PubMed Health⌕ Search

Biomedical subjects

C Le Rest

Publications and source records attributed to C Le Rest.

9 recordsLinked to original sources
PubMed2001

Functional imaging of malignant paragangliomas and carcinoid tumours.

Complete staging is mandatory for the management and therapy of neuroendocrine tumours. Various radiotracers are available but the best imaging strategy has yet to be defined. In this study we retrospectively compared 123I-MIBG, 111In-[D-Phe1]-DTPA-octreotide and 18F-FDG (PET) imaging in 15 patients with metastatic neuroendocrine tumours (11 carcinoid tumours, 4 paragangliomas). Planar images were acquired 1, 4, 24 and 48 h following the injection of 111In-[D-Phe1]-DTPA-octreotide and 123I-MIBG. Whole-body PET scans were performed 45 min after injection of 18F-FDG. 111In-[D-Phe1]-DTPA-octreotide was positive in 11/15 patients and identified 44 lesions, 18F-FDG PET was positive in 11/15 patients and identified 107 lesions and 123I-MIBG was positive in 8/15 patients and identified 67 lesions. No single scintigraphic technique identified all metastatic sites. In one patient all studies were negative. 18F-FDG PET identified more abnormal sites than the other two modalities. Combination of all three imaging modalities with X-ray CT helps to provide a more comprehensive map of the disease.

3-Iodobenzylguanidine↗
PubMed2001

Post-synchronized scintigraphic data to estimate antral motility.

We evaluated an improved dynamic antral scintigraphy (DAS) technique, without any frequency filtering or computation of an autocorrelation function. This DAS was performed in 15 consecutive patients and 10 healthy volunteers. Antral frequency was first estimated and was given as an input parameter to compute phase and amplitude values in each antral pixel. Motility indices were calculated by multiplying the frequency by a normalized amplitude in the whole antrum. In addition, a gastric emptying (GE) test was performed. Only 10 patients had a delayed GE when using a cut-off value of the mean of half emptying time (T +2SD) obtained in controls. Antral frequencies were significantly increased but motility indices were significantly lower in patients than in controls. These results in patients were accounted for by a retention of food in the antrum. Therefore, amplitude normalization by the antral mean count activity of each set of data was essential for discriminating between patients and controls and normalized indices appeared early predictors of hypomotility in patients with normal GE. This improved DAS technique should be a useful tool to assess antral dysmotility noninvasively, and may be of physiological and clinical interest.

Adult↗
PubMed2000

Gastric emptying of solids: estimates of lag phase and constant emptying times.

There is no consensus regarding the best way to estimate the lag phase time (Tlag) and the constant emptying time (TRE) of the gastric emptying of solids. Furthermore, biphasic gastric emptying is usually described by the modified power exponential function of either Elashoff or Siegel. In an attempt to test the validity of the power exponential functions and to identify relevant parameters of biphasic gastric emptying, we followed an approach which consists of describing the power exponential function by two straight lines. The first line is horizontal and represents Tlag. The second line is tangential to the constant emptying [tangent at the maximum slope (MS) or at the half-emptying value]. Scintigraphic data of 132 patients and 15 controls were fitted by both power exponential functions. Each corresponding half-emptying time, Tlag and TRE estimated from the Elashof and Siegel power exponential functions were strongly correlated (0.93 < r < 1, P < 0.0001). The Bland and Altman statistical method demonstrated good agreement (<5% outliers). The half-emptying tangent method sometimes gave negative Tlag and should be abandoned. Tlag(MS) and TRE(MS) did not correlate and therefore were independent parameters. We conclude that the Elashoff and Siegel functions are equivalent and that the maximum slope tangent method allows a reliable description of the two independent phases of gastric emptying.

Adult↗
PubMed2000

Post-synchronization of dynamic images of periodically moving organs.

The motion of periodically moving organs can be studied by acquisition of dynamic image series. When time is short, it is necessary either to find a sync signal to sum synchronous images in real time or to acquire a regular time series and to synchronize a posteriori. Dynamic acquisitions were performed (gastric and lung studies). The activity in each pixel of the moving organ can be expressed as h(t)=a0 + a1 cos(omegao0t - phi). The time-activity curve u(t) over a region of interest (ROI) of the considered organ was computed. When the ROI is well chosen, the power spectrum of u(t) exhibits a sharp peak near the characteristic frequency of the periodic motion. The DC component, amplitude and phase in each pixel can be then estimated by minimizing the following function: J=sigma[h(t) - g(t)]2, where g(t) is a noisy measurement of h(t). It is then easy to reconstruct an a posteriori gated time series by computing h(t) for various times over a single period. This approach was successful in characterizing lung and gastric motions. Dynamic series were acquired as for gastric emptying studies. The characteristic frequency of antral motility was easily and unambiguously estimated and DC, amplitude and phase images were computed. Dynamic pulmonary functional imaging was performed with 81Krm. The characteristic frequency was also easily estimated from the time-activity curve power spectrum using a ROI drawn over the lower part of the lungs. The DC, amplitude and phase images were then computed from the dynamic series and the characteristic frequency. In conclusion, a posteriori gating of dynamic series of periodically moving organs can be achieved in a simple fashion. This approach overcomes the difficulty of direct analysis of time-activity curves and provides amplitude and phase images.

Algorithms↗
PubMed2000

Three-dimensional attenuation map reconstruction using geometrical models and free-form deformations.

We address the issue of using deformable models to reconstruct an unknown attenuation map of the torso from a set of transmission scans. We assume the three-dimensional (3-D) distribution of attenuation coefficients to be piecewise uniform. We represent the unknown distribution by a set of closed surfaces defining regions having the same attenuating properties. The methods of reconstruction published so far tend to directly deform the surfaces, the parameters being the surface elements. Rather than deforming the surfaces, we explore the possibility of deforming the space in which the geometrical primitives are contained. We focus on the use of free-form deformations (FFD's) to describe the continuous transformation of space used to match a set of transmission measurements. We illustrate this approach by reconstructing realistically simulated transmission scans of the torso with various noise levels and compare the results to standard reconstruction methods.

Algorithms↗
PubMed1999

Determination of age at death: assessment of an algorithm of age prediction using numerical three-dimensional CT data from pubic bones.

The determination of age at death is an important part of physical and forensic anthropology. Because of resistance to decomposition and the simplicity/accuracy ratio, the direct observation of the os pubis by Suchey-Brooks phase analysis is the preferred reference system for determination of age at death. We propose an age-prediction system using a pubic symphysis numerical database obtained from CT x-ray through quantification of age-linked parameters. Our system increases the accuracy of age estimation and at the same time preserves the integrity of the archeological material.

Adult↗
PubMedDate not supplied

Use of left ventricular pacing in heart failure: evaluation by gated blood pool imaging.

BACKGROUND: Left ventricular (LV) pacing has been suggested to complement other forms of therapy in patients with heart failure. METHODS AND RESULTS: We investigated 17 patients (15 men, 2 women, aged 68 +/- 6 years, 10 ischemic and 7 primary dilated cardiomyopathy) with heart failure (13 were in New York Heart Association class IV and 4 in class III). One month after LV pacer implantation, 12 patients reported clinical improvement (mean class 3.7 before pacing vs 2.6 with LV pacing; P = .001). We report the results of 3 equilibrium-gated blood pool studies performed in each patient, 1 before pacing and 2 after pacer implantation (1 with pacing on, and 1 after turning off the pacer). LV pacing did not modify LV ejection fraction. Phase analysis demonstrated a significant decrease of the interventricular phase shift (delta(pi)) with LV pacing (no pacing, delta(pi) = 8.99 degrees +/- 19.05 degrees; delta7n= -0.97 degrees +/- 27.85 degrees with LV pacing). Clinical improvement was observed in patients with an initial positive delta(pi) that decreased with pacing and/or an initial LV phase standard deviation >50 degrees that decreased with pacing. CONCLUSION: LV pacing induces interventricular and intraventricular synchronization. A decrease of the interventricular phase shift seems to be the most important predictor of functional recovery for paced patients with heart failure.

Aged↗