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Ulrike Attenberger
Ulrike Attenberger

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Figure 4. One such innovation is liquid biopsy. Slope parametric images also show initially intense uptake in the area of the tumor, which responds with an essential decrease after therapy due to a decrease in the phosphorylation middle row.

I completed my medical PhD thesis Dr. Alumni of the GYA Member - Author Contributions Conceptualization, C.

High time to act, says Professor Dr…. Received May 8; Accepted Jun 6. Materials and Methods 2. Dimitrakopoulou-Strauss A.

Mean time to progression TTP after pazopanib treatment was 1. The model parameters were accepted when K 1 , k 2 , k 3 , and k 4 were less than 1 and V B exceeded zero. I started my research career as medical student in in the Institute of Radiology at the Munich University hospital — Grosshadern campus.

With the help of AI procedures, quantitative information is extracted from image features which can then be integrated and evaluated with clinical, molecular and genetic data. Published online Jun 8. The computer can create heat maps and correlate the information generated from the image with clinical data such as outcome, disease progress or genetic data and laboratory values.

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Thus, liquid biopsy can potentially revolutionise oncological diagnostics — and put a spoke in the wheel of radiology. In total, 14 patients were evaluable after pazopanib treatment in terms of histopathology. Support Center Support Center. High time to act, says Professor Dr… CT laboratory monitoring oncology radiology.

Ulrike Attenberger. Nevertheless, parametric imaging analysis was not the focus of the present work. Tomographic measurement of local cerebral glucose metabolic rate in humans with F 2-fluorodeoxy-d-glucose: Validation of method.

Introduction The outcome of high-risk soft tissue sarcoma STS is poor. On the fractal nature of positron emission tomography PET studies. Burger C. With the help of AI procedures, quantitative information is extracted from image features which can then be integrated and evaluated with clinical, molecular and genetic data.

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The outcome of high-risk soft tissue sarcoma STS is poor with radical surgery being the only potentially curative modality. Pazopanib is a multikinase inhibitor approved for the treatment of metastatic STS.

Sixteen STS patients treated with pazopanib as neoadjuvant Analsex Plug before surgery were enrolled in the analysis. On the other hand, 18 F-FDG kinetic analysis revealed a significant decrease in the perfusion-related parameter K 1which reflects the carrier-mediated transport of 18 F-FDG from plasma to tumor.

This decrease can be considered as a marker in response to pazopanib in STS and could be due to the anti-angiogenic effect of the therapeutic agent. The outcome of high-risk soft tissue sarcoma STS is poor. Radical surgery, usually in combination with radiotherapy, is the mainstay of treatment and the only potentially curative modality [ 1 ].

Surgical removal can, however, be cumbersome due to the large tumor size with infiltration of adjacent structures, and extensive tumor vasculature [ 2 ].

In this context, the development and application of a fast acting, preoperative STS therapy that would facilitate tumor resection and at the same time have low toxicity would be of high significance. Pazopanib is a multikinase inhibitor, approved for the treatment of metastatic STS based on a phase III trial in patients with non-adipocytic STS, who had progressed on at least one prior chemotherapy regimen [ 3 ]. Nevertheless, metabolic response was observed in a single patient. Nevertheless, the generally accepted method for accurate analysis of 18 F-FDG metabolism and kinetics is a two-tissue compartment model [ 6 ].

A prerequisite for this is the performance of full dynamic PET studies for at least 60 min. Patients with metastases at presentation were excluded from the study.

Treatment consisted of pazopanib mg daily for 21 days as a neoadjuvant therapy before surgery. An interval of 7—14 days between pazopanib therapy completion and surgery was allowed in order to minimize potential perioperative complications due to pazopanib. The herein presented patient cohort has already been studied, and patient data derived from a different analysis have been published elsewhere [ 5 ].

The histopathological classification as well as the localization of the sarcomas is presented in Table 1. Histopathological characteristics and localization of the soft tissue sarcoma STS of the 16 studied patients. The data were acquired in list mode. A frame protocol 10 frames of 30 s, 5 frames of 60 s, 5 frames of s, and 4 frames of s was applied.

After the end of the dynamic acquisition, whole body, Oleander Bienenfreundlich imaging was performed in all patients with image duration of 2 min per bed position.

Iterative images reconstruction was based on the ordered subset expectation maximization OSEM algorithm with two iterations and 21 subsets as well as time of flight TOF. Qualitative analysis was based on the identification of the STS lesions as sites of increased 18 F-FDG uptake greater than the background or liver activity.

SUV measurements were performed at the min post injection frames. One problem in patients is the accurate measurement of input function, which theoretically requires arterial blood sampling. It has been shown however, that input function can be accurately retrieved from image data [ 13 ].

For the input function, the mean value of the VOI data from a large arterial vessel e. The recovery Erotik 80er was 0. The application of a two-tissue compartment Ulrike Attenberger leads to the extraction of the kinetic parameters K 1k 2k 3and k 4 as well as the influx K i that describes specific molecular processes: K 1 reflects the carrier-mediated transport of 18 F-FDG from plasma to tissue, while k 2 reflects its transport back from the tissue to plasma, and k 3 represents the phosphorylation rate, while k 4 the dephosphorylation rate of the glucose analog.

The model parameters were accepted when K 1k 2Filmy Pprno 3and k 4 were less than 1 and V B exceeded zero. The two-tissue compartment model we applied is a modification of the one proposed by Sokoloff et al. This lack of k 4 and V B however, leads to different values of the parameters k 1 and k 3since k 1 is dependent on V B and k 3 on k 4. Apart from performing compartment analysis, a non-compartment model based on the fractal dimension FD for the time activity data was applied.

FD is a parameter of heterogeneity of tracer kinetics based on the box counting procedure of chaos theory and was calculated in each individual voxel of a VOI. Parametric imaging is a method for feature extraction, enabling the visualization of single parameters of tracer kinetics, with images of the slope reflecting primarily the trapping of 18 F-FDG and images of the intercept reflecting the distribution volume of the tracer.

These images may be used for the delineation of the malignant lesions and the VOIs placement due to potentially high contrast in the surrounding tissue. Details of this method have been described elsewhere [ 1718 ]. Nevertheless, parametric imaging analysis was not the focus of the present work.

Resection specimens were histopathologically assessed. For Margot Dumont survival analysis, Kaplan—Meier plots were used. Non-events were censored with the last recorded follow-up date.

The same procedure was used for overall survival with the event of death. The statistical tool used was SAS 9. Graphical data were used in Microsoft Excel.

Median overall survival OS was 3. Regarding the four patients with relapse, three patients showed local relapse and distant metastases, while one of them had only distant metastases. Mean time to progression TTP after pazopanib treatment was 1. In total, 14 patients were evaluable after pazopanib treatment in terms of histopathology.

Waterfall plot of the grade of histopathological regression, available for 14 patients. Regarding 18 F-FDG kinetic analysis, K 1 was the only parameter that significantly decreased after therapy. All other kinetic parameters did not show any significant change in response to pazopanib. Descriptive statistics of mean and median values prior and after pazopanib therapy for the 18 F-FDG semi-quantitative and quantitative parameters in STS. SUV, standardized uptake value; FD, fractal dimension.

Figure 4 depicts a metabolic non-responder to pazopanib. Clear metabolic remission of the initially intense metabolic lesion with areas of central necrosis in response to pazopanib. Standardized uptake value SUV images acquired after 60 min of dynamic PET acquisition show a clear metabolic remission of the intense metabolic lesion with central necrosis in response to pazopanib upper row.

Slope parametric images also show initially intense uptake in the Edurne Bikini of the tumor, which responds with an essential decrease after therapy due to Schaebens Kapseln decrease in the phosphorylation middle row.

Intercept parametric images demonstrate the tumor very faintly due to the low distribution volume lower row. Persistent metabolic activity in the tumor after pazopanib treatment.

The TACs are derived from volumes of interest VOIs corresponding to the tumor blue curve and the descending aorta red curve. The tumor curves show an increase in the fludeoxyglucose F 18 F-FDG accumulation in the tumor VOI during the 60 min of dynamic PET acquisition reflected by an increase in standardized uptake value-SUV valuesbut at the same time a decrease in the carrier-mediated transport of the tracer from plasma to the tumor reflected by a decrease in K 1 in response to pazopanib.

VB: blood Ulrike Attenberger. We further performed comparisons of the PET parameters between the groups of responders PR and non-responders SDaccording to Penis 22cm histopathological criteria applied in the study. No significant correlation between histopathological regression and 18 F-FDG kinetics response was observed. Similarly to histopathological regression, no association between tracer kinetics and time to tumor relapse was observed.

No statistically significant changes of the semi-quantitative parameters SUV average and SUV max in response to pazopanib could be demonstrated. However, the 18 F-FDG uptake 60 min after tracer injection is the result of a dynamic process. One important aspect of PET is the possibility of performing accurate, Ulrike Attenberger quantitative measurements of tracer concentration in patients.

Particularly in STS, the application of dPET and the subsequent acquisition of 18 F-FDG kinetic information have been shown useful in early prediction of chemosensitivity in the neoadjuvant context [ 8 ]. Pazopanib exerts its action through inhibition of growth factor receptors associated with angiogenesis and tumor cell proliferation [ 22 ]. Given that K 1 is a perfusion-related parameter [ 23 ], it could be suggested that the anti-angiogenic effect of pazopanib is responsible for this finding.

On the other hand, the phosphorylation rate of 18 F-FDG k 3its influx K iand the fractal dimension FD did not show any significant change. This is in line with the lack of significant tracer uptake SUV decrease in response to treatment. Although the reason for this lacking response is unknown, apart from the Zabou Breitman sample size, a targeted anti-angiogenic action of pazopanib without a pronounced and fast effect on tumor glucose metabolism could be hypothesized.

The comparison of the PET parameters between these groups showed no statistically significant differences both at baseline and as response to treatment. Although the follow-up time was rather short, TTP data were also utilized in the present analysis to search for potential associations between 18 F-FDG kinetics and disease relapse.

On the other hand, the perfusion-related, kinetic parameter K 1 —reflecting the carrier-mediated transport of 18 F-FDG from plasma to tumor—significantly decreased during pazopanib treatment. This finding could be due to the anti-angiogenic effect of the agent.

Based on these findings, K 1 could be potentially used as an early response marker of the pazopanib treatment efficacy, with changes of this parameter being used for therapeutic management decisions.

Conceptualization, C. National Center for Biotechnology InformationU. Journal List Cancers Basel v. Cancers Basel. Published online Jun 8. Find articles by Ioannis Karampinis. Find articles by Peter Hohenberger. Author information Article notes Copyright and License information Disclaimer. Received May 8; Accepted Jun 6. This article has been cited by other articles in PMC. Abstract The outcome of high-risk soft tissue sarcoma STS is poor with radical surgery being the only potentially curative modality.

Introduction The outcome of high-risk soft tissue sarcoma STS is poor. Materials and Methods 2. Table 1 Histopathological characteristics and localization of the soft tissue sarcoma STS Tittenmelken Net the 16 studied patients.

Histology No. Open in a separate window. Histological Response Resection specimens were histopathologically assessed. Follow-up Status Median overall survival OS was 3. Table 2 Follow up status of the 16 studied patients treated with pazopanib.

This is needed to develop image-based biomarkers. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: Review and EORTC recommendations.

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Ulrike I Attenberger's research works with 1, citations and 6, reads, including: Wie können wir Frauen für die Radiologie gewinnen und halten?How can we win women for radiology and. 1. Introduction. The outcome of high-risk soft tissue sarcoma (STS) is poor. Radical surgery, usually in combination with radiotherapy, is the mainstay of treatment and the only potentially curative modality [].Surgical removal can, however, be cumbersome due to the large tumor size with infiltration of adjacent structures, and extensive tumor vasculature [].Author: Christos Sachpekidis, Ioannis Karampinis, Jens Jakob, Bernd Kasper, Kai Nowak, Lothar Pilz, Ulrike A. Essentials der klinischen MRT [Attenberger, Ulrike I., Runge, Val M., Schönberg, Stefan O.] on euromacpaints.in *FREE* shipping on qualifying offers. Essentials der Reviews: 1.
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Jul 10,  · Surgical exploration and bowel resection are frequently required for treating non-occlusive mesenteric ischemia. Intraoperative evaluation of intestinal perfusion is subjective and challenging. In this feasibility study, ICG fluorescence angiography was performed in order to evaluate intestinal perfusion in patients with acute mesenteric ischemia. This is a retrospective analysis of OCLC Number: Notes: München, Univ., Diss., Description: Online-Ressource: Responsibility: vorgelegt von Ulrike Attenberger. Correspondence to: Ulrike I. Attenberger, MD, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Theodor-Kutzer-Ufer , D , Mannheim, Germany. E-mail: [email protected]

Ulrike Attenberger, University Medical Center Mannheim, Heidelberg University, Germany Qian Dong, University of Michigan, Ann Arbor, USA N. Reed Dunnick, University of Michigan, Ann Arbor, USA. 4. Kubik-Huch RA, Vilgrain V, Krestin G, Reiser MF, Attenberger UI, Muellner AU, Hricak H () Gender diversity is not a metric—it is a tool for excellence. This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of .

4. Kubik-Huch RA, Vilgrain V, Krestin G, Reiser MF, Attenberger UI, Muellner AU, Hricak H () Gender diversity is not a metric—it is a tool for excellence. Jul 10,  · Surgical exploration and bowel resection are frequently required for treating non-occlusive mesenteric ischemia. Intraoperative evaluation of intestinal perfusion is subjective and challenging. In this feasibility study, ICG fluorescence angiography was performed in order to evaluate intestinal perfusion in patients with acute mesenteric ischemia. This is a retrospective analysis of Ulrike Attenberger, M.D.1; Johannes Budjan, M.D.2; Katrin Koziel3 1 Vice Chair of Clinical Operations, Head of Oncologic and Preventive Imaging 2 Section Chief of MRI, Head of Multiparametric Imaging 3 Lead Technician, SMRT policy board member Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim.

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