Biomedical subjects

Thomas Allkemper

Publications and source records attributed to Thomas Allkemper.

8 recordsLinked to original sources

PubMed2006

Detection of colorectal polyps: comparison of multi-detector row CT and MR colonography in a colon phantom.

PURPOSE: To compare multi-detector row (four- and 16-section) computed tomography (CT), including a low-dose protocol, with high-field-strength (1.5- and 3.0-T) magnetic resonance (MR) imaging for reader detection of colorectal polyps in a colon phantom. MATERIALS AND METHODS: A colon phantom with simulated haustral folds and 10 polyps of varying size (2.0-8.0 mm) was imaged at four- and 16-section CT (section thicknesses of 1.25 and 0.75 mm, reconstruction increments of 0.8 and 0.7 mm, and 100 and 10 mAs, respectively, and 120 kV for both) and at 1.5- and 3.0-T MR imaging (three-dimensional gradient-recalled echo sequence, section thickness of 1.4 mm). Three-dimensional endoluminal images were assessed by 10 reviewers for each modality regarding polyp detection. Comparisons of sensitivities were performed by using logistic regression. RESULTS: Overall, polyps were detected with a sensitivity of 87% (95% confidence interval [CI]: 80%, 94%) at four-section CT, 92% (95% CI: 87%, 97%) at 16-section CT, 56% (95% CI: 46%, 66%) at 1.5-T MR imaging, and 55% (95% CI: 45%, 65%) at 3.0-T MR imaging. The detection of polyps at least 4 mm in diameter was not influenced by the modality or radiation dose (sensitivity of 100%). CT performed in low-dose mode depicted all polyps with a diameter of at least 3 mm. Polyps smaller than 3 mm in diameter were detected with a sensitivity of 7.5% (1.5-T MR imaging), 22.5% (3.0-T MR imaging), and 20% (low-dose CT); detection rates were significantly greater (P < .001) with normal-dose CT (four section, 67.5%; 16 section, 82.5%). Increased spatial resolution (with CT) and higher field strength (with MR imaging) had no significant effect on polyp detection. CONCLUSION: With both multi-detector row CT and MR imaging, readers detected polyps above the clinically relevant threshold diameter of 6 mm, with similar sensitivities.

Colonic Polyps↗

PubMed2006

Effect of field strengths on magnetic resonance angiography: comparison of an ultrasmall superparamagnetic iron oxide blood-pool contrast agent and gadopentetate dimeglumine in rabbits at 1.5 and 3.0 tesla.

OBJECTIVES: We sought to compare the intravascular enhancement of an ultrasmall superparamagnetic iron oxide (USPIO) blood-pool contrast agent to gadopentetate dimeglumine for contrast-enhanced magnetic resonance angiography (CE-MRA) at field strengths of 1.5 and 3.0 T in rabbits. MATERIALS AND METHODS: CE-MRA at 1.5 and 3.0 T was performed at several time points (50 seconds and 5, 10, 20, and 30 minutes) after the manual intravenous injection of 40 micromol Fe/kg body weight of an USPIO (SH U 555 C; Schering AG, Berlin, Germany) and 100 micromol/kg body weight gadopentetate dimeglumine (Magnevist; Schering AG, Berlin, Germany). MRA was performed with comparable acquisition parameters at both field strengths (Turbo-gradient sequence; 1.5 T: TR/TE/alpha: 5.5/1.7 milliseconds/40 degrees ; 3.0 T: TR/TE/alpha: 5.1/1.8 milliseconds/40 degrees ) on clinical imaging systems (both: Gyroscan Intera, Philips Medical Systems, Best, The Netherlands). At either field strength, 6 rabbits were studied with both contrast agents (n = 24 in total). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated from signal intensity measurements in the abdominal aorta. RESULTS: Compared with 1.5 T, the SNR and CNR of gadopentetate dimeglumine significantly increased at 3.0 T by a factor of 2.2 and 2.3, respectively (P or= 0.05). At both field strength and either time point, CNR and SNR of SH U 555 C were significantly higher compared with gadopentetate dimeglumine at 3.0 T (P <or= 0.01). CONCLUSIONS: SNR and CNR of gadopentetate dimeglumine significantly increased with increasing field strength. No SNR or CNR gain was observed for SH U 555 C. However, blood-pool MRA with SH U 555 C is feasible at 3.0 T. Compared with gadopentetate dimeglumine, SNR and CNR of SH U 555 C were significantly higher from 5 to 30 minutes at both field strengths (P <or= 0.01).

Animals↗

PubMed2004

Acute and subacute intracerebral hemorrhages: comparison of MR imaging at 1.5 and 3.0 T--initial experience.

PURPOSE: To assess and describe the appearance of intracerebral hemorrhage (ICH) at 3.0-T magnetic resonance (MR) imaging as compared with the appearance of this lesion type at 1.5-T MR imaging. MATERIALS AND METHODS: Sixteen patients with 21 parenchymal ICHs were examined. ICHs were classified as hyperacute, acute, early subacute, late subacute, or chronic. Patients underwent 1.5- and 3.0-T MR imaging with T2-weighted fast spin-echo, fluid-attenuated inversion-recovery (FLAIR), and T1-weighted spin-echo (1.5-T) and gradient-echo (3.0-T) sequences within 4 hours of each other. The central (ie, core) and peripheral (ie, body) parts of the ICHs were analyzed quantitatively by using contrast-to-noise ratio (CNR) calculations derived from signal intensity (SI) measurements; these values were statistically evaluated by using the Mann-Whitney U test. Two readers qualitatively determined SIs of the cores and bodies of the ICHs, degrees of apparent susceptibility artifacts, and lesion ages. The chi(2) test was used to determine statistically significant differences. RESULTS: With the exception of the bodies of late subacute ICHs at 3.0-T T2-weighted imaging, which had increased positive CNRs and SI scores (P </=.05), all parts of the ICHs at all stages showed increased negative CNRs and SI scores at 3.0-T FLAIR and T2-weighted imaging, as compared with these values at 1.5 T (P </=.05). No significant CNR or SI score differences at any ICH stage were observed between 1.5-T spin-echo and 3.0-T gradient-echo T1-weighted imaging (P >.05). With the exception of minor susceptibility artifacts seen in acute and early subacute ICHs at 3.0-T T1-weighted gradient-echo imaging, no susceptibility artifacts were noticed. The ages of most lesions were identified correctly without significant differences between the two field strengths (P >.05), with the exception of the ages of acute ICHs, which were occasionally misinterpreted as early subacute lesions at 3.0 T. CONCLUSION: At 3.0 T, all parts of acute and early subacute ICHs had significantly increased hypointensity on FLAIR and T2-weighted MR images as compared with the SIs of these lesions at 1.5 T. However, 1.5- and 3.0-T MR images were equivalent in the determination of acute to late subacute ICHs.

Acute Disease↗

PubMed2004

Myocardial perfusion and MR angiography of chest with SH U 555 C: results of placebo-controlled clinical phase i study.

PURPOSE: To evaluate SH U 555 C for contrast material-enhanced three-dimensional magnetic resonance (MR) angiography of the chest and myocardial perfusion. MATERIALS AND METHODS: For chest MR angiography, SH U 555 C was intravenously injected at four doses (5, 10, 20, and 40 micromol iron [Fe] per kilogram of body weight) into three healthy volunteers per dose group, and placebo (saline) was injected into one additional volunteer per dose group (16 subjects). With a body phased-array coil, serial high-spatial-resolution breath-hold three-dimensional MR angiography of the chest was performed at baseline, first pass, and 6, 12, 18, 24, 30, 36, and 42 minutes after injection. SH U 555 C (40 micromol Fe/kg) was injected into four additional volunteers to evaluate cardiac perfusion. Signal intensity (SI) was measured in vessels, cardiac chambers, and myocardium to calculate relative SI changes during time. Analysis of variance for multiple comparisons was applied for statistical analysis. Two readers assessed image quality. Subjects were monitored for side effects (cardiovascular reactions) for 24 hours. RESULTS: SH U 555 C showed a dose-dependent increase in SI enhancement during first pass and equilibrium phase. SH U 555 C showed dose-dependent increase (range, 259% +/- 160 [SD] at 5 micromol Fe/kg to 907% +/- 370 at 40 micromol Fe/kg) for thoracic aorta during first pass. Intravascular SI did not significantly decrease with time during equilibrium phase within arterial and venous vessels. Image quality remained stable and was diagnostic for highest dose group to 30 minutes, with good to excellent contrast even in smaller blood vessels. For cardiac perfusion, SH U 555 C showed peak enhancement during first pass through right and left ventricles, as well as stable SI during equilibrium phase within cardiac chambers and myocardium. Peak enhancement during first pass was limited due to susceptibility effects, which were more pronounced in right ventricle than in left. Contrast agent was well tolerated, and no cardiovascular reactions occurred. CONCLUSION: SH U 555 C bolus injected at highest dose of 40 micromol Fe/kg has capability for depiction at first-pass MR angiography and for cardiac perfusion.

Adult↗

PubMed2004

First-pass and equilibrium-MRA of the aortoiliac region with a superparamagnetic iron oxide blood pool MR contrast agent (SH U 555 C): results of a human pilot study.

The purpose of this study was to study different doses for first-pass and equilibrium phase MRA of aortoiliac vessels with a superparamagnetic iron oxide (SPIO) intravascular MR contrast agent (SH U 555 C) after single i.v. bolus injection. Sixteen healthy volunteers were prospectively enrolled into this single-blind, placebo-controlled clinical trial. SHU 555 C was injected as an i.v. bolus at stepwise increased dose levels of 5, 10, 20 and 40 micromol Fe/kg bodyweight (b.w.) corresponding to injection volumes of 0.01, 0.02, 0.04 and 0.08 ml/kg b.w. Serial high-resolution three-dimensional MRA of the aortoiliac vessels was acquired during first-pass and equilibrium, at 6 min intervals up to 42 min after contrast application using a breath-hold three-dimensional FLASH sequence on a 1.5 T scanner. Intravascular enhancement was calculated within the abdominal aorta and the inferior vena cava and a statistical analysis for significant differences in vessel enhancement was performed during the bolus and equilibrium phases. The visibility of vessels was ranked and effects of potential artifacts on image quality were graded for each time point and dose group. SH U 555 C showed a dose-dependent intravascular enhancement during the observation period (42 min). The highest dose of 40 micromol Fe/kg b.w. revealed the highest image quality during first-pass and equilibrium phases. The intravascular enhancement in the aorta increased dose-dependently from 5 to 40 micromol kg b.w. during first-pass and equilibrium phases (p<0.05). Intravascular signal inhomogeneities were observed at lower doses and decreased with increasing doses. First-pass MRA was diagnostic at doses of 10, 20 and 40 micromol Fe/kg b.w. For equilibrium MRA, a dose of 40 micromol Fe/kg b.w. was considered to be diagnostic. SH U 555 C proved to be a contrast agent with a high T1-effect suitable for both first-pass MRA comparable to gadolinium-enhanced MRA and high resolution equilibrium MRA up to 42 min post-injection (p.i.).

Adult↗

PubMed2003

CT colonography: Protocol optimization with multi-detector row CT--study in an anthropomorphic colon phantom.

PURPOSE: To determine optimal detector collimation, section thickness, and tube current for multi-detector row computed tomography (CT) colonography. MATERIALS AND METHODS: An anthropomorphic colon phantom with simulated polyps of varying size (2, 6, 8, 10, and 12 mm) was examined by using multi-detector row CT with varying combinations of detector collimation (4 x 1.0 mm and 4 x 2.5 mm), dose per section (10, 20, 40, 60, 80, 100, and 140 mAs), and section thickness/reconstruction interval (1.25/0.6, 2.0/1.0, 3.0/1.0, and 5.0/2.0 mm). Polyp depiction, longitudinal polyp distortion, and presence of rippling artifacts were assessed on reformatted three-dimensional endoluminal images by three reviewers. RESULTS: Longitudinal distortion and rippling artifacts increased with increasing section thickness and use of broader detector collimation. Polyps 8 mm or larger were depicted with any combination of section thickness, detector collimation, and tube current. Depiction of polyps 6 mm or smaller depended on the detector collimation/reconstructed section thickness and was rated optimal for the 4 x 1.0-mm detector collimation with a section thickness of 1.25 mm. This was also observed for low-dose protocols. Polyps 6 mm or smaller that were not detected with 3-mm section thickness and 4 x 2.5-mm detector collimation were detected with 1.25-mm section thickness and 10 mAs. CONCLUSION: A narrow detector collimation with thin-section imaging (4 x 1.0-mm detector collimation, 1.25-mm section thickness) is a prerequisite for low-dose (10-mAs) multi-detector row CT colonography.

Artifacts↗

PubMed2002

Contrast-enhanced blood-pool MR angiography with optimized iron oxides: effect of size and dose on vascular contrast enhancement in rabbits.

PURPOSE: To investigate intravascular enhancement of bolus-injectable small and ultrasmall superparamagnetic iron oxides (USPIOs) of different particle sizes and relaxivities for first-pass and blood-pool magnetic resonance (MR) angiography. MATERIALS AND METHODS: Iron oxides with different particle sizes (hydrodynamic diameters, 21, 33, 46, and 65 nm) were bolus injected intravenously at three doses (10, 20, and 40 micromol per kilogram body weight). An extracellular contrast agent (gadopentetate dimeglumine) served as a control. MR angiography was performed multiple times after intravenous injection (5-120 minutes and 24 hours later). Signal enhancement was calculated from signal intensity measurements in the abdominal aorta and renal and iliac arteries. RESULTS: Highest enhancement was seen during the first pass with all contrast agents. USPIO enhancement in the abdominal aorta increased significantly with decreasing particle size (65 nm vs 33 nm, 65 nm vs 21 nm; P <.01). CONCLUSION: The smallest iron oxide provided signal enhancement comparable with that of gadopentetate dimeglumine at 40 micromol iron per kilogram for first-pass investigations, with prolonged signal enhancement up to 25 minutes, allowing multiple measurements after injection of a single bolus.

Analysis of Variance↗

PubMed2002

Analysis of vertebral morphology in idiopathic scoliosis with use of magnetic resonance imaging and multiplanar reconstruction.

BACKGROUND: Several studies have provided data on the vertebral morphology of normal spines, but there is a paucity of data on the vertebral morphology in patients with idiopathic scoliosis. METHODS: The morphology of the pedicles and bodies of 307 vertebrae as well as the distance between the pedicles and the dural sac (the epidural space) in twenty-six patients with right-sided thoracic idiopathic scoliosis were analyzed with use of magnetic resonance imaging and multiplanar reconstruction. RESULTS: A distinct vertebral asymmetry was found at the apical region of the thoracic curves, with significantly thinner pedicles on the concave side than on the convex side (p < 0.05). The degree of intravertebral deformity diminished farther away from the apex, with vertebral symmetry restored at the neutral level. In the thoracic spine, the transverse endosteal width of the apical pedicles measured between 2.3 mm and 3.2 mm on the concave side and between 3.9 mm and 4.4 mm on the convex side (p < 0.05). In the lumbar spine, the pedicle width measured between 4.6 mm at the cephalad part of the curve and 7.9 mm at the caudad part of the curve. The chord length and the pedicle length gradually increased from 34 mm and 18 mm, respectively, at the fourth thoracic vertebra to 51 mm and 25 mm, respectively, at the third lumbar vertebra. The transverse pedicle angle measured 15 in the cephalad aspect of the thoracic spine, decreased to 7 at the twelfth thoracic vertebra, and increased again to 16 at the fourth lumbar vertebra. The width of the epidural space was <1 mm at the thoracic apical vertebral levels and averaged 1 mm at the lumbar apical vertebral levels on the concave side, whereas it was between 3 mm and 5 mm on the convex side (p < 0.05). CONCLUSION: Idiopathic scoliosis is associated with distinctive intravertebral deformity, with smaller pedicles on the concave side and a shift of the dural sac toward the concavity.

Adolescent↗