This paper presents a fully automated method for the identification of bone marrow infiltration in femurs in low-dose CT of patients with multiple myeloma. We automatically find the femurs and the bone marrow within them. In the next step, we create a probabilistic, spatially dependent density model of normal tissue. At test time, we detect unexpectedly high density voxels which may be related to bone marrow infiltration, as outliers to this model. Based on a set of global, aggregated features representing all detections from one femur, we classify the subjects as being either healthy or not. This method was validated on a dataset of 127 subjects with ground truth created from a consensus of two expert radiologists, obtaining an AUC of 0.996 for the task of distinguishing healthy controls and patients with bone marrow infiltration. To the best of our knowledge, no other automatic image-based method for this task has been published before.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• metastázy nádorů MeSH
• mnohočetný myelom MeSH
• nádory kostní dřeně MeSH
• počítačová rentgenová tomografie metody   MeSH
• počítačové zpracování obrazu * MeSH
• senioři MeSH
• strojové učení * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

In October 1995 the World Marrow Donor Association (WMDA) was restructured in order to facilitate its primary function of establishing guidelines in relation to international bone marrow and blood stem cell transplants -- transplants in which the donor is in one country and the patient is in another country. Five new working groups were established -- Donor Registries, Ethics, Quality Assurance, Finances, and Stem Cells. This paper, prepared by members of the Donor Registries Working Group, in consultation with the Quality Assurance Working Group, provides recommendations for the 'donor work-up'. This term covers events that start when the definitive donor has been identified, includes the harvesting (collection) and transportation of the stem cell product and ends when the product reaches the transplant centre. The paper includes examples of the documentation intended to ensure compliance with the recommendations at all key points in the sequence.

• MeSH
• dodržování směrnic MeSH
• důvěrnost informací MeSH
• lidé MeSH
• odběr biologického vzorku normy   MeSH
• průzkumy a dotazníky MeSH
• registrace MeSH
• řízení kvality MeSH
• testování histokompatibility MeSH
• transplantace kostní dřeně normy   MeSH
• uchovávání tkání normy   MeSH
• žijící dárci MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• směrnice pro lékařskou praxi MeSH
• směrnice MeSH

BACKGROUND: To test the hypothesis that atlas-based active bone marrow (ABM)-sparing intensity modulated radiation therapy (IMRT) yields similar dosimetric results compared to custom ABM-sparing IMRT for cervical cancer patients. METHODS: We sampled 62 cervical cancer patients with pre-treatment FDG-PET/CT in training (n=32) or test (n=30) sets. ABM was defined as the subvolume of the pelvic bone marrow (PBM) with standardized uptake value (SUV) above the mean on the average FDG-PET image (ABMAtlas) vs. the individual's PET (ABMCustom). Both were deformed to the planning CT. Overlap between the two subvolumes was measured using the Dice coefficient. Three IMRT plans designed to spare PBM, ABMAtlas, or ABMCustomwere compared for 30 test patients. Dosimetric parameters were used to evaluate plan quality. RESULTS: ABMAtlasand ABMCustomvolumes were not significantly different (p=0.90), with a mean Dice coefficient of 0.75, indicating good agreement. Compared to IMRT plans designed to spare PBM and ABMCustom, ABMAtlas-sparing IMRT plans achieved excellent target coverage and normal tissue sparing, without reducing dose to ABMCustom(mean ABMCustomdose 29.4Gy vs. 27.1Gyvs. 26.9Gy, respectively; p=0.10); however, PTV coverage and bowel sparing were slightly reduced. CONCLUSIONS: Atlas-based ABM sparing IMRT is clinically feasible and may obviate the need for customized ABM-sparing as a strategy to reduce hematologic toxicity.

• MeSH
• celková dávka radioterapie MeSH
• dospělí MeSH
• fluorodeoxyglukosa F18 MeSH
• kostní dřeň účinky záření   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory děložního čípku radioterapie   MeSH
• PET/CT MeSH
• plánování radioterapie pomocí počítače metody   MeSH
• radioterapie s modulovanou intenzitou škodlivé účinky   metody   MeSH
• senioři MeSH
• studie proveditelnosti MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• autologní transplantace metody   MeSH
• infarkt myokardu diagnóza   terapie   MeSH
• jednofotonová emisní výpočetní tomografie využití   MeSH
• leukocyty mononukleární transplantace   MeSH
• lidé MeSH
• sloučeniny technecia diagnostické užití   MeSH
• transplantace kostní dřeně metody   využití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• multicentrická studie MeSH

Mastocytosis is a clonal hematopoietic disorder characterized by proliferation of abnormal mast cells in various organs including the skin, digestive system, lymph nodes, and bone marrow. We report on a 75-year-old woman presenting with abdominal pain, vomiting, diarrhoea, myalgia, and weight loss. Abdominal CT showed hepatosplenomegaly with heterogeneous splenic parenchyma, lymphadenopathy, and osteopenia with areas of osteosclerosis but no primary tumour. An 18F-FDG PET/CT revealed an overall low metabolic activity of the lesions with a diffuse bone marrow involvement raising suspicion of a haematological neoplasm. Subsequently, bone marrow and peripheral blood examinations confirmed the diagnosis of aggressive systemic mastocytosis.

• MeSH
• fluorodeoxyglukosa F18 * MeSH
• kostní dřeň diagnostické zobrazování   MeSH
• lidé MeSH
• PET/CT MeSH
• pozitronová emisní tomografie MeSH
• senioři MeSH
• systémová mastocytóza * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND CONTEXT: Spondylodesis in the operative management of lumbar spine diseases has been the subject of numerous studies over several decades. The posterolateral fusion (PLF) with pedicle screw fixation is a commonly used procedure. PURPOSE: To determine whether the addition of bone marrow concentrate (BMC) to allograft bone increases fusion rate after instrumented posterior lumbar fusion. STUDY DESIGN: The study was prospective, randomized, controlled, and blinded. METHODS: Eighty patients with degenerative disease of the lumbar spine underwent instrumented lumbar or lumbosacral PLF (22 men, 58 women; body mass index less than 35 for a good visualization of the PLF in the X-rays). In 40 cases, the PLF was done with spongious allograft chips alone (Group I, age 62.7 years in average, range 47-77 years, level of fusion 1-2). In another 40 cases, spongious allograft chips were mixed with BMC (Group II, age 58.5 years in average, range 42-80, level of fusion 1-3), including the mesenchymal stem cells (MSCs). Patients were scheduled for anteroposterior and lateral radiographs 12 and 24 months after the surgery and for computed tomography scanning 24 months after the surgery. Fusion status and the degree of mineralization of the fusion mass were evaluated separately by two radiologists blinded to patient group affiliation. The bony mass was judged as fused if there was uninterrupted bridging of well-mineralized bone between the transverse processes or sacrum, with trabeculation indicating bone maturation on least at one side of the spines. RESULTS: In Group I at 12 months, the bone graft mass was assessed in X-rays as fused in no cases (0%) and at 24 months in four cases (10%). In Group II, 6 cases (15%) achieved fusion at 12 months and 14 cases (35%) at 24 months. The statistically significant difference between both groups was proven for complete fusion at both 12 (p=.041) and 24 months (p=.011). Computed tomography scans showed that 16 cases (40%) in Group I and 32 cases (80%) in Group II had evidence of at least unilateral continuous bridging bone between neighboring vertebrae at 24 months (p<.05). CONCLUSIONS: We have confirmed the hypothesis that the autologous BMC together with the allograft is a better alternative for PLF than the allograft alone. The use of autologous MSCs in form of BMC in combination with allograft is an effective option to enhance the PLF healing.

• MeSH
• bederní obratle radiografie   chirurgie   MeSH
• dospělí MeSH
• fúze páteře metody   MeSH
• homologní transplantace MeSH
• křížová kost radiografie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci páteře radiografie   chirurgie   MeSH
• počítačová rentgenová tomografie MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transplantace kostní dřeně metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

The utility of posttreatment bone marrow biopsy (BMB) histology to confirm complete response (CR) in lymphoma clinical trials is in question. We retrospectively evaluated the impact of BMB on response assessment in immunochemotherapy-treated patients with previously untreated follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) in the phase 3 Study of Obinutuzumab (RO5072759) Plus Chemotherapy in Comparison With Rituximab Plus Chemotherapy Followed by Obinutuzumab or Rituximab Maintenance in Patients With Untreated Advanced Indolent Non-Hodgkin's Lymphoma (GALLIUM; NCT01332968) and A Study of Obinutuzumab in Combination With CHOP Chemotherapy Versus Rituximab With CHOP in Participants With CD20-Positive Diffuse Large B-Cell Lymphoma (GOYA; NCT01287741) trials, respectively. Baseline BMB was performed in all patients, with repeat BMBs in patients with a CR by computed tomography (CT) at end of induction (EOI) and a positive BMB at baseline, to confirm response. Positron emission tomography imaging was also used in some patients to assess EOI response (Lugano 2014 criteria). Among patients with an EOI CR by CT in GALLIUM and GOYA, 2.8% and 4.1%, respectively, had a BMB-altered response. These results suggest that postinduction BMB histology has minimal impact on radiographically (CT)-defined responses in both FL and DLBCL patients. In GALLIUM and GOYA, respectively, 4.7% of FL patients and 7.1% of DLBCL patients had a repeat BMB result that altered response assessment when applying Lugano 2014 criteria, indicating that bone marrow evaluation appears to add little value to response assessment in FL; however, its evaluation may still have merit in DLBCL.

• MeSH
• biopsie MeSH
• fluorodeoxyglukosa F18 MeSH
• galium * MeSH
• kostní dřeň * MeSH
• lidé MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Cíl. Prezentovat případ 68leté ženy léčené pro karcinom cervicis uteri, která podstoupila scintigrafii kostní dřeně s 99mTc-nanokoloidem, jež měla za cíl určit rozsah aktivní kostní dřeně před plánovaným radikálním ozářením nádoru technikou IMRT a při které se náhodně zobrazilo fotopenické ložisko (studený uzel) v těle obratle L4, jehož příčinou byl následně identifikovaný hemangiom. Metoda. Pacientka s karcinom cervicis uteri (T2b, NI, MO) podstoupila scintigrafii kostní dřeně s 99mTc-nanokoloidem. Aplikovaná aktivita 99mTc-nanokoloidu činila 440 MBq. Za 45 minut po i.v. aplikaci radiofarmaka byla provedena celotělová scintigrafie kostní dřeně z přední a zadní projekce doplněná o statickou scintigrafii L páteře. Vyšetření se uskutečnilo na dvouhlavé digitální rotační gamakameře VariCam (Elscint) s velkým zorným polem scintilačních detektorů. Gamakamera byla osazena kolimátory pro nízké energie s vysokým rozlišením a paralelními otvory. Výsledky. Scintigrafie kostní dřeně s 99mTc-koloidem zjistila fotopenické ložisko postihující téměř celé tělo obratie L4. V diferenciální diagnostice na prvním místě bylo pomýšleno na metastázu karcinomu cervicis uteri v kostní dřeni, ale následný RTG snímek L páteře byl normální a stejně tak i celotělová scintigrafie skeletu. Následovalo CT L páteře, které zjistilo, že se jedná o hemangiom. Závěr. Fotopenická ložiska tvořená benigními hemangiomy v tělech obratlových těl mohou být na celotělové scintigrafii kostní dřeně s 99mTc-nanokoloidem považována za metastázy a mohou představovat obtíže v diferenciální diagnostice fotopenických lézí.

Aim. To present a case report of the detection of the cold lesion vertebral hemangioma by means of the bone marrow scintigraphy with 99mTc labelled nanocolloid in woman with carcinoma cervicis uteri. Method. 68-years-old woman with carcinoma cervicis uteri (T2b, Nl, MO) underwent the bone marrow scintigraphy with 99mTc labelled nanocolloid for assessment of the red bone marrow range before IMRT pelvis radiotherapy. The applied activity of the 99mTc-nano-colloid was 440 MBq. The whole body scintigraphy (anterior and posterior views) was started 45 minutes after intravenous injection of the radiotracer. The static spine scintigraphy with zoom two was added to improve sensitivity. The rotating, digital, double-head gamma camera VariCam (Elscint) with infrared body contouring and large field of view was used. Gamma camera was fitted with low-energy high resolution, parallel-hole collimators. Images were evaluated by conventional processing system Xpert-Pro (Elscint). Results. The bone marrow whole body scintigraphy with 99mTc-nanocolloid demonstrated the large photopenic, cold lesion was in body vertebra L4, reported as bone marrow metastasis. Subsequent L, S spine x-ray and whole body bone scintigraphy with 99mTc-MDP were normal. CT scan confirmed the presence of vertebral hemangioma. Conclusion. Photopenic, cold lesion in the benign vertebral hemangioma should be considered metastasis on bone marrow whole body scintigraphy and could have made difficulties in the differential diagnosis of the focal cold lesion.

• Klíčová slova
• fotopenické ložisko, scintigrafie kostní dřeně, 99mTc-nano-koloid,
• MeSH
• bederní obratle MeSH
• diagnostické techniky a postupy využití   MeSH
• diferenciální diagnóza MeSH
• hemangiom diagnóza   etiologie   MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• nádory děložního čípku komplikace   terapie   MeSH
• nádory páteře komplikace   MeSH
• radiofarmaka diagnostické užití   MeSH
• radiografie využití   MeSH
• radioisotopová scintigrafie metody   využití   MeSH
• senioři MeSH
• technecium diagnostické užití   MeSH
• vyšetřování kostní dřeně metody   využití   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• bakteriální infekce a mykózy diagnóza   mikrobiologie   MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• plicní nemoci diagnóza   etiologie   MeSH
• počítačová rentgenová tomografie statistika a číselné údaje   MeSH
• transplantace kostní dřeně metody   škodlivé účinky   statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH

ACKGROUND: There are only few data on long-term effectiveness of the stem cell therapy. AIM: We studied the time course of global and regional left ventricular function in patients with acute myocardial infarction within 1 year after the autologous mononuclear bone marrow cell transplantation. METHODS: Sixty patients with a first acute myocardial infarction, who had been randomized into 3 groups, completed a 12-month protocol. Two groups were intracoronarily given bone marrow cells in either higher (10(8) cells, HD group, n=20) or lower (10(7) cells, LD group, n=20) doses. Twenty patients without cell transplantation served as a control (C) group. Doppler tissue imaging and the gated technetium-99m sestamibi single photon emission computed tomography were performed before cell transplantation and at 3, 6, and 12 months later. RESULTS: The baseline peak systolic velocities of longitudinal contraction of the infarcted wall (S(infarct)) of 5.2 cm/s, 4.6 cm/s, and 4.4 cm/s in C, LD, and HD groups increased by 0.0 cm/s, 0.3 cm/s (p=NS vs. C group), and by 0.7 cm/s (p<0.05 vs. C group), respectively, at 3 months. At 12 months, however, the corresponding changes from baseline values of 0.1 cm/s, 0.2 cm/s, and 0.6 cm/s did not differ significantly (all p=NS). In contrast, the post-transplant improvements in the left ventricular ejection fraction by 6%, 7%, and 7% at months 3, 6, and 12, respectively, were preserved in HD group patients during the whole 12-month follow-up and remained significantly better as compared to controls. CONCLUSIONS: In our study, the autologous mononuclear bone marrow cell transplantation provided sustained improvement in global left ventricular systolic function in patients with acute myocardial infarction. However, when evaluating regional systolic function of the infarcted wall, the short-term benefit was partially lost during the 12-month follow-up.

• MeSH
• analýza rozptylu MeSH
• autologní transplantace MeSH
• barevná dopplerovská echokardiografie MeSH
• financování organizované MeSH
• funkce levé komory srdeční MeSH
• infarkt myokardu chirurgie   patologie   MeSH
• jednofotonová emisní výpočetní tomografie MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• obnova funkce MeSH
• pozitronová emisní tomografie MeSH
• transplantace kmenových buněk metody   MeSH
• transplantace kostní dřeně metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• randomizované kontrolované studie MeSH