Percentage Of Increase In Volume Research Articles

NEIM-12 PRE- AND POST-TREATMENT RADIOLOGIC FEATURES AND VOLUMETRIC CHANGES LINKED TO TREATMENT RESPONSE OF BRAIN METASTASES AFTER LASER INTERSTITIAL THERMAL THERAPY (LITT)

Abstract OBJECTIVE To identify pre-treatment imaging features of brain metastases (BM) associated with lesion-specific progression free survival (PFS-L) after laser interstitial thermal therapy (LITT) and to report longitudinal volumetric changes following the treatment. METHODS Forty-seven BM treated with LITT were retrospectively examined. BM were followed until clinical progression, radiologic progression according to the modified RANO criteria, or censoring. The association between imaging features and PFS-L was assessed with survival analyses. Post-LITT volume shrinkage over time was fit to an exponential decay model. RESULTS Thirteen BM progressed after LITT (median time to progression 3.9 months), seventeen met radiologic criteria for response after LITT (median time to response 12.1 months), and seventeen were stable at time of censoring. Median follow-up duration for censored BM was 18.5 months. The probability of PFS-L at six months (PFS6) was 70.6% for the whole cohort. Pre-LITT enhancing volume <2.5 cc (p=0.0004) and sphericity ≥0.705 (p=0.0026) predicted longer PFS-L (PFS6=86.8%), and BM meeting both cutoffs showed a cumulative benefit (p<0.0001, PFS6=100%). Pre-LITT diffusion imaging did not predict PFS-L, while a subset of lesions (n=7) with highly perfused hotspots had worse PFS-L (p=0.0012). Immediate post-LITT volume was increased compared to pre-LITT (p<0.0001, median increase 80.3%). The percentage of volume increase was not a predictor of PFS-L (p=0.56). In fifteen responding BM (88.2%), the post-LITT volumetric shrinkage over time was described by an exponential decay (R2 ranging 0.92-1.0), and the kinetics of shrinkage was heterogeneous (half-life ranging 0.3-5.4 months). CONCLUSIONS Pre-treatment small size and high sphericity are ideal baseline features for BM considered for LITT treatment and could aid patient selection. Modeling longitudinal volumetric changes of BM responding to LITT is a potential approach to identify BM at risk for progression which deviate from a typical shrinkage pattern.

Diamond-coated ultrasonic tip decreases debris and uninstrumented surface after preparation of curved canals with isthmus.

The aim of this study was to evaluate root canal preparation with nickel titanium rotary instruments and complementary preparation with ultrasonic tip in curved canals of mandibular molars with isthmus. Twenty-eight mesial roots of mandibular molars with curvature between 20° and 40° and presence of isthmus throughout the entire extension of the root canals were prepared using ProDesign Logic CM (PDL) up to size 40.05, or HyFlex EDM (HFEDM) up to size 40.04. Complementary preparation was performed in the isthmus region using the ultrasonic insert E18D (Helse, Istmo Diamantada). The root canals were scanned using micro-CT (SkyScan 1176) at 9 µm voxel size before and after each preparation step. Transportation, percentage of increase in volume, debris and uninstrumented surface (UNS) were evaluated. Mann Whitney, Wilcoxon, paired and non-paired t-tests were used for statistical analysis (α = 0.05). The canals prepared with PDL and HFEDM obtained similar results for all the variables assessed before using E18D (p > 0.05). E18D significantly decreased the percentage of debris and UNS values in both Groups (p < 0.05). The complementary preparations with E18D caused a smaller quantity of debris in the isthmus of the canals previously prepared with PDL in comparison with HFEDM (p < 0.05). PDL and HFEDM provided similar root canal preparation. PDL promoted a smaller quantity of Debris in the isthmus than HFEDM after using E18D. E18D significantly improved cleaning, and reduced Debris and UNS.

Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals.

ObjectivesThis study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals.Materials and MethodsThirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05).ResultsNo significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05).ConclusionsHigh percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.

Root Canal Preparation and Enlargement Using Thermally Treated Nickel-Titanium Rotary Systems in Curved Canals

IntroductionThe purpose of this study was to evaluate root canal preparation and apical enlargement of curved canals using rotary heat-treated and heat/surface-treated systems by micro–computed tomographic imaging. MethodsCurved mesial root canals (n = 48) of mandibular molars (20°–40°) were prepared using ProDesign Logic (PDL; Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) 25/.01 and 25/.06 or HyFlex EDM (HFEDM) 10/.05, HyFlex CM 20/.04, and HFEDM 25/.08. Apical enlargement was performed using PDL 40/.05 or HFEDM 40/.04. Scanning (9 μm) was performed before and after preparation and after apical enlargement using micro–computed tomographic imaging. Volume, percentage of volume increase, debris, untouched root canal surface, and centering ability were analyzed. Statistical analysis was performed using Mann-Whitney, Wilcoxon, and unpaired t tests (α = .05). ResultsHFEDM promoted a higher volume increase of the root canals than PDL after preparation and after apical enlargement (P < .05). The apical enlargement promoted a significant decrease in debris and untouched surface in both groups (P < .05). The percentage of debris and untouched surface were similar between HFEDM and PDL after preparation and after apical enlargement (P > .05). Both systems promoted centered canals (P > .05). ConclusionsHFEDM instruments promoted greater volume of the root canal than PDL. However, the cleaning ability of the instruments was similar. The apical increase up to size 40 with both instruments provided less debris and untouched surfaces and allowed centralization of the curved root canals.

New Ultrasonic Tip Decreases Uninstrumented Surface and Debris in Flattened Canals: A Micro–computed Tomographic Study

IntroductionThe preparation of flattened root canals using reciprocating or rotary nickel-titanium instruments associated with the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) was evaluated by micro–computed tomographic imaging. MethodsTwenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were randomly divided into 2 experimental groups for preparation: a Reciproc Blue (RB; VDW GmbH, Munich, Germany) 40/.06 file in reciprocating motion or ProDesign Logic (PDL; Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) 40/.01 and 40/.05 files in rotary motion (n = 12). A complementary preparation was performed with the Flatsonic ultrasonic tip for both preparations. Micro–computed tomographic scanning at a resolution of 8.74 μm was performed before and after preparation with the nickel-titanium instruments and after the use of the Flatsonic tip. The percentages of increase in volume, debris, and uninstrumented surface were analyzed. The data obtained were submitted to the paired and unpaired t test, analysis of variance, and the Tukey test (α = 5%). ResultsThe percentage increase in volume, debris, and uninstrumented surface was similar between RB and PDL in the entire root canal (P > .05). The PDL promoted a lower percentage of debris in the cervical third and a lower percentage of increase in volume in the apical third in comparison with RB (P < .05). The Flatsonic decreased debris and uninstrumented surface after PDL preparation in all thirds (P < .05). After preparation with RB, the Flatsonic decreases the debris in the cervical third and the uninstrumented surface in the cervical and middle thirds (P < .05). ConclusionsThe preparation of flattened root canals using RB or PDL produced a high percentage of debris and uninstrumented surface. The Flatsonic ultrasonic tip significantly improved the cleaning of flattened root canals.

Assessing splenic enlargement on CT by unidimensional measurement changes in patients with colorectal liver metastases.

The aim of this study was to assess splenic volume and to correlate unidimensional measurements with reference volumetric changes in chemotherapy-treated patients with colorectal cancer (CRC) liver metastases. Forty consecutive patients were selected from the cohort of a previously reported study of chemotherapy-related morbidity following major hepatectomy for CRC liver metastases. Patients were treated for 6months prior to resection, with imaging performed at baseline and after 6months of chemotherapy. Three unidimensional spleen measurements were recorded-width, thickness, and height (W, T, and H). Reference splenic volume was measured at baseline and after chemotherapy. The best unidimensional splenic measurement was determined by regression analysis. The 95% CI for the predicted values and R (2) values was calculated for each regression. The percentage of volume increase at 6months was calculated. W and H showed the highest correlation with splenic volume prior to and following chemotherapy (R (2)=0.65-0.74, p<0.001), while T showed a low correlation (R (2)=0.11 and 0.18, p<0.05). The mean reference splenic volume increased after 6months of chemotherapy compared to baseline (326 vs. 278mL). Splenic volume changes showed the highest correlation with changes in W (R (2)=0.56, p<0.001), then H (R (2)=0.40, p<0.001), but were not significantly correlated with changes in T (R (2)=0.01, p=0.055). Our results show the potential utility of measuring changes in splenic width to predict clinically significant changes in splenic volume in chemotherapy-treated patients with CRC liver metastases.

Impact of photon energy recovery on the assessment of left ventricular volume using myocardial perfusion SPECT

Background Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter removal in patients and phantom studies. The purpose of this study was to examine the impact of PER on left ventricular volume measurement based on myocardial perfusion single photon emission computed tomography (SPECT). Methods and results SPECT acquisitions were performed by use of a static cardiac phantom and in 25 patients after a rest injection of technetium 99m sestamibi by use of multiple energy windows (126-136, 137-144, and 145-154 keV). Data were successively reconstructed with and without PER, by use of iterative reconstruction and post-processing filtering (Butterworth filter; order, 5; cutoff, 0.30 cycles/pixel). Image contrast was evaluated in reconstructed data, and volumes were calculated by use of QGS. PER increased reconstructed image contrast from 62% ± 2.7% to 84.3% ± 5.7% in the phantom studies ( P < .0001) and from 49% ± 2% to 73% ± 2% in patients ( P < .0001). Although it remained underestimated ( P < .0001), phantom volume was higher after PER correction compared with uncorrected data (50.9 ± 0.8 mL vs 44.6 ± 1 mL, P < .0001). The error in volume measurement was decreased by PER correction (16.6% ± 1.3% vs 27% ± 1.7% [uncorrected data], P < .0001). In patients, left ventricular volume increased from 83 ± 10 mL to 91 ± 10 mL ( P < .0001), and the PER-induced volume increase was correlated with the image contrast increase ( r = 0.61, P = .001). Finally, the percentage of volume increase was higher in patients with small left ventricular volumes. Conclusions PER has a significant impact on image contrast and left ventricular volume measurement by use of perfusion SPECT. PER improves the accuracy of phantom volume assessment. In patients, volume increase is correlated to image contrast increase and is higher in those with small ventricles.

Nocturnal electrobioimpedance volumetric assessment of patients with erectile dysfunction

Objectives. Electrobioimpedance volumetric assessment is a procedure that can measure penile length, cross-sectional area, and volume. From these variables, the number and duration of erectile events, volume change, and percentage of volume increase from baseline can be determined. This procedure was performed on patients with erectile dysfunction (ED) and findings were compared with patients with no history of ED. Examples of etiology are reported. Methods. Two groups of patients with ED were evaluated by electrobioimpedance assessment. Group 1 patients (n = 23), ranging in age from 26 to 60 years (mean 50), were involved in simultaneous electrobioimpedance assessment and duplex Doppler ultrasound penile volume measurements. A tissue correction was derived. Group 2 patients (n = 10), ranging in age from 38 to 64 years (mean 50), used nocturnal electrobioimpedance volumetric assessment (NEVA) at home for 2 consecutive nights. Results. After deriving an expression to correct for tissue volume, simultaneous measurement of penile blood volume by NEVA and duplex Doppler showed that the regression line for study participants and the identity line was not significantly different by analysis of variance. Using NEVA in comparing patients with ED to a reference population with no history of ED, and using a two-tailed Student’s t test for means, the data demonstrated a statistically significant ( P ≤0.05) difference in the number of erectile events and percentage of volume change over baseline. With NEVA data, it was possible to distinguish arterial insufficiency from veno-occlusive dysfunction. Conclusions. The present study demonstrates that electrobioimpedance volumetric assessment can be used in patients with ED. Compared with a reference population with no history of ED, the group with ED had fewer nocturnal erectile events that resulted in a smaller increase in penile blood volume change over baseline. Although the time dependence of the measured variables identifies the cause of ED, the application of NEVA to a larger population will allow further analysis of the dynamic information contained in the NEVA data.