Biomedical subjects

Nora Tgavalekos

Publications and source records attributed to Nora Tgavalekos.

3 recordsLinked to original sources

PubMed2006

Regional pulmonary perfusion, inflation, and ventilation defects in bronchoconstricted patients with asthma.

RATIONALE: Bronchoconstriction in asthma leads to heterogeneous ventilation and the formation of large and contiguous ventilation defects in the lungs. However, the regional adaptations of pulmonary perfusion (Q) to such ventilation defects have not been well studied. METHODS: We used positron emission tomography to assess the intrapulmonary kinetics of intravenously infused tracer nitrogen-13 ((13)NN), and measured the regional distributions of ventilation and perfusion in 11 patients with mild asthma. For each subject, the regional washout kinetics of (13)NN before and during methacholine-induced bronchoconstriction were analyzed. Two regions of interest (ROIs) were defined: one over a spatially contiguous area of high tracer retention (TR) during bronchoconstriction and a second one covering an area of similar size, showing minimal tracer retention (NR). RESULTS: Both ROIs demonstrated heterogeneous washout kinetics, which could be described by a two-compartment model with fast and slow washout rates. We found a systematic reduction in regional Q to the TR ROI during bronchoconstriction and a variable and nonsignificant change in relative Q for NR regions. The reduction in regional Q was associated with an increase in regional gas content of the TR ROI, but its magnitude was greater than that anticipated solely by the change in regional lung inflation. CONCLUSION: During methacholine-induced bronchoconstriction, perfusion to ventilation defects are systematically reduced by a relative increase in regional pulmonary vascular resistance.

Adult↗

PubMed2005

Self-organized patchiness in asthma as a prelude to catastrophic shifts.

Asthma is a common disease affecting an increasing number of children throughout the world. In asthma, pulmonary airways narrow in response to contraction of surrounding smooth muscle. The precise nature of functional changes during an acute asthma attack is unclear. The tree structure of the pulmonary airways has been linked to complex behaviour in sudden airway narrowing and avalanche-like reopening. Here we present experimental evidence that bronchoconstriction leads to patchiness in lung ventilation, as well as a computational model that provides interpretation of the experimental data. Using positron emission tomography, we observe that bronchoconstricted asthmatics develop regions of poorly ventilated lung. Using the computational model we show that, even for uniform smooth muscle activation of a symmetric bronchial tree, the presence of minimal heterogeneity breaks the symmetry and leads to large clusters of poorly ventilated lung units. These clusters are generated by interaction of short- and long-range feedback mechanisms, which lead to catastrophic shifts similar to those linked to self-organized patchiness in nature. This work might have implications for the treatment of asthma, and might provide a model for studying diseases of other distributed organs.

Asthma↗

PubMed2005

Enhanced parameter estimation from noisy PET data: Part II--evaluation.

RATIONALE AND OBJECTIVES: Positron emission tomography (PET) is a minimally invasive imaging modality that provides three-dimensional distribution data for a radioactive tracer concentration within the body. Local functional parameters are estimated from these images by fitting tracer kinetic data with mathematical models. However, in some applications, the reliability of parameter estimates may be hindered by the presence of noise. In the accompanying report in this issue of Academic Radiology, a novel method using principal component analysis (PCA) was presented and used for deriving parametric images of lung function from imaged tracer kinetics of intravenously injected nitrogen 13 (13NN) in saline solution. The PCA method averages 13NN concentrations from groups of voxels (volume elements) selected for their similarity in kinetics, rather than their spatial proximity. The goal of this study is to conduct a Monte Carlo simulation to evaluate the robustness to noise of parameters derived by means of the PCA method. MATERIALS AND METHODS: This evaluation involved: (1) generating "noise-free" synthetic PET images from experimental PET data, (2) adding noise to these images, (3) applying the PCA method to yield parametric images, and (4) comparing these parametric images with original noise-free images. RESULTS: Local parameters recovered by using the PCA method deviated from noise-free parameters on average by less than 1% for up to 32-fold of expected noise levels. These deviations were much less than those (>10%) recovered by using a direct curve-fitting method. CONCLUSION: The novel PCA approach provides robust parametric lung functional images while preserving the spatial resolution of the original images.

Humans↗