and in vivo in a xenotransplant model.

OBJECT: Demonstrating the feasibility of magnetic resonance imaging (MRI) at 1.5 T of ultrasmall particle iron oxide (USPIO)-antibody bound to tumor cells in vitro and in a murine xenotransplant model. METHODS: Human D430B cells or Raji Burkitt lymphoma cells were incubated in vitro with different amounts of commercially available USPIO-anti-CD20 antibodies and cell pellets were stratified in a test tube. For in vivo studies, D430B cells and Raji lymphoma cells were inoculated subcutaneously in immunodeficient mice. MRI at 1.5 T was performed with T1-weighted three-dimensional fast field echo sequences (17/4.6/13 degrees ) and T2-weighted three-dimensional fast-field echo sequences (50/12/7 degrees ). For in vivo studies MRI was performed before and 24 h after USPIO-anti-CD20 administration. RESULTS: USPIO-anti-CD20-treated D430B cells, showed a dose-dependent decrease in signal intensity (SI) on T2*-weighted images and SI enhancement on T1-weighted images in vitro. Raji cells showed lower SI changes, in accordance to the fivefold lower expression of CD20 on Raji with respect to D430B cells. In vivo 24 h after USPIO-anti-CD20 administration, both tumors showed an inhomogeneous decrease of SI on T2*-weighted images and SI enhancement on T1-weighted images. CONCLUSIONS: MRI at 1.5 T is able to detect USPIO-antibody conjugates targeting a tumor-associated antigen in vitro and in vivo.

Animals↗

Characterization of adrenal adenomas and metastases: correlation between unenhanced computed tomography and chemical shift magnetic resonance imaging.

PURPOSE: To evaluate the correlation of absolute attenuation values of unenhanced computed tomography (CT) with signal intensity (SI) quantitative analysis on chemical shift (CS) magnetic resonance (MR) imaging in differentiating adrenal adenomas from metastases. MATERIAL AND METHODS: Forty-one adrenal masses (27 adenomas, 14 metastases) were studied with CS MR imaging and unenhanced CT. MR included T1-weighted breathhold gradient-echo in-phase (IP) and opposed-phase (OP) sequences. The SI index (SI-i) [(SIIP-SIOP/SIIP)] x 100% and chemical-shift ratio (CS-r) relative to the spleen [(SIlesion/ SIspleen)OP/(SIlesion/SIspleen)IP] were calculated for each lesion. CT absolute attenuation values were also determined. RESULTS: The mean attenuation value of metastases was significantly greater than that of adenomas (< 0.0001). On MR, the mean SI-i of adenomas was significantly greater than that of metastases (P < 0.0001) and no overlaps were evident. The CS-r of malignant and benign lesions overlapped considerably, and five adenomas (all with indeterminate Hounsfield Unit values at CT) were misclassified as potentially malignant. CT attenuation values were significantly correlated with both MR quantitative analyses. CONCLUSION: Since CS MR imaging and CT both depict the presence of lipids within adrenal lesions, absolute attenuation values are highly correlated with MR quantitative analysis. SI-i is the most reliable tool for differentiating adrenal adenomas from metastases, showing better accuracy than lesion-to-spleen CS-r, in particular for adenomas with indeterminate absolute attenuation values.

Adenoma↗

Inadequacy of the new Response Evaluation Criteria in Solid Tumors (RECIST) in patients with malignant pleural mesothelioma: report of four cases.

Unidimensional Response Evaluation Criteria in Solid Tumor (RECIST) has been recently proposed in the attempt to simplify the standardized bidimensional World Health Organization (WHO) criteria. The complete accord between these two measurement systems was established in a large comparative study [J. Natl. Cancer Inst. 92(3) (2000) 205] that demonstrated the validity and the good performance of RECIST criteria. We report four cases of inadequacy of RECIST criteria in the evaluation of response to chemotherapy in patients with malignant pleural mesothelioma. These four patients were enrolled in two consecutive multicenter phase II clinical trials investigating the activity of a novel chemotherapy regimen in advanced pleural mesothelioma. They were judged as having an objective response to chemotherapy according to WHO criteria. Reassessed according to both methods, we found that results obtained with RECIST criteria do not correspond to WHO underestimating response to chemotherapy. Our data raise doubts about the applicability of unidimensional RECIST response criteria to mesothelioma and, possibly, to any tumor involving the chest wall.

Aged↗

Calcific tendinitis of the rotator cuff as a cause of drooping shoulder.

We describe a case of inferior glenohumeral subluxation or drooping shoulder secondary to acute calcific tendinitis of the rotator cuff. The various etiologies of drooping shoulder and the specific causes determining glenohumeral widening in our report are discussed. The importance in recognizing this uncommon complication of a common abnormal finding and correction by aspiration is stressed.

Calcinosis↗

Role of ultrasonography in the staging of gastrointestinal neoplasms.

This article reviews the capabilities and limits of ultrasonography (US) in the staging of gastrointestinal neoplasms. US is a well-established tool in the investigation of abdominal diseases. Its role is very important in the first approach to liver, gallbladder, biliary, and pancreatic diseases, but its abilities for accurate staging may be limited by various factors, which will be discussed. In the evaluation of the stomach and intestine, US is rarely utilized, but it can occasionally demonstrate an unsuspected gastrointestinal mass that usually must be evaluated further with specific techniques (endoscopy and barium studies) to confirm the diagnosis and to perform an accurate staging (with endosonography and computed tomography).

Diagnosis, Differential↗

Penile sonography.

Explore the source record for details and available documents.

Blood Flow Velocity↗

Normal prostate gland: examination with color Doppler US.

PURPOSE: To evaluate the vascular anatomy of the prostate gland with transrectal color Doppler ultrasound (US). MATERIALS AND METHODS: Thirty-five normal prostate glands were studied. Imaging findings were interpreted on the basis of findings from previous anatomic studies. RESULTS: Distribution of flow signals within the gland was differentiated into two parenchymal groups of arteries, urethral and capsular. The urethral group entered the prostate at the bladder neck and sent forth branches to supply the periurethral zone and the inner portion of the gland. The capsular group coursed along the anterolateral surface of the prostate and sent forth perforating branches to the outer portion of the gland. Intraprostatic venous signals were seen mainly within the periurethral zone. CONCLUSION: Transrectal color Doppler US can depict the vascular anatomy of the prostate gland. Knowledge of the normal vascular appearance of the gland should aid in the differentiation of normal from abnormal findings.

Adult↗

Klatskin tumour: radical and palliative treatment.

Primitive neoplasms of proximal extrahepatic bile ducts keep their peculiar morphological and spreading patterns, as firstly described by J. Klatskin. Diagnostic and therapeutic approach were modified in the last year, on the basis of technological progress in imaging and more aggressive surgical attitude. Authors reviewed their clinical experience from 1970 to 1995 concerning proximal extrahepatic bile ducts tumors management, mainly evaluating the evolution of diagnostic work-up and the role of resection. Preoperative work-up is now trimed to non invasive techniques, in order to evaluate the intra and extra biliary diffusion; PTC-PTBD performed preoperatively give a clear biliary map, and could be the first step of a palliative definitive treatment in case of non operable patients. Radical resection remains the gold standard of therapy, with the best long-term results. Palliation must be obtained by the easiest comfortable method for the patient (i.e. self-blocking percutaneously inserted endoprosthesis).

Adult↗

Case report: US detection of tendinous metastasis from malignant melanoma.

The introduction of high frequency transducers has considerably improved the application of US in the study of musculo-tendinous diseases. We report a rare case of tendinous metastasis from malignant melanoma. The tumour (high karyokinetic index, Clark level IV) arose 4 years earlier in the dorsal region. The patient was admitted for pain in the left knee. A nodular hypoechoic lesion, 0.8 cm in diameter, poorly marginated, located in the subcutaneous tissue and involving the patellar tendon was identified with ultrasound. Histological examination confirmed the diagnosis.

Adult↗

[Evaluation of rheumatoid arthritis of the knee with Doppler color].

Color-Doppler US was used to study the vascularization of the synovial membrane and of the periarticular tissues of the knee in 14 normal subjects and 15 patients with active rheumatoid arthritis. The normal subjects exhibited few spot signals within the connectival spaces surrounding the knee and adjacent to the femoral condyles and to the tibial plates. The signals were mostly arterial and impedance was high because of the absence of inversion of diastole. A hypervascular pattern was detected in 13/15 patients with rheumatoid arthritis as a result of hyperemia associated with inflammation and synovial neoangiogenesis. In these patients, the signals came mostly from the synovial pannus and the soft tissues surrounding the joint. Spectral analysis detected both venous and arterial waveforms with lower resistance than normal (resistive index ranging 0.65 to 0.76). After local treatment, both venous and low-impedance arterial signals were no longer detectable in 4/9 patients with clinical remission. In conclusion, color-Doppler US can support gray-scale US in the assessment of joint inflammation in rheumatoid arthritis patients. Vascular findings seem to correlate well with local symptoms. Color-Doppler US could make a useful tool for monitoring the clinical activity of the disease in selected joints.

Adult↗

Sonographic characterization of an accessory fissure of the left hepatic lobe determined by omental infolding.

This article describes the sonographic appearance of a very common accessory fissure of the liver located on the inferior side of the left lobe. The fissure was recognized in about 5% of 800 consecutive subjects and showed variable appearance owing to different insertion levels on the inferior hepatic surface. It extended from the left hepatic border to the Rex's recess or alternatively to the falciform ligament or the gallbladder fossa and contained the hepatogastric and hepatoduodenal ligaments, as demonstrated by laparotomy in six cases. At surgery, there was no evidence of thickening of Glisson's capsule at the fissure site, thus suggesting that the fissure is the result of extrinsic remodeling of the left lobe by omental infolding.

Adolescent↗

Value of computerized tomography and ultrasonography in the preoperative diagnosis of renal cell carcinoma extending into the inferior vena cava.

During a 15-year period, 34 patients with renal cell carcinoma extending into the inferior vena cava were submitted to radical ablative surgery at our institution. 8 patients had caval tumor thrombus (TT) extension at the level of the renal veins, 17 had infrahepatic, 8 retrohepatic and 1 atrial TT extension. Cavography, computerized tomography (CT) and ultrasonography (US) were performed preoperatively on 34, 24 and 16 of these 34 patients, respectively. The sensitivity of the techniques used in diagnosing caval involvement was 100, 97 and 87.5% for US, cavography and CT, respectively. The upper limits of TT were clearly detected by US, CT and cavography in 100, 95 and 76% of diagnosed cases, respectively. From this study it appears that US and CT have a sensitivity comparable to cavography in the detection of caval TT. However, US and CT allow a more precise delineation of the upper limits of TT if compared to cavography. This implies that the role of cavography in diagnosing caval TT and its upper limits must be reappraised in light of the progress of noninvasive outpatient procedures.

Adult↗

Spontaneous rupture of renal angiomyolipoma with perinephric haemorrhage: sonographic findings.

The sonographic findings observed in four patients with spontaneous rupture of a renal angiomyolipoma and perinephric haemorrhage are presented. In all cases, a hyperechoic renal mass surrounded by a large hypoechoic haematoma was identified. Furthermore, the actual site of rupture of the tumour could be seen in one case as a wedge-shaped hypoechoic structure extending from the periphery to the centre of the mass. CT has been suggested as the method of choice in the assessment of both the presence and extent of haemorrhagic complications of angiomyolipomas. However, since such lesions can be demonstrated and identified by ultrasound, which is often used as the first imaging procedure in abdominal complaints, the technique may also prove of value in planning further diagnostic tests and in choosing the appropriate therapeutic approach to these patients.

Adult↗