The subtalar and talonavicular joints: a way to access the long-term load intake using conventional CT-data

Background: There is insufficient information in the literature on the comparative efficacy and tolerability of methotrexate (MTX) and methylprednisolone (MP) in patients with pulmonary sarcoidosis in assessing primary outcomes and the relapse rate. Purpose: The aim of our study was to evaluate primary and long-term outcomes of using MTX and MP in patients with pulmonary sarcoidosis. Methods: A total of 143 patients with newly diagnosed pulmonary sarcoidosis, verified by high-resolution computed tomography (CT) data, were examined. Corticosteroid (CS) therapy was used in 97 patients using MP at a dose of 0.4 mg/kg body weight for 4 weeks, followed by a dose reduction to 0.1 mg/kg by the end of the sixth month. The total duration of CS therapy was 12 months on average. Forty-six patients were treated with MTX at a dose of 10 mg/week (28) and 15 mg/week (18) per os for 6 to 12 months. The study of the relapse rate was conducted within 12 months after the CT data normalization in 60 patients after CS therapy and in 24 after MTX treatment. Results: MP treatment was successfully completed in 68 (70.1%), and MTX in 29 (60.4%) patients. In five MP patients (5.2%) and in five (10.9%) MTX, treatment was discontinued due to serious side effects. In seven (7.2%) MP patients and ten (21.7%) MTX patients, treatment required additional therapy due to the lack of efficacy. Progression with MP treatment (17–17.5%) was more common than with MTX (2–4.3%; Chi square = 4.703, p = 0.031). Relapses after MP therapy were observed in 26 (43.3%) patients, and after MTX therapy in 2 (8.3%; Chi square = 9.450, p = 0.003). Conclusion: In patients with pulmonary sarcoidosis, MTX monotherapy does not differ significantly from MP monotherapy in terms of the level of efficacy and the rate of serious side effects. Increasing the MTX dose from 10 to 15 mg/week accelerates the rate of regression of sarcoidosis, improves treatment efficacy, and does not affect the rate of serious side effects. When using MTX, there is a significant decrease in the incidence of treatment resistance and the relapse rate.

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Impact of 4D CT for treatment planning of moving targets: a computer-based biological evaluation

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2017-0140 ◽

2017 ◽

Vol 3 (2) ◽

pp. 665-668

Author(s):

Eike Helf ◽

Oliver Waletzko ◽

Christian Mehrens ◽

Ralf Rohn ◽

Andreas Block

Keyword(s):

Treatment Plan ◽

Tumour Volume ◽

Target Volume ◽

Biological Evaluation ◽

Internal Target Volume ◽

4D Ct ◽

Tumour Control ◽

Ct Data ◽

Conventional Ct ◽

The Impact

AbstractThis study deals with comparison of conventional and 4D CT (GE Lightspeed) planning on the tumour control probability (TCP), using the TCP model of the AAPM-Report Task Group 166. In the first step a VMAT treatment plan was calculated (Varian Eclipse 13.7) on basis of conventional CT data. This treatment plan was transferred to the complete 4D CT, which represents the tumour volume in motion. Due to the increased volume and the resulting decrease of tumour coverage the TCP went down from 97,6% to 91,2%. After adding an internal target volume (ITV, ICRU 62) to the conventional CT according to our clinical protocols (1,0 cm cc and 0,3 cm axial plane) the TCP increased to 98,0% when applying the conventional plan to the 4D CT. This finding demonstrates the need of 4D CT for moving tumours in chest and abdomen region.Average IPs with increasing width have been created to evaluate the impact on the TCP and the non-malignant tissue. Our observations had shown that heart, lung and spinal cord radiation exposure did not correlate to chosen respiration segment. This could be explained by the extremely slight ratio of the planning target volume and the irradiated normal tissue.This procedure enables us to evaluate the efficacy of treatment plans. Furthermore, optimizing trials like the influence of respiration-gated RT, setting individual margins and fitting planning objectives and parameters are still under investigation.

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Aortic Aneurysm Morphology for Planning Endovascular Aortic Grafts: Limitations of Conventional Imaging Methods

Journal of Endovascular Therapy ◽

10.1177/152660289500200204 ◽

1995 ◽

Vol 2 (2) ◽

pp. 139-148 ◽

Cited By ~ 13

Author(s):

Hugh G. Beebe ◽

Tonya Jackson ◽

John P. Pigott

Keyword(s):

Aortic Aneurysms ◽

Neck Length ◽

Detailed Measurement ◽

Abdominal Aortic ◽

Computed Tomography Scanning ◽

Dimensional Measurements ◽

Aneurysm Morphology ◽

Ct Data ◽

Conventional Ct ◽

Adequate Data

Purpose: To test whether conventional computed tomography scanning (CT) and contrast aortography (CA) provide adequate data for planning endovascular aortic grafting by measuring 33 parameters in patients having both imaging examinations for evaluation of abdominal aortic aneurysms (AAA). Methods: Fifty consecutive patients with AAA (41 men, 9 women; average age 65 years) had CT and CA (mean 26 days between exams). The data collected and analyzed included: 8 sites of diameter, 4 lengths, 6 angles, and 15 other dimensional measurements. Results: Conflicts between CA and CT data were common. Eighteen patients appeared to have a distal cuff by CA but not by CT. Proximal neck length could not be assessed by CT in 5 and had a difference between CA and CT > 1 cm in 25 patients. CA overestimated neck length in 11 patients. Common iliac artery angulation > 60° occurred unilaterally in 27 patients and bilaterally in 5. Seven patients had both iliac aneurysm and > 60° iliac angulation. Thirteen patients had one or more iliac aneurysms (> 2 cm) shown by CT but not by CA. Conclusions: For endovascular graft planning: (1) more detailed measurement is required than for traditional surgery; and (2) conventional CT and CA are complementary imaging studies, but each has important limitations.

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Neosuture formation after endoscope-assisted craniosynostosis repair

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.2.peds15231 ◽

2016 ◽

Vol 18 (2) ◽

pp. 196-200 ◽

Cited By ~ 6

Author(s):

Afshin Salehi ◽

Katherine Ott ◽

Gary B. Skolnick ◽

Dennis C. Nguyen ◽

Sybill D. Naidoo ◽

...

Keyword(s):

Three Dimensional ◽

Head Width ◽

Long Term Outcomes ◽

Sagittal Synostosis ◽

Helmet Therapy ◽

Age At Surgery ◽

Significant Difference ◽

Ct Data ◽

Strip Craniectomy

OBJECTIVE The goal of this study was to identify the rate of neosuture formation in patients with craniosynostosis treated with endoscope-assisted strip craniectomy and investigate whether neosuture formation in sagittal craniosynostosis has an effect on postoperative calvarial shape. METHODS The authors retrospectively reviewed 166 cases of nonsyndromic craniosynostosis that underwent endoscope-assisted repair between 2006 and 2014. Preoperative and 1-year postoperative head CT scans were evaluated, and the rate of neosuture formation was calculated. Three-dimensional reconstructions of the CT data were used to measure cephalic index (CI) (ratio of head width and length) of patients with sagittal synostosis. Regression analysis was used to calculate significant differences between patients with and without neosuture accounting for age at surgery and preoperative CI. RESULTS Review of 96 patients revealed that some degree of neosuture development occurred in 23 patients (23.9%): 16 sagittal, 2 bilateral coronal, 4 unilateral coronal, and 1 lambdoid synostosis. Complete neosuture formation was seen in 14 of those 23 patients (9 of 16 sagittal, 1 of 2 bilateral coronal, 3 of 4 unilateral coronal, and 1 of 1 lambdoid). Mean pre- and postoperative CI in the complete sagittal neosuture group was 67.4% and 75.5%, respectively, and in the non-neosuture group was 69.8% and 74.4%, respectively. There was no statistically significant difference in the CI between the neosuture and fused suture groups preoperatively or 17 months postoperatively in patients with sagittal synostosis. CONCLUSIONS Neosuture development can occur after endoscope-assisted strip craniectomy and molding helmet therapy for patients with craniosynostosis. Although the authors did not detect a significant difference in calvarial shape postoperatively in the group with sagittal synostosis, the relevance of neosuture formation remains to be determined. Further studies are required to discover long-term outcomes comparing patients with and without neosuture formation.

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Distribution of organic carbon in the stable soil humic fractions as affected by tillage management

Canadian Journal of Soil Science ◽

10.4141/s06-059 ◽

2008 ◽

Vol 88 (1) ◽

pp. 99-106 ◽

Cited By ~ 10

Author(s):

Evah W Murage ◽

Paul Voroney

Keyword(s):

C Sequestration ◽

No Tillage ◽

Sampling Depth ◽

Soil C ◽

Tillage Practices ◽

Conventional Ct ◽

Humin Fraction ◽

Humic Fractions ◽

Soil C Sequestration

Soil humus comprises a large and stable pool of soil organic matter (SOM); hence a better understanding of the fate of C in soil humic fractions can provide valuable information for the development of alternative tillage practices that will lead to long-term soil C sequestration. We used δ13C techniques to investigate the effects of tillage on the dynamics of native (C3–C) and corn derived C (C4–C) in fulvic acid (FA), humic acid (HA) and humin fractions. Humic substances were extracted from soils cropped to corn for 11 yr and managed under either conventional (CT) or no-tillage (NT), and from a conventionally tilled soil under > 55 yr of tobacco/rye rotation. No-tillage resulted in higher proportions of C4–C in the upper 5 cm and generally lower C4–C proportions below 5 cm than CT. Up to 31, 27 and 34% of C4–C were assimilated into FA, HA and humin fractions, respectively, indicating that even the humin fraction, often described as passive, old or resistant, acted as a sink of recently added C, and that it is heterogeneous with some of its components being young. Recovery of large proportions of C3–C in the humic fractions demonstrated their importance in the long-term stabilization of SOM. Within each sampling depth, there were no unique differences in the distribution of C3–C among the three humic fractions, suggesting similar turnover of C3–C in all the fractions. Therefore, there was no unique active fraction corresponding with the concept of C pools with defined turnover characteristics used in models of SOM turnover. Key words: Soil humic fractions, corn derived C, native C, δ13C techniques, tillage practices

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Patterns of PET response after long-term sunitinib therapy in patients (pts) with imatinib (IM)-resistant gastrointestinal stromal tumors (GIST)

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.9547 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 9547-9547 ◽

Cited By ~ 2

Author(s):

C. P. Raut ◽

A. Van Den Abbeele ◽

N. Ramaiya ◽

J. A. Morgan ◽

S. George ◽

...

Keyword(s):

Treatment Period ◽

Pet Imaging ◽

Complete Suppression ◽

Initial Development ◽

Sunitinib Malate ◽

Drug Dosing ◽

Metastatic Lesions ◽

Ct Data ◽

Pet Scans

9547 Background: Sunitinib malate (previously known as SU11248) is an active therapy for GIST patients resistant to or intolerant of IM. During initial development, sunitinib was administered in 4–6 week cycles, with 2–4 weeks of drug dosing followed by 2 weeks off treatment. We previously reported suppression of tumor-related 18FDG avidity on PET imaging during sunitinib dosing, with rebound tumor uptake while off drug. This rebound, seen in 80% with initial PET suppression, did not correlate with lack of clinical benefit. We asked if this pattern persists in pts who benefited from long term (> 2 years) sunitinib therapy. Methods: Of 77 pts in our initial Phase I/II study, 7 remain on therapy with sunitinib for more than 2 years, 4 of whom had matched baseline PET and CT data to assess tumor metabolic activity on and off sunitinib dosing. PET scans were obtained at baseline, during initial treatment, during the off-treatment period, and again after > 2 years therapy. These 4 pts were followed for a median 39 months (range 35–45 months) and for a median of 35 cycles (range 27–47). Two achieved PR and two SD. Results: Initially, all 4 exhibited suppression of tumor FDG avidity with treatment followed by rebound during the off-treatment period. By 6 months, all showed complete suppression of FDG activity. After > 2 years on sunitinib, GIST lesions in 2 pts showed no activity on PET, even while off sunitinib, while GIST in 2 pts demonstrated rebound flare when off therapy. The GIST lesions have not progressed despite the transient metabolic rebound while off sunitinib. Conclusions: Metastatic lesions in pts with IM-resistant GIST benefiting from long-term sunitinib therapy display two patterns on PET imaging. GIST in certain pts who benefit from therapy demonstrates metabolic rebound of activity when off dosing, while lesions in other pts remain metabolically inert on PET even during the brief dosing breaks. Functional imaging may yield insights to differences in the underlying biology of GIST subtypes in different pts. [Table: see text]

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Functional respiratory imaging provides novel insights into the long-term respiratory sequelae of bronchopulmonary dysplasia

European Respiratory Journal ◽

10.1183/13993003.02110-2020 ◽

2020 ◽

pp. 2002110

Author(s):

Kristien Vanhaverbeke ◽

Monique Slaats ◽

Mohammed Al-Nejar ◽

Niek Everaars ◽

Annemiek Snoeckx ◽

...

Keyword(s):

Preterm Birth ◽

Lung Function ◽

Bronchopulmonary Dysplasia ◽

Functional Assessment ◽

Airway Resistance ◽

Ct Images ◽

Air Trapping ◽

Distal Airway ◽

Conventional Ct

RationaleBronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Lung function and imaging are classically used to assess BPD. Functional Respiratory Imaging (FRI) combines a structural and functional assessment of the airways and their vasculature. We aimed to assess BPD with FRI and to correlate these findings with the clinical presentation.MethodsWe included 37 adolescents with a history of preterm birth (22 BPD cases and 15 preterm controls). The study protocol included a detailed history, lung function testing and CT (at TLC and FRC) with FRI. CT images were also assessed using the Aukland scoring system.ResultsBPD patients had lower FEV1/FVC (p=0.02) and impaired diffusion capacity (p=0.02).Aukland CT scores were not different between the two groups. FRI analysis showed higher lobar volumes in BPD patients at FRC (p<0.01) but not at TLC. Airway resistance was significantly higher in the BPD group, especially in the distal airways. Additionally, FRI showed more air trapping in BPD patients, in contrast to findings on conventional CT images.ConclusionThis study is the first to use FRI in research for BPD. FRI analysis showed higher lobar volumes in BPD patients, indicating air trapping and reduced inspiratory capacity. In contrast to Aukland CT scores, FRI showed more air trapping in the BPD group, suggesting that FRI might be a more sensitive detection method. Importantly, we also showed increased distal airway resistance in BPD patients. By combining structural and functional assessment, FRI may help to better understand the long-term sequelae of BPD.

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Carbon fraction concentrations in a haplic Luvisol as affected by tillage

Plant Soil and Environment ◽

10.17221/7416-pse ◽

2014 ◽

Vol 60 (No. 6) ◽

pp. 262-266 ◽

Cited By ~ 3

Author(s):

J. Horáček ◽

E. Strosser ◽

V. Čechová

Keyword(s):

Cultural Practices ◽

Fulvic Acids ◽

Soil Samples ◽

Water Soluble ◽

Hot Water ◽

Protection Measures ◽

Humus Substances ◽

Conventional Ct ◽

Soluble Carbon

Changes of soil organic matter (SOM) parameters were investigated in a haplic Luvisol with medium-heavy texture. Soil samples were taken from several layers at minimum (MT) and conventional (CT) tillage plots of a field experiment in Sitzenhof (Germany). All cultural practices except for tillage (crop rotation, fertilizing, protection measures, etc.) were identical over the whole time of the experiment. The concentrations of oxidizable carbon C<sub>ox</sub> and its constituents (humic acids (HA), fulvic acids (FA), and hot-water soluble carbon) are comparable in layers 15–20 cm in both variants. In 0–15 cm and 30–55 cm layers, these concentrations were higher in the MT variant. A similar trend was observed in the colour quotient values of humic substances Q4/6, which indicates increasing condensation of humus substances (HS) at deeper layers in both variants, and it is also confirmed by a humic to fulvic acids ratio HA:FA. Concentrations of SOM fractions were higher (except 15–20 cm layers) in the MT than CT treatment throughout the profile, especially below the 30 cm depth. The SOM did not accumulate markedly in the surface layer of long-term MT treatment.

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