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Biomedical subjects

K M Horton

Publications and source records attributed to K M Horton.

At least 19 recordsLinked to original sources
PubMed2001

Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector ct and three-dimensional CT.

Renal cell carcinoma is the most common primary tumor of the kidney, with more than 30,000 new cases diagnosed in the United States each year. With the widespread use of cross-sectional imaging, many tumors are detected incidentally. Single- and multidetector computed tomography (CT) have helped refine the diagnostic work-up of renal masses by allowing image acquisition in various phases of renal enhancement after intravenous administration of a single bolus of contrast material. The scanning protocol should include unenhanced CT followed by imaging during the corticomedullary and nephrographic phases of enhancement. The nephrographic phase is the most sensitive for tumoral detection, while the corticomedullary phase is essential for imaging the renal veins for possible tumoral extension and the parenchymal organs for potential metastases. Knowledge of the tumoral stage at the time of diagnosis is essential for prognosis and surgical planning. The accuracy of CT for staging has been reported to reach 91%, with most staging errors related to the diagnosis of perinephric extension of tumor. Three-dimensional CT provides the urologist with an interactive road map of the relationships among the tumor, the major vessels, and the collecting system. This information is particularly critical if the tumor extends into the inferior vena cava and if nephron-sparing surgery is being planned.

Carcinoma, Renal Cell↗
PubMed2001

Imaging pancreatic cancer: the role of multidetector CT with three-dimensional CT angiography.

Over the past two decades, there have been significant technical advancements in computed tomography (CT). This has allowed CT to remain the gold standard for the evaluation of pancreatic pathology despite the advent of other imaging modalities, including MRI, PET and endoscopic ultrasound. Initially, CT scanners could only obtain 10-mm-thick slices at a rate of 4 slices per minute. Today, the current state of the art is multidetector CT (MDCT) technology, which allows the entire pancreas to be imaged by 1-mm slices in under 20 s. In addition, these new scanners allow true volume acquisition. The resultant data sets can be displayed not only as axial slices but also as a three-dimensional (3D) volume. The detail of these reconstructions when performed with volume rendering and maximum intensity projection techniques allows a detailed vascular mapping with accuracy that may exceed classic angiography. The use of thin collimation and dual-phase acquisition also improves the detection of hepatic metastasis as well as other sites of extrapancreatic disease. This article reviews the current state of the art of pancreatic imaging with specific emphasis on the use of MDCT, volume acquisitions and 3D arterial- and venous-phase vascular mapping. The advantages of these techniques and their impact on diagnosis and patient management are also addressed.

Angiography↗
PubMed2000

The Internet as a potential source of information about radiological procedures for patients.

The purposes of this study were to determine what percentage of patients in a typical radiology outpatient setting own or have access to a computer with internet capabilities and how many of these patients would find an educational radiology website useful. During a 3-month period, surveys were given to all adult outpatients undergoing computed tomography. The survey asked 4 questions: (1) Do you own a computer?, (2) If you own a computer, does it have Internet access?, (3) If you do not own a computer, do you have access to a computer with Internet capabilities?, and (4) If we provide helpful information regarding preparation for and the conduct of various radiological procedures on the Internet, would you use it? Four hundred surveys were collected. Two hundred one of the respondents (50.3%) owned a computer; 189 of the 201 (94.0%) had Internet access on their computer or had access to another computer with Internet capabilities. One hundred ninety-nine of the 400 respondents (49.8%) did not own a computer, 57 of these (28.6%) had access to a computer and the Internet. Of the 246 of those with Internet access, 205 (83.3%) indicated that they would use a website that provided helpful information regarding radiological examinations. The Internet is an excellent resource for educational information for patients about various radiological procedures. This study showed that 61.5% of patients had access to the Internet, and 83.3% of these would use such a site. It is likely that these numbers will increase with the rapid growth of the Internet and the steadily increasing number of homes with computers.

Adult↗
PubMed2000

Local tumor recurrence following hepatic cryoablation: radiologic-histopathologic correlation in a rabbit model.

PURPOSE: To use radiologic-histopathologic correlation in an animal model to distinguish normal postoperative findings from evidence of residual tumor after cryoablation of malignant hepatic tumors. MATERIALS AND METHODS: Hepatic cryoablation was performed in 12 rabbits with VX2 tumors and in two healthy rabbits. Nonenhanced and dynamic contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging and power and color Doppler flow ultrasonography (US) were performed 7-8 days after cryoablation. Histopathologic findings were correlated with imaging findings. RESULTS: Twenty tumors of 5-20 mm (mean, 10 mm) and seven areas of normal liver were treated with cryolesions of 11-21 mm (mean, 15 mm). All cryolesions exhibited arterial phase rim enhancement at CT and MR imaging, and 13 (57%) of 23 lesions demonstrated peripheral flow at US because of granulation tissue. There was macroscopic recurrence in 15 (75%) of 20 treated tumors; 14 (93%) appeared as peripheral nodularity with low-grade enhancement. Necrotic tissue did not enhance. Intact vessels extended up to 6 mm inside cryolesion margins and caused focal internal enhancement and Doppler flow. Areas of high signal intensity on T2-weighted MR images correlated with liquefaction necrosis, granulation tissue, and tumor. CONCLUSION: In this animal model, recurrent tumor typically appeared as focal nodules at the cryolesion periphery. Rim and central foci of enhancement, Doppler flow, and increased signal intensity on T2-weighted MR images can be normal findings after hepatic cryoablation.

Animals↗
PubMed2000

Experimental transmission of Sarcocystis speeri Dubey and Lindsay, 1999 from the South American opossum (Didelphis albiventris) to the North American opossum (Didelphis virginiana).

Sarcocystis speeri Dubey and Lindsay, 1999 from the South American opossum Didelphis albiventris was successfully transmitted to the North American opossum Didelphis virginiana. Sporocysts from a naturally infected D. albiventris from Argentina were fed to 2 gamma-interferon knockout (KO) mice. The mice were killed 64 and 71 days after sporocyst feeding (DAF). Muscles containing sarcocysts from the KO mouse killed 71 DAF were fed to a captive D. virginiana; this opossum shed sporocysts 11 days after ingesting sarcocysts. Sporocysts from D. virginiana were fed to 9 KO mice and 4 budgerigars (Melopsittacus undulatus). Schizonts, sarcocysts, or both of S. speeri were found in tissues of all 7 KO mice killed 29-85 DAF; 2 mice died 39 and 48 DAF were not necropsied. Sarcocystis stages were not found in tissues of the 4 budgerigars fed S. speeri sporocysts and killed 35 DAE These results indicate that S. speeri is distinct from Sarcocystis falcatula and Sarcocystis neurona, and that S. speeri is present in both D. albiventris and D. virginiana.

Animals↗
PubMed2000

1999 ARRS Executive Council Award. Contrast-enhanced CT of small hypovascular hepatic tumors: effect of lesion enhancement on conspicuity in rabbits. American Roentgen Ray Society.

OBJECTIVE: The purpose of this study was to evaluate the effect of lesion enhancement on the conspicuity of small hypovascular hepatic tumors in an animal model. MATERIALS AND METHODS: Seven VX2 hepatic tumors in five rabbits were imaged. Dynamic contrast-enhanced CT was performed at a single level centered over the lesions at 5-sec intervals for 119 sec after injection of 2 ml/kg i.v. contrast material at 2 ml/sec. Attenuation was measured over time within regions of interest in the tumor and normal liver, aorta, inferior vena cava, and portal vein. Lesion conspicuity, defined as the difference between the attenuation of the uninvolved liver and neoplasm, was calculated. RESULTS: The mean diameter of the tumors on CT was 10 mm (range, 6-15 mm). The tumors appeared as low-attenuation lesions with progressive enhancement during the arterial phase and early portal phase. Peak mean lesion attenuation was 60 +/- 27 H (enhancement, 23 H) at 64 sec. Peak mean lesion conspicuity was 80 +/- 18 H at 39 sec, occurring 10 sec before the peak mean hepatic attenuation of 135 +/- 15 H (enhancement, 67 H) at 49 sec. Relative lesion conspicuity paralleled relative enhancement of the liver throughout the imaging period. CONCLUSION: Although low-level tumor enhancement during the arterial phase and early portal phase reduced the conspicuity of small hypovascular tumors in this animal model, our results support the use of maximum liver enhancement as a marker for peak lesion conspicuity.

Animals↗
PubMed2000

CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment?

OBJECTIVE: The purpose of this study was to determine whether CT can be used to distinguish serous cystadenomas from mucinous cystadenomas or cystadenocarcinomas of the pancreas and play an enhanced role in patient triage and treatment. MATERIALS AND METHODS: A blinded retrospective analysis of CT scans from 50 patients with pathologically proven primary cystic pancreatic neoplasms was performed independently by three radiologists. Using classic CT criteria as reported in the literature, each tumor was categorized as definitely serous, mucinous, or indeterminate. Tumor location, size, presence of calcification, and size of largest cyst were recorded. Data for each reviewer were analyzed independently. Consensus data were then subjected to multivariate logistic regression analysis. RESULTS: The ability of our reviewers to diagnose serous neoplasms ranged from 23% to 41%. Eight mucinous neoplasms were mistaken for serous tumors by two of the three reviewers. When consensus between at least two of the three reviewers was used for diagnosis, 27% of serous neoplasms were correctly diagnosed and all of the mucinous tumors were correctly identified as uncertain or mucinous, yielding the same clinical end point. For multivariate logistic regression analysis, a cyst smaller than 2 cm had a statistically significant association (p = 0.005) with serous tumors, and the presence of peripheral tumoral calcification had a statistically significant association (p = 0.01) with mucinous tumors. CONCLUSION: There is significant variability in the CT appearance of serous and mucinous neoplasms of the pancreas, making CT an insensitive tool for differentiating these tumors. All tumors with peripheral calcifications were identified as mucinous neoplasms.

Adult↗
PubMed1999

Development of Sarcocystis falcatula in cell cultures demonstrates that it is different from Sarcocystis neurona.

The development of Sarcocystis falcatula merozoites in bovine turbinate (BT) cell cultures is described and compared with development of Sarcocystis neurona merozoites. Merozoites of S. falcatula entered BT cell cultures and increased in size until 3 days post-inoculation when the nucleus of some merozoites developed lobes. Developing schizonts present at 4 days contained a lobed nucleus or appeared multinucleate. A single mature schizont was observed 4 days p.i. Schizonts were numerous 5 and 6 days p.i. Merozoites were produced from blastophores on the schizont. S. neurona merozoites developed to mature schizonts by 3 days p.i. in BT cells and a residual body was often present. Transmission electron microscopy revealed that S. falcatula merozoites possessed more micronemes than did S. neurona merozoites. Our study demonstrates that S. falcatula and S. neurona are not the same parasite.

Animals↗