bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological 99mTc-sestamibi myocardial perfusion scintigraphy is independently associated with emerging cardiac events in elderly patients with known or suspected coronary artery disease
Authors: Bucerius Jan , Joe Alexius Y , Herder Ellen , Brockmann Holger , Biermann Kim , Palmedo Holger , Tiemann Klaus , Biersack Hans-Jürgen 
Published: May 2011

Background Only few data are available regarding the prognostic impact of myocardial perfusion scintigraphy with 99mTc-sestamibi (MPS) regarding emerging cardiac events in elderly patients Purpose To evaluate the prognostic value of MPS regarding emerging cardiac events in patients aged ≥70 years with known or suspected coronary artery disease (CAD). Material and Methods One hundred and thirty-three patients (74.6 ± 3.7 years) who underwent exercise or pharmacological stress/rest MPS were included in this analysis. Semi-quantitative visual interpretation of MPS images was performed and Summed-Stress- (SSS), Summed-Difference- (SDS), and Summed-Rest Scores (SRS) were calculated. Multivariate logistic regression analyses were calculated for evaluation of the independent prognostic impact of MPS results and several cardiac-related patient characteristics with regard to emerging cardiac events. Kaplan-Meier survival- and log rank analyses were calculated for assessment of cardiac event-free survival. Results Pathological SSS (OR: 3.3), angina (OR: 2.7) and ischemic ECG (OR: 3.0) were independently associated with cardiac events. Patients with pathological SSS (p = 0.005) and ischemic ECG (p = 0.012) had a significantly lower incidence of cardiac event-free survival. Conclusion Pathological MPS is independently associated with emerging cardiac events predicting a significantly lower incidence of cardiac event-free survival in patients aged ≥70 years.
Phantom and cadaver measurements of dose and dose distribution in micro-CT of the chest in mice
Authors: Rodt Thomas , Luepke Matthias , Boehm Claudia , von Falck Christian , Stamm Georg , Borlak Jürgen , Seifert Hermann , Galanski Michael 
Published: May 2011

Background Micro-computed tomography (CT) allows high-resolution imaging of the chest in mice for small animal research with a significant radiation dose applied. Purpose To report on measurement of the applied radiation dose using different scan protocols in micro-CT of the chest in mice. Material and Methods Repetitive dose measurements were performed for four different micro-CT protocols (with/without respiratory gating) and for micro-CT fluoroscopy used for chest imaging. Measurements were carried out using thermoluminescence dosimeters (TLD) in mouse cadavers and in a PMMA phantom allowing measurement of the radiation dose in the direct path of rays and assessment of scattered radiation. Results The dose measured inside and outside the chests of the cadavers varied between 190 und 210 mGy, respectively. The expected mean doses in mice in the direct path of rays for the four examined micro-CT protocols varied between 170 and 280 mGy. The mean values for 1 and 5 minutes of fluoroscopy were 17 mGy and 105 mGy, respectively. Conclusion The measured dose values are similar to the dose values for micro-CT of the chest reported so far. A relevant dose can be delivered by micro-CT of the chest, which could possibly interact with small animal studies. Therefore, the applied dose for a specific protocol should be known and adverse radiation effects be considered.
Multidetector computed tomography evaluation of bony fragments and donor sites in acute patellar dislocation
Authors: Peltola Erno K , Koskinen Seppo K 
Published: May 2011

Background Patellar dislocation is frequently associated with bony fragments that are difficult to see on radiographs. MRI or MDCT are often used to rule out or characterize these bony fragments. Purpose To assess the use of MDCT for locating bony fragments and donor sites in patients with acute patellar dislocation, and to test whether sizes and quantity of bony fragments differ between first-time dislocations and recurrent dislocations. Material and Methods Retrospective data from two hospitals during a 96-month period were collected, and a total of 46 patients (mean age 27 years, range 9–69 years) that had sustained an acute patellar dislocation (22 first-time, 24 recurrent) were identified. Size, location and donor site of bony fragments were evaluated on MDCT images. Surgical correlation was available for 22 of 46 patients. Results On MDCT images, the likely donor site could be identified in 62 of 71 (87%) bony fragments. Of the bony fragments that were seen on MDCT images, 40 of 68 (59%) were not seen on AP and lateral views of the conventional radiographs. There was no significant difference in size of bony fragments between first-time or recurrent dislocators (p = 0.77). The average number of bony fragments were 2.1 and 1.0 in first-time and recurrent dislocators, respectively. The location and donor site of bony fragments was similar between two patients groups. Conclusion MDCT is a suitable imaging method to locate bony fragments and donor sites. The number of bony fragments seems to be higher in first-time dislocators than recurrent dislocators, otherwise findings between the two patient groups were similar.
The assessment of breast cancer response to neoadjuvant chemotherapy: comparison of magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography
Authors: Park Jeong Seon , Moon Woo Kyung , Lyou Chae Yeon , Cho Nariya , Kang Keon Wook , Chung June-Key 
Published: May 2011

Background Neoadjuvant chemotherapy for locally advanced breast cancer is a widely accepted treatment. For assessment of the tumor response after chemotherapy, both magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography (PET) are promising methods. Purpose To retrospectively compare MRI and PET in the assessment of tumor response to neoadjuvant chemotherapy for primary breast cancer with the pathologic response as the reference standard. Material and Methods Between August 2006 and May 2008, 32 women with breast cancer underwent concurrent MRI and PET before and after neoadjuvant chemotherapy. For response assessment, we calculated the changes in the maximum diameters of the tumor (ΔDmax) on MRI, and the changes in the standard uptake values (ΔSUV) on PET. The correlation between the ΔDmax and ΔSUV was analyzed using Pearson's correlation coefficient. The correspondence rates between each imaging modality and pathologic assessment were calculated. For prediction of the pathologic complete response (pCR), the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were analyzed using the McNemar test. Results The pathologic assessment of tumor response to neoadjuvant chemotherapy identified eight complete responses (25.0%), 10 partial responses (31.2%), and 14 non-responses (43.8%). The change in size on MRI was moderately correlated with the change in SUV on PET (r = 0.574, p = 0.001). The correspondence rate of response assessment was 75.0% (24/32) between MRI and pathologic response and 53.1% (17/32) between PET and pathologic response. For the pCR, specificity (95.8% vs. 62.5%) and PPV (83.3% vs. 47.1%) were statistically higher on MRI than PET (p < 0.05), while sensitivity (100.0% vs. 62.5%) and NPV (100.0% vs. 88.5%) on PET tended to be higher than MRI. Conclusion Before and after neoadjuvant chemotherapy for breast cancer, the ΔDmax of MRI correlated moderately with the ΔSUV on PET. For prediction of the pCR, MRI proved to be a more specific modality than PET.
Breast cancers initially detected by hand-held ultrasound: detection performance of radiologists using automated breast ultrasound data
Authors: Chang Jung Min , Moon Woo Kyung , Cho Nariya , Park Jeong Seon , Kim Seung Ja 
Published: May 2011

Background Ultrasonography (US) has been used as an important adjunct to mammography (MG), and automated breast US (ABUS) scanners were originally designed to effectively examine the breast in its entirety. Purpose To retrospectively assess the performance of radiologists in the detection of breast cancers, initially detected by hand-held ultrasound (HHUS), using 3D breast volume data obtained from a commercial ABUS system. Material and Methods Bilateral whole breast US was performed using ABUS in 61 consecutive women who were scheduled to undergo US-guided needle biopsy due to suspicious breast masses detected during screening HHUS. Fourteen cancers in 13 women and 48 normal breasts of 48 women with benign disease in the contralateral breast were selected. Three radiologists who had not performed the HHUS examinations independently reviewed the 3D ABUS data for any lesions that required recall for further evaluation. Sensitivities and false-positive rates were calculated. Results The sensitivities of the three readers for cancer detection were 78.6% (11/14), 78.6%, and 57.1% (8/14), respectively, with false-positive rates of 20.8% (10/48), 12.5% (6/48) and 8.3% (4/48). Seven cancers were detected by all three readers, four cancers by two readers, and one cancer by one reader. Two invasive cancers were not detected by any reader. Conclusion Of HHUS-detected cancers, only 57.1–78.6% were identified with ABUS. A substantial level of experience and training is necessary to improve cancer detection by ABUS.
Muscle hardness measurement by using ultrasound elastography: a feasibility study
Authors: Niitsu Mamoru , Michizaki Akie , Endo Asako , Takei Hitoshi , Yanagisawa Osamu 
Published: May 2011

Background Muscle hardening, including delayed onset muscle soreness, can be found after vigorous exercise. Some techniques for measuring muscle hardness have been proposed. Freehand ultrasound (US) elastography has been developed and applied to breast imaging. Purpose To evaluate the feasibility of US elastography for investigating changes in muscle hardness after eccentric exercise of the elbow flexor muscles. Material and Methods Six healthy male volunteers performed eccentric contractions of the elbow flexor muscles of their non-dominant arms. US elastography was performed by using 14-6 MHz linear array transducer combined with a stabilizer and a gel pack of reference agent. Color-coded elasticity images and the relative strain ratio of the biceps brachii muscle to the reference were obtained. To verify the US elastography measurements, a commercially available durometer was also employed. Both measurements were performed before, immediately after, and 1– 4 days after exercise. The mean scores of strain ratios of the US elastography and durometer measurements were examined using repeated-measures ANOVA. Results US elastography demonstrated significant muscle hardening and recovery after exercise ( P < 0.01). Muscle hardness increased up immediately after the exercise and continued to increase, peaking on day 2 post-exercise, and then decreased until day 4. The durometer indicated similar changes to US elastography. The control arms did not demonstrate any significant change. Conclusion US elastography is feasible to measure muscle hardness and to produce a two-dimensional hardness map of the muscle.
Detection of hemorrhagic hypointense foci in radiation injury region using susceptibility-weighted imaging
Authors: Zeng Qing-Shi , Kang Xiao-Shui , Li Chuan-Fu , Zhou Geng-Yin 
Published: May 2011

Background Susceptibility-weighted imaging (SWI), a novel, highly sensitive 3D gradient echo MR imaging technique, is used to detect hemorrhage. Purpose To evaluate SWI at 3.0T for detection and visualization of hemorrhage at radiation injury region after radiotherapy for brain glioma. Material and Methods In 16 patients who had radiation injury in the vicinity of the previously resected and irradiated high-grade brain glioma, SWI examinations were performed on a 3T MR scanner. The presence of intralesional hypointense foci on SWI was evaluated by two neuroradiologists. Frequency of these foci on SWI was assessed and the number of these foci was counted. Diagnosis of radiation injury was assigned by means of histopathology or follow-up MR image. Results In all 16 cases with cerebral radiation injury, nine were verified by means of histopathologic examination, seven by follow-up image. While in one patient quality of SWI was poor, in all remaining patients diagnostic-quality SWI was obtained. The intralesional hypointense foci were detected in 12 of 15 patients. These hypointense foci were nodular, angular, or tubular regions of low signal intensity on SWI. The distribution of these foci was diffusive ( n = 5) or scattered ( n = 7). Number of these foci per cm2 on SWI was 7.25 ± 3.67. Conclusion SWI is a novel and promising technique for evaluation of hemorrhage at radiation injury regions in the vicinity of the previously treated gliomas.
Staging of hip avascular necrosis: is there a need for DWI?
Authors: Öner A Yusuf , Aggunlu Levent , Akpek Sergin , Celik Azim , Le Roux Patrick , Tali Turgut , Gultekin Serap 
Published: May 2011

Background No comprehensive study has been performed to stage avascular necrosis of the hip using diffusion-weighted imaging (DWI). Purpose To determine apparent diffusion co-efficient (ADC) alterations in hip avascular necrosis (AVN) and to determine variations of ADC values according to stages of disease. Material and Methods The study is approved by our institutional review board and local ethical committee. Written informed consent was present for each subject. Thirty-five femoral heads of 21 cases affected by AVN were included in the study. Control group consisted of both femoral heads of 10 healthy volunteers. The hips affected by AVN were staged according to Ficat and Arlet classification system from I to IV. All cases underwent to routine hip magnetic resonance imaging (MRI) and DWI performed with a single-shot fast spin echo sequence at a b value of 600 s/mm2. The ADC values were calculated automatically by placing ROIs on AVN lesions in affected patients and both femoral heads of control group. The median ADC value obtained from femoral heads of control group and that from AVN lesions were compared by Mann-Whitney U test. The median ADC values of AVN lesions at different stages were compared by Kruskal-Wallis test. Results The median ADC value of normal bone measured in control group was 185.5 ± 133.2 x 10−6 mm2/s. The median ADC value measured in hip avascular necrosis lesions was 988.0 ± 332.7 x 10−6 mm2/s. ADC values in hip AVN lesions were statistically significantly higher than normal bone marrow ( P < 0.01). The median ADC values of hips with avascular necrosis at stage I, II, III, IV were 817.5 ± 172.1 x 10−6 mm2/s, 902.0 ± 181.0 x 10−6 mm2/s, 1200.0 ± 363.2 x 10−6 mm2/s and 1024.0 ± 324.0 x 10−6 mm2/s, respectively. There was no statistically significant difference among AVN lesions at stages I, II, III and IV ( P > 0.05). Conclusion Although DWI is a promising imaging tool that provides valuable diagnostic information in hip AVN, it fails to distinguish between different stages, and therefore is of limited value.
Feasibility of power contrast injections and bolus triggering during CT scans in oncologic patients with totally implantable venous access ports of the forearm
Authors: Goltz Jan Peter , Machann Wolfram , Noack Claudia , Hahn Dietbert , Kickuth Ralph 
Published: May 2011

Background Conventional totally implantable venous access ports (TIVAPs) are not approved for power contrast injections but often remain the only venous access site in oncologic patients. Therefore, these devices can play an important role if patients with a TIVAP are scheduled for a contrast-enhanced computed tomography (ceCT) as vascular access may become more difficult during the course of chemotherapy. Purpose To evaluate the feasibility and safety of power injections in conventional TIVAPs in the forearm and to analyze the feasibility of bolus triggering during CT scans. Material and Methods In this retrospective study we analyzed 177 power injections in 141 patients with TIVAPs in the forearm. Between October 2008 and March 2010 all patients underwent power injections (1.5 mL/s, 150 psi) via the TIVAP for ceCT because conventional vascular access via a peripheral vein had failed. Adequate functioning and catheter's tip location after injection were evaluated. Peak injection pressure and attenuation levels of aorta, liver and spleen were analyzed and compared with results of 50 patients who were injected via classical peripheral cannulas (3 mL/s, 300 psi). Feasibility of automatic scan initiation was evaluated. In vitro the port was stressed with 5 mL/s (300 psi). Results One TIVAP showed tip dislocation with catheter rupture. Three (2.1%) devices were explanted owing to assumed infection within 4 weeks after the injection. Mean injection pressure was 121.9 +/−24.1 psi. Triggering with automatic scan initiation succeeded in 13/44 (29.6%) scans. Injection via classical cannulas resulted in significantly higher enhancement (p < 0.05). In vitro the port system tolerated flow rates of up to 5 mL/s, injection pressures of up to 338 psi. Conclusion Power injection is a safe alternative for patients with TIVAPs in the forearm if classic vascular access ultimately fails. Triggering was successful in one-third of the attempts. Image quality in the arterial phase scan may be hampered. In vitro results suggest that the device tolerates even higher flow rates.
Sonographically-guided vacuum-assisted biopsy with digital mammography-guided skin marking of suspicious breast microcalcifications: comparison of outcomes with stereotactic biopsy in Asian women
Authors: Hahn Soo Yeon , Shin Jung Hee , Han Boo-Kyung , Ko Eun Young 
Published: May 2011

Background Management of suspicious microcalcifications in very thin breasts is problematic. Purpose To evaluate whether sonographically-guided vacuum-assisted biopsy (USVAB) with digital mammography-guided skin marking (DM) for the diagnosis of breast microcalcifications is comparable to stereotactic-guided vacuum-assisted biopsy (SVAB) in Asian women with thin breasts. Material and Methods Retrospective review was performed for 263 consecutive suspicious microcalcification lesions in 261 women who underwent USVAB with DM or SVAB using a prone table between January 2004 and December 2007. SVAB was performed for 190 lesions and USVAB for 73 lesions. Biopsy results were correlated with surgical pathology or followed up for at least 12 months. The diagnostic outcomes of SVAB and USVAB to diagnose microcalcifications were compared. Results Of 263 lesions, 104 (40%) underwent surgery and 159 (60%) were followed up. SVAB and USVAB groups showed similar final categories or the extent of microcalcifications. US visible lesions were 57 (78%) of 73 at USVAB and 14 (10%) of 140 at SVAB. Of 57 US visible lesions at USVAB, 29 (51%) were not found in initial US but were detectable with the help of DM. Specimen radiographs were negative in 2.1% of lesions at SVAB and in 4.1% at USVAB ( p = 0.4008). The under-estimation rate and false-negative rate were similar in SVAB and USVAB. Conclusion US with DM facilitates US visibility of microcalcifications. USVAB with DM can produce acceptable biopsy results, as can SVAB, to diagnose breast microcalcifications in patients with thin breasts.
Localization of pulmonary nodules with lipiodol prior to thoracoscopic surgery
Authors: Kim Yeong Dae , Jeong Yeon Joo , Hoseok I , Cho Jeong Su , Lee Ji Won , Kim Hak Jin , Lee Suk Hong , Kim Dong Hyun 
Published: May 2011

Background Preoperative localization with lipiodol for identifying small or deeply seated pulmonary nodules is simple and useful for thoracoscopic surgery. Although several studies about performance and complication rates of lipiodol localization have been reported, there has been no report about the performance and complication rates of lipiodol localization with regard to the CT appearance of pulmonary nodules. Purpose To evaluate the performance and complication rates of localization of pulmonary nodules with lipiodol prior to video-assisted thoracoscopic surgery with regard to the CT appearance of nodules. Material and Methods After institutional review board approval and informed consent were obtained, lipiodol marking was performed in 67 patients (33 men and 34 women; mean age 58 years) with 68 nodules. All nodules were marked with 0.4–0.5 mL lipiodol under CT guidance on the day of surgery. The size of the targeted nodule and the shortest distance to the accessible pleural surface were measured. Lipiodol accumulation of a targeted nodule was scored by use of a four-point scale (0: none, 1: within 1 cm around a nodule, 2: partial accumulation within a nodule, 3: total accumulation within a nodule). Any complications after localization of nodules were noted. We analyzed the score of lipiodol accumulation and the presence of complications for the CT appearance of pulmonary nodules using the Mann Whitney U test, Fisher's exact test and the Kruskall Walis test. Results The average nodule size was 11.4 mm (range 3.0–28.3 mm) and the average distance to the pleural surface was 13.7 mm (range 0–51.4 mm). Lipiodol accumulation scores of nodules were as follows: score 3 ( n = 19, 28%), score 2 ( n = 37, 54%), score 1 ( n = 11, 16%), and score 0 ( n = 1, 2%). Lipiodol accumulation scores of nodules were different according to the size of nodules (Kruskal Wallis test, p = 0.023). Pneumothorax after localization occurred in 20 (29%) patients and the incidence was higher in nodules located in the subpleural area (Mann Whitney U test, p = 0.048). Pulmonary hemorrhage along the needle tract occurred in five (7%) patients and was more frequent in patients with deep nodules as compared to shallow nodules (Mann Whitney U test, p < 0.001). Conclusion Lipiodol marking under CT guidance is a useful and safe procedure for the intraoperative localization of pulmonary nodules. Of variable CT findings, lesion size is important to determine the degree of lipiodol accumulation and the lesion depth is the most important feature for the development of postprocedural complications.
Effect of Initial Stress Levels on Strength Parameters of Reinforced Concrete Beams Retrofitted Using Ferrocement Jackets
Authors: Bansal Prem Pal , Kumar Maneek , Kaushik S. K. 
Published: May 2011

Abstract
Ferrocement jackets and sheets can be used for local rehabilitation and retrofitting of structures due to their high tensile strength, light weight, overall economy, water tightness, and ease of application. In the present paper the effects of number of layers of wire mesh in the ferrocement jackets, type of section (balanced or under reinforced) and initial stress level on the strength of retrofitted stressed reinforced cement concrete beams have been studied. The results show that there is higher increase in the maximum load, safe load carrying capacity, ductility and toughness for beams with three layers woven wire mesh ferrocement jackets as compared to beams reinforced with two layers of woven wire mesh. It is further seen that the percentage improvement in above properties decreases with increase in initial stress level and change in type of section from under reinforced to balanced. Subsequently an analytical model, based on principles of compatibility of strain and equilibrium of forces, has been presented to predict the safe and maximum load carrying capacity. It is found that predicted safe and maximum load carrying capacities are within 5 % of the experimental one.