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Biomedical subjects

M E Bellemann

Publications and source records attributed to M E Bellemann.

At least 37 records · Page 2Linked to original sources

Direct detection of intratumoral 5-fluorouracil trapping using metabolic 19F MR imaging.

The effective use of 5-fluorouracil (5-FU) in cancer therapy requires the noninvasive assessment of its transport, metabolism, and retention ("trapping") in the different tissues of the organism, particularly in the tumor. We used a chemical-shift selective 19F magnetic resonance (MR) imaging technique to map selectively 5-FU and its major catabolite alpha-fluoro-beta-alanine (FBAL) in six ACI rats bearing Morris hepatoma. After i.v. administration of 200 mg/kg-bw 5-FU, three metabolic MR maps were acquired consecutively in each animal: 1) an early 5-FU image (5-37 min post-injection (p.i.); dominant Fourier line, 8 min p.i.) characterizing the early uptake of 5-FU into the various tissues; 2) an FBAL image (40-72 min p.i.; dominant Fourier line, 56 min p.i.) reflecting the catabolism of the drug; and 3) a late 5-FU image (75-107 min p.i.; dominant Fourier line, 78 min p.i.) to assess the retention of unmetabolized 5-FU and its MR-visible anabolites. In the early 5-FU maps, the drug was detected in all major organs (e.g., heart, liver, kidneys) as well as in the muscular system. The FBAL maps showed no FBAL accumulation in the hepatoma which reveals that the tumor cells have lost hepatocellular functions relevant for 5-FU catabolism. On the late 5-FU maps, a significant amount of 5-FU was detected in only one of the six Morris hepatomas. The observation in this rat verifies directly that 5-FU can be trapped in solid tumors. The images, moreover, emphasize the necessity of acquiring spatially-resolved MR data to detect metabolic tumor heterogeneity.

Animals↗

Subsets and overrelaxation in iterative image reconstruction.

A number of iterative image reconstruction algorithms were integrated into one formula characterizing each algorithm by only two parameters: overrelaxation and number of subsets. From the formula it follows that the ordered-subsets iteration (OS-EM) is equivalent to iteration with overrelaxation, where the OS level corresponds to the overrelaxation parameter. Algorithms represented by the formula were studied with respect to speed of convergence and image characteristics. In particular, OS-EM was compared with a single-projection iteration procedure using an optimized sequence of overrelaxation parameters (HOSP) which combines rapid convergence with reduced storage requirements. As a result, OS-EM with a constant number of subsets either needed more iteration steps than HOSP or provoked additional noise, depending on the number of subsets used during iteration. OS-EM can be improved by using decreasing OS levels, imitating the decreasing overrelaxation parameters used for HOSP. The resulting OS-EM may be slightly more rapid than HOSP, due to the increasing number of projections used simultaneously.

Algorithms↗

Noninvasive determination of the arterial input function of an anticancer drug from dynamic PET scans using the population approach.

For the application of a kinetic model to PET data, it is generally necessary to obtain the arterial input function (AIF). It was the aim of the present study to introduce a method suitable for the determination of the AIF of a substance that undergoes biochemical transformation from noisy PET data: the population approach. F-18 labeled 5-fluorouracil (5-[18F]FU) was administered i.v. to eight patients suffering from liver metastases of colorectal carcinoma. Radioactivity concentrations in liver and aorta were dynamically measured with PET over 120 min. Pharmacokinetic analysis was carried out by applying a five-compartment model to individual activity-time data for the eight patients or to the mean activity-time data among the eight patients. The mean values of all parameters describing 5-FU transport and catabolism, i.e., volumes of distribution and clearances, as well as interindividual coefficients of variation (CV) were calculated according to both approaches. With our model, we were able to separate the concentration-time course of 5-FU in plasma, i.e., the AIF, from that of its major catabolite alpha-fluoro-beta-alanine (FBAL). As far as the mean parameter estimates are concerned, the differences between both approaches are not significant. For the liver data, the CV's are almost the same for both approaches. For the parameters concerning the aorta, however, there is a decrease in the CV's by using the population approach. For example, the CV of the central distribution volume of 5-FU was 30% for the individual approach and 18% for the population approach. With the population approach, it is possible to determine the AIF of drugs that undergo metabolic conversion, such as anticancer drugs, from the abdominal aorta visualized on PET images. The population approach helps to overcome noise in individual data. Since no measurements are needed in addition to the PET examination, the suggested method helps to reduce risk and pain for the patients as well as cost and thus facilitates large scale patient studies.

Adenocarcinoma↗

[Reduction of radiation exposure in PET examinations by data acquisition in the 3D mode].

AIM: Modern volume PET systems offer the possibility to measure without the shadowing effect of interplane septa (2D mode) and thus to detect coincident events between detectors on distant rings (3D mode). It was the aim of the present paper to characterize the count rate behaviour of a latest-generation whole-body PET system in the 2D and 3D mode as well as to discuss the consequences for the radiation hygiene of PET examinations with 2-[F-18]-fluoro-2-deoxyglucose (18-F-FDG). METHODS: All experiments were performed with the PET system ECAT EXACT HR+. For 2D data acquisition, a collimator of thin tungsten septa was positioned in the field-of-view. The count rate behaviour of the scanner was evaluated in the 2D and 3D mode over a wide range of F-18 activity concentrations following the NEMA protocol. Moreover, PET images of the EEC whole-body phantom with different inserts were acquired in the 2D and 3D mode over a period of 15 min each. For the 3D measurement, the activity concentrations of the F-18 solution were only half of those used for the 2D measurement. RESULTS: For the circular NEMA phantom (phi = 19.4 cm, length = 19.0 cm), we observed an increase of the system sensitivity in the 3D mode by a factor of about 5 with respect to the 2D mode (27.7 vs. 5.7 cps/Bq/ml). The evaluation of the activity distributions of the EEC phantom reconstructed from the 3D data set revealed a superior image quality compared to the corresponding 2D images despite the fact that the activity concentrations were only half as high. CONCLUSIONS: By using the 3D data acquisition mode, it is possible to markedly reduce the amount of activity to be applied to the patient and nevertheless to improve image quality. In our experience, it is sufficient to administer an activity of 150-200 MBq for whole-body examinations with F-18-FDG, which results in an effective equivalent dose of 3 or 4 mSv, respectively.

Environmental Exposure↗

Functional magnetic resonance imaging of category-specific cortical activation: evidence for semantic maps.

Functional magnetic resonance imaging (fMRI) was used to examine the pattern of cortical activity during a picture naming task. Subjects (n=12) had to covertly name either animals or furniture items. Functional scanning was performed using a conventional 1.5-Tesla whole-body MRI system. Images obtained during naming the two categories were compared using a non-parametric test. The study revealed evidence for domain-specific lexical regions in left middle, right middle and inferior frontal areas, as well as in superior and middle temporal areas. The results corroborate neuropsychological data and demonstrate directly and non-invasively in human volunteers that semantic representations in frontal and temporal areas are, to some degree, localized and possibly implemented as multiple maps. A completely distributed storage of semantic information is rendered unlikely.

Adult↗

Uncoupling of 2-fluoro-2-deoxyglucose transport and phosphorylation in rat hepatoma during gene therapy with HSV thymidine kinase.

This animal study investigates the application of positron emission tomography (PET) with tracers of tumour metabolism for monitoring suicide gene therapy with herpes simplex virus thymidine kinase (HSVtk). After transplantation of HSVtk-expressing Morris hepatoma cells into ACI rats, dynamic PET measurements of 18F-labeled 2-fluoro-2-deoxyglucose (FDG) uptake were performed in animals 2 days (n = 7) and 4 days (n = 5) after the onset of therapy with 100 mg ganciclovir (GCV)/kg body weight as well as after administration of sodium chloride (n = 8). The arterial FDG plasma concentration was measured dynamically in an extracorporeal loop and the rate constants for FDG transport (K1, k2) and FDG phosphorylation (k3) were calculated using a three-compartment model modified for heterogeneous tissues. Also, quantification using the metabolic rate of FDG turnover and the standardized uptake value (SUV) was done. Furthermore, the thymidine incorporation into the tumour DNA was determined after i.v. administration of 3H-thymidine. An uncoupling of FDG transport and phosphorylation was found with enhanced K1 and k2 values and a normal k3 after 2 days of GCV treatment. The increase in FDG transport normalized after 4 days whereas the phosphorylation rate k3 increased. Quantification using the metabolic rate or the SUV showed congruent but less sensitive results compared with the modeling approach. The thymidine incorporation into the DNA of the tumours declined to 10.5% of the controls after 4 days of GCV treatment. The data indicate that PET with 18FDG and 11C-thymidine may be applied for monitoring of gene therapy with the HSVtk/GCV suicide system. Increased transport rates are evidence of stress reactions early after therapy. The measurement of thymidine incorporation into the tumour DNA can be used as an indicator of therapy efficacy.

Animals↗

[Functional magnetic resonance tomography in psychopathological research].

Mental disorders are characterised by psychopathological symptoms which correspond to functional brain states. Functional magnetic resonance imaging (fMRI) is used for the non-invasive study of cerebral activation patterns in man. First of all, the neurobiological principles and presuppositions of the method are outlined. Results from the Heidelberg imaging lab on several simple sensorimotor tasks as well as higher cognitive functions, such as working and semantic memory, are then presented. Thereafter, results from preliminary fMRI studies of psychopathological symptoms are discussed, with emphasis on hallucinations, psychomotoric phenomena, emotions, as well as obsessions and compulsions. Functional MRI is limited by the physics underlying the method, as well as by practical constraints regarding its use in conjunction with mentally ill patients. Within this framework, the problems of signal-to-noise ratio, data analysis strategies, motion correction, and neurovascular coupling are considered. Because of the rapid development of the field of fMRI, maps of higher cognitive functions and their respective pathology seem to be coming within easy reach.

Brain↗

Intra- and extracellular fluorouracil uptake: assessment with contrast-enhanced metabolic F-19 MR imaging.

PURPOSE: To assess the extra- and intracellular uptake of the anticancer drug fluorouracil and its major catabolite alpha-fluoro-beta-alanine (FBAL) at gadolinium-enhanced fluorine-19 magnetic resonance (MR) imaging. MATERIALS AND METHODS: The relative fluorouracil and FBAL F-19 signal intensity increases due to extracellular and hepatobiliary paramagnetic contrast media were evaluated in ACI rats with transplanted Morris hepatoma. Control rats (n = 6) did not receive contrast medium; study rats received gadopentetate dimeglumine (n = 6) or gadoxetic acid (n = 6) before intravenous fluorouracil administration. The biodistributions of fluorouracil and FBAL were mapped at metabolic F-19 MR imaging at about 6 minutes (early distribution phase) and 64 minutes (metabolic phase), respectively, after drug administration. RESULTS: Gadopentetate dimeglumine induced a significant (P < .05) increase in the signal intensity of fluorouracil (70%) in the hepatoma; gadoxetic acid induced a significant increase in the signal intensity of fluorouracil in the hepatoma (85%) and of FBAL in the liver (71%). The fluorouracil liver signal intensity did not increase with either contrast medium. CONCLUSION: Whereas a marked amount of fluorouracil is in the extracellular tumor compartment 6 minutes after fluorouracil administration, the dominant fluorouracil signal intensity in the liver at 6 minutes arises from the intracellular compartment, which can be explained as retention of fluorouracil in hepatocytes. The marked increase in the FBAL signal intensity about 1 hour after fluorouracil administration is congruent with our observation of a high intracellular uptake of gadoxetic acid in the liver at about 1 hour.

Animals↗

[Optimization of PET image quality by means of 3D data acquisition and iterative image reconstruction].

PURPOSE: In the recent past, several algorithms have been developed in order to transform 3D sinograms acquired at volume PET systems into 2D data sets. These methods offer the possibility to combine the high sensitivity of the 3D measurement with the advantages of iterative 2D image reconstruction. The purpose of our study was the assessment of this approach by using phantom measurements and patient examinations. METHODS: The experiments were performed at the latest-generation whole-body PET system ECAT EXACT HR+. For 2D data acquisition, a collimator of thin tungsten septa was positioned in the field-of-view. Prior to image reconstruction, the measured 3D data were sorted into 2D sinograms by suing the Fourier rebinning (FORE) algorithm developed by M. Defrise. The standard filtered backprojection (FBP) method and an optimized ML/EM algorithm with overrelaxation for accelerated convergence were employed for image reconstruction. The spatial resolution of both methods as well as the convergence and noise properties of the ML/EM algorithm were studied in phantom measurements. Furthermore, patient data were acquired in the 2D mode as well as in the 3D mode and reconstructed with both techniques. RESULTS: At the same spatial resolution, the ML/EM-reconstructed images showed fewer and less prominent artefacts than the FBP-reconstructed images. The resulting improved detail conspicuously was achieved for the data acquired in the 2D mode as well as in the 3D mode. The best image quality was obtained by iterative 2D reconstruction of 3D data sets which were previously rebinned into 2D sinograms with help of the FORE algorithm. The phantom measurements revealed that 50 iteration steps with the optimized ML/EM algorithm were sufficient to keep the relative quantitation error below 5%. CONCLUSION: Our measurements show that the image quality in 3D PET can be improved by using iterative reconstruction techniques. The concept of 3D data acquisition and combining the FORE algorithm with 2D ML/EM reconstruction can readily be employed in clinical practice since the computation time is not considerably longer than that in iterative reconstruction of true 2D data.

Aged↗

[Investigation of the signal-to-noise ratio on a state-of-the-art PET system: measurements with the EEC whole-body phantom].

AIM: The spatial resolution of PET scanners can be improved by using smaller detector elements. This approach, however, results in poorer counting statistics of the reconstructed images. Therefore, the aim of this study was to investigate the influence of different acquisition parameters on the signal-to-noise ratio (SNR) and thus to optimize PET image quality. METHODS: The experiments were performed with the latest-generation whole-body PET system (ECAT Exact HR+, Siemens/CTI) using the standard 2D and 3D data acquisition parameters recommended by the manufacturer. The EEC whole-body phantom with different inserts was used to simulate patient examinations of the thorax. Emission and transmission scans were acquired with varying numbers of events and at different settings of the lower level energy discriminator. The influence of the number of counts on the SNR was parameterized using a simple model function. RESULTS: For count rates frequently encountered in clinical PET studies, the emission scan has a stronger influence on the SNR in the reconstructed image than the transmission scan. The SNR can be improved by using a higher setting of the lower energy level provided that the total number of counts is kept constant. Based on the established model function, the relative duration of the emission scan with respect to the total acquisition time was optimized, yielding a value of about 75% for both the 2D and 3D mode. CONCLUSION: The presented phenomenological approach can readily be employed to optimize the SNR and thus the quality of PET images acquired at different scanners or with different examination protocols.

Computer Simulation↗

Pharmacokinetic analysis of 5-[18F]fluorouracil tissue concentrations measured with positron emission tomography in patients with liver metastases from colorectal adenocarcinoma.

The purpose of our study was to develop a pharmacokinetic model to quantify the intracellular 5-fluorouracil (5-FU) concentration in liver metastases, which is expected to be closely correlated to therapy response. In addition, the influence of the biomodulator folinic acid on the action of 5-FU in the metastases was investigated. After i.v. application of 5-FU labeled with the positron emitter fluorine-18 (5-[18F]FU), the kinetics of the regional 5-[18F]FU/uptake was measured dynamically with positron emission tomography over 120 min in 14 patients with a total of 27 liver metastases from colorectal adenocarcinoma. Activity-time curves were evaluated in the metastases, the normal liver tissue, as well as in the aorta and analyzed by a six-compartment model. The catabolic breakdown of 5-FU to alpha-fluoro-beta-alanine (FBAL) in the normal liver tissue was modeled to separate the catabolites from the cytostatic agent 5-[18F]FU and the active 5-[18F]fluorodeoxyuridine nucleotides. With our model, all measured activity-time courses could be described adequately with only small interindividual variations in parameters connected with liver and blood. Extrahepatic clearance of 5-FU was estimated as 0.66 +/- 0.33 liters/min, whereas the hepatic clearance was 0.52 +/- 0.25 liters/min. The Michaelis-Menten parameters describing the nonlinear conversion of 5-FU to FBAL were Km = 11.3 +/- 6.4 micromol and Vmax = 147.1 +/- 130.7 micromol/min. The maximum FBAL concentration in the liver was reached between 35 and 65 min after i.v. 5-FU infusion. The most sensitive parameters for therapy monitoring were k(in) and k(out), which characterize the transport in and out of the intracellular volume of the metastases, respectively. Tumor response can only be expected if k(in) is high and k(out) is low ("trapping"). These criteria were met by 6 of the 27 metastases, which were identical to those with high values for the area under the intracellular 5-FU concentration curve (AUC[meta,IC]5-FU). The parameters k(in) and k(out) were also used to investigate the influence of the biomodulating agent folinic acid on drug effect. Five of the six metastases that showed trapping belonged to patients who received folinic acid. With the exception of one patient, however, all patients who received folinic acid had multiple metastases, of which only one was able to trap 5-FU. Because patient response can only be expected when all metastases trap 5-FU, folinic acid showed no effect on the overall clinical response. With the quantitative modeling approach used, trapping of 5-FU can be assessed noninvasively and on an individual basis. This makes it possible to adjust the dose for each individual patient to optimize the treatment schedule.

Adult↗

Use of scanner characteristics in iterative image reconstruction for high-resolution positron emission tomography studies of small animals.

The purpose of this work was to improve of the spatial resolution of a whole-body positron emission tomography (PET) system for experimental studies of small animals by incorporation of scanner characteristics into the process of iterative image reconstruction. The image-forming characteristics of the PET camera were characterized by a spatially variant line-spread function (LSF), which was determined from 49 activated copper-64 line sources positioned over a field of view (FOV) of 21.0 cm. This information was used to model the image degradation process. During the course of iterative image reconstruction, the forward projection of the estimated image was blurred with the LSF at each iteration step before the estimated projections were compared with the measured projections. The imaging characteristics of the high-resolution algorithm were investigated in phantom experiments. Moreover, imaging studies of a rat and two nude mice were performed to evaluate the imaging properties of our approach in vivo. The spatial resolution of the scanner perpendicular to the direction of projection could be approximated by a one-dimensional Gaussian-shaped LSF with a full-width at half-maximum increasing from 6.5 mm at the centre to 6.7 mm at a radial distance of 10.5 cm. The incorporation of this blurring kernel into the iteration formula resulted in a significantly improved spatial resolution of about 3.9 mm over the examined FOV. As demonstrated by the phantom and the animal experiments, the high-resolution algorithm not only led to a better contrast resolution in the reconstructed emission scans but also improved the accuracy for quantitating activity concentrations in small tissue structures without leading to an amplification of image noise or image mottle. The presented data-handling strategy incorporates the image restoration step directly into the process of algebraic image reconstruction and obviates the need for ill-conditioned "deconvolution" procedures to be performed on the projections or on the reconstructed image. In our experience, the proposed algorithm is of special interest in experimental studies of small animals.

Algorithms↗

Functional MR imaging of the prefrontal cortex: specific activation in a working memory task.

Functional magnetic resonance imaging was used to identify cortical regions activated by a working memory task involving letter detection. Twenty four normal subjects were scanned with a conventional 1.5-T magnet while performing one of two tasks: In the activation task, subjects responded by pressing a button whenever any presented letter was the same as the second last in the sequence. In the control condition, subjects had to respond to a single predefined letter without memory update requirements. The activation task and the control condition were identical with regard to perceptual input and motor output. They were different only regarding the task demand. Movement artifacts were minimized in a two way strategy and eight subjects were excluded from further analysis. Functional MR data from the remaining 16 subjects were analyzed on the basis of anatomical regions-of-interest which were manually defined in each subject. The engagement of working memory produced significant activation in the dorsolateral prefrontal cortex (Brodmann's areas 9, 10, 46, and 47) in both hemispheres. Results demonstrate the applicability of the paradigm within a clinical MRI setup and corroborate previous findings of non-lateralized dorsolateral prefrontal activation during continuous context updating and active maintenance.

Adult↗

Iterative reconstruction of PET images using a high-overrelaxation single-projection algorithm.

An iterative image reconstruction procedure is described which is able to calculate high-precision images within eight iterative steps. High initial overrelaxation parameters are used which drop down towards about one during continuing iteration. The parameters are determined pragmatically, postulating-maximum gain of image quality during a sequence of iterative steps. Results with simulated and measured data show that parameters derived from one data set may be widely used for other data sets. The acceleration of iterative reconstruction achieved by the estimation of optimum overrelaxation parameters is important for large data sets, especially for fully 3D reconstruction.

Algorithms↗

PET 2-fluoro-2-deoxyglucose uptake in rat prostate adenocarcinoma during chemotherapy with gemcitabine.

UNLABELLED: This study was performed to investigate the effect of the new chemotherapeutic agent gemcitabine on glucose transport and metabolism in prostate carcinoma in vitro and in vivo. METHODS: After transplantation of rat prostate adenocarcinoma cells, dynamic PET measurements with fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (18FDG) were performed in 15 animals before and 1 day after therapy with 90 mg/kg of body weight (n = 8) and 180 mg/kg of body weight (n = 7) gemcitabine. In the second examination, the animals received a simultaneous injection of 18FDG and [3H]thymidine. Quantitative evaluation of the PET data was done using the standardized uptake value (SUV) as well as a three-compartment pharmacokinetic model. Furthermore, the incorporation of [3H]thymidine into the DNA was determined. In vitro measurements of the FDG, 3-O-methylglucose and thymidine uptake were performed immediately and 4 hr after a 24-hr incubation period with different doses of gemcitabine. RESULTS: FDG-SUV and the metabolic rate of FD 3 utilization did not change significantly after therapy. However, the values for the transport rate constants K1 and K2 increased significantly. The incorporation of thymidine into the DNA of treated tumors showed an 80% decline as compared with a control group. In the cell culture experiments, a dose-dependent increase of FDG (up to 178%) and 3-O-methylglucose uptake (up to 305%) was demonstrated. The thymidine uptake showed a 96% decline in the nucleic acid fraction and an increase of up to 337% in the cytoplasmic fraction. CONCLUSION: The more global measures of FDG metabolism as SUV and metabolic rate of FDG utilization were unchanged after therapy, while DNA synthesis and cell viability declined. However, in vitro and in vivo evidence of an enhancement of glucose transport is presented, indicating that quantification by modelling may be superior for the evaluation of metabolic effects during chemotherapy.

Adenocarcinoma↗

Performance evaluation of a whole-body PET scanner using the NEMA protocol. National Electrical Manufacturers Association.

UNLABELLED: This study evaluates the performance of the newly developed high-resolution whole-body PET scanner ECAT EXACT HR+. METHODS: The scanner consists of four rings of 72 bismuth germanate block detectors each, covering an axial field of view of 15.5 cm with a patient port of 56.2 cm. A single block detector is divided into an 8 x 8 matrix, giving a total of 32 rings with 576 detectors each. The dimensions of a single detector element are 4.39 x 4.05 x 30 mm3. The scanner is equipped with extendable tungsten septa for two-dimensional two-dimensional measurements, as well as with three 68Ge line sources for transmission scans and daily quality control. The spatial resolution, scatter fraction, count rate, sensitivity, uniformity and accuracy of the implemented correction algorithms were evaluated after the National Electrical Manufacturers Association protocol using the standard acquisition parameters. RESULTS: The transaxial resolution in the two-dimensional mode is 4.3 mm (4.4 mm) in the center and increases to 4.7 mm (4.8 mm) tangential and to 8.3 mm (8.0 mm) radial at a distance of r = 20 cm from the center. The axial slice width measured in the two-dimensional mode varies between 4.2 and 6.6 mm FWHM over the transaxial field of view. In the three-dimensional mode the average axial resolution varies between 4.1 mm FWHM in the center and 7.8 mm at r = 20 cm. The scatter fraction is 17.1% (32.5%) for a lower energy discriminator level of 350 keV. The maximum true event count rate of 263 (345) kcps was measured at an activity concentration of 142 (26.9) kBq/ml. The total system sensitivity for true events is 5.7 (27.7) cps/Bq/ml. From the uniformity measurements, we obtained a volume variance of 3.9% (5.0%) and a system variance of 1.6% (1.7%). The implemented three-dimensional scatter correction algorithm reveals very favorable properties, whereas the three-dimensional attenuation correction yields slightly inaccurate results in low- and high-density regions. CONCLUSION: The ECAT EXACT HR+ has an excellent, nearly isotropic spatial resolution, which is advantageous for brain and small animal studies. While the relatively low slice sensitivity may hamper the capability for performing fast dynamic two-dimensional studies, the scanner offers a sufficient sensitivity and count rate capacity for fully three-dimensional whole-body imaging.

Adenocarcinoma, Follicular↗