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PubMed2005

A novel brainstem tumor model: guide screw technology with functional, radiological, and histopathological characterization.

OBJECT: Survival rates for high-grade brainstem tumors are approximately 10% and optimal therapy has yet to be determined. Development of a satisfactory brainstem tumor model is necessary for testing new therapeutic paradigms that may prolong survival. The authors report the technique, functional progression, radiological appearance, and histopathological features of a novel brainstem tumor model in rats. METHODS: Thirty female Fischer 344 rats were randomized (10 animals/group) to receive an injection of either 3 ml of 9L gliosarcoma cells (100,000 cells), 3 ml of F98 glioma cells (100,000 cells), or 3 ml of medium (Dulbecco modified Eagle medium) into the pontine tegmentum of the brainstem. Using a cannulated guide screw system implanted in the skull of the animal, rats in each group were injected at coordinates 1.4 mm to the right of the sagittal and 1 mm anterior to the lambdoid sutures, at a depth of 7 mm from the dura mater. The angle of the syringe during injection was anteflexed 5 degrees from the vertical. Postoperatively, the rats were evaluated for neurological deficits by using an automated rotarod test. High-resolution [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) fused with computerized tomography (CT) scans were acquired pre- and postoperatively through the onset of hemiparesis and correlated accordingly. Kaplan-Meier curves were generated for survival and disease progression, and brains were processed postmortem for histopathological investigation. The 9L and F98 tumor cells grew in 95% of the animals in which they were injected and resulted in a statistically significant mean onset of hemiparesis of 16.5 6 0.56 days (p = 0.001, log-rank test), compared with animals in the control group, which had no neurological deficits by Day 45. The FDG-PET studies coregistered with CT scans demonstrated space-occupying brainstem lesions, and this finding was confirmed by histological studies. Animals in the control group showed no functional, radiological, or pathological signs of tumor. CONCLUSIONS: Progression to hemiparesis was consistent in all tumor-injected animals, with predictable onset of symptoms occurring approximately 17 days postsurgery. The histopathological and radiological characteristics of the 9L and F98 brainstem tumors were comparable to those of aggressive primary human brainstem tumors. Establishment of this animal tumor model will facilitate the testing of new therapeutic paradigms for the treatment of these lesions.

Animals↗
PubMed1985

Diagnostic imaging, a "parallel" discipline. Can current technology provide a reliable digital diagnostic radiology department?

Only recently has any detailed criticism been voiced about the practicalities of the introduction of generalised, digital, imaging complexes in diagnostic radiology. Although attendant technological problems are highlighted we argue that the fundamental causes of current difficulties are not in the generation but in the processing, filing and subsequent retrieval for display of digital image records. In the real world, looking at images is a parallel process of some complexity and so it is perhaps untimely to expect versatile handling of vast image data bases by existing computer hardware and software which, by their current nature, perform tasks serially. Successes in applying new imaging devices using digital technology, numerical methods and more easily available computing power are directing radiology towards the concept of all-digital departmental complexes. Hence a critical discussion of fundamental problems should be encouraged, to promote a thorough understanding of what may be involved (Gray et al, 1984) in following such a course. It is equally important to gain some perspective about the development possibilities for existing, commercially available equipment being offered to the medical community.

Computers↗
PubMed1996

Technology assessment methods for radiology systems.

This article discusses the strengths and weaknesses of technology assessment methods for the evaluation of novel and complex radiology systems, including picture archiving and communication systems (PACS), computed radiography (CR), teleradiology, and other new models for the delivery of radiology services. Using examples from PACS and CR, we review early economic assessments of PACS from the radiology department. We then broaden our perspective to discuss the analytic criteria that can be used to evaluate economic analyses of PACS as the health care delivery system shifts toward managed care. We close with a proposal for optimizing the integration of information technology into the clinical environment through ongoing target data collection during the implementation of new radiology systems.

Cost Savings↗