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Biomedical subjects

Stefan P Müller

Publications and source records attributed to Stefan P Müller.

9 recordsLinked to original sources

Relationship between cumulative radiation dose and salivary gland uptake associated with radioiodine therapy of thyroid cancer.

AIM: To estimate the individual absorbed dose to the parotid and submandibular salivary glands in radioiodine therapy and its dependence from the previous cumulative therapy. METHODS: Fifty-five patients with differentiated thyroid carcinoma after thyroidectomy received 1-21 GBq (131)I using single activities of 1-6 GBq. The patients were stratified according to the cumulative activities into low-activity (1-2 GBq), middle-activity (3-7 GBq), and high-activity groups (9-21 GBq). The time-activity curves over the respective salivary glands were derived from multiple static calibrated images measured for each patient up to 48 h after ingestion of the radioiodine therapy capsule with a gamma camera. Manually drawn regions of interests were used to determine the background activities and the activities arising from the salivary glands. The gland volumes were determined by ultrasonography using appropriate volume models. RESULTS: The median absorbed dose per administered activity of each single parotid and submandibular gland was about 0.15 Gy.GBq (range, 0.1-0.3 Gy.GBq(-1)) and 0.48 Gy.GBq(-1) (range, 0.2-1.2 Gy.GBq(-1)), respectively. The maximum uptake of both gland types was significantly lower for the high-activity than for the low-activity groups and correlated with the mean cumulative administered activity of the activity groups. CONCLUSION: The iodine uptake of salivary glands is significantly reduced, whereas the absorbed dose per administered (131)I activity was not significantly decreased during the course of therapy. Comparing the well-known dose-effect relationships in external radiation therapy, the absorbed dose per administered (131)I activity is too low to induce comparable radiation damage, suggesting an inhomogeneous distribution of (131)I in human salivary glands.

Adult↗

Respiration artifacts in whole-body (18)F-FDG PET/CT studies with combined PET/CT tomographs employing spiral CT technology with 1 to 16 detector rows.

PURPOSE: Co-registration accuracy in combined whole-body (WB) PET/CT imaging is impaired by respiration-induced mismatches between the CT and the PET. Furthermore, PET/CT misregistration may bias the PET tracer distribution following CT-based attenuation correction (CT-AC). With the introduction of multi-row CT technology of up to 16 detector rows into PET/CT designs, we investigated the incidence of respiration artifacts in WB PET/CT examinations of patients who were unable to follow any breath-hold instructions. METHODS: A total of 80 WB studies from six international sites operating PET/CT tomographs with 1-, 2-, 4-, 6-, 8-, and 16-row spiral CT were included. PET/CT examinations were acquired with the patients breathing normally during both the CT and the PET scan, and CT-AC was performed routinely. All studies were anonymized and reviewed independently by three radiologists and three nuclear medicine specialists. We report the frequency and severity of artifacts on CT and PET for the thorax and the abdomen. RESULTS: In WB PET/CT imaging of normally breathing patients, significant gains in diagnostic image quality can be expected from employing CT technology with six or more detector rows. In our study, fewer PET images appear distorted than corresponding CT images, which is due to the limited propagation of only mild CT image artifacts after the resampling of the CT-based attenuation map during CT-AC. CONCLUSION: In whole-body PET/CT imaging of normally breathing patients, respiration-induced artifacts are reduced in both magnitude and prominence for PET/CT systems employing CT components of six or more detector rows.

Adolescent↗

Measures of performance in nonlinear estimation tasks: prediction of estimation performance at low signal-to-noise ratio.

Maximum-likelihood (ML) estimation is an established paradigm for the assessment of imaging system performance in nonlinear quantitation tasks. At high signal-to-noise ratio (SNR), ML estimates are asymptotically Gaussian-distributed, unbiased and efficient, thereby attaining the Cramer-Rao bound (CRB). Therefore, at high SNR the CRB is useful as a predictor of the variance of ML estimates and, consequently, as a basis for measures of estimation performance. At low SNR, however, the achievable parameter variances are often substantially larger than the CRB and the estimates are no longer Gaussian-distributed. These departures imply that inference about the estimates that is based on the CRB and the assumption of a normal distribution will not be valid. We have found previously that for some tasks these effects arise at noise levels considered clinically acceptable. We have derived the mathematical relationship between a new measure, chi2(pdf-ML), and the expected probability density of the ML estimates, and have justified the use of chi2(pdf-ML)-isocontours in parameter space to describe the ML estimates. We validated this approach by simulation experiments using spherical objects imaged with a Gaussian point spread function. The parameters, activity concentration and size, were estimated simultaneously by ML, and variances and covariances calculated over 1000 replications per condition from 3D image volumes and from 2D tomographic projections of the same object. At low SNR, where the CRB is no longer achievable, chi2(pdf-ML)-isocontours provide a robust prediction of the distribution of the ML estimates. At high SNR, the chi2(pdf-ML)-isocontours asymptotically approach the analogous chi2(pdf-F)-contours derived from the Fisher information matrix. The chi2(pdf-ML) model appears to be suitable for characterization of the influence of the noise level and characteristics, the task, and the object on the shape of the probability density of the ML estimates at low SNR. Furthermore, it provides unique insights into the causes of the variability of estimation performance.

Algorithms↗

Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations.

UNLABELLED: We investigated radiation exposure of patients undergoing whole-body 18F-FDG PET/CT examinations at 4 hospitals equipped with different tomographs. METHODS: Patient doses were estimated by using established dose coefficients for 18F-FDG and from thermoluminescent measurements performed on an anthropomorphic whole-body phantom. RESULTS: The most relevant difference between the protocols examined was the incorporation of CT as part of the combined PET/CT examination: Separate low-dose CT scans were acquired at 2 hospitals for attenuation correction of emission data in addition to a contrast-enhanced CT scan for diagnostic evaluation, whereas, at the other sites, contrast-enhanced CT scans were used for both purposes. Nevertheless, the effective dose per PET/CT examination was similar, about 25 mSv. CONCLUSION: The dosimetric concepts presented in this study provide a valuable tool for the optimization of whole-body 18F-FDG PET/CT protocols. Further reduction of patient exposure can be achieved by modifications to the existing hardware and software of PET/CT systems.

Body Burden↗

Cerebellar representation of the eyeblink response as revealed by PET.

Blink reflex-related areas in the human cerebellum were studied using [15O]H2O PET in eight healthy subjects. Eyeblinks were evoked by airpuff stimulation and recorded via surface electrodes. PET analysis revealed a cerebellar increase of regional cerebral blood flow in vermal lobule VI and a small ipsilateral paravermal extension in the eyeblink condition compared to rest. This activation partly overlapped with areas found in recent fMRI and animal studies investigating the cerebellar involvement in control of the unconditioned and acquisition of the conditioned eyeblink response. In conclusion, vermal lobule VI extending to ipsilateral paravermal areas appears to be involved in control of the unconditioned eyeblink response.

Adult↗

Limb flexion reflex-related areas in human cerebellum.

Numerous studies have shown that the cerebellum is involved in classical conditioning of specific aversive reactions. Only few studies, however, have examined the exact localization of cerebellar areas involved in the control of unconditioned reflex responses. The present study investigated cerebellar areas, which are activated during eliciting of the limb flexion reflex in healthy controls using [15O]H2O PET. Limb flexion reflex related areas were found in vermal lobules III-VI with the local maximum in vermal lobule V. Areas of activation were more widespread compared to a voluntary foot movement and a sensory foot stimulation condition. Limb flexion reflex areas probably reflect efferent reflex modulation as well as sensory inputs from the stimulus itself and/or the reflex response.

Adult↗

Involvement of the human cerebellum in fear-conditioned potentiation of the acoustic startle response: a PET study.

Fear-conditioned potentiation of the startle response was used to study the role of the cerebellum in associative learning of non-specific aversive reactions in healthy human subjects using PET. Prior PET scanning initially neutral light stimuli were paired with painful electric shocks (fear-conditioning phase). Four PET-scans each were performed with presentation of acoustic startle stimuli (T), fear-conditioned light stimuli (L) or acoustic stimuli paired with light (LT, potentation phase). As a measure of fear-conditioning subtraction of condition T from LT revealed an increase of regional cerebellar blood flow (rCBF) in the left cerebellar hemisphere. Subtraction of condition L from LT, as a measure of fear-conditioned potentiation, revealed an increase of rCBF in the medial cerebellum. Different parts of the cerebellum appear to be involved in this form of motor associative learning.

Acoustic Stimulation↗

Positron emission tomography/computed tomography--imaging protocols, artifacts, and pitfalls.

There has been a longstanding interest in fused images of anatomical information, such as that provided by computed tomography (CT) or magnetic resonance imaging (MRI) systems, with biological information obtainable by positron emission tomography (PET). The near-simultaneous data acquisition in a fixed combination of a PET and a CT scanner in a combined PET/CT imaging system minimizes spatial and temporal mismatches between the modalities by eliminating the need to move the patient in between exams. In addition, using the fast CT scan for PET attenuation correction, the duration of the examination is significantly reduced compared to standalone PET imaging with standard rod-transmission sources. The main source of artifacts arises from the use of the CT-data for scatter and attenuation correction of the PET images. Today, CT reconstruction algorithms cannot account for the presence of metal implants, such as dental fillings or prostheses, properly, thus resulting in streak artifacts, which are propagated into the PET image by the attenuation correction. The transformation of attenuation coefficients at X-ray energies to those at 511 keV works well for soft tissues, bone, and air, but again is insufficient for dense CT contrast agents, such as iodine or barium. Finally, mismatches, for example, due to uncoordinated respiration result in incorrect attenuation-corrected PET images. These artifacts, however, can be minimized or avoided prospectively by careful acquisition protocol considerations. In doubt, the uncorrected images almost always allow discrimination between true and artificial finding. PET/CT has to be integrated into the diagnostic workflow for harvesting the full potential of the new modality. In particular, the diagnostic power of both, the CT and the PET within the combination must not be underestimated. By combining multiple diagnostic studies within a single examination, significant logistic advantages can be expected if the combined PET/CT examination is to replace separate state-of-the-art PET and CT exams, thus resulting in significantly accelerated diagnostics.

Humans↗