Perfusion Computed Tomography: A Non-invasive Technique to Early Evaluating the Therapeutic Effect of Radiotherapy for Primary Hepatic Cancer

Author(s):  
Qiwen Duan ◽  
Wen Chen ◽  
Junhua Liu ◽  
Yingchun Duan ◽  
Jianhua Ren ◽  
...  
2020 ◽  
pp. 197140092095723
Author(s):  
Angela Guarnizo ◽  
Rafael Glikstein ◽  
Vered Tsehmaister-Abitbul ◽  
Ionut Busca ◽  
Samy El-Sayed ◽  
...  

Background and purpose Computed tomography virtual endoscopy (CT-VE) is a non-invasive technique which allows visualisation of intraluminal surfaces by tridimensional reconstruction of air/soft tissues. The aim of this study was to compare the diagnostic accuracy of CT-VE and flexible fibre-optic laryngoscopy (FFL) in identifying normal neck anatomic structures and pharyngeal and laryngeal lesions. Methods Forty-two patients with a history of neck cancer were assessed by two ENT surgeons using FFL and by one neuroradiologist using CT-VE in order to evaluate the visualisation of the epiglottis, vallecula, glossoepiglottic folds, pyriform sinuses, vocal cords and mass pathology. The visualisation of the structures in both modalities was assessed according to the following score: 0 = not visualised, 1 = partial visualisation, 2 = complete and clear visualisation. A weighted kappa coefficient was used to evaluate the inter-observer agreement. McNemar’s test was performed to compare the two diagnostic tests. Results The inter-observer agreement between FFL and CT-VE was fair in the assessment of the vocal cords ( k = 0.341); moderate in the assessment of the glossoepiglottic folds ( k = 0.418), epiglottis ( k = 0.513) and pyriform sinuses ( k = 0.477); and substantial in the assessment of the vallecula ( k = 0.618) and the tumour (0.740). McNemar’s test showed no significant difference between the two tests ( p<0.05). Conclusion CT-VE is a non-invasive technique with a diagnostic accuracy comparable to FFL in terms of visualisation of anatomical structures and pharyngeal and laryngeal lesions.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Masakazu Shinohara ◽  
Tomoya Yamashita ◽  
Hideto Tawa ◽  
Masafumi Takeda ◽  
Naoto Sasaki ◽  
...  

Background: Reliable non-invasive imaging modalities to characterize atherosclerotic plaque components are clinically desirable for detecting unstable coronary plaques, which cause acute coronary syndrome or sudden death. Although recent clinical developments in computed tomography (CT) have enabled the visualization of luminal narrowing and calcified plaques in coronary arteries, the evaluation of non-calcified plaque components remains difficult. Phase-contrast X-ray CT imaging has great potential to reveal the structures inside soft tissues because its sensitivity to light elements is almost 1000 times greater than that of absorption-contrast clinical X-ray imaging. We for the first time examined mouse atherosclerotic plaques using phase-contrast X-ray CT and found promising results. Methods and Results: Ex vivo phase-contrast X-ray CT was performed using a synchrotron radiation source (SPring-8, Japan) to investigate atherosclerotic plaque components in mice. Samples were also histologically analyzed. Phase-contrast X-ray CT at a spatial resolution of 10 –20 μm revealed atherosclerotic plaque components, and thin fibrous caps could be easily detected. The specific mass densities of these components were estimated using dδ (differences in the refractive indexes relative to water). While lipid-rich areas showed low dδ (0.79 ± 0.13 × 10 −8 ) and mass density (1.011 ± 0.001 g/ml), the smooth muscle- and collagen-rich areas showed high dδ (4.18 ± 0.10 × 10 −8 and 5.93 ± 0.13 × 10 −8 , respectively) and mass density (1.057 ± 0.001 g/ml and 1.08 ± 0.002 g/ml, respectively). It was rather easy to evaluate or differentiate the atherosclerotic plaque components using this novel phase-contrast X-ray CT imaging. Moreover, the three-dimensional assessment of plaques was possible, and it enabled the imaging of their anatomical information. Conclusions: Phase-contrast X-ray CT can estimate the tissue-mass density of atherosclerotic plaques and distinguish the lipid-rich areas from the collagen-rich areas. This is a promising non-invasive technique for the investigation of plaque components and detection of unstable coronary plaques.


Author(s):  
P.J. de Feijter ◽  
C. Schultz

In recent years coronary computed tomography (CT) has developed as a spectacular non-invasive technique to visualize the coronary arteries and its manifestations of coronary atherosclerosis. The coronary CT scanner has rapidly evolved from the initial 4-and 16-slice CT scanners, to the now considered state-of-the-art 64-slice CT scanners, while 256- and 320-slice CT-prototype scanners have now been introduced for clinical evaluation. It is expected that the CT technique will further evolve and eventually will become of sufficient diagnostic quality that it may replace invasive coronary angiography (CA) to reliably assess both non-obstructive and obstructive coronary lesions.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Baggiano ◽  
M Guglielmo ◽  
G Muscogiuri ◽  
L Fusini ◽  
A Del Torto ◽  
...  

Abstract Background Computed tomography-derived fractional flow reserve (FFRCT) and stress computed tomography perfusion (stress-CTP) are new techniques that combine anatomy and functional evaluation to improve assessment of coronary artery disease (CAD) using coronary computed tomography angiography (cCTA). Purpose This study sought to determine the effect of adding FFRCT and stress-CTP to cCTA alone for assessment of lesion severity and patient management of patients referred for chest pain. Methods 289 patients with stable chest pain scheduled for clinically indicated invasive coronary angiography (ICA) plus invasive FFR were evaluated with cCTA, FFRCT, and stress-CTP. Of 289 patients, 147 underwent static stress-CTP, while 142 were evaluated with dynamic stress-CTP. Management plan with optimal medical therapy (OMT) or percutaneous coronary intervention (PCI) for each patient according to results of each non-invasive technique was recorded, and then compared to what effectively applied according to results of reference standard technique (ICA + FFR). The primary endpoints for the study were the correct allocation of patients to OMT or PCI using cCTA, cCTA + FFRCT and cCTA + stress-CTP, and the correct assessment of non-invasive techniques for all three vessels in relation to angiographically and FFR-defined significance. Results Compared to cCTA alone, the addition of FFRCT and stress-CTP to cCTA alone increased the agreement in allocating patients to OMT from 24% to 38% and 44%, respectively, while the addition of FFRCT and stress-CTP to cCTA alone increased the agreement in allocating patients to PCI from 29% to 32% and 36%, respectively. Using ICA + FFR as standard reference, cCTA showed agreement for all three vessels in 56% of patients, while combined approaches of cCTA + FFRCT and cCTA + stress-CTP showed agreement in 66% and 82% of patients, respectively. Conclusions The addition of functional assessment with FFRCT or Stress-CTP to cCTA has a substantial effect on the evaluation of the relevance of coronary artery disease and therefore on the management of patients compared to cCTA alone.


Author(s):  
H.W. Deckman ◽  
B.F. Flannery ◽  
J.H. Dunsmuir ◽  
K.D' Amico

We have developed a new X-ray microscope which produces complete three dimensional images of samples. The microscope operates by performing X-ray tomography with unprecedented resolution. Tomography is a non-invasive imaging technique that creates maps of the internal structure of samples from measurement of the attenuation of penetrating radiation. As conventionally practiced in medical Computed Tomography (CT), radiologists produce maps of bone and tissue structure in several planar sections that reveal features with 1mm resolution and 1% contrast. Microtomography extends the capability of CT in several ways. First, the resolution which approaches one micron, is one thousand times higher than that of the medical CT. Second, our approach acquires and analyses the data in a panoramic imaging format that directly produces three-dimensional maps in a series of contiguous stacked planes. Typical maps available today consist of three hundred planar sections each containing 512x512 pixels. Finally, and perhaps of most import scientifically, microtomography using a synchrotron X-ray source, allows us to generate maps of individual element.


2009 ◽  
Vol 5 (2) ◽  
pp. 15
Author(s):  
Wanda Acampa ◽  
Mario Petretta ◽  
Carmela Nappi ◽  
Alberto Cuocolo ◽  
◽  
...  

Many non-invasive imaging techniques are available for the evaluation of patients with known or suspected coronary heart disease. Among these, computed-tomography-based techniques allow the quantification of coronary atherosclerotic calcium and non-invasive imaging of coronary arteries, whereas nuclear cardiology is the most widely used non-invasive approach for the assessment of myocardial perfusion. The available single-photon-emission computed tomography flow agents are characterised by a cardiac uptake proportional to myocardial blood flow. In addition, different positron emission tomography tracers may be used for the quantitative measurement of myocardial blood flow and coronary flow reserve. Extensive research is being performed in the development of non-invasive coronary angiography and myocardial perfusion imaging using cardiac magnetic resonance. Finally, new multimodality imaging systems have recently been developed bringing together anatomical and functional information. This article provides a description of the available non-invasive imaging techniques in the assessment of coronary anatomy and myocardial perfusion in patients with known or suspected coronary heart disease.


2014 ◽  
pp. 9-18
Author(s):  
Thi Linh Giang Truong ◽  
Vu Quoc Huy Nguyen

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries


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