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Biomedical subjects

Joerg Barkhausen

Publications and source records attributed to Joerg Barkhausen.

8 recordsLinked to original sources

Diagnostic accuracy of colorectal cancer staging with whole-body PET/CT colonography.

CONTEXT: Staging of patients with colorectal cancer often requires a multimodality, multistep imaging approach. Colonography composed of a combined modality of positron emission tomography (PET) and computed tomography (CT) provides whole-body tumor staging in a single session. OBJECTIVES: To determine the staging accuracy of whole-body PET/CT colonography compared with the staging accuracies of CT followed by PET (CT + PET) and CT alone and to evaluate the effect of PET/CT colonography on therapy planning compared with conventional staging (CT of the abdomen and thorax and optical colonoscopy). DESIGN, SETTING, AND PATIENTS: Prospective study of 47 patients enrolled between May 2004 and June 2006 with clinical findings and optical colonoscopy that suggested primary colorectal cancer (mean [SD] age, 71 [11] years; range, 47-92 years). Patients underwent whole-body PET/CT colonography 1 day after colonoscopy. The study was conducted at a university hospital with a mean (SD) follow-up of 447 (140) days (range, 232-653 days). MAIN OUTCOME MEASURES: Correct classification of overall TNM stage using PET/CT colonography compared with CT + PET and CT alone. Secondary outcome measures were the accurate assessment of T-stage, N-stage, and M-stage by PET/CT colonography compared with CT + PET and CT alone and the effect of PET/CT colonography on therapy planning. RESULTS: Of the 47 patients with a total of 50 lesions, the overall TNM stage was correctly determined for 37 lesions with PET/CT colonography (74%; 95% confidence interval [CI], 60%-85%), 32 lesions with CT + PET (64%; 95% CI, 49%-77%), and 26 lesions with CT alone with a 0.7-cm node threshold (52%; 95% CI, 37%-66%). Compared with optimized abdominal CT staging alone, PET/CT colonography was significantly more accurate in defining TNM stage (difference, 22%; 95% CI, 9%-36%; P=.003), which was mainly based on a more accurate definition of the T-stage. Differences were not detected for defining N-stage between PET/CT colonography and CT alone with a threshold of 0.7 cm for malignant nodes but were detected with a threshold of 1 cm. Differences were not detected in defining M-stage separately or when comparing the accuracies of PET/CT colonography with CT + PET. PET/CT colonography affected consecutive therapy decisions in 4 patients (9%; 95% CI, 2.4%-20.4%) compared with conventional staging (CT alone and colonoscopy). CONCLUSIONS: In this preliminary study, PET/CT colonography is at least equivalent to CT + PET for tumor staging in patients with colorectal cancer. Thus, PET/CT colonography in conjunction with optical colonoscopy may be a suitable concept of tumor staging for patients with colorectal cancer.

Aged↗

High-resolution continuously acquired peripheral MR angiography featuring partial parallel imaging GRAPPA.

Continuously-moving-table MRI, in contrast to traditional multistation techniques, potentially can improve the scan time efficiency of whole-body applications and provide seamless images of an extended field of view (FOV). Contrast-enhanced MR angiography (CE-MRA) in particular requires high spatial resolution and at the same time has rigid scan time constraints due to the limited arterial contrast window. In this study a reconstruction method for continuously acquired 3D data sets during table movement was combined with a self-calibrated partial parallel imaging algorithm (generalized autocalibrating partially parallel acquisitions (GRAPPA)). The method was applied to peripheral CE-MRA and compared with a standard continuously-moving-table MRA protocol. The gain in scan time was used to increase the data acquisition matrix and decrease the slice thickness. The method was evaluated in five healthy volunteers and applied to one patient with peripheral arterial occlusive disease (PAOD). The protocols were intraindividually compared with respect to the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in selected vessel segments, as well as overall vessel depiction. The combination of the continuously-moving-table technique with parallel imaging enabled the acquisition of seamless peripheral 3D MRA with increased resolution and an overall crisper appearance.

Algorithms↗

Detection of coronary stenoses with contrast enhanced, three-dimensional free breathing coronary MR angiography using the gadolinium-based intravascular contrast agent gadocoletic acid (B-22956).

PURPOSE: To determine the diagnostic value of the intravascular contrast agent gadocoletic acid (B-22956) in three-dimensional, free breathing coronary magnetic resonance angiography (MRA) for stenosis detection in patients with suspected or known coronary artery disease. METHODS: Eighteen patients underwent three-dimensional, free breathing coronary MRA of the left and right coronary system before and after intravenous application of a single dose of gadocoletic acid (B-22956) using three different dose regimens (group A 0.050 mmol/kg; group B 0.075 mmol/kg; group C 0.100 mmol/kg). Precontrast scanning followed a coronary MRA standard non-contrast T2 preparation/turbo-gradient echo sequence (T2Prep); for postcontrast scanning an inversion-recovery gradient echo sequence was used (real-time navigator correction for both scans). In pre- and postcontrast scans quantitative analysis of coronary MRA data was performed to determine the number of visible side branches, vessel length and vessel sharpness of each of the three coronary arteries (LAD, LCX, RCA). The number of assessable coronary artery segments was determined to calculate sensitivity and specificity for detection of stenosis > or = 50% on a segment-to-segment basis (16-segment-model) in pre- and postcontrast scans with x-ray coronary angiography as the standard of reference. RESULTS: Dose group B (0.075 mmol/kg) was preferable with regard to improvement of MR angiographic parameters: in postcontrast scans all MR angiographic parameters increased significantly except for the number of visible side branches of the left circumflex artery. In addition, assessability of coronary artery segments significantly improved postcontrast in this dose group (67 versus 88%, p < 0.01). Diagnostic performance (sensitivity, specificity, accuracy) was 83, 77 and 78% for precontrast and 86, 95 and 94% for postcontrast scans. CONCLUSIONS: The use of gadocoletic acid (B-22956) results in an improvement of MR angiographic parameters, asssessability of coronary segments and detection of coronary stenoses > or = 50%.

Aged↗

Hydro-MRI of the small bowel: effect of contrast volume, timing of contrast administration, and data acquisition on bowel distention.

OBJECTIVE: The purpose of this study was to assess oral contrast agents, volumes of the agents, and time points of data acquisition in regard to small-bowel distention and patient acceptance. SUBJECTS AND METHODS: Six healthy volunteers underwent imaging on 16 different days. Four volumes (450, 900, 1,350, and 1,800 mL) of each of the four contrast compounds (0.2% locust bean gum plus 2.5% mannitol, VoLumen containing 2.0% sorbitol, VoLumen containing 1.4% sorbitol, and tap water) were used. Two-dimensional true fast imaging with steady-state free precession data sets were acquired at 5-minute intervals after contrast ingestion. Distention values for small-bowel segments (duodenum, proximal and distal jejunum, ileum) and occurrence of side effects were documented. RESULTS: Analysis of bowel distention revealed significantly greater distention for all carbohydrate sugar alcohol-containing solutions compared with water but no significant difference among the three contrast agents. Sufficient duodenal distention was achieved with 900 mL of any of the contrast agents, but imaging had to be performed soon after ingestion. For MRI of the distal jejunum and ileum, a volume of 1,350 mL is preferable, and the time point of data acquisition plays a minor role. Ingestion of 1,800 mL of the carbohydrate sugar alcohol solutions led to a significantly higher rate of side effects such as abdominal cramps than did ingestion of smaller volumes. CONCLUSION: The data indicate that sufficient contrast consumption and optimal timing of data acquisition are essential to distention of the small bowel. Oral contrast agent protocols should be adapted to the bowel region in question.

Administration, Oral↗

Whole-body magnetic resonance imaging featuring moving table continuous data acquisition with high-precision position feedback.

A novel setup for whole-body MR imaging with moving table continuous data acquisition has been developed and evaluated. The setup features a manually positioned moving table platform with integrated phased-array surface radiofrequency coils. A high-precision laser position sensor was integrated into the system to provide real-time positional data that were used to compensate for nonlinear manual table translation. This setup enables continuous 2D and 3D whole-body data acquisition during table movement with surface coil image quality. The concept has been successfully evaluated with whole-body steady-state free precession (TrueFISP) anatomic imaging in five healthy volunteers. Seamless coronal and sagittal slices of continually acquired whole-body data during table movement were accurately reconstructed. The proposed strategy is potentially useful for a variety of applications, including whole-body metastasis screening, whole-body MR angiography, large field-of-view imaging in short bore systems, and for moving table applications during MR-guided interventions.

Algorithms↗

Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography.

BACKGROUND: Left ventricular (LV) volume-time curves (VTC) have been described to provide quantitative data on the dynamics of global LV performance beyond ejection fraction. However, generation of VTCs by conventional 2-dimensional imaging techniques is inherently limited because of inaccurate geometric volume assumptions. We, therefore, studied whether the new concept of volumetric scanning as realized by real-time 3-dimensional echocardiography (RT-3DE) can be used to provide accurate VTCs. METHODS: In 30 healthy participants, VTCs were generated from 18 to 24 absolute LV volumes per second by transthoracic RT-3DE and compared with magnetic resonance imaging (MRI) used for reference. LVs were traced manually in 9 to 11 parallel, short-axis planes and volumes calculated by disk method. From VTCs, we determined peak ejection rate (PER), peak early filling rate (PFR), time to PER and PFR, and end-diastolic and end-systolic volumes. For initial clinical application, 2 patient groups of coronary (n = 15) and hypertensive heart disease (n = 16) were studied. RESULTS: In healthy participants, VTCs agreed with MRI (mean errors: PER, -39 +/- 67 mL/s; PFR, -18 +/- 84 mL/s; time to PER, 8 +/- 21 milliseconds; time to PFR 4 +/- 18 milliseconds [not significant vs 0]) whereas VTCs in coronary and hypertensive groups revealed significantly impaired diastolic function. Scanning time for VTCs was only 1 to 2 minutes by RT-3DE and 8 +/- 2 minutes by MRI (P <.001) and time for offline analysis was 22 +/- 5 minutes versus 24 +/- 4 minutes by MRI (not significant). CONCLUSIONS: Generation of VTCs by RT-3DE is feasible and shows excellent agreement with MRI used for reference. Thus, VTCs by RT-3DE is a promising new approach providing access to quantitative information on global LV performance such as LV filling rates that is currently unavailable for the cardiologist.

Adult↗