Combined transmission and emission tomography in a vastus intermedius muscle stress syndrome.
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Athletic Injuries↗
Biomedical subjects
S M Eschmann
Publications and source records attributed to S M Eschmann.
On biologically conformal boost dose optimization.
A method is described that allows the inclusion of biological imaging data in the optimization of intensity-modulated radiotherapy to produce dose boosts that conform with target subvolumes of potentially reduced radiosensitivity. The biological image (e.g. PET, fMRI, etc) is transformed into a dose efficiency distribution using a piecewise linear calibration function with a prescribed maximum boost factor. Instead of dose alone, the cost function of the optimization algorithm depends on the product of the physical dose times dose efficiency. An example case of a base-of-tongue tumour which was imaged with the hypoxia tracer fluoro-misonidazole is presented, showing the excellent capability of IMRT to produce dose distributions that conform to spatially variable dose prescriptions.
Algorithms↗
FDG PET for staging of advanced non-small cell lung cancer prior to neoadjuvant radio-chemotherapy.
The aim of this study was to evaluate positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) for the staging of non-small cell lung cancer (NSCLC) before combined neoadjuvant, i.e. preoperative, radio-chemotherapy (RCT). From November 1998 until September 2001, 101 patients with NSCLC were investigated prospectively. The inclusion criterion was a histologically proven NSCLC of stage IIIA or B according to conventional staging including biopsy. The results of PET were compared with those obtained by mediastinoscopy, computed tomography (CT), bone scan and abdominal ultrasonography. Validation of discrepant findings was achieved by biopsy or repeated CT. PET proved to be highly accurate for the detection of lymph node metastases (sensitivity 96%, specificity 73%, positive predictive value 88%, negative predictive value 89%, accuracy 88%) as well as distant metastases (in 25/101 patients, all previously unknown). PET findings changed further treatment in 29/101 patients (29%). Twenty-five were excluded from RCT due to the presence of previously unknown distant metastases. One patient was free of metastases and therefore was operated on without pre-treatment. Two patients did not receive any further treatment because a malignant tumour could be excluded after PET. In the final patient PET demonstrated a tumour pattern not typical for NSCLC which could be attributed to a seminoma after repeated biopsy. FDG PET is the most accurate non-invasive diagnostic procedure for the staging of advanced NSCLC. Therefore use of FDG PET is highly recommended in order to select patients for neoadjuvant or other stage-dependent treatment modalities.
Adult↗
[18F-fluorodeoxyglucose positron emission tomography in the diagnosis of lung cancer].
Positron emission tomography (PET) is a new diagnostic procedure which allows to image tissue metabolism in vivo. Utilizing increased substrate metabolism or transport as a marker of malignant disease, primary as well as metastatic or recurrent lung cancer can be detected. This allows for improved differential diagnosis of pulmonary nodules or staging of non small cell lung cancer as has been documented in several studies. New applications of PET may include non-invasive evaluation of tissue proliferation or hypoxia to predict individual prognosis or treatment response.
Carcinoma, Non-Small-Cell Lung↗
Bone marrow scintigraphy with technetium-99m anti-NCA-95 to monitor therapy in malignant osteopetrosis.
We report a case of a 2-mo-old girl with malignant osteopetrosis. Conventional radiological investigations of the skull and left hand showed the characteristic pattern of generalized sclerosis. Bone marrow immunoscintigraphy with 99mTc-labeled antibodies against nonspecific cross-reactive antigen (NCA) 95 was performed before and after bone marrow transplantation. Before transplantation, whole-body images showed bone marrow stores exclusively in the base of the skull. The rest of the skeleton did not reveal any hematopoietic activity. The liver and spleen showed increased antibody uptake as expected in extramedullary hematopoiesis. Repeat scintigraphy after bone marrow transplantation from her haploidentical father demonstrated an almost completely normalized tracer distribution corresponding to her clinical and hematological improvement. Bone marrow immunoscintigraphy appears to be an ideal complement to radiograph diagnostics in malignant osteopetrosis. In primary diagnosis, scintigraphy demonstrates the quantitative extent of bone marrow displacement. It also proves an ideal tool in monitoring the effectiveness of therapy after bone marrow transplantation.
Antibodies, Monoclonal↗
[Efficiency and efficacy of radiologic diagnosis in skeletal trauma in childhood and adolescence].
In a retrospective analysis, 2,006 X-ray examinations of the skeleton obtained after trauma in 1,386 children were examined; 354 fractures were diagnosed. X-ray films of the skull were requested in 596 (29.7%); fractures were diagnosed in only 13 patients (2.2%). The radiological result changed the medical management in none of these cases. On the other hand, X-ray after trauma in the extremities is indispensable, except for the knee region. Examinations of the lower arm showed a fracture in 54.9%, X-ray of the shoulder 47.7%.
Adolescent↗
[Percutaneous sclerotherapy of varicocele--results in children and adolescents].
65 percutaneous transvenous sclerotherapy of the internal spermatic vein in 58 children and adolescents with varicoceles are reported. Their age ranged from 9.4 to 18 years (mean 14.7 years). The success rate of the sclerotherapy amounted 91.4% while 8.6% recidivations were seen. In three patients slight complications occurred (2 extravasations, 1 spasm of the spermatic vein) which required no further therapy. By repeating the sclerotherapy finally 94.8% of the patients were treated successfully.
Adolescent↗