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Steffen Appold

Publications and source records attributed to Steffen Appold.

4 recordsLinked to original sources

Effects of radiotherapy on olfactory function.

BACKGROUND AND PURPOSE: Changes in olfactory function have been reported in patients receiving significant doses of radiation to the olfactory epithelium. Aim of this study was to investigate severity and time course of changes in olfactory function in patients irradiated for tumours of the head and neck region. MATERIAL AND METHODS: Forty-four patients receiving radiotherapy (RT) for tumours in the area of the head and neck participated (16 women, 28 men; age 11-81 y; mean 55 y). Olfactory function was measured before and bi-weekly during RT for 6 weeks. A subgroup (25 patients) was followed for 12 months. Patients were divided into two groups according to the dose to the olfactory epithelium. Twenty-two patients ('OLF group') had radiation doses to the olfactory epithelium between 23.7 and 79.5 Gy (median 62.2 Gy). In the 22 patients of the 'non-OLF group' the dose applied to the olfactory epithelium was significantly lower (2.9-11.1 Gy, median 5.9 Gy). Total tumour dose (30-76.8 Gy), age, sex distribution, and baseline chemosensory function were not significantly different between groups. Testing was performed for odour identification, odour discrimination, and olfactory thresholds. RESULTS: Odour discrimination, but not odour identification or odour threshold, was significantly decreased 2-6 weeks after begin of therapy in the OLF group. In addition, a significant effect of the radiation dose was observed for odour discrimination. More than 6 months after therapy, OLF group patients had significantly lower odour identification scores compared to the non-OLF group. CONCLUSION: As indicated through the non-significant change of olfactory thresholds, the olfactory epithelium is relatively resistant against effects of radiation. It is hypothesized that RT has additional effects on the olfactory bulb/orbitofrontal cortex responsible for the observed changes of suprathreshold olfactory function.

Adolescent↗

MR perfusion measurements on pharyngeal tumors: comparison of quantification strategies.

For the case of pharyngeal carcinomas, the clinical value as well as the stability of several evaluation methods of MR tomographic perfusion measurement are compared. Eighteen patients suffering from histologically proven squamous cell carcinomas were investigated by MR tomography (1.5 T, 0.2 mmol/kg Gd-DTPA) prior to and during radiation therapy. Perfusion measurements were performed using a double-echo FLASH sequence. Parameters describing regional blood flow, blood volume, mean transit time, and interstitial concentration of contrast medium (CM) were calculated, applying seven different combinations of correction approaches (separating the shortening of T1 and T2*, arterial input function (AIF), and tumor shunts). Their correlations to MR independent tumor physiological parameters were analyzed (metabolic activity measurements using 18F-FDG-PET, polarographical pO2 measurement, tumor volume). Significant improvements of the correlation between perfusion-dependent and other tumor physiological parameters could be achieved by decoupling the shortening of T1 and T2* and by applying of the tumor shunt model. Deconvolution from the AIF deteriorated the correlation. Therefore, the elimination of the T1 shortening due to interstitial CM proves to be essential for MR perfusion measurements on contrast medium uptaking lesions. Depending on the measurement conditions (temporal resolution, signal-to-noise ratio), the consideration of the AIF can even make the results significantly worse by introducing additional measuring errors.

Adult↗

Gadomer-17-enhanced 3D navigator-echo MR angiography of the pulmonary arteries in pigs.

The goal of this study was visualisation and quality assessment of the pulmonary arteries in pigs with modified navigator-echo magnetic resonance angiography using an intravascular contrast agent. Five sedated pigs were examined in a clinical 1.5-T system with modified three-dimensional navigator-echo magnetic resonance angiography (slice thickness 3 mm, pixel size 2.4x1.8 mm2) to evaluate the pulmonary arteries. Using a phased-array four-element thorax coil the entire thorax was scanned before and after intravenous infusion of a gadolinium-based intravascular contrast agent. Assessment of image quality, enhancement-related contrast-to-noise ratio (CNR) measurements and improvement of visibility of peripheral pulmonary vessels was performed. Improvement of quality using Gadomer-17 was found for smaller vessels; pulmonary trunks and the main pulmonary arteries were sufficiently imaged without enhancement. Mean rise of CNR measured in the pulmonary trunks was 28.64% ( P=0.0002), mean rise of CNR in the main pulmonary arteries and the segmental arteries were 79.6% and 148.2%, respectively. Mean distance between the visible peripheral end of 60 sub-segmental arteries and the inner thoracic wall was 12.2 +/- 0.4 mm, and was significantly ( P=0.00002) reduced after contrast infusion to 8.0 +/- 0.4 mm. The combination of inherent flow sensitivity of navigator-echo angiography and Gadomer-17 proved effective for imaging of the pulmonary arteries. In contrast to standard contrast-enhanced pulmonary MRA studies, breath holding is not required. Further studies and the evaluation of findings of patients suffering from pulmonary embolism are needed to evaluate the possible benefits of a higher spatial resolution which is achievable using navigator-echo techniques in contrast to the higher temporal resolution of ultra-fast pulmonary MRA.

Animals↗