Serial MRI
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47 mužů s první epizodou schizofrenie bylo vyšetřeno magnetickou rezonancí s následnou volumetrií hipokampu, neuropsychologickými testy exekutivních funkcí a krátkodobé paměti a škálou PANSS. Rok po první epizodě byli pacienti pozváni k prešetrení. Nebyly nalezeny vztahy mezi velikostí hipokampu a kognitivními funkcemi vázanými na mediotemporální a frontální oblasti, tedy pamětí a exekutivními funkcemi. Velikost hipokampu nekorelovala s mírou symptomatologie v akutní fázi první epizody, velikost hipokampu v akutní fázi nepredikovala míru symptomatologie rok po ní. Velikost hipokampu také nebyla spojená s reaktivitou k léčbě v průběhu akutní fáze první epizody. Současná analýza vztahů velikosti hipokampu a funkce prefrontálního kortexu ukázala souvislost s produktivní symptomatologií schizofrenie. Nebyly nalezeny parametry, které by umožňovaly jednoletou predikci stavu pacienta. Z uvedených výsledků vyplývá potřeba vícerozměrné analýzy při pátrání po neuronálních podkladech klinické manifestace tohoto onemocnění.
Forty seven first episode schizophrenia men were assessed by MRI with hippocampal volumetry, short-term memory and executive functions tests and their symptomatology was assessed by PANSS. They were re-assessed one year after their first episode. We did not find any correlations between hippocampal volume and cognitive functions linked with mediotemporal and frontal regions - memory and executive functions. Hippocampal volume did not correlate with symptoms during the acute phase of first episode schizophrenia, and did not predict symptoms in the one-year follow-up. There was also no connection of hippocampal volume with treatment reactivity during the acute phase of first episode schizophrenia. Analysis including both baseline hippocampal volume and prefrontal functioning shows an association with positive symptoms. We did not find parameters suitable for one-year outcome prediction. Our results show that multimodal analysis is necessary in the search of neuronal basis of clinical manifestation of schizophrenia.
- MeSH
- finanční podpora výzkumu jako téma MeSH
- hipokampus anatomie a histologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody přístrojové vybavení MeSH
- neurologické manifestace MeSH
- neuropsychologické testy statistika a číselné údaje MeSH
- paměť MeSH
- prefrontální mozková kůra fyziologie MeSH
- psychopatologie MeSH
- schizofrenie etiologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- srovnávací studie MeSH
Polymers with lower critical solution temperature (LCST) are molecularly soluble in their solutions at low temperatures but, when heated above their cloud point temperature, these polymers assemble into supramolecular particles or macroscopic precipitates. These particles or precipitated polymeric depots can be used for diagnostics, targeted drug delivery, controlled drug release from a depot or a combination of diagnostics and therapy (theranostics). Herein, we describe smart polymer systems which contain N-(2,2-difluoroethyl)acrylamide monomer unit (DFEA) and form polymeric nanoparticles upon heating or precipitate after injection to polymeric implants/depots. Due to a high fluorine content and to relaxation properties of this element, these polymers are suitable as tracers for the 19F MRI method, a promising non-invasive diagnostic tool. Moreover, DFEA copolymers can contain monomers that react to additional physicochemical properties, resulting in multiresponsive polymers (pH- or redox-responsive), which can be used for smart drug delivery systems with controlled release of drugs in the target environment.
- MeSH
- dichlorethyleny MeSH
- kontrastní látky * MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- Check Tag
- lidé MeSH
2nd compl. rev. and expanded ed. VIII, 213 s. : il.
PURPOSE: To investigate combined MRI and 18F-FDG PET for assessing breast tumor metabolism/perfusion mismatch and predicting pathological response and recurrence-free survival (RFS) in women treated for breast cancer. METHODS: Patients undergoing neoadjuvant chemotherapy (NAC) for locally-advanced breast cancer were imaged at three timepoints (pre, mid, and post-NAC), prior to surgery. Imaging included diffusion-weighted and dynamic contrast-enhanced (DCE-) MRI and quantitative 18F-FDG PET. Tumor imaging measures included apparent diffusion coefficient, peak percent enhancement (PE), peak signal enhancement ratio (SER), functional tumor volume, and washout volume on MRI and standardized uptake value (SUVmax), glucose delivery (K1) and FDG metabolic rate (MRFDG) on PET, with percentage changes from baseline calculated at mid- and post-NAC. Associations of imaging measures with pathological response (residual cancer burden [RCB] 0/I vs. II/III) and RFS were evaluated. RESULTS: Thirty-five patients with stage II/III invasive breast cancer were enrolled in the prospective study (median age: 43, range: 31-66 years, RCB 0/I: N = 11/35, 31%). Baseline imaging metrics were not significantly associated with pathologic response or RFS (p > 0.05). Greater mid-treatment decreases in peak PE, along with greater post-treatment decreases in several DCE-MRI and 18F-FDG PET measures were associated with RCB 0/I after NAC (p < 0.05). Additionally, greater mid- and post-treatment decreases in DCE-MRI (peak SER, washout volume) and 18F-FDG PET (K1) were predictive of prolonged RFS. Mid-treatment decreases in metabolism/perfusion ratios (MRFDG/peak PE, MRFDG/peak SER) were associated with improved RFS. CONCLUSION: Mid-treatment changes in both PET and MRI measures were predictive of RCB status and RFS following NAC. Specifically, our results indicate a complementary relationship between DCE-MRI and 18F-FDG PET metrics and potential value of metabolism/perfusion mismatch as a marker of patient outcome.
- MeSH
- dospělí MeSH
- fluorodeoxyglukosa F18 terapeutické užití MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- nádory prsu * diagnostické zobrazování farmakoterapie MeSH
- neoadjuvantní terapie metody MeSH
- pozitronová emisní tomografie metody MeSH
- prospektivní studie MeSH
- radiofarmaka terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Research Support, N.I.H., Extramural MeSH
CONTEXT: Although magnetic resonance imaging (MRI) is broadly implemented into active surveillance (AS) protocols, data on the reliability of serial MRI in order to help guide follow-up biopsy are inconclusive. OBJECTIVE: To assess the diagnostic estimates of serial prostate MRI for prostate cancer (PCa) progression during AS. EVIDENCE ACQUISITION: We systematically searched PubMed, Scopus, and Web of Science databases to select studies analyzing the association between changes on serial prostate MRI and PCa progression during AS. We included studies that provided data for MRI progression, which allowed us to calculate diagnostic estimates. We compared Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) accuracy with institution-specific definitions. EVIDENCE SYNTHESIS: We included 15 studies with 2240 patients. Six used PRECISE criteria and nine institution-specific definitions of MRI progression. The pooled PCa progression rate, which included histological progression to Gleason grade ≥2, was 27%. The pooled sensitivity and specificity were 0.59 (95% confidence interval [CI] 0.44-0.73) and 0.75 (95% CI 0.66-0.84) respectively. There was significant heterogeneity between included studies. Depending on PCa progression prevalence, the pooled negative predictive value for serial prostate MRI ranged from 0.81 (95% CI 0.73-0.88) to 0.88 (95% CI 0.83-0.93) and the pooled positive predictive value ranged from 0.37 (95% CI 0.24-0.54) to 0.50 (95% CI 0.36-0.66). There were no significant differences in the pooled sensitivity (p = 0.37) and specificity (p = 0.74) of PRECISE and institution-specific schemes. CONCLUSIONS: Serial MRI still should not be considered a sole factor for excluding PCa progression during AS, and changes on MRI are not accurate enough to indicate PCa progression. There was a nonsignificant trend toward improved diagnostic estimates of PRECISE recommendations. These findings highlight the need to further define the optimal triggers and timing of biopsy during AS, as well as the need for optimizing the quality, interpretation, and reporting of serial prostate MRI. PATIENT SUMMARY: Our study suggests that serial prostate magnetic resonance imaging (MRI) alone in patients on active surveillance is not accurate enough to reliably rule out or rule in prostate cancer progression. Other clinical factors and biomarkers along with serial MRI are required to safely tailor the intensity of follow-up biopsies.
- MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- nádory prostaty diagnostické zobrazování patologie MeSH
- pozorné vyčkávání * MeSH
- progrese nemoci MeSH
- prostata diagnostické zobrazování MeSH
- reprodukovatelnost výsledků MeSH
- ultrazvukem navigovaná biopsie * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
- systematický přehled MeSH
Cognitive impairment (CI) may occur in clinically isolated syndrome (CIS) patients. While the relationship between CI and magnetic resonance imaging (MRI) has been investigated extensively in multiple sclerosis (MS), MRI correlates of CI in CIS patients are unknown. To investigate the evolution of CI and to determine brain MRI structural correlates associated with CI in CIS patients. This prospective 24-month observational study examined 81 CIS patients treated with 30 µg of intramuscular interferon beta 1a once a week. MRI acquisition and neuropsychological (NP) assessment were performed at baseline, 6, 12 and 24 months. Participants were tested with Czech-validated version of Minimal Assessment of Cognitive Function in MS battery and MRI measures of lesion activity and burden, and global, tissue-specific and regional brain atrophy were performed. Over 24 months, 36 CIS patients developed clinically definite MS (CDMS). CI was observed in 10 (12.3 %) CIS patients at baseline and at the 24 months follow-up. Eight CIS patients changed their CI status over the follow-up (four improved and four worsened). No significant difference in development of CI was detected between stable CIS patients and those who developed CDMS. In multivariate regression and mixed-effect model analyses, no significant relationship was found between NP and MRI parameters. The lack of significant relationship between MRI metrics and cognition in this group of CIS patients could be attributed to several factors including the cognitive reserve, effect of disease-modifying therapy and relatively short follow-up period.
- MeSH
- demyelinizační nemoci farmakoterapie imunologie patologie psychologie MeSH
- dospělí MeSH
- interferon beta 1a MeSH
- interferon beta aplikace a dávkování farmakologie MeSH
- kognice účinky léků MeSH
- kognitivní dysfunkce farmakoterapie imunologie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozek patologie MeSH
- následné studie MeSH
- neuropsychologické testy MeSH
- progrese nemoci MeSH
- prospektivní studie MeSH
- roztroušená skleróza farmakoterapie imunologie patologie psychologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVES: We measured the volumes of the amygdala to test the hypothesis that the reduction of amygdalar volume may be associated with psychiatric symptoms in Alzheimer's disease. MATERIALS AND METHODS: Twenty-seven patients underwent neuropsychological investigation including the assessment of general clinical severity by the Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI). All patients underwent magnetic resonance imaging (MRI) of the head, from which the volumes of the amygdalae were measured. The obtained values were compared with those of controls (n = 15). RESULTS: Patients with Alzheimer's dementia showed significant reduction in MRI volumetric measurements compared with controls. We found a significant correlation of MMSE score and absolute amygdala volume (r = 0.62, P < 0.01). Neither the absolute nor relative volume of the amygdala showed any correlation with NPI scores. CONCLUSIONS: The atrophy of the amygdala does not have a direct association with the existence of neuropsychiatric symptoms. MRI volumetry of the amygdala may be relevant as a marker of dementia severity in Alzheimer's disease.
- MeSH
- Alzheimerova nemoc komplikace patologie psychologie MeSH
- amygdala patologie MeSH
- atrofie MeSH
- duševní poruchy etiologie patologie MeSH
- financování organizované MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- neuropsychologické testy MeSH
- průřezové studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- záznam o duševním stavu MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
BACKGROUND: Although there is evidence that shows worse cognitive functioning in male patients with multiple sclerosis (MS), the role of brain pathology in this context is under-investigated. OBJECTIVE: To investigate sex differences in cognitive performance of MS patients, in the context of brain pathology and disease burden. METHODS: Brain MRI, neurological examination, neuropsychological assessment (Brief International Cognitive Assessment in MS-BICAMS, and Paced Auditory Verbal Learning Test-PASAT), and patient-reported outcome questionnaires were performed/administered in 1052 MS patients. RESULTS: Females had higher raw scores in the Symbol Digit Modalities Test (SDMT) (57.0 vs. 54.0; p < 0.001) and Categorical Verbal Learning Test (CVLT) (63.0 vs. 57.0; p < 0.001), but paradoxically, females evaluated their cognitive performance by MS Neuropsychological Questionnaire as being worse (16.6 vs 14.5, p = 0.004). Females had a trend for a weaker negative correlation between T2 lesion volume and SDMT ([Formula: see text] = - 0.37 in females vs. - 0.46 in men; interaction p = 0.038). On the other hand, women had a trend for a stronger correlation between Brain Parenchymal Fraction (BPF) and a visual memory test (Spearman's [Formula: see text] = 0.31 vs. 0.21; interaction p = 0.016). All these trends were not significant after correction for false discovery rate. CONCLUSIONS: Although, females consider their cognition as worse, males had at a group level slightly worse verbal memory and information processing speed. However, the sex differences in cognitive performance were smaller than the variability of scores within the same sex group. Brain MRI measures did not explain the sex differences in cognitive performance among MS patients.
- MeSH
- kognice MeSH
- kognitivní dysfunkce * MeSH
- kognitivní poruchy * diagnóza MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozek diagnostické zobrazování MeSH
- neuropsychologické testy MeSH
- pohlavní dimorfismus MeSH
- roztroušená skleróza * komplikace diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
