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  1. Article: TriDFusion (3DF) image viewer.

    Lafontaine, Daniel / Schmidtlein, C Ross / Kirov, Assen / Reddy, Ryan P / Krebs, Simone / Schöder, Heiko / Humm, John L

    EJNMMI physics

    2022  Volume 9, Issue 1, Page(s) 72

    Abstract: Background: An open-source, extensible medical viewing platform is described, called the TriDFusion image viewer (3DF). The 3DF addresses many broad unmet needs in nuclear medicine research; it provides a viewer with several tools not available in ... ...

    Abstract Background: An open-source, extensible medical viewing platform is described, called the TriDFusion image viewer (3DF). The 3DF addresses many broad unmet needs in nuclear medicine research; it provides a viewer with several tools not available in commercial nuclear medicine workstations, yet invaluable for imaging in research studies.
    Results: The 3DF includes an image integration platform to register images from multiple imaging modalities together with delineated volumes of interest (VOIs), structures and dose distributions. It can process images from different vendors' systems and is therefore vendor neutral. The 3DF also provides a convenient tool for performing multi-modality image analysis and fusion. The functional components currently being distributed is open-source code that includes: (1) a high quality viewer that can display axial, coronal, and sagittal tomographic images, maximum intensity projection images, structure contours, and isointensity contour lines or dose colorwash, (2) multi-image fusion allowing multiple images to be fused with VOI and dose distributions, (3) a suite of segmentation tools to edit and/or create tumor and organ VOIs, (4) dosimetry tools for several radioisotopes, (5) clinical tools for correcting acquisition errors, including patient orientation, and (6) the ability to save the resultant image and VOI as DICOM files or to export the numerical results as comma separated values files. Because the code is written in MATLAB™, it is highly readable and is easier for the coder to make changes compared to languages such as C or C++. In what follows, we describe the content of the new TriDFusion (3DF) image viewer software platform using examples of a number of clinical research workflows. Such examples vary in complexity but illustrate the main attributes of the software.
    Conclusions: In summary, 3DF provides a powerful, convenient, easy-to-use suite of open-source imaging research tools for the nuclear medicine community that allows physicians, medical physicists, and academic researchers to display, manipulate, and analyze images.
    Language English
    Publishing date 2022-10-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2768912-8
    ISSN 2197-7364
    ISSN 2197-7364
    DOI 10.1186/s40658-022-00501-y
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  2. Article ; Online: The Quest for an Accurate Functional Tumor Volume with

    Reddy, Ryan P / Ross Schmidtlein, C / Giancipoli, Romina G / Mauguen, Audrey / LaFontaine, Daniel / Schoder, Heiko / Bodei, Lisa

    Journal of nuclear medicine : official publication, Society of Nuclear Medicine

    2021  Volume 63, Issue 7, Page(s) 1027–1032

    Abstract: ... ...

    Abstract 68
    MeSH term(s) Gallium Radioisotopes ; Humans ; Neuroendocrine Tumors/metabolism ; Organometallic Compounds/metabolism ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography ; Radionuclide Imaging ; Radiopharmaceuticals ; Somatostatin ; Tumor Burden
    Chemical Substances Gallium Radioisotopes ; Organometallic Compounds ; Radiopharmaceuticals ; copper dotatate CU-64 ; Somatostatin (51110-01-1)
    Language English
    Publishing date 2021-11-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80272-4
    ISSN 1535-5667 ; 0097-9058 ; 0161-5505 ; 0022-3123
    ISSN (online) 1535-5667
    ISSN 0097-9058 ; 0161-5505 ; 0022-3123
    DOI 10.2967/jnumed.121.262782
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  3. Article ; Online: Treatment Response and Clinical Outcomes of Well-Differentiated High-Grade Neuroendocrine Tumors to Lutetium-177-DOTATATE.

    Raj, Nitya / Coffman, Kelley / Le, Tiffany / Do, Richard Kinh Gian / Rafailov, Johnathan / Choi, Ye / Chou, Joanne F / Capanu, Marinela / Dunphy, Mark / Fox, Josef J / Grewal, Ravinder K / Reddy, Ryan P / Riedl, Christopher / Schoder, Heiko / Bodei, Lisa / Reidy-Lagunes, Diane

    Neuroendocrinology

    2022  Volume 112, Issue 12, Page(s) 1177–1186

    Abstract: Introduction: Lutetium-177 (177Lu)-DOTATATE received FDA approval in 2018 to treat somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (NETs). Little data are available on response and outcomes for well-differentiated (WD) high- ... ...

    Abstract Introduction: Lutetium-177 (177Lu)-DOTATATE received FDA approval in 2018 to treat somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (NETs). Little data are available on response and outcomes for well-differentiated (WD) high-grade (HG) NETs treated with 177Lu-DOTATATE.
    Materials and methods: Patients with WD HG NETs treated with 177Lu-DOTATATE at MSK from 2018 to 2020 were identified. Demographics, response (RECIST 1.1), and progression-free survival (PFS) were determined. Next-generation sequencing (NGS) was performed in the archival tumor.
    Results: Nineteen patients, all with progressive, heavily treated disease, were identified. Sites of tumor origin were: pancreas (74%), small bowel (11%), rectum (11%), and lung (5%); median Ki-67 was 32% (range 22-56). Thirteen patients (68%) completed all four 177Lu-DOTATATE cycles. Best response (N = 18 evaluable) was: 5/18 (28%) partial response, 8/18 (44%) stable disease, and 5/18 (28%) disease progression. Median PFS was 13.1 months (95% CI: 8.7-20.9). Most common treatment-related toxicities were thrombocytopenia (9 patients, 47%; G3/4, 1 patient, 5%), anemia (7 patients, 37%; G3/4, 2 patients, 11%), leukopenia (6 patients, 32%; G3/4, 0 patients), and liver function test elevation (4 patients, 21%; G3/4, 0 patients). NGS results were available from 13/19 tumors (68%). The most observed alterations were in MEN1 (6/13, 46%) and DAXX (4/13, 31%). No RB1 alterations identified.
    Conclusion: We observed a meaningful disease control rate of 72% during treatment of WD HG NETs with 177Lu-DOTATATE. In this heavily pre-treated population, more than half of patients received all four treatment cycles with toxicities largely bone marrow-related. As would be expected in WD NETs, the vast majority had alterations in chromatin remodeling genes and no RB1 alterations.
    MeSH term(s) Humans ; Neuroendocrine Tumors/drug therapy ; Neuroendocrine Tumors/pathology ; Octreotide/therapeutic use ; Lutetium/adverse effects ; Radioisotopes/therapeutic use ; Organometallic Compounds/adverse effects ; Radiopharmaceuticals
    Chemical Substances Lutetium-177 (BRH40Y9V1Q) ; copper dotatate CU-64 ; Octreotide (RWM8CCW8GP) ; Lutetium (5H0DOZ21UJ) ; Radioisotopes ; Organometallic Compounds ; Radiopharmaceuticals
    Language English
    Publishing date 2022-05-24
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 123303-8
    ISSN 1423-0194 ; 0028-3835
    ISSN (online) 1423-0194
    ISSN 0028-3835
    DOI 10.1159/000525216
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  4. Article ; Online: A trial of drug-induced sleep endoscopy in the surgical management of sleep-disordered breathing.

    Gillespie, M Boyd / Reddy, Ryan P / White, David R / Discolo, Christopher M / Overdyk, Frank J / Nguyen, Shaun A

    The Laryngoscope

    2013  Volume 123, Issue 1, Page(s) 277–282

    Abstract: Objectives/hypothesis: To determine the reliability and validity of drug-induced sleep endoscopy (DISE) for patients undergoing surgery for sleep-disordered breathing (SDB).: Study design: Non-randomized, prospective clinical trial.: Methods: ... ...

    Abstract Objectives/hypothesis: To determine the reliability and validity of drug-induced sleep endoscopy (DISE) for patients undergoing surgery for sleep-disordered breathing (SDB).
    Study design: Non-randomized, prospective clinical trial.
    Methods: Patients with sleep-disordered breathing were evaluated for multi-level upper airway surgery by awake and drug-induced sleep endoscopy to identify levels and degree of airway collapse. The reliability of a drug-induced sleep endoscopy rating index was assessed by comparing scores of three blinded investigators. The validity was assessed by comparison of drug-induced sleep endoscopy index scores from awake and drug-induced sleep endoscopy; correlation between drug-induced sleep endoscopy scores and Apnea-Hypopnea Index; and determination whether drug-induced sleep endoscopy affected the original surgical plan.
    Results: Thirty-eight patients (22 M, 16 F) underwent preoperative assessment with awake and drug-induced sleep endoscopy. Drug-induced sleep endoscopy was successfully performed in all but one patient (97%) who became combative during propofol infusion. Using an internal airway grading scale, drug-induced sleep endoscopy demonstrated more severity of collapse than awake endoscopy (P = 0.0001). The surgical plan was changed after drug-induced sleep endoscopy in 23 (62%) cases and unchanged in 14 (38%). The majority (73%) had multi-segmental airway collapse with fewer having single-level palatal (16%) or tongue base (11%) collapse. Scoring of drug-induced sleep endoscopy videos demonstrated good intrarater (κ 0.61) and interrater (κ 0.65) correlation.
    Conclusions: Drug-induced sleep endoscopy provides more clinical information to assess airway function and collapse than awake endoscopy alone and assists in the surgical planning. Additional investigation is needed to standardize drug-induced sleep endoscopy techniques, training, and interpretation.
    MeSH term(s) Adult ; Aged ; Anesthetics, Intravenous/pharmacology ; Endoscopy/methods ; Female ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; Sleep Apnea Syndromes/diagnosis ; Sleep Apnea Syndromes/physiopathology ; Sleep Apnea Syndromes/surgery ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/physiopathology ; Sleep Apnea, Obstructive/surgery ; Young Adult
    Chemical Substances Anesthetics, Intravenous
    Language English
    Publishing date 2013-01
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.23506
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  5. Article ; Online: Potential of right to left ventricular volume ratio measured on chest CT for the prediction of pulmonary hypertension: correlation with pulmonary arterial systolic pressure estimated by echocardiography.

    Lee, Heon / Kim, Seok Yeon / Lee, Soo Jeong / Kim, Jae Kyun / Reddy, Ryan P / Schoepf, U Joseph

    European radiology

    2012  Volume 22, Issue 9, Page(s) 1929–1936

    Abstract: Objectives: To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio measured by chest CT with pulmonary arterial systolic pressure (PASP) estimated by echocardiography.: Methods: 104 patients (72.47 ± 13.64 ... ...

    Abstract Objectives: To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio measured by chest CT with pulmonary arterial systolic pressure (PASP) estimated by echocardiography.
    Methods: 104 patients (72.47 ± 13.64 years; 39 male) who had undergone chest CT and echocardiography were divided into two groups (hypertensive and normotensive) based upon an echocardiography-derived PASP of 25 mmHg. RV to LV volume ratios (RV(V)/LV(V)) were calculated. RV(V)/LV(V) was then correlated with PASP using regression analysis. The Area Under the Curve (AUC) for predicting pulmonary hypertension on chest CT was calculated.
    Results: In the hypertensive group, the mean PASP was 46.29 ± 14.42 mmHg (29-98 mmHg) and there was strong correlation between the RV(V)/LV(V) and PASP (R = 0.82, p < 0.001). The intraobserver and interobserver correlation coefficients for RV(V)/LV(V) were 0.990 and 0.892. RV(V)/LV(V) was 1.01 ± 0.44 (0.51-2.77) in the hypertensive and 0.72 ± 0.14 (0.52-1.11) in the normotensive group (P <0.05). With 0.9 as the cutoff for RV(V)/LV(V), sensitivity and specificity for predicting pulmonary hypertension over 40 mmHg were 79.5 % and 90 %, respectively. The AUC for predicting pulmonary hypertension was 0.87
    Conclusion: RV/LV volume ratios on chest CT correlate well with PASP estimated by echocardiography and can be used to predict pulmonary hypertension over 40 mmHg with high sensitivity and specificity.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Arterial Pressure ; Echocardiography/methods ; Feasibility Studies ; Female ; Humans ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/physiopathology ; Middle Aged ; Pulmonary Artery/diagnostic imaging ; Pulmonary Artery/physiopathology ; Radiography, Thoracic/methods ; Stroke Volume ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2012-04-27
    Publishing country Germany
    Document type Comparative Study ; Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-012-2454-x
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  6. Article ; Online: Image quality and radiation dose of low dose coronary CT angiography in obese patients: sinogram affirmed iterative reconstruction versus filtered back projection.

    Wang, Rui / Schoepf, U Joseph / Wu, Runze / Reddy, Ryan P / Zhang, Chuanchen / Yu, Wei / Liu, Yi / Zhang, Zhaoqi

    European journal of radiology

    2012  Volume 81, Issue 11, Page(s) 3141–3145

    Abstract: Purpose: To investigate the image quality and radiation dose of low radiation dose CT coronary angiography (CTCA) using sinogram affirmed iterative reconstruction (SAFIRE) compared with standard dose CTCA using filtered back-projection (FBP) in obese ... ...

    Abstract Purpose: To investigate the image quality and radiation dose of low radiation dose CT coronary angiography (CTCA) using sinogram affirmed iterative reconstruction (SAFIRE) compared with standard dose CTCA using filtered back-projection (FBP) in obese patients.
    Materials and methods: Seventy-eight consecutive obese patients were randomized into two groups and scanned using a prospectively ECG-triggered step-and-shot (SAS) CTCA protocol on a dual-source CT scanner. Thirty-nine patients (protocol A) were examined using a routine radiation dose protocol at 120 kV and images were reconstructed with FBP (protocol A). Thirty-nine patients (protocol B) were examined using a low dose protocol at 100 kV and images were reconstructed with SAFIRE. Two blinded observers independently assessed the image quality of each coronary segment using a 4-point scale (1=non-diagnostic, 4=excellent) and measured the objective parameters image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Radiation dose was calculated.
    Results: The coronary artery image quality scores, image noise, SNR and CNR were not significantly different between protocols A and B (all p>0.05), with image quality scores of 3.51±0.70 versus 3.55±0.47, respectively. The effective radiation dose was significantly lower in protocol B (4.41±0.83 mSv) than that in protocol A (8.83±1.74 mSv, p<0.01).
    Conclusion: Compared with standard dose CTCA using FBP, low dose CTCA using SAFIRE can maintain diagnostic image quality with 50% reduction of radiation dose.
    MeSH term(s) Adult ; Algorithms ; Coronary Angiography ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Obesity/complications ; Obesity/diagnostic imaging ; Radiation Dosage ; Radiation Protection/methods ; Radiographic Image Enhancement/methods ; Radiographic Image Interpretation, Computer-Assisted/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed
    Language English
    Publishing date 2012-11
    Publishing country Ireland
    Document type Comparative Study ; Evaluation Studies ; Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2012.04.012
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