301
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Alnaqbi KAY, Joshi S, Ghazal-Aswad S, Abu Zidan FM. Primary umbilical adenocarcinoma. Singapore Med J 2007; 48:e308-e310. [PMID: 18043824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Primary umbilical tumours are extremely rare. We report primary serous adenocarcinoma arising from the coelomic mesothelium of the hernial sac. A 60-year-old woman presented with an umbilical swelling of six months duration that became painful in the last three days. Examination revealed a tender umbilical swelling diagnosed as obstructive hernia that needed surgery. When dissecting the sac during surgery, a small subcutaneous abscess was encountered. The sac contained an omentum with a hard nodule at the surface which was excised. Umbilical hernia repair was performed. Histology of the omental nodule revealed serous papillary adenocarcinoma. Chest and abdomen computed tomography, pelvic magnetic resonance imaging, gastroscopy, colonoscopy and laparotomy did not reveal the primary site of the tumour.
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Singh SK, Joshi S, Singh AR, Saxena JK, Pandey DS. DNA Binding and Topoisomerase II Inhibitory Activity of Water-Soluble Ruthenium(II) and Rhodium(III) Complexes. Inorg Chem 2007; 46:10869-76. [DOI: 10.1021/ic700885m] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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303
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Joglekar N, Joshi S, Kakde M, Fang G, Cianciola M, Reynolds S, Mehendale S. Acceptability of PRO2000 vaginal gel among HIV un-infected women in Pune, India. AIDS Care 2007; 19:817-21. [PMID: 17573603 DOI: 10.1080/09540120601133576] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Acceptability of PRO2000 Gel, a candidate vaginal microbicide, among participants of its Phase I safety study in Pune, India is reported here. Forty-two eligible women were enrolled in a study requiring twice daily intra-vaginal product use for 14 consecutive days between menses. Acceptability was assessed at study exit through structured questionnaires among 41 participants who completed the product use, and five focus group discussions involving 31 study participants. The participants generally liked the product (40/41, 97.2%), especially its colour (40, 97.2%) and consistency (35, 85.3%). Thirty-four participants reported sexual intercourse within one hour of product use, at least once during the study period and sexual pleasure was reported to be better or unaffected among (30, 88.2%) participants. Nearly 70% did not like its smell and mentioned preference for a product that would be unnoticeable to the male partner. Participating women were concerned about privacy in usage and storage of the product. Acceptability of PRO2000 vaginal gel was good, but its smell will have to be improved. Counselling to address women's concerns about privacy and storage will be crucial. Women's preference for unnoticeable product indicates their empowerment and willingness to accept female-controlled options for HIV prevention.
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304
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Gupta A, Kumar S, Gupta R, Chaudhury S, Joshi S. Enhancement of Old Manuscript Images. NINTH INTERNATIONAL CONFERENCE ON DOCUMENT ANALYSIS AND RECOGNITION (ICDAR 2007) VOL 2 2007. [DOI: 10.1109/icdar.2007.4377014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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305
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Joshi S, Agarwal B, Malla G, Karmacharya B. Complete elimination of tetanus is still elusive in developing countries: a review of adult tetanus cases from referral hospital in Eastern Nepal. Kathmandu Univ Med J (KUMJ) 2007; 5:378-381. [PMID: 18604058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM To analyse demography, clinical presentation, treatment, complications and outcome of patients with tetanus over a 2-year period. MATERIALS AND METHODS A retrospective analysis of medical records of all patients with tetanus admitted to the intensive care unit of B.P Koirala Institute of Health Sciences, Dharan, Nepal between July 2004 and June 2006. RESULTS Tetanus accounted for 1.1 % of our ICU admission. Eight tetanus patients (mean age 52 years; M: F ratio 7:1) were admitted. The tetanus prone wounds of seven patients were managed at home. The most common presenting complaints were trismus and stiffness of neck and back (87.5%). Elective intubation was followed by tracheostomy in all the patients. Overall mean duration of ventilatory support was 12.5 days. Treatments given in ICU were diazepam, magnesium sulphate, tetanus immunoglobulin, metronidazole, wound management and supportive measures. Five patients (62.5%) developed autonomic instability and three patients had ventilatory associated pneumonia (37.5%). Average ICU stay was 15.1 days while hospital stay was 20.1 days. Five patients (62.5%) survived the course of disease. Two patients (25%) left the hospital against medical advice while the other (12.5%) died in ICU. CONCLUSION Tetanus is a vaccine preventable disease. Tetanus prone wounds should be managed appropriately. Respiratory compromise and autonomic instability are the main causes of morbidity and mortality. Early recognition, intense support and prompt treatment improves morbidity and mortality of patients diagnosed with tetanus.
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Chaudhury A, Khatirkar R, Viswanathan N, Singal V, Ingle A, Joshi S, Samajdar I. Low silicon non-grain-oriented electrical steel: Linking magnetic properties with metallurgical factors. JOURNAL OF MAGNETISM AND MAGNETIC MATERIALS 2007; 313:21-28. [DOI: 10.1016/j.jmmm.2006.11.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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307
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Kashani R, Balter J, Kessler M, Hub M, Dong L, Zhang L, Xing L, Xie Y, Hawkes D, Schnabel J, McClelland J, Joshi S. TU-C-M100J-03: Objective Assessment of Deformable Image Registration in Radiotherapy - a Multi-Institution Study. Med Phys 2007. [DOI: 10.1118/1.2761334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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308
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Foskey M, Gash A, Han Q, Tracton G, Joshi S, Pizer S, Chaney E. SU-FF-I-58: A Software Toolkit for Multi-Image Registration and Segmentation in IGRT and ART. Med Phys 2007. [DOI: 10.1118/1.2760435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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309
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Joshi S, Amarnath SK. Fluoroquinolone resistance in Salmonella typhi and S. paratyphi A in Bangalore, India. Trans R Soc Trop Med Hyg 2007; 101:308-10. [PMID: 16950486 DOI: 10.1016/j.trstmh.2006.05.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 04/29/2006] [Accepted: 05/02/2006] [Indexed: 10/24/2022] Open
Abstract
Fluoroquinolone resistance in Salmonella typhi and S. paratyphi A is being increasingly reported. The minimum inhibitory concentrations (MICs) of ciprofloxacin, ofloxacin, levofloxacin and gatifloxacin against S. typhi and S. paratyphi A were compared. Fifty blood culture isolates, 25 S. typhi and 25 S. paratyphi A, were studied. The MICs were determined by the agar dilution method. Disc diffusion was done for the fluoroquinolones and other antibiotics. Nalidixic acid resistance was seen in 21/25 S. paratyphi A and 17/25 S. typhi isolates, and these had higher MICs to fluoroquinolones. Five S. typhi and six S. paratyphi A were fully resistant to ciprofloxacin (MIC >2 microg/l). No multidrug resistance was seen in S. typhi. The absence of multidrug resistance and presence of fluoroquinolone resistance warrants a review of therapy for enteric fever.
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310
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Bociek R, Talmadge J, Loberiza F, Kuszynski C, Bierman P, Vose J, Devetten M, Maness L, Armitage J, Joshi S, Wisecarver J, Enke C, McGuire T, Bernal K, Pavletic S. 228: Nonmyeloablative allogeneic stem cell transplantation (NST) for hematologic malignancies (HM) using pentostatin/low-dose total body irradiation (Pt-TBI). Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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311
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Barth S, Joshi S, Marburger S, Ulrich V, Lindblad A, Ohrwall G, Björneholm O, Hergenhahn U. Observation of resonant interatomic coulombic decay in Ne clusters. J Chem Phys 2007; 122:241102. [PMID: 16035737 DOI: 10.1063/1.1937395] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We have measured the electron spectra of Ne clusters after excitation with photon energies around the 2s inner valence threshold. At two photon energies below threshold, a resonantly enhanced surplus of low kinetic-energy electrons is observed. The kinetic energy of the peak does not vary with the photon energy and is slightly larger than the transition energy of Interatomic Coulombic Decay (ICD) above threshold. This leads us to assume that an ICD-like process is present. In analogy to the Auger and the resonant Auger decay this new phenomenon is termed resonant ICD.
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312
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Zentner D, Joshi S, Price P, Ryan M, Kurzel A, Treacher B, Grigg L. Multidisciplinary Community Care for Congestive Cardiac Failure Decreases Hospital Admissions in an Elderly Patient Population. Heart Lung Circ 2007. [DOI: 10.1016/j.hlc.2007.06.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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313
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Joshi S, Guleria RS, Pan J, Bayless KJ, Davis GE, DiPette D, Singh US. Ethanol impairs Rho GTPase signaling and differentiation of cerebellar granule neurons in a rodent model of fetal alcohol syndrome. Cell Mol Life Sci 2006; 63:2859-70. [PMID: 17109064 PMCID: PMC11136092 DOI: 10.1007/s00018-006-6333-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Developmental exposure to ethanol impairs fetal brain development and causes fetal alcohol syndrome. Although the cerebellum is one of the most alcohol-sensitive brain areas, signaling mechanisms underlying the deleterious effects of ethanol on developing cerebellar granule neurons (CGNs) are largely unknown. Here we describe the effects of in vivo ethanol exposure on neurite formation in CGNs and on the activation of Rho GTPases (RhoA and Rac1), regulators of neurite formation. Exposure of 7-day-old rat pups to ethanol for 3 h moderately increased blood alcohol concentration (BAC) ( approximately 40 mM) and inhibited neurite formation and Rac1 activation in CGNs. Longer exposure to ethanol for 5 h resulted in higher BAC ( approximately 80 mM), induced apoptosis, inhibited Rac1, and activated RhoA. Studies demonstrated a regulatory role of Rho GTPases in differentiation of cerebellar neurons, and indicated that ethanol-associated impairment of Rho GTPase signaling might contribute to brain defects observed in fetal alcohol syndrome.
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315
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Joshi S, Hawken MJ. Loose-patch–juxtacellular recording in vivo—A method for functional characterization and labeling of neurons in macaque V1. J Neurosci Methods 2006; 156:37-49. [PMID: 16540174 DOI: 10.1016/j.jneumeth.2006.02.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Revised: 02/03/2006] [Accepted: 02/03/2006] [Indexed: 10/24/2022]
Abstract
We describe a method that uses a modified version of juxtacellular labeling [Pinault D. A novel single-cell staining procedure performed in vivo under electrophysiological control: morpho-functional features of juxtacellularly labeled thalamic cells and other central neurons with biocytin or neurobiotin. J Neurosci Meth 1996;65:113-36], which allows us to functionally characterize and subsequently label single neurons in vivo in macaque V1. The method is generally applicable in acute in vivo preparations. Extracellular recording is made with a patch electrode when the electrode is attached to the cell membrane. Initially a 'blind' search method is used as a guide to obtaining a cell attached configuration that we refer to as a loose-patch (LP). The neuron's receptive field properties are functionally characterized, the neuron is labeled and then characterization is confirmed, all in the LP configuration. There are a number of advantages of the method that we describe over other methods. First, we have found that we can obtain stable extracellular recordings for periods of hours that enable us to make a relatively comprehensive visual functional characterization of a neuron's receptive field properties. Second, because the electrode is closely apposed to the cell we obtain excellent isolation of the extracellular spike. Third, the method provides labeling that gives complete dendritic and axonal filling that survives over a number of days, which is an important feature in acute primate experiments. Fourth, the in vivo method of labeling and reconstructing neurons gives complete three-dimensional structure of the neuron including its intra-cortical axonal arbor. These features overcome known limits of the established methods of studying neuronal morphology including the Golgi stain (limited when adult tissue is used) and in vitro whole cell methods (incomplete axonal filling due to limited slice thickness). They also overcome the known limits of the established method of combined function-morphology studies i.e. intracellular recording in vivo. The modified juxtacellular method provides a reliable alternative to the difficult method of characterization by extracellular recording and subsequent intracellular labeling [Anderson JC, Martin KAC, Whitteridge D. Form, function and intracortical projections of neurons in the striate cortex of the monkey Macacus nemestrinus. Cerebral Cortex 1993;3:412-20]. We show the method can be used to record at a range of depths through V1 cortex allowing for sampling of neurons in the different layers and functional subpopulations. Links can then be made with existing knowledge about the anatomical organization of V1, the various morphological classes of neurons found therein, their functional connectivity and visual response properties.
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Kulkarni S, Mohanty D, Gupte S, Vasantha K, Joshi S. Flow cytometric quantification of antigen D sites on red blood cells of partial D and weak D variants in India. Transfus Med 2006; 16:285-9. [PMID: 16879157 DOI: 10.1111/j.1365-3148.2006.00667.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The D antigenic sites are diminished in weak D and partial D variants. The aim of this study was to estimate D antigen on RBC in weak D and partial D variants in Indian population by using flow cytometric method. Blood samples of 42 cases of partial D, eight cases of weak D and 123 normal Rh phenotypes identified by serological methods were used in the study. An indirect immunofluorescence method was employed using 29 monoclonal anti-D as primary antibody. The D antigenic sites were calculated using control RBC as internal standard. The D antigenic sites in weak D and partial D variants are less than that found in normal Rh phenotypes. In weak D, the D antigenic sites were between 1500 and 7000 D antigens per cell. Among partial D variants, DVI had minimum and DVa had maximum number of D sites. Flow cytometry is a very good tool for demonstrating minor variation in D antigen when serological methods are inconclusive. The D antigenic sites per RBC in partial D variants identified in Indian population are reported for the first time.
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317
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Wijesooriya K, Weiss E, Dill V, Dong L, Mohan R, Joshi S, Keall P. TU-C-ValA-06: Quantifying the Properties and Accuracy of a Deformable Image Registration Algorithm for 4D Treatment Planning. Med Phys 2006. [DOI: 10.1118/1.2241511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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318
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Joshi S, Agrawal B, Deo GP, Bhattarai BK, Rahman TR, Biswas BK. Percutaneous dilational tracheostomy: an initial experience in community based teaching hospital. Kathmandu Univ Med J (KUMJ) 2006; 4:275-280. [PMID: 18603919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED Percutaneous dilational tracheostomy (PDT) is frequently performed in the intensive care unit to prevent the long term complications associated with prolonged endotracheal intubation. OBJECTIVE To report the analysis of our experience with percutaneous dilation tracheostomy. STUDY DESIGN A prospective documentation of 40 patients who received percutaneous dilational tracheostomy in a multidisciplinary intensive care unit during a 12-month period. METHOD The patients demographic, indications of intubation and PDT, time required to perform the procedure, complications and the outcome of these patients in the intensive care unit were noted. RESULT Among 425 patients, 40 underwent percutaneous dilational tracheostomy that included 22 females and 18 males with the median age of 35 years. Prolonged ventilatory support was the most common indication for tracheostomy. The average duration of intubation before PDT was 5 days. Median procedure time was 20 minutes. Complications included minor bleeding in two (5%), subcutaneous emphysema with pneumothorax in two patients (5%), tracheal stenosis in three (7.5%), tracheo-esophageal fistula and glottic granuloma in one patient each (2.5%). Among forty patients, 28 (70%) were discharged to the ward, 8 died in intensive care unit and 4 left hospital against medical advice. CONCLUSION Percutaneous dilational tracheostomy is a safe, quick and effective way for long term airway management in critically ill patients.
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319
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Dickinson W, Ferreyra J, Imbesi KL, Joshi S, Kingsolver C, Klein E, Lessios N, Ng A, Stamp T, White K, Xu D, Vidra RL. The Ethical Challenges Faced by Ecological Restorationists. ECOL RESTOR 2006. [DOI: 10.3368/er.24.2.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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320
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Pevsner A, Erdi Y, Nemeh S, Davis B, Joshi S, Yorke E, Rosenzweig K, Humm J, Larson S, Ling C, Mageras G. SU-FF-I-95: The Use of Deformable Registration Model to Improve Visibility of the Lesion in Gated PET Images. Med Phys 2006. [DOI: 10.1118/1.2240775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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321
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Hefny AF, Joshi S, Saadeldin YA, Fadlalla H, Abu-Zidan FM. Primary anterior abdominal wall actinomycosis. Singapore Med J 2006; 47:419-21. [PMID: 16645694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Actinomycosis of the anterior abdominal wall is rare. We report a 50-year-old diabetic man who presented with a left hypochondrial mass of three weeks duration associated with fever. Abdominal computed tomography showed a 2 x 4 cm mass projecting from the internal abdominal wall associated with surrounding inflammation. The mass did not decrease after a week of intravenous antibiotics. Excision of the mass and primary closure of the abdominal wall were performed. The mass involved the deep muscles of anterior abdominal wall. The omentum was adherent to the parietal peritoneum underneath the mass. Microscopical examination of the mass was consistent with actinomycosis. The postoperative period was uneventful and the patient recovered completely. The patient received penicillin for six months.
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322
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Joshi S, Bajracharya BL, Baral MR. Kala-azar (visceral Leishmaniasis) from Khotang. Kathmandu Univ Med J (KUMJ) 2006; 4:232-234. [PMID: 18603904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Kala-azar is a chronic infection of reticuloendothelial system caused by flagellated protozoan, leishmania donovani injected into human host by the bite of the sand fly (phlebotomous) previously infected by biting and sucking the blood of a patient of leishmaniasis. It is characterized by irregular fever of long duration, large spleen and liver, anaemia, leucopenia and progressive emaciation. This article reports a case of a 10 year old girl from Khotang, a nonendemic zone for Kala-azar, who presented with long history of abdominal distension for 11 months, fever for 9 months, cough for a week and weight loss. Clinical examination revealed pallor, enlarged liver and huge splenomegaly. Investigations confirmed the diagnosis of kala-azar by the presence of L.D bodies in bone marrow smear. The patient is being treated with i.v Amphotericin B in Infectious Disease Hospital, Teku.
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Joshi S, Guleria R, Pan J, DiPette D, Singh US. Retinoic acid receptors and tissue-transglutaminase mediate short-term effect of retinoic acid on migration and invasion of neuroblastoma SH-SY5Y cells. Oncogene 2006; 25:240-7. [PMID: 16158052 DOI: 10.1038/sj.onc.1209027] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Long-term treatment with all trans-retinoic acid (RA) induces neuronal differentiation and apoptosis. However, the effect of short-term RA treatment on cell proliferation, migration and invasion of neuroblastoma cell lines (SH-SY5Y and IMR-32) remains unclear. RA induces expression of tissue-transglutaminase (TGase) and promotes migration and invasion after 24 h of treatment in SH-SY5Y cells, but not in IMR-32 cells. RA receptor (RAR) agonist (4-(E-2-[5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl]-1-propenyl) benzoic acid) and RAR/retinoid X receptor (RXR) agonist (9-cis-RA) promote expression of TGase, migration and invasion of SH-SY5Y cells, while RXR agonist has no significant effect. RAR antagonist blocks RA effect on migration and invasion, indicating that RAR receptors are required. Retinoid receptors are expressed and activated by RA in both cell lines. However, only transient activation of RAR is observed in IMR-32 cells. These findings suggest that different responses observed in SH-SY5Y and IMR-32 cells could be due to differential activation of retinoid receptors. Overexpression of TGase has no effect on migration or invasion, while overexpression of antisense TGase blocks RA-induced migration and invasion, indicating that other molecules along with TGase mediate RA effects. In addition to the long-term effects of RA that are coupled with cell differentiation, short-term effects involve migration and invasion of neuroblastoma SH-SY5Y cells.
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Mathpal R, Joshi BK, Joshi S, Kandpal ND. Intermolecular Forces of Sugars in Water. MONATSHEFTE FUR CHEMIE 2006. [DOI: 10.1007/s00706-005-0435-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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325
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Pevsner A, Davis B, Joshi S, Hertanto A, Mechalakos J, Yorke E, Rosenzweig K, Nehmeh S, Erdi YE, Humm JL, Larson S, Ling CC, Mageras GS. Evaluation of an automated deformable image matching method for quantifying lung motion in respiration-correlated CT images. Med Phys 2006; 33:369-76. [PMID: 16532942 DOI: 10.1118/1.2161408] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We have evaluated an automated registration procedure for predicting tumor and lung deformation based on CT images of the thorax obtained at different respiration phases. The method uses a viscous fluid model of tissue deformation to map voxels from one CT dataset to another. To validate the deformable matching algorithm we used a respiration-correlated CT protocol to acquire images at different phases of the respiratory cycle for six patients with nonsmall cell lung carcinoma. The position and shape of the deformable gross tumor volumes (GTV) at the end-inhale (EI) phase predicted by the algorithm was compared to those drawn by four observers. To minimize interobserver differences, all observers used the contours drawn by a single observer at end-exhale (EE) phase as a guideline to outline GTV contours at EI. The differences between model-predicted and observer-drawn GTV surfaces at EI, as well as differences between structures delineated by observers at EI (interobserver variations) were evaluated using a contour comparison algorithm written for this purpose, which determined the distance between the two surfaces along different directions. The mean and 90% confidence interval for model-predicted versus observer-drawn GTV surface differences over all patients and all directions were 2.6 and 5.1 mm, respectively, whereas the mean and 90% confidence interval for interobserver differences were 2.1 and 3.7 mm. We have also evaluated the algorithm's ability to predict normal tissue deformations by examining the three-dimensional (3-D) vector displacement of 41 landmarks placed by each observer at bronchial and vascular branch points in the lung between the EE and EI image sets (mean and 90% confidence interval displacements of 11.7 and 25.1 mm, respectively). The mean and 90% confidence interval discrepancy between model-predicted and observer-determined landmark displacements over all patients were 2.9 and 7.3 mm, whereas interobserver discrepancies were 2.8 and 6.0 mm. Paired t tests indicate no significant statistical differences between model predicted and observer drawn structures. We conclude that the accuracy of the algorithm to map lung anatomy in CT images at different respiratory phases is comparable to the variability in manual delineation. This method has therefore the potential for predicting and quantifying respiration-induced tumor motion in the lung.
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