Biomedical subjects

S Blüml

Publications and source records attributed to S Blüml.

28 records · Page 2Linked to original sources

PubMed1994

Improved target volume definition for precision radiotherapy planning of meningiomas by correlation of CT and dynamic, Gd-DTPA-enhanced FLASH MR imaging.

In this methodological paper the authors report a fast, T1-weighted gradient-echo sequence (FLASH) for dynamic, Gd-DTPA-enhanced magnetic resonance (MR) imaging of meningiomas and its application in precision radiotherapy planning. Indications for radiotherapy included unresected tumors, tumor remaining after surgery, and recurrences. The patient's head was fixed in a stereotactic localization system which is usable at the CT, MR and the linear accelerator installations. By phantom measurements different materials (steel, aluminum, titanium, plastic, wood, ceramics) used for the stereotactic system were tested for mechanical stability and geometric MR image distortion. All metallic stereotactic rings (closed rings made of massive metal) led to a more or less dramatic geometric distortion and signal cancellation in the MR images. The best properties--nearly no distortion and high mechanic stability--are provided by a ceramic ring. If necessary, the remaining geometric MR image distortion can be 'corrected' (reducing displacements to the size of a pixel) by calculations based on modeling the distortion as a fourth order two-dimensional polynomial. The target volume was defined in dynamic, T1-weighted FLASH MR images, which were measured before, during, and after the controlled intravenous infusion of 0.1 mmol/kg body weight Gd-DTPA. The stereotactic localization technique allows the precise transfer of the target volume information from MR onto CT data to provide a map of the radiation attenuation coefficient for dose calculation. In genera, the superior soft tissue contrast of MR showed an excellent tumor delineation, especially in regions, such as the base of the skull, where the target often was obscured in CT images.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

PubMed1994

Radiosurgical treatment planning of brain metastases based on a fast, three-dimensional MR imaging technique.

A fast, three-dimensional (3D) sequence for magnetic resonance (MR) imaging of the brain and its application in radiosurgical treatment planning of brain metastases is reported. The measuring sequence (MPRAGE) requires magnetization-prepared 180 degrees inversion pulses followed by rapid low angle excitation pulses and gradient-echoes for image generation. The resulting T1-weighted MPRAGE images were compared with two-dimensional (2D) T1-weighted spin-echo (SE) images after administration of 0.1 mmol/kg b.w. Gd-DTPA in 10 patients with known brain metastases. Original or multiplanar reformatted images obtained from a 128 partition data set of the 3D MPRAGE sequence offered comparable diagnostic quality to that of 2D SE imaging. Gd-DTPA enhancement and lesion targeting was similar in most of the patients in SE as well as MPRAGE imaging. During imaging and therapy the patient's head was fixed in a stereotactic localization system which is usable at the MR and the linear accelerator installations. The dose calculation of the radiosurgery planning was based on 3D MR imaging data assuming a homogenous attenuation value inside the head which was sufficient for an accurate dose calculation since tissue inhomogeneities do not significantly influence the shape of the relative dose distribution especially for radiosurgery of the brain. Under this circumstance the dose calculation can be based only on the 3D geometric conformation of the patient's head. A simple algorithm for treatment planning can be used if the MR data are free of geometric distortion.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

PubMed1994

3D MPRAGE evaluation of lesions in the posterior cranial fossa.

Standard spin-echo images of the posterior cranial fossa are usually impaired by pulsation artifacts. We evaluated a heavily T1 weighted MPRAGE sequence (TR/TE/alpha/TI = 10/4/10-15 degrees/200-350) for detection of intracerebral lesions in the posterior fossa in 11 patients. Overall quality of the MPRAGE images was superior due to the lack of pulsation artifacts, high S/N and excellent gray-white matter contrast. Lesion detection was better in one patient, equal in six and inferior in four patients compared to SE technique. A cerebellar metastasis (8 mm) in one patient was completely blurred from pulsation artifacts on the SE images. Whereas multiple small lesions (< or = 4 mm) with discrete contrast enhancement were missed on the MPRAGE images in three patients. We conclude, that the MPRAGE sequence yields high quality images with isotropic spatial resolution in a reasonable time. But MPRAGE with these parameters can not replace standard SE images in screening the posterior fossa, because of a decreased sensitivity in the detection of small contrast-enhancing lesions.

Adolescent↗

PubMed1994

[MR tomography of lung metastases with rapid gradient echo sequences. Initial results in diagnostic applications].

Rapid gradient echo sequences enable MR imaging (MRI) of pulmonary metastases with acquisition times of less than 1 s per slice. By optimization of this technique, density, T1- and T2-weighted images can be obtained (FLASH: TR 6.5 ms, TE2 = 3 ms, alpha = 10 degrees; T1w-Turbo-FLASH: TI 200 ms, TR 6.5 ms, TE2 = 3 ms, alpha = 10 degrees; T2w-Turbo-FLASH: TE1 = 50 ms, TR = 6.5 ms, TE2 = 3.5 ms; alpha = 10 degrees). In a prospective study 25 patients in whom pulmonary metastases were suspected were examined with three techniques in all three anatomical planes prior to surgery. All lung metastases revealed a high signal intensity on the FLASH as well as the T2w-Turbo-FLASH images, whereas vascular structures revealed a low signal intensity on the T2-weighted Turbo-FLASH images. Analysis regarding detection and correct number of lung metastases per patient with MRI compared with the histology revealed (n = 25): sensitivity of 82%, specificity 67%, positive predictive value of 95% and negative predictive value of 33%. While MRI does not currently have any diagnostic advantages over CT, the excellent differentiation of parenchymal lesions and vascular structures without the use of contrast medium and the variability of imaging planes are significant methodological advantages.

Adolescent↗

PubMed1993

Spin-lattice relaxation time measurement by means of a TurboFLASH technique.

Rapid measurements of in vivo proton spin-lattice relaxation times (T1) in human tissues were performed by magnetic resonance imaging in a 1.5 T whole-body super-conducting MR scanner. The measurements employ serial TurboFLASH imaging (Snapshot-FLASH) with scan times for a single experiment below 4 s. Using centric phase encoding order, an appropriate fitting of the T1-parameter from images with minimum motion artifacts is possible. Comparative T1-determination with a multipoint inversion recovery and spin-echo technique was performed on phantoms containing Gd-DTPA solutions with different T1-values. We found a maximum deviation of 3.3% for T1 < 1100 ms and of 12.1% for 1100 ms < T1 < 1700 ms from the results obtained by the IR technique. In vivo measurements of T1-relaxation times were performed in white and grey matter, cerebrospinal fluid, kidney, liver, spleen, muscle, and bone marrow, and yielded values that are in good agreement with reported data.

Abdomen↗

PubMed1993

MR image texture analysis--an approach to tissue characterization.

The role and value of texture analysis in the quantification of medical images is reviewed and the various methods described. The promise in magnetic resonance imaging is discussed and the coordinated research programme being carried out within the framework of the European Economic Community Concerted Action on Tissue Characterization by MRS and MRI is outlined. Tissue characterization of the human brain has been performed by texture analysis of proton relaxation time images using a standard MR whole body imager operating at 1.5 T and the results are presented.

Brain↗

PubMed1993

MR tissue characterization of intracranial tumors by means of texture analysis.

Tissue characterization of the human brain has been performed by texture analysis of proton relaxation time images using a standard MR whole body imager operating at 1.5 T. A combined CP/CPMG multi-echo, multislice sequence was used to measure T1 and T2 in each pixel with an uncertainty not exceeding 10%. In a prospective clinical study, 12 patients with histologically confirmed brain tumors were investigated. For each ROI in the calculated T1 and T2 parameter images, texture parameters originating from the grey level distribution, the gradient distribution, the grey level co-occurrence matrix, and the grey level runlength histogram were used for classification and discrimination between tissues. All regions corresponding to the normal brain tissue (white matter, grey matter, cerebrospinal fluid) were successfully discriminated from each other as well as from the pathological tissue parts (edema and tumor). The classification of 10 edematous and 8 tumorous tissue regions yielded only one misclassification. Together with additional rules, these discrimination rules formed the knowledge base of an expert system for segmentation of the brain images. In cases of tumors without Gd-DTPA contrast medium uptake or in cases of Gd-DTPA contraindication, segmentated images can help solve nontrivial diagnostical problems such as delineating the target volume in radiation therapy.

Adolescent↗

PubMedDate not supplied

1H MRS in acute traumatic brain injury.

The objective of this study was to demonstrate 1H MR spectroscopy (MRS) changes in cerebral metabolites after acute head trauma. Twenty-five patients (12 children, 13 adults) were examined with quantitative 1H MRS after closed head injury. Clinical grade (Glasgow Coma Scale [GCS]) and outcome (Rancho Los Amigos Medical Center Outcome Score [ROS]) were correlated with quantitative neurochemical findings. N-acetylaspartate (NAA), a neuronal and axonal marker, was reduced (P < .03-.001). In children, a reduced NAA/creatine plus phosphocreatine (Cr) level and the presence of detectable lipid/lactate predicted bad outcome (sensitivity, 89%; specificity, 89%). The first MRS examination of all patients correlated with ROS versus NAA (r = .65, P < .0001). Although most patients showed MRS abnormalities, striking heterogeneity of 1H MRS characterized the individual patients. 1H MRS identifies multiple patterns of diffuse brain injury after blunt head trauma. There was a strong correlation between MRS and outcome. Future prospective studies will be needed to determine the clinical usefulness of MRS in predicting outcome from closed head injury.

Adult↗

PubMedDate not supplied

Rapid automatic brain volumetry on the basis of multispectral 3D MR imaging data on personal computers.

Fast magnetic resonance imaging sequences are an excellent basis for the volumetry of the human brain. We present a concept for an automatic three-dimensional (3D) segmentation and volumetry which provides rapid image processing along with minimal requirements of manual interaction on low-end hardware platforms. The concept is based on standard image segmentation techniques and provides for the determination of the total brain tissue and cerebrospinal fluid volumes from the input data base, a T1- and a T2-weighted 3D image data cube. We used a 3D MPRAGE sequence for the T1- and a 3D PSIF sequence for the T2-weighted images; both 3D image data cubes consisted of 128 sagittal image slices with a voxel size of 1.0 x 1.0 x 1.2 mm3. The segmentation and volumetry tool was applied to clinical image data of volunteers and Alzheimer patients in order to prove its stability.

Adult↗

PubMedDate not supplied

Quantitative proton-decoupled 31P MRS of the schizophrenic brain in vivo.

Quantitative proton MR spectroscopy (MRS) and proton-decoupled phosphorus MRS were applied in the parietal cortex of 13 schizophrenic subjects (11 drug-treated and 2 neuroleptic-naive) and 15 normal control subjects. Significantly increased concentrations of glycerophosphorylcholine (1.18 +/- 0.16 vs. 0.93 +/- 0.14 mmol/kg brain; p < 0.001), glycerophosphoethanolomine (0.70 +/- 0.19 vs. 0.59 +/- 0.07 mmol/kg; p < 0.04), and phosphocreatine (3.73 +/- 0.39 vs. 3.41 +/- 0.13 mmol/kg; p < 0.007), but no differences in N-acetylaspartate, total creatine, or myo-inositol, were determined in treated schizophrenic subjects. Identical abnormalities were found in two neuroleptic-naive patients. These results provide new evidence of disordered cerebral membrane and high energy phosphate metabolism in schizophrenia.

Adult↗