PubMed Health⌕ Search

Biomedical subjects

Jörg van den Hoff

Publications and source records attributed to Jörg van den Hoff.

8 recordsLinked to original sources

Optimized list-mode acquisition and data processing procedures for ACS2 based PET systems.

PET systems using the acquisition control system version 2 (ACS2), e.g. the ECAT Exact HR PET scanner series, offer a rather restricted list-mode functionality. For instance, typical transfers of acquisition data consume a considerable amount of time. This represents a severe obstacle to the utilization of potential advantages of list-mode acquisition. In our study, we have developed hardware and software solutions which do not only allow for the integration of list-mode into routine procedures, but also improve the overall runtime stability of the system. We show that our methods are able to speed up the transfer of the acquired data to the image reconstruction and processing workstations by a factor of up to 140. We discuss how this improvement allows for the integration of list-mode-based post-processing methods such as an event-driven movement correction into the data processing environment, and how list-mode is able to improve the overall flexibility of PET investigations in general. Furthermore, we show that our methods are also attractive for conventional histogram-mode acquisition, due to the improved stability of the ACS2 system.

Equipment Design↗

Regional differences in cerebral blood flow and cerebral ammonia metabolism in patients with cirrhosis.

Clinical and histopathological findings hint at regional differences in the brain's sensitivity to metabolic changes in cirrhosis. The aim of the present study was to examine regional differences in cerebral ammonia metabolism in patients with cirrhosis and grade 0-to-I hepatic encephalopathy (HE). (13)N-ammonia, (15)O-water positron emission tomography (PET) and magnetic resonance imaging (MRI) were performed. Quantitative values of cerebral blood flow (CBF) and the initial cerebral ammonia uptake rate (K1) were derived for several regions of interest from images of the desired parameters after interactive coregistration with the patients' MRI-studies. CBF (mL/mL/min), K1 (mL/mL/min), and the ammonia extraction fraction (K1/CBF) showed marked regional variance with the highest levels in the thalamus, the lenticular nucleus, and the cerebellum. In conclusion, the regional differences in cerebral ammonia uptake correspond to the distribution of histopathological changes in the brain of patients with cirrhosis as well as clinical features of HE, characterized by signs of basal ganglia and cerebellar dysfunction with corresponding signs of functional impairment, especially of the frontal cortex and cingulate gyrus.

Adult↗

Functional imaging of the brain in patients with liver cirrhosis.

Brain imaging techniques have provided substantial insight into the pathophysiology of hepatic encephalopathy (HE). Magnetic resonance imaging gave hint to the fact that there is an increased deposition of manganese especially in the basal ganglia. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) showed that the preference of the basal ganglia might be due to differences in regional cerebral blood flow and an additional redistribution of blood flow from the cortex to subcortical regions in cirrhotics. PET studies using ammonia as tracer showed that the cerebral metabolism of ammonia and the permeability of the blood brain barrier for ammonia is increased in cirrhotic patients compared to healthy controls. The regional ammonia supply is in accordance with the regional blood flow. In accordance with these findings fluorodesoxyglucose-PET-studies of the brain in cirrhotics showed characteristic alterations of glucose utilisation in the patients with a relative decrease of the glucose utilisation of the cingulate gyrus, the frontomedial, frontolateral, and parieto-occipital cortex, while the glucose utilisation of the basal ganglia, the hippocampus, and the cerebellum was relatively increased. These findings fit well with the clinical characteristics of early stages of HE such as deficits in attention, visuo-spatial orientation, visuo-constructive abilities, motor speed, and accuracy.

Ammonia↗

An accurate method for correction of head movement in PET.

A method is presented to correct positron emission tomography (PET) data for head motion during data acquisition. The method is based on simultaneous acquisition of PET data in list mode and monitoring of the patient's head movements with a motion tracking system. According to the measured head motion, the line of response (LOR) of each single detected PET event is spatially transformed, resulting in a spatially fully corrected data set. The basic algorithm for spatial transformation of LORs is based on a number of assumptions which can lead to spatial artifacts and quantitative inaccuracies in the resulting images. These deficiencies are discussed, demonstrated and methods for improvement are presented. Using different kinds of phantoms the validity and accuracy of the correction method is tested and its applicability to human studies is demonstrated as well.

Algorithms↗

Improved statistical power of the multilinear reference tissue approach to the quantification of neuroreceptor ligand binding by regularization.

A multilinear reference tissue approach has been widely used recently for the assessment of neuroreceptor-ligand interactions with positron emission tomography. The authors analyzed this "multilinear method" with respect to its sensitivity to statistical noise, and propose regularization procedures that reduce the effects of statistical noise. Computer simulations and singular value decomposition of its operational equation were used to investigate the sensitivity of the multilinear method to statistical noise. Regularization was performed by truncated singular value decomposition, Tikhonov-Phillips regularization, and by imposing boundary constraints on the rate constants. There was a significant underestimation of distribution volume ratios. Singular value decomposition showed that the bias was caused by statistical noise. The regularization procedures significantly increased the test-retest stability. The bias could be reduced by applying linear constraints on the rate constants based on their normal range. Underestimation of distribution volume ratios by the multilinear method is caused by its sensitivity to statistical noise. Statistical power in the discrimination of different groups of subjects can be significantly improved by regularization procedures without introducing additional bias. Correct distribution volume ratios can be obtained by imposing physiologic constraints on the rate constants.

Brain Chemistry↗

[N-methyl 11C]meta-Hydroxyephedrine positron emission tomography in Parkinson's disease and multiple system atrophy.

Orthostatic hypotension (OH) can be present in idiopathic Parkinson's disease (IPD) as well as in atypical parkinsonian syndromes such as multiple system atrophy (MSA). According to clinical tests of sympathetic nerve function and histopathological data, OH is caused by primarily postganglionic sympathetic dysfunction in IPD and by predominantly central and preganglionic degeneration in MSA. It has been proposed that this concept of a different underlying pathogenesis for OH should be applied in the differential diagnosis of parkinsonian disorders, in the form of measurements of sympathetic myocardial innervation. In this pilot study, myocardial imaging with [ N-methyl (11)C]meta-hydroxyephedrine ((11)C-HED) and positron emission tomography (PET) was used as a quantitative tool to evaluate the feasibility of such an approach. Seven patients were included in the study. Two had MSA and OH, three had probable IPD and OH (duration of disease, >3 years), one had probable IPD without OH (disease duration, 3 years) and one had possible IPD without OH (disease duration, 2 years). Ratios of maximal (11)C-HED uptake in the myocardium to that in the liver at 5 and 40 min post injection (p.i.) and - based on kinetic modelling - tracer influx rates K(1) were calculated. Compared with MSA patients ( n=2), IPD patients with OH ( n=3) showed definitely lower uptake ratios at both 5 min p.i. (0.39-0.57 vs 0.78-0.79) and 40 min p.i. (0.21-0.60 vs 0.89-1.06), as well as lower K(1) values (0.198-0.359 vs 0.384-0.450 min(-1)). The patient with probable IPD without OH showed intermediate values (uptake ratio at 5 min: 0.65; uptake ratio at 40 min: 0.87; K(1)=0.363). In the patient with possible IPD, values (uptake ratio at 5 min: 0.96; uptake ratio at 40 min: 1.04; K(1)=0.400) did not differ from those observed in MSA. These results support the hypothesis that measurement of myocardial innervation may contribute to the differential diagnosis of parkinsonian disorders and suggest a need for quantitative pathophysiological imaging, particularly at early stages of disease.

Carbon Radioisotopes↗

Use of positron emission tomography for the assessment of skeletal muscle glucose metabolism.

Positron emission tomography (PET) is a unique tool for studying regional skeletal muscle glucose metabolism and blood flow in vivo. The application of PET in the assessment of skeletal muscle glucose metabolism depends on recent improvements in instrumentation, data analysis, and production of (18)F-fluorodeoxyglucose (FDG) and (15)O water. The data presented support the validity of the (15)O water model to measure blood flow and the FDG model for the determination of glucose uptake and glucose kinetic constants (influx, efflux, and phosphorylation) in skeletal muscle. However, quantification of absolute glucose transport and backflux rates should be applied with caution because those calculations are based on unproven assumptions such as validity of the lumped constant for these individual processes and constancy of the free and accessible intracellular glucose pool. It is evident that quantification of glucose fluxes using the triple tracer technology generates conflicting data that violate assumptions inherent in triple tracer or PET modeling. Further FDG-PET studies will have to solve those problems to provide more insight into the regulatory processes of glucose transport and phosphorylation of different insulin-resistant disease states. Promising new areas of PET research will include not only detailed study of glucose kinetics but also the measurement of muscle protein synthesis in vivo, which is of interest in a variety of conditions.

Glucose↗

Accurate determination of metabolic rates from dynamic positron emission tomography data with very-low temporal resolution.

PURPOSE: The graphical approach is widely used for the pixelwise determination of local metabolic rate of glucose from dynamic positron emission tomography (PET) data. In its conventional implementation, measured integrals over time frames are used to approximate instantaneous tracer concentrations at midframe times ("midframe approach"). This is justified in case of high temporal resolution of the PET measurement; that is, if scan protocols with a large number of short frames are used. This requires fast data handling and large amounts of memory. Cardiac gating and three-dimensional (3D) acquisition of dynamic studies is hardly possible with this approach. Therefore, a new variant of the graphical method is proposed which can be used with a very low number of rather long frames. METHODS: An operational equation of the graphical method was derived which uses measured time integrals only and, thus, avoids the systematic errors of the midframe approximation. This "integral approach" was evaluated in computer simulations based on experimental data. RESULTS: The integral approach enables the use of protocols with 3 frames only without compromising accuracy of the derived metabolic rates whereas the midframe approach leads to bias of about 10% to 20% for these protocols. Furthermore, test-retest stability can significantly be improved when using the integral approach. CONCLUSION: The integral approach to the graphical evaluation of dynamic PET data yields accurate and precise results using scan protocols with down to only 3 frames. This can be relevant to gating and/or 3D acquisition of dynamic studies. The integral approach is applied most naturally whenever the input function is derived from the dynamic PET data.

Brain↗