Lewy body dementia and Parkinson’s disease with dementia

Journal of Neurology - Parkinson’s disease (PD) is characterized by its motor impairment. However, non-motor symptoms such as psychiatric disorders, autonomic disturbances and sleep disorders...     

Prognostic factors in stereotactic body radiotherapy of lung metastases

Purpose

The aim of this study was to evaluate prognostic factors in patients with lung metastases who undergo lung stereotactic body radiotherapy (SBRT).

Materials and methods

A total of 87 patients with 129 lung metastases who underwent SBRT between November 2004 and May 2012 were enrolled in this retrospective study. The patient collective consisted of 54 men (62.1%) and 33 women (37.9%); the median age was 65 years (range 36–88). The Karnofsky performance index was ≥70% (median 90%) for all cases, but one (60%). Adverse effects were categorized using the CTCAE 4.0 classification system. Retrospective analyses regarding patients’ characteristics, progression-free survival (PFS), overall survival (OS), disease-specific survival (DSS), and local tumor control rates (LTC) were performed.

Results

On univariate and multivariate analysis OS, DSS, and PFS were significantly (p?<?0.05) better for patients with ≤3 lung metastases; no extrathoracic metastases at the time of the SBRT; a gross tumor volume (GTV) <7.7?cm³ and patients that received a staging that included positron emission tomography with fluorine 18 fluorodeoxyglucose/computed tomography (FDG-PET/CT) imaging. Furthermore, a longer OS was observed if newly diagnosed metastases during follow-up were limited to the lung (median survival: 43.7 months versus 21.7 months; p?=?0.023).

Conclusion

The number and pattern of metastases, and the size of the target volume are strong predictors for the outcome of patients receiving SBRT of lung tumors. FDG-PET/CT should be part of pretherapeutic staging before SBRT.

     

Quantitative contrast‐enhanced perfusion measurements of the human lung using the prebolus approach

Purpose

To investigate dynamic contrast‐enhanced MRI (DCE‐MRI) for quantification of pulmonary blood flow (PBF) and blood volume (PBV) using the prebolus approach and to compare the results to the global lung perfusion (GLP).

Materials and Methods

Eleven volunteers were examined by applying different contrast agent doses (0.5, 1.0, 2.0, and 3.0 mL gadolinium diethylene triamine pentaacetic acid [Gd‐DTPA]), using a saturation‐recovery (SR) true fast imaging with steady precession (TrueFISP) sequence. PBF and PBV were determined for single bolus and prebolus. Region of interest (ROI) evaluation was performed and parameter maps were calculated. Additionally, cardiac output (CO) and lung volume were determined and GLP was calculated as a contrast agent–independent reference value.

Results

The prebolus results showed good agreement with low‐dose single‐bolus and GLP: PBF (mean ± SD in units of mL/minute/100 mL) = single bolus 190 ± 73 (0.5‐mL dose) and 193 ± 63 (1.0‐mL dose); prebolus 192 ± 70 (1.0–2.0‐mL dose) and 165 ± 52 (1.0–3.0‐mL dose); GLP (mL/minute/100 mL) = 187 ± 34. Higher single‐bolus resulted in overestimated values due to arterial input function (AIF) saturation.

Conclusion

The prebolus approach enables independent determination of appropriate doses for AIF and tissue signal. Using this technique, the signal‐to‐noise ratio (SNR) from lung parenchyma can be increased, resulting in improved PBF and PBV quantification, which is especially useful for the generation of parameter maps. J. Magn. Reson. Imaging 2009;30:104–111. © 2009 Wiley‐Liss, Inc.     

Production and specificity of antibodies against the central region of type II collagen

Collagen type-specific antibodies as well as antibodies to particular portions of the molecule are extremely useful tools especially for the quantification of collagens and for immunohistochemical examinations in developing embryos. Quantification of collagens in CNBr-solubilized tissue samples presupposes the production of antibodies against CNBr-derived collagen fragments. For the first time, as antigens for the immunization of rabbits, cyanogen-bromide derived fragments of collagen type II were used, obtained by direct digestion of tissue (Swarm chondrosarcoma from rat) and separation by gel filtration chromatography. Antisera were applied to affinity chromatography and the eluted antibodies were characterized by ELISA, immunoblotting, inhibition studies and immunohistochemistry. The antibodies from five different rabbits show high specificity for type II collagen and are directed against sequential determinants in the central portion of the type II collagen molecule. The easy way of obtaining the fragments directly from tissue, combined with their immune response in rabbits, gives the possibility of producing type II collagen-specific, fragment-directed antibodies in a convenient and rapid way.