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Results for “multimodal integration”

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At least 595 records · Page 33Linked to original sources
PubMed1991

Principles of treatment of pediatric solid tumors.

Great strides have been made in the treatment of pediatric solid tumors over the last three decades. A multimodality approach involving a combination of surgery, radiation therapy, and chemotherapy is now used in the treatment of these diseases. This article reviews the principles that guide the use of these modalities and the multidisciplinary approach used to integrate them into a coordinated treatment plan. The role of each modality in the control of local and systemic disease is described. Radiation treatment planning, dose fractionation, and toxicity are also discussed.

Antineoplastic Agents↗
PubMed2006

Optimized temporal response in multichannel two-photon fluorescence lifetime microscopy using a photonic crystal fibre.

The integration of fibre optics into an imaging system for the convenient delivery and collection of light has resulted in many hybrid forms of novel biomedical optical instrumentation. Although it is extremely robust and cost effective, fibre integration requires special consideration in a time-domain fluorescence lifetime imaging schema where multipath propagation in the fibre causes significant spread in photon transit times. In this study, we investigated the effect of the length of a multimode collection fibre on the temporal performance of a multichannel fluorescence lifetime microscope and demonstrated the effectiveness of a photonic crystal fibre as a means of optimizing the collection and delivery of emitted fluorescence in terms of temporal resolution. The findings are pertinent to all studies that employ a multimode optical fibre to collect and deliver an emitted fluorescence signal from a sample to a remote detector for measurement of the characteristic fluorescence lifetime.

Animals↗
PubMedDate not supplied

[Multimodal treatment of liver metastases: our experience].

Our recent experience in multimodal treatment of liver metastases. Surgical treatment of liver metastases is increasing in these years regarding more and more patients, as well as more and more surgeons. In the same time the introduction of therapies allows today the integration of surgical treatment and also satisfactory palliation. Authors report their experience in these last 4 years and suggest interdisciplinary approach to get good results even in non dedicated centres.

Combined Modality Therapy↗
PubMed1996

[Low rectal cancer: conservative approach integrating radiotherapy].

During the past two decades, the general acceptance of the surgical conservative treatments in tumors such as breast cancer, bone and soft tissue sarcoma, represents one of the significant steps achieved in the treatment of solid tumors. For low rectal cancer, abdominoperineal resection is considered the standard treatment. However, conservative treatments (mono- or multimodality) seem to be as effective, provided that the selection of patients and the choice of the treatment are adequate. This opens a real perspective in favour of conservative treatments resulting already in a restriction in the indications of abdominoperineal resection. In those conservative strategies, radiotherapy has often been used, and some authors consider it essential in several clinical situations.

Anastomosis, Surgical↗
PubMed1989

The brain: integrated three-dimensional display of MR and PET images.

Three patients with intractable epilepsy, two with brain tumors, and one with encephalitis were imaged with magnetic resonance (MR) and positron emission tomography (PET). MR data were used to construct a three-dimensional (3D) computer model of the brain surface depicting the precentral (movement), postcentral (sensation), left inferior frontal (speech), and left superior temporal (hearing) gyri. PET-derived measurements of average surface metabolism were encoded as colors and mapped onto the 3D model by means of a retrospective technique for registering the two scans. The integrated 3D model depicted the location of PET-detected metabolic abnormalities with respect to the gyral anatomy visualized with MR. In each case, the predicted relationships were confirmed intraoperatively by means of inspection of the brain and electroencephalography. Multimodality 3D displays are likely to be particularly valuable for interpreting PET studies of epileptic patients and others with normal MR anatomy.

Brain↗
PubMed2000

Using Bayes' rule to model multisensory enhancement in the superior colliculus.

The deep layers of the superior colliculus (SC) integrate multisensory inputs and initiate an orienting response toward the source of stimulation (target). Multisensory enhancement, which occurs in the deep SC, is the augmentation of a neural response to sensory input of one modality by input of another modality. Multisensory enhancement appears to underlie the behavioral observation that an animal is more likely to orient toward weak stimuli if a stimulus of one modality is paired with a stimulus of another modality. Yet not all deep SC neurons are multisensory. Those that are exhibit the property of inverse effectiveness: combinations of weaker unimodal responses produce larger amounts of enhancement. We show that these neurophysiological findings support the hypothesis that deep SC neurons use their sensory inputs to compute the probability that a target is present. We model multimodal sensory inputs to the deep SC as random variables and cast the computation function in terms of Bayes' rule. Our analysis suggests that multisensory deep SC neurons are those that combine unimodal inputs that would be more uncertain by themselves. It also suggests that inverse effectiveness results because the increase in target probability due to the integration of multisensory inputs is larger when the unimodal responses are weaker.

Acoustic Stimulation↗
PubMed2006

Model-based imaging.

The concept of model-based imaging provides a possibility of integration of both structural and functional information obtained by imaging and nonimaging sources of diagnostically relevant information. Merging information of different origin and nature in a simulated computer patient-specific three-dimensional (3-D) model is important for multimodal imaging approaches to medical diagnostics. The work of F. L. Lizzi on life-like imaging done nearly 20 years ago was the first successful attempt of patient-specific 3-D computer modeling using conventional ultrasonography data. He demonstrated the applications of such 3-D models, which incorporated acoustic, optical and thermal properties of imaged tissue, in physiologic studies, in planning and monitoring ultrasonic hyperthermia and ablation. However, numerous obstacles hinder the wide use of the model-based imaging concept. Using the example of model-based imaging of prostate, the advantages and limitation on the applicability of the concept are discussed. Attempts of implementing the model-based imaging concept in the mechanical imaging technology--imaging with the use of measurements of stress pattern on the surface of tissue--are described. It is shown that composing a patient-specific 3-D model requires well-defined and carefully validated algorithms for translating features of the object assessed by an imaging modality into the quantitative anatomic and histopathologic parameters.

Algorithms↗
PubMedDate not supplied

Open magnetic and electric graphic analysis.

The OMEGA software provides an analysis platform for user-independent, fast, and reproducible multimodal data analysis in one single software environment. Synergetic interactions pursued between the two functional imaging techniques fMRI and MEG use the morphological MRI recording as a basis for a common coordinate frame. In this way, direct interchange, comparison, and integration among the results of the different modalities have become feasible. The fMRI data analysis provides information about the localization of functional activity with low temporal resolution, whereas the MEG recording complements the corresponding time evolution with a high temporal resolution. The implementation of OMEGA allows the analyst to receive comprehensive MEG/fMRI results in a matter of minutes after the measurements have been completed. With OMEGA, the clinical researcher gets comprehensive information in a quick and standardized approach about the sites and the time course of neurological activation, which is useful for clinical applications and diagnostics.

Algorithms↗
PubMed2002

Imaging databases and neuroscience.

Brain atlases are equivalent to neuroimage databases provided an appropriate coordinate system to enable multisubject comparisons, along with comprehensive descriptions of the data, are included. Warping tools, visualization, and statistical analyses that accommodate the various neuroimaging modalities can be used to integrate diverse data and form comprehensive maps describing a particular subpopulation's brain structure and function. By linking task performance and genetic information to brain morphology, complex interrelations between genotype, phenotype, and behavior can be established. Several examples of these multimodal, multisubject atlases, including those that are dynamic, are presented.

Animals↗
PubMed2004

Use of stereotactic PET images in dosimetry planning of radiosurgery for brain tumors: clinical experience and proposed classification.

UNLABELLED: We developed a technique that allows the routine integration of PET in stereotactic neurosurgery, including radiosurgery. We report our clinical experience with the combined use of metabolic (i.e., PET) and anatomic (i.e., MRI and CT) images for the radiosurgical treatment of brain tumors. We propose a classification describing the relative role of the information provided by PET in this multimodality image-guided approach. METHODS: Between December 1999 and March 2003, 57 patients had stereotactic PET as part of their image acquisition for the planning of gamma knife radiosurgery. Together with stereotactic MRI and CT, stereotactic PET images were acquired on the same day using either (18)F-FDG or (11)C-methionine. PET images were imported in the planning software for the radiosurgery dosimetry, and the target volume was defined using the combined information of PET and MRI or CT. To analyze the specific contribution of the PET findings, we propose a classification that reflects the strategy used to define the target volume. RESULTS: The patients were offered radiosurgery with PET guidance when their tumor was ill-defined and we anticipated some limitation of target definition on MRI alone. This represents 10% of the radiosurgery procedures performed in our center during the same period of time. There were 40 primary brain lesions, 7 metastases, and 10 pituitary adenomas. Abnormal PET uptake was found in 62 of 72 targets (86%), and this information altered significantly the MRI-defined tumor in 43 targets (69%). CONCLUSION: The integration of PET in radiosurgery provides additional information that opens new perspectives for the optimization of the treatment of brain tumors.

Adolescent↗
PubMed1995

Standard views in cardiac multimodality tomographic imaging.

In cardiology, it is often necessary to acquire more than one type of image to investigate a given clinical problem of a single patient. Images obtained from different imaging modalities are usually recorded and displayed in different orientations, at different positions, and at different scale factors. It is then necessary for the physician to mentally integrate the image information from the different imaging modalities. This phenomenon is particularly true with tomographic imaging techniques that allow complete freedom of the acquisition plane. In particular, when comparing images obtained from ultrasound, computed tomography, magnetic resonance imaging, positron-emission tomography, and single-photon emission computed tomography. The purpose of this article is to propose a standard set of slice orientations that could be easily applied to all modalities. Such common views could greatly facilitate the user's perception of the regional abnormalities observed in the different imaging modalities. This standardization is certainly useful for clinical application but also for every research study that requires a comparative evaluation of the different imaging modalities. Although exact registration of the images from the different modalities requires sophisticated computer programs, the simple reference method in plane positioning proposed here based on plane orientation according to the cardiac geometry can certainly provide a practical and convenient method for the reasonably accurate image registration required for visual comparative studies.

Diagnostic Imaging↗
PubMed2004

Experimental confirmation of matched bends.

Modal conversion between the fundamental mode and the first-order (leaky) mode has been experimentally investigated in high-index-contrast integrated-optical bent waveguides. The matched bend condition has been experimentally confirmed on cascaded bends, and the effect of both matched and unmatched bends on Y branches has been investigated. Good agreement between theoretical predictions and experimental results for both monomode and multimode waveguides is achieved. It is demonstrated that, in bent waveguides, the modal conversion between the fundamental mode and the first (leaky) mode can be accurately controlled to avoid additional losses and transfer function impairments.

Journal Article↗
PubMed2003

Induction or consolidation systemic therapy in the multimodality treatment of unresectable locally advanced non-small cell lung cancer.

Chemoradiotherapy has been shown to improve survival over radiation alone for unresectable locally advanced non-small cell lung cancer (NSCLC). Large randomized trials comparing sequential to concomitant platinum based chemoradiotherapy have demonstrated improved median survival times in favor of concomitant treatment. Recent phase II trials have evaluated the integration of advanced radiotherapy techniques, novel chemotherapy combinations, induction chemotherapy, and consolidation chemotherapy with concomitant chemoradiotherapy. On-going or recently completed phase III trials are evaluating whether the promising regimens from phase II studies are superior to concomitant chemoradiotherapy alone. Molecular therapies now need to be integrated with chemoradiotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

[Surgery for oesophageal cancer: current controversies].

Any attempt to define the present role of surgery in the treatment of oesophageal cancer should integrate the dramatic changes that occurred within this disease over the last 2 decades: major shift in the histologic type of tumours, improved staging methods, spectacular reduction of operative risks, standardization of oncologic principles focusing on the completeness of resection, and development of multimodality therapeutic strategies. Surgery has still a pivotal role. Esophagectomy should be performed by trained surgeons in high-volume institutions. Radical surgery with en-bloc resection and 2 fields lymphadenectomy, should be encouraged in low-risk patients with subcarinal tumors. Although multimodality treatment strategy is commonly applied for locally advanced disease, few data support its superiority over surgical resection alone, followed by adjuvant therapy when appropriate. One may thus hypothesize that the risk/benefit ratio of such strategies is probably optimal in case of early stage tumors, and future studies may further clarify this issue. Conversely, locally advanced tumors, particularly those located in the upper mediastinum and the neck, may be managed alternatively without surgery. However, surgery remains an important tool to ensure optimal palliation of dysphagia, to achieve local control, and finally to improve quality of life. In that way, video-assisted techniques and/or trans hiatal approaches aiming to minimize the surgical insult may have a place in the treatment of patients who have substantially responded to induction therapy. Tumors located close to the pharyngo-oesophageal junction are best managed with chemotherapy and radiotherapy. Finally, salvage surgery may be considered in highly selected patients in case of non-response or local relapse without distant metastases.

Combined Modality Therapy↗
PubMed1998

Clinical studies in non-small cell lung cancer: the CALGB experience.

Since 1984, the Cancer and Leukemia Group B (CALGB) has focused its clinical research in stage IV non-small cell lung cancer (NSCLC) on investigations of new agents and combinations. Currently, efforts are aimed at identifying non-cisplatin-based combinations with an increased therapeutic index. In stage III disease multimodality therapies have been pursued. Dillman et al. reported a study comparing standard radiotherapy versus induction chemotherapy followed by radiotherapy in patients with unresectable stage III NSCLC. The chemotherapy-treated patients were found to benefit with a 4-month increase in median survival time compared with patients receiving radiotherapy alone (13.8 vs. 9.7 months) and an increased 3-year survival rate of 23% versus 11%. This was the first randomized cooperative group study demonstrating a survival advantage resulting from the use of induction chemotherapy in locoregionally advanced NSCLC. In a subsequent study, the administration of additional "posterior" chemotherapy was not found to be feasible because of early disease progression and toxicity, while the administration of induction chemotherapy followed by concomitant chemoradiotherapy was feasible; therefore, the latter approach was studied further in a randomized phase III setting. This study compared a standard of two cycles of cisplatin and vinblastine followed by radiotherapy with an experimental arm of cisplatin and vinblastine followed by radiotherapy and concomitant carboplatin. Accrual to this study has been completed and results are expected in the near future. In resectable stage III disease, studies have focused on the optimal sequencing of multimodality therapy. A randomized study comparing standard regional therapy with radiotherapy and surgery versus a previously piloted approach combining chemotherapy, surgery, and radiotherapy was closed prematurely due to poor accrual. The next generation of studies in stage III NSCLC will focus on the integration of new chemotherapy agents into the treatment armamentarium for NSCLC. A randomized phase II study investigating paclitaxel, gemcitabine, and vinorelbine in combination with cisplatin in the induction setting and as concomitant chemoradiotherapy has recently been activated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Anthropometric multivariate structure and dermatoglyphic peculiarities in biochemically and morphologically different heterozygous groups.

Multivariate analysis of the relationship between degree of heterozygosity at four blood group loci and the morphological variability in a human population was carried out. Additionally, the possibility that dermatoglyphic patterns correlate with biochemical and anthropometric variables was also investigated. A strong and significant increase in the frequency of morphologically multimodal individuals was observed, which paralleled the heterozygosity level. Discriminant analysis, by quantitative characters, of the closest pair of biochemically different samples yielded a satisfactory discrimination. Multiple correlations of each variable with all the others (18 traits), the communality of characters, the index of integration, and the Mahalanobis distances of the factor scores for each individual (all extracted from principal component analysis) were all indicative of the different multivariate structures of homo- and heterozygous individuals and thus supported the hypothesis that heterozygotes tend to cluster near the center of the joint multivariate distribution. The dermatoglyphic patterns showed a certain relationship with the morphological makeup of individuals. Correlations between biochemical heterozygosity at blood group loci and patterns of digital dermatoglyphics were rather irregular.

Adolescent↗
PubMed2003

The management of the patient undergoing combined modality therapy for locally advanced non-small cell lung cancer.

Multimodality management of locally advanced non-small cell lung cancer is commonplace. Locally advanced disease is defined as patients with stage IIIA, IIIB (without pleural effusions), and Pancoast tumors. Improvements in the median and landmark survival rates of patients have been accomplished by integration of chemotherapy, radiotherapy, and surgery. Although the optimal sequencing and number of modalities remains to be established, the safe treatment of patients requires cooperation of the specialties (joint clinics and tumor boards). The toxicities of chemoradiotherapy are esophagitis, pneumonitis, and myelosuppression. These complications are a function of the dose and fractionation scheme of radiotherapy and the dose, schedule, and specific chemotherapy agents used. The use of modern techniques, including three-dimensional conformal radiotherapy, limitation of field size, and aggressive treatment of symptoms reduces toxicity and the number of treatment breaks, and allows delivery of planned therapy in many patients. In appropriate patients, surgery may be successful after induction chemotherapy or chemoradiotherapy. In addition to exclusion of medically inappropriate patients, patients with persistent mediastinal adenopathy after induction therapy are not likely to benefit from resection. Therefore, mediastinal sampling must be repeated after chemoradiotherapy and before surgery.

Carcinoma, Non-Small-Cell Lung↗