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Biomedical subjects

M Laniado

Publications and source records attributed to M Laniado.

At least 19 recordsLinked to original sources
PubMed2002

MR-guided interventional breast procedures considering vacuum biopsy in particular.

Histologic work-up of just MR-detected breast lesions has become essential with increasing use of contrast-enhanced MR imaging. In the present article an overview is given about the different MR-guided breast interventions, performed since 1990. Presently, for reasons of costs and image quality closed magnets are most widely used. The following approaches have been described: MR-guided freehand localization in supine position, stereotaxic localization in supine position and most frequently used localization in the prone position by means of a compression device that immobilises the breast to prevent tissue shift during intervention. Only limited experience exists with interventions on open magnets. MR-guided wire localization is a well-established procedure. Recently, percutaneous vacuum biopsy of enhancing breast lesions has become possible under MR guidance. The new system allows accurate and safe access to lesions in any location of the breast and direct check-up of representative excision by visualisation of the cavity. Thus reliable histologic evaluation of lesions smaller than 10 mm is possible with this approach.

Biopsy, Needle↗
PubMed2002

MR perfusion measurement of contrast uptaking lesions: consideration of T2* shortening due to interstitial contrast agent.

AIM: In MR perfusion measurements of contrast uptaking lesions, time intensity curves are hampered by T 1 shortening as well as by the change of T 2 * due to interstitial contrast material (CM). Using double echo sequences, the influence of T 1 can be mathematically eliminated. For correction of the T 2 * influence an empirical algorithm using time-intensity-curves exclusively measured in the suspected lesion is proposed. METHODS: The interstitial CM concentration is assumed to be proportional to the change of the intensity for T E = 0 or to the change of the relaxation rate DeltaR 1 respectively. The intravascular CM concentration is estimated from DeltaR 2 *. It is adjusted to zero for a time point sufficiently late after the bolus injection by subtraction of the interstitial concentration. This method was applied to double echo FLASH measurements on 15 pharyngeal tumors. RESULTS: The proposed correction transforms the time dependence of the estimated intravascular CM concentration into a plausible course. CONCLUSION: Double echo perfusion measurements can be corrected for the interstitial CM induced T 2 * shortening without additional measurements with proneness to errors. This does not necessarily improve the diagnostic value, since possibly "implied multivariate aspects" of uncorrected parameters (here: contrast uptake of the lesion is related to tumor neoangiogenesis as well) are eliminated.

Algorithms↗
PubMed2001

High-grade lymphoma mimicking bone crisis in Gaucher's disease.

A 33-year-old woman with type 1 Gaucher's disease developed painful swelling of her right tibia. Initial diagnostics suggested a typical bone crisis. However, clinical course and subsequent imaging pointed to malignant disease, which was specified as high-grade lymphoma. Chemotherapy was applied together with enzyme replacement and resulted in complete remission of the lymphoma. We conclude that osseous lesions, although suggestive of common manifestations of Gaucher's disease, should be discriminated very carefully from neoplastic infiltration to maintain curative treatment options.

Adult↗
PubMed2000

Synergistic effect between iron and gadolinium in MRI.

Different combinations of iron glycerophosphate (Fe) and gadolinium-diethylene triamine pentaacetic acid (DTPA) (Gd) were imaged with a three-dimensional (3D) gradient-recalled echo (GRE), a 2D GRE, and a HASTE sequence on a 1.5-T MR scanner. A combination of Fe and Gd results in a synergistic effect, which improves the signal gain for selective 3D imaging of the colon and simultaneously decreases the endoluminal signal on the HASTE and 2D GRE images for better visualization of water and Gd-enhanced structures in the gut wall.

Colonic Diseases↗
PubMed2000

Dynamic MR imaging of liver metastases with Gd-EOB-DTPA.

PURPOSE: To assess liver and lesion enhancements by dynamic MR imaging after bolus injection of the hepatobiliary contrast agent gadolinium ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) in patients with liver metastases and to compare the effect of different doses. MATERIAL AND METHODS: A randomized double-blinded trial with doses of 12.5, 25 and 50 micromol/kg Gd-EOB-DTPA was performed in 35 patients with liver metastases. Liver enhancement, tumor enhancement and liver lesion contrast-to-noise (C/N) ratios were calculated from breath-hold gradient echo images (100/5/80 degrees) recorded precontrast and at different times up to 10 min postcontrast. RESULTS: Normal liver showed a characteristic enhancement pattern, with a rapid enhancement in the first 45 s postcontrast and a slight but significant further increase up to 600 s. The initial enhancement in the lesions was also pronounced, but the enhancement was slightly decreased after 240 s postcontrast. At dose levels of 12.5 and 25 micromol/kg Gd-EOB-DTPA, C/N ratios significantly increased compared to baseline from 90 to 600 s. Postcontrast C/N-values obtained using 50 micromol/kg Gd-EOB-DTPA were not significantly increased, except for the examinations 480 s postcontrast. CONCLUSION: In liver metastases, C/N ratios obtained with doses of 12.5 and 25 micromol/kg Gd-EOB-DTPA were slightly superior to 50 micromol/kg Gd-EOB-DTPA. This finding is probably due to a more pronounced extracellular effect of the contrast medium at higher doses.

Adult↗
PubMed2000

Focal liver lesions: evaluation of the efficacy of gadobenate dimeglumine in MR imaging--a multicenter phase III clinical study.

PURPOSE: To evaluate gadobenate dimeglumine (Gd-BOPTA) for dynamic and delayed magnetic resonance (MR) imaging of focal liver lesions. MATERIALS AND METHODS: In 126 of 214 patients, MR imaging was performed before Gd-BOPTA administration, immediately after bolus administration of a 0.05- mmol/kg dose of Gd-BOPTA, and 60-120 minutes after an additional intravenously infused 0.05-mmol/kg dose. In 88 patients, imaging was performed before and 60-120 minutes after a single, intravenously infused 0.1-mmol/kg dose. T1- and T2-weighted spin-echo and T1-weighted gradient-echo images were acquired. On-site and blinded off-site reviewers prospectively evaluated all images. Intraoperative ultrasonography, computed tomography (CT) during arterial portography, and/or CT with iodized oil served as the reference methods in 110 patients. RESULTS: Significantly more lesions were detected on combined pre- and postcontrast images compared with on precontrast images alone (P <. 01). All reviewers reported a decreased mean size of the smallest detected lesion and improved lesion conspicuity on postcontrast images. All on-site reviewers and two off-site reviewers reported increased overall diagnostic confidence (P <.01). Additional lesion characterization information was provided on up to 109 (59%) of 184 delayed images and for up to 50 (42%) of 118 patients in whom dynamic images were assessed. Gd-BOPTA would have helped change the diagnosis in 99 (47%) of 209 cases and affected patient treatment in 408 (23%) of 209 cases. CONCLUSION: Gd-BOPTA increases liver lesion conspicuity and detectability and aids in the characterization of lesions.

Adult↗
PubMed1999

[Value of CT in diagnosis of respirator-associated pneumonia].

PURPOSE: To analyse the diagnostic accuracy of computed tomography (CT) in ventilator-associated pneumonia (VAP). MATERIALS AND METHODS: 23 patients on mechanical ventilation with a new pulmonary abnormality on chest X-ray were examined with both spiral-CT and high-resolution CT. The diagnosis VAP was made according to prospectively defined criteria. Bronchoscopic specimen asservation with protected specimen brushing (PSB) served as gold standard. RESULTS: With PSB, 11 of 23 patients were found to have VAP. CT showed a sensitivity and specificity of 53% and 63%, respectively. Ground glass infiltrates appeared to have a 100% specificity but were found in only 5/11 patients. CONCLUSIONS: CT is not the method of choice for diagnosing VAP. Ground glass infiltrates seeming to be highly specific are only inconstantly found.

Adult↗
PubMed1999

Correlation between androgen receptor expression and FGF8 mRNA levels in patients with prostate cancer and benign prostatic hypertrophy.

AIM: To investigate the correlation between androgen receptor expression and fibroblast growth factor 8 (FGF8) mRNA levels. METHODS: 39 human prostate cancers and 14 benign prostatic hypertrophy specimens were examined immunohistochemically for androgen receptor expression and by in situ hybridisation and reverse transcription polymerase chain reaction for FGF8 expression. RESULTS: In 39 tumours there was a statistically significant negative correlation between tumour grade and FGF8 expression and a positive correlation between FGF8 and androgen receptor expression. All 14 benign hypertrophy specimens expressed moderate to high levels of FGF8 and androgen receptor. CONCLUSIONS: Loss of FGF8 may be a factor involved in the development of prostatic cancer.

Fibroblast Growth Factor 8↗
PubMed1999

Inverted papilloma of the nasal cavity and the paranasal sinuses: using CT for primary diagnosis and follow-up.

OBJECTIVE: Morphologic criteria for the diagnosis of primary and recurrent inverted papilloma as revealed on CT were evaluated in a large series. MATERIALS AND METHODS: Findings of 121 CT examinations that had been performed in 32 patients with histologically proven inverted papilloma were retrospectively analyzed using the following morphologic criteria: localization, size, surface configuration, and bony changes. RESULTS: Unilateral tumor localization involving the lateral nasal wall and the middle meatus was the feature that best correlated with the finding of primary inverted papilloma. A lobulated surface pattern was another typical sign, which was revealed on 19 of the 29 CT scans of patients with primary inverted papilloma. Although tumor localization and the finding of a newly grown soft-tissue mass were less reliable criteria to differentiate between recurrent inverted papilloma and postoperative complications or concomitant inflammatory disease, a lobulated surface pattern was seen on 26 of the 28 CT scans of patients with tumor recurrence but on only three of the 64 follow-up CT scans of patients without recurrent inverted papilloma. CONCLUSION: A unilateral mass within the nasal cavity or paranasal sinuses with a surface configuration that appears lobulated on CT is, to our knowledge, a new sign that strongly suggests inverted papilloma as a primary diagnosis and also suggests inverted papilloma in patients with tumor recurrence.

Adult↗
PubMed1997

Perianal complications of Crohn disease: MR imaging findings.

The aim of this study was to revisit anal anatomy, to explain surgical terminology in perianal complications of Crohn disease, and to show the MR imaging findings of perianal fistulas and abscesses. To this end more than 200 patients were studied using surface coils (Helmholtz; phased array) at 1.0 and 1.5 T. Transverse and coronal T1- and T2-weighted images were obtained. Parks' classification was used to describe perianal abscesses and fistulas. This pictorial essay shows the normal anal anatomy and pathologic findings such as subcutaneous, para-anal, ischiorectal, intersphincteric, and supralevatoric abscesses and fistulas. MR imaging with surface coils is well suited to showing the anal anatomy and to reliably describing perianal abscesses and fistulas according to surgical terminology.

Abscess↗
PubMed1997

[Current status of the clinical development of MR contrast media].

The paramagnetic extracellular Gd contrast media (Gd-CM) Magnevist, Dotarem, Omniscan, and ProHance are on the market, whereas Gadovist, Optimark, and MultiHance (also used as a hepatobiliary CM) are undergoing clinical trials (phase III). Among other indications, Gd-CM are applied in tumours, inflammation, vascular pathologies, and MR-angiography. The paramagnetic hepatobiliary CM Teslascan, Eovist and MultiHance are in clinical trials (phase II and III). They improve tumour detection and characterisation. The Mn-CM Teslascan is also suited for pancreatic imaging, the Gd-CM MultiHance for imaging of myocardial infarction and the brain, and the Gd-CM Eovist has been used in liver CT. The superparamagnetic reticuloendothelial CM Endorem is on the market whereas Resovist is undergoing phase-III trials. Both agents have the same indications as the hepatobiliary CM. Sinerem is another superparamagnetic CM. However, it acts as a blood pool agent and accumulates in lymph nodes (MR lymphography). Gastrointestinal CM are divided into paramagnetic, superparamagnetic and diamagnetic agents acting either as positive or negative CM. Some are on the market, but their clinical value is limited.

Adult↗
PubMed1997

Expression of bcl-2 in bladder neoplasms is a cell lineage associated and p53-independent event.

AIMS: To investigate bcl-2 and p53 protein expression in hyperplastic, metaplastic and neoplastic epithelia of the urinary bladder in relation to cell lineages (transitional versus glandular epithelia). METHODS: Formalin fixed, paraffin wax embedded archival tissue blocks of 29 transitional cell carcinomas (TCC), 11 adenocarcinomas, five specimens of cystitis glandularis, four papillomas, and seven samples of morphologically normal bladder mucosa were examined immunohistochemically with antibodies specific to bcl-2 and p53. Consecutive sections were used to assess co-expression of the two proteins. RESULTS: bcl-2 protein was expressed heterogeneously in basal cells of the normal transitional epithelium, whereas p53 was rarely detectable in either normal or hyperplastic epithelium. Of the 29 TCCs, 20 (69%) expressed immunodetectable p53 which was positively associated with grade. In contrast, bcl-2 was detected in four (14%) TCCs and its expression was not associated with grade. bcl-2 was expressed constitutively in all five specimens of cystitis glandularis and in all adenocarcinomas; p53 was co-expressed in most of the latter. There was no association between bcl-2 and p53 protein expression in the TCCs. Expression of bcl-2 protein correlated negatively with grade of adenocarcinoma. CONCLUSION: In bladder adenocarcinomas, bcl-2 expression correlated negatively with tumour grade whereas p53 was associated positively with tumour grade. The association of bcl-2 with cystitis glandularis and adenocarcinoma but not TCC suggests that it may be involved in triggering a lineage switch converting transitional epithelium to a glandular phenotype.

Adenocarcinoma↗
PubMed1997

MR imaging of the liver with Resovist: safety, efficacy, and pharmacodynamic properties.

PURPOSE: To evaluate the safety, efficacy, and pharmacodynamic properties of a new superparamagnetic parenteral iron oxide contrast agent for magnetic resonance (MR) imaging. MATERIALS AND METHODS: Thirty-six patients with liver lesions received a bolus injection of Resovist (SH U 555 A; Schering, Berlin, Germany) at a dose of 4, 8, or 16 micromol iron per kilogram body weight (micromol Fe/kg). Fast low-angle shot, spin-echo, and turbo gradient spin-echo MR images were obtained before and 10, 40, and 70 minutes after injection. Blood samples were obtained, vital signs were monitored, and adverse events were recorded. Lesion detection was assessed by two independent, blinded readers. RESULTS: No drug-related adverse events occurred. Serum iron and ferritin levels were increased at all dose levels. Partial thromboplastin time increased and factor XI level decreased 4 hours after injection of 16 micromol Fe/kg. Lesion detection and diagnostic confidence were increased in patients who received 4 or 8 micromol Fe/kg, with no further increase with a 16-micromol dose. CONCLUSION: Resovist is safe and effective. The best MR imaging results were obtained 40 minutes after injection of 8 micromol Fe/kg.

Adult↗