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El Hadji S, Bonilauri A, De Momi E, Castana L, Macera A, Berta L, Cardinale F, Baselli G. Validation of SART 3.5D algorithm for cerebrovascular dynamics and artery versus vein classification in presurgical 3D digital subtraction angiographies. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8c7f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/24/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Classification of arteries and veins in cerebral angiograms can increase the safety of neurosurgical procedures, such as StereoElectroEncephaloGraphy, and aid the diagnosis of vascular pathologies, as arterovenous malformations. We propose a new method for vessel classification using the contrast medium dynamics in rotational digital subtraction angiography (DSA). After 3D DSA and angiogram segmentation, contrast enhanced projections are processed to suppress soft tissue and bone structures attenuation effect and further enhance the CM flow. For each voxel labelled as vessel, a time intensity curve (TIC) is obtained as a linear combination of temporal basis functions whose weights are addressed by simultaneous algebraic reconstruction technique (SART 3.5D), expanded to include dynamics. Each TIC is classified by comparing the areas under the curve in the arterial and venous phases. Clustering is applied to optimize the classification thresholds. On a dataset of 60 patients, a median value of sensitivity (90%), specificity (91%), and accuracy (92%) were obtained with respect to annotated arterial and venous voxels up to branching order 4–5. Qualitative results are also presented about CM arrival time mapping and its distribution in arteries and veins respectively. In conclusion, this study shows a valuable impact, at no protocol extra-cost or invasiveness, concerning surgical planning related to the enhancement of arteries as major organs at risk. Also, it opens a new scope on the pathophysiology of cerebrovascular dynamics and its anatomical relationships.
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Pärsson HN, Lundin N, Lindgren H. 2D perfusion-angiography during endovascular intervention for critical limb threatening ischemia - A feasibility study. JRSM Cardiovasc Dis 2020; 9:2048004020915392. [PMID: 32284859 PMCID: PMC7133075 DOI: 10.1177/2048004020915392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/05/2020] [Accepted: 02/27/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Two-dimensional perfusion angiography is a new method to quantify and evaluate tissue perfusion during endovascular intervention. The aim was to evaluate time-patterns and dynamics of contrast arrival and distribution before and after endovascular intervention in patients with critical limb threatening ischemia. Methods Data were collected from 37 patients with critical limb threatening ischemia due to infra-inguinal occlusive disease having a successful endovascular procedure. two-dimensional perfusion angiography was used as a post-processing software with analysis of numeric parameters related to arrival and distribution patterns of contrast. Results Thirty-three patients were successfully analysed whereas four patients were excluded due to motion artefacts. All patients were successfully treated with recanalization of the superficial femoral, popliteal, below the knee-vessels or a combination. Short-term improvement at 30-day follow-up was noted both clinically and by ankle-brachial index and toe pressure measurements. A significant reduction in contrast arrival time between pre-and post-angioplasty runs was noted as measured by arrival time median 3.2 and interquartile range (2.5–4.2) vs. 2.6 (1.6–3.4) and time-to-peak 4.1 (3.6–5.0) vs. 3.1 (2.3–3.9) p = 0.009. An increased wash-in rate was also observed 18.3 (12.6–21) vs. 30.1 (22–30.5) p = 0.001 between pre-and post-angioplasty runs. Conclusions The use of perfusion angiography for evaluation of foot-circulation during endovascular interventions provides new information regarding quantitative assessment of contrast inflow before and after endovascular intervention without the need for extra contrast or runs. No selective catheterisation is necessary. The technique is easily adopted in a clinical setting. Further studies are necessary to create robust clinical endpoints.
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Affiliation(s)
- Håkan N Pärsson
- Department of Experimental Medicine and Surgery, Medical faculty, Linköping University, Linkoping, Sweden
| | - Niklas Lundin
- Medicinska Fakulteten, Lunds Universitet, Malmö, Sweden
| | - Hans Lindgren
- Faculty of Medicine, Lunds University, Helsingborg, Sweden
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Maksimovich IV. Differences in Cerebral Angioarchitectonics in Alzheimer's Disease in Comparison with Other Neurodegenerative and Ischemic Lesions. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/wjns.2018.84036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Asai K, Nakamura H, Watabe T, Nishida T, Sakaguchi M, Hatazawa J, Yoshimine T, Kishima H. X-ray angiography perfusion imaging with an intra-arterial injection: comparative study with 15O-gas/water positron emission tomography. J Neurointerv Surg 2017; 10:780-783. [DOI: 10.1136/neurintsurg-2017-013487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 11/12/2017] [Accepted: 11/14/2017] [Indexed: 11/03/2022]
Abstract
BackgroundX-ray angiography perfusion (XAP) is a perfusion imaging technique based on conventional DSA.ObjectiveIn this study, we aimed to validate parameters derived from XAP by comparing them with 15O-gas/water positron emission tomography (PET), using data from patients with chronic ischemic cerebrovascular disease.Methods18 consecutive patients were included. XAP was performed with intra-arterial infusion of contrast media, and a time–density curve was constructed for each cerebral hemisphere. From the curves, the relative values of mean transit time (rMTT) and wash-in rate (rWiR) were obtained by dividing the values of the right hemisphere by those of the left hemisphere. These were then compared with the relative values of cerebral blood flow (rCBF) and rMTT calculated from the PET data.ResultsXAP rWiR correlated strongly with PET rCBF (r=0.86, P<0.0001). rMTT measurements from the two modalities were also strongly correlated (r=0.85, P<0.0001). Bland–Altman analysis revealed a bias of 0.14±0.18 (95% limits of agreement −0.22 to 0.51) for PET rCBF versus XAP rWiR, and 0.016±0.093 (95% limits of agreement −0.17 to 0.20) for rMTT between the two modalities.ConclusionsThe relative values obtained from XAP were validated across a population of patients with chronic ischemic cerebrovascular disease.
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Abstract
Purpose: To report the feasibility, technical considerations, and initial results of 2-dimensional (2D) perfusion angiography of the foot before and after endovascular interventions. Methods: A retrospective single-center study involved 21 patients (mean age 73.4±10.5 years; 14 men) with severe peripheral vascular disease [Fontaine stage III (n=10) or IV (n=14)] who underwent lower limb digital subtraction angiography (DSA) prior to and following endovascular treatment of above- and/or below-knee lesions. A standardized contrast administration protocol (15 mL iodixanol 320 mg I/mL at 3 mL/s via a 5/6-F antegrade sheath) was applied during DSA using a 2D perfusion–enabled image intensifier. Representative hindfoot and forefoot regions of interest were analyzed, and representative numeric density values [time to peak (TTP), peak density value (PDV), and area under the (time-density) curve (AUC)] were calculated using 2D perfusion–enabled angiographic software to assess foot perfusion. Values were compared before and after angioplasty and by level of treatment (above or below knee). The parameters were correlated with disease severity (stenosis vs occlusion) and symptom level (Fontaine stage). Results: A clinically significant improvement (29.4%) in the AUC was noted following angioplasty, reaching statistical significance within the hindfoot (p=0.03). No significant change in TTP or PDV was detected following angioplasty. Foot movement remained problematic when measuring time-density values. No statistical difference in perfusion values was appreciable between above- and below-knee angioplasty. Conclusion: Two-dimensional perfusion angiography of the foot allows quantitative evaluation using various density values with potential benefit for treatment planning and technical outcome analysis. Methodical restrictions currently remain, mainly regarding patient movement.
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Affiliation(s)
- Timothy Murray
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Thomas Rodt
- Department of Radiology, Hannover Medical School, Hannover, Germany
| | - Michael J. Lee
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
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Maeda A, Kulbatski I, DaCosta RS. Emerging Applications for Optically Enabled Intravital Microscopic Imaging in Radiobiology. Mol Imaging 2015. [DOI: 10.2310/7290.2015.00022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Azusa Maeda
- From the Princess Margaret Cancer Centre, University Health Network, MaRS Centre; Techna Institute for Advancement of Technologies for Health; and Department of Medical Biophysics, University of Toronto, MaRS Centre, Toronto, ON
| | - Iris Kulbatski
- From the Princess Margaret Cancer Centre, University Health Network, MaRS Centre; Techna Institute for Advancement of Technologies for Health; and Department of Medical Biophysics, University of Toronto, MaRS Centre, Toronto, ON
| | - Ralph S. DaCosta
- From the Princess Margaret Cancer Centre, University Health Network, MaRS Centre; Techna Institute for Advancement of Technologies for Health; and Department of Medical Biophysics, University of Toronto, MaRS Centre, Toronto, ON
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Asai K, Imamura H, Mineharu Y, Tani S, Adachi H, Narumi O, Sato S, Sakai C, Sakai N. X-ray Angiography Perfusion Analysis for the Balloon Occlusion Test of the Internal Carotid Artery. J Stroke Cerebrovasc Dis 2015; 24:1506-12. [PMID: 25873471 DOI: 10.1016/j.jstrokecerebrovasdis.2015.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 01/13/2015] [Accepted: 03/12/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A perfusion study should be performed during the balloon occlusion test (BOT) to prevent ischemic events after therapeutic carotid occlusion. We evaluated the efficacy of X-ray angiography perfusion analysis during the BOT. METHODS Twenty-one consecutive patients who underwent the BOT of the internal carotid artery were included. Patients who had a venous phase delay of less than .5 seconds and a mean stump pressure of more than 50 mm Hg without any neurologic symptoms were considered tolerant, and other patients were considered intolerant. A time-density curve was constructed for each hemisphere using X-ray angiography perfusion software (2D-Perfusion). The mean transit time and area under the curve, which correspond to cerebral blood volume, were calculated from the curve. Differences in these parameters between the occluded and nonoccluded hemispheres and the perfusion index were compared between the tolerant and intolerant groups. RESULTS In the intolerant group, the mean transit time was significantly longer (1.31 ± .72 seconds versus .44 ± .21 seconds, P = .001) and the perfusion index was significantly lower (.72 ± .16 versus .94 ± .08, P = .001) compared with those in the tolerant group. The area under the curve was not different between the groups. CONCLUSIONS Parameters obtained by X-ray angiography perfusion analysis were significantly different between the tolerant and intolerant groups. The X-ray angiography perfusion analysis could be a safe and effective method for assessing ischemic tolerance before therapeutic carotid occlusion.
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Affiliation(s)
- Katsunori Asai
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan.
| | - Hirotoshi Imamura
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan
| | - Shoichi Tani
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hidemitsu Adachi
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Osamu Narumi
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shinsuke Sato
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Chiaki Sakai
- Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan
| | - Nobuyuki Sakai
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan
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El-Salam M, Reda S, Lotfi S, Refaat T, El-Abd E. Imaging Techniques in Cancer Diagnosis. Cancer Biomark 2014:19-38. [DOI: 10.1201/b16389-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Allison RR, Sibata C, Patel R. Future radiation therapy: photons, protons and particles. Future Oncol 2013; 9:493-504. [DOI: 10.2217/fon.13.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Radiation therapy plays a critical role in the current management of cancer patients. The most common linear accelerator-based treatment device delivers photons of radiation. In an ever more precise fashion, state-of-the-art technology has recently allowed for both modulation of the radiation beam and imaging for this treatment delivery. This has resulted in better patient outcome with far fewer side effects than were achieved even a decade ago. Recently, a push has begun for proton therapy, which may have clinical advantage in select indications, although significant limitations for these devices have become apparent. In addition, currently, heavy particle therapy has been touted as a potential means to improve cancer patient outcomes. This article will highlight current benefits and drawbacks to modern radiation therapy and speculate on future tools that will likely dramatically improve radiation oncology.
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Affiliation(s)
- Ron R Allison
- 21st Century Oncology, 801 WH Smith Blvd., Greenville, NC 27834, USA.
| | | | - Rajen Patel
- 21st Century Oncology, 801 WH Smith Blvd., Greenville, NC 27834, USA
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