Browsing by Author "Masulovic, D. (57215645003)"

Purpose: To estimate if CT perfusion parameter values of the esophageal cancer, which were obtained with the deconvolution-based software and maximum slope algorithm are in agreement, or at least interchangeable. Methods: 278 esophageal tumor ROIs, derived from 35 CT perfusion studies that were performed with a 64-MDCT, were analyzed. "Slice-by-slice" and average "whole-covered-tumor-volume" analysis was performed. Tumor blood flow and blood volume were manually calculated from the arterial tumortime- density graphs, according to the maximum slope methodology (BFms and BV ms), and compared with the corresponding perfusion values, which were automatically computed by commercial deconvolutionbased software (BF deconvolution and BVdeconvolution), for the same tumor ROIs. Statistical analysis was performed using Wilcoxon matched-pairs test, paired-samples t-test, Spearman and Pearson correlation coefficients, and Bland-Altman agreement plots. Results: BFdeconvolution (median: 74.75 ml/min/100 g, range, 18.00-230.5) significantly exceeded the BF ms(25.39 ml/min/100 g, range, 7.13-96.41) (Z = -14.390, p < 0.001), while BVdeconvolution (median: 5.70 ml/100 g, range: 2.10-15.90) descended the BVms(9.37 ml/100 g, range: 3.44-19.40) (Z = -13.868, p < 0.001). Both pairs of perfusion measurements significantly correlated with each other: BFdeconvolution, versus BFms (rS = 0.585, p < 0.001), and BVdeconvolution, versus BV ms (rS = 0.602, p < 0.001). Geometric mean BF deconvolution/BFms ratio was 2.8 (range, 1.1-6.8), while geometric mean BVdeconvolution/BVms ratio was 0.6 (range, 0.3-1.1), within 95% limits of agreement. Conclusions: Significantly different CT perfusion values of the esophageal cancer blood flow and blood volume were obtained by deconvolution-based and maximum slope-based algorithms, although they correlated significantly with each other. Two perfusion-measuring algorithms are not interchangeable because too wide ranges of the conversion factors were found. © 2013 Elsevier Ireland Ltd.

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Purpose Standardized perfusion value (SPV) is a universal indicator of tissue perfusion, normalized to the whole-body perfusion, which was proposed to simplify, unify and allow the interchangeability among the perfusion measurements and comparison between the tumor perfusion and metabolism. The aims of our study were to assess the standardized perfusion value (SPV) of the esophageal carcinoma, and its correlation with quantitative CT perfusion measurements: blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) of the same tumor volume samples, which were obtained by deconvolution-based CT perfusion analysis. Methods Forty CT perfusion studies of the esophageal cancer were analyzed, using the commercial deconvolution-based CT perfusion software (Perfusion 3.0, GE Healthcare). The SPV of the esophageal tumor and neighboring skeletal muscle were correlated with the corresponding mean tumor and muscle quantitative CT perfusion parameter values, using Spearman's rank correlation coefficient (rS). Results Median SPV of the esophageal carcinoma (7.1; range: 2.8-13.4) significantly differed from the SPV of the skeletal muscle (median: 1.0; range: 0.4-2.4), (Z = -5.511, p < 0.001). The cut-off value of the SPV of 2.5 enabled discrimination of esophageal cancer from the skeletal muscle with sensitivity and specificity of 100%. SPV of the esophageal carcinoma significantly correlated with corresponding tumor BF (rS = 0.484, p = 0.002), BV (rS = 0.637, p < 0.001) and PS (rS = 0.432, p = 0.005), and SPV of the skeletal muscle significantly correlated with corresponding muscle BF (rS = 0.573, p < 0.001), BV (rS = 0.849, p < 0.001) and PS (rS = 0.761, p < 0.001). Conclusions We presented a database of the SPV for the esophageal cancer and proved that SPV of the esophageal neoplasm significantly differs from the SPV of the skeletal muscle, which represented a sample of healthy tissue. The SPV was validated against quantitative CT perfusion measurements and statistically significant correlation was proved. © 2015 Elsevier Ireland Ltd. All rights reserved.

Background: The modern concept of type-related individualized groin hernia surgery imposes a demand for precise and accurate preoperative determination of the type of groin hernia. The aim of this prospective study was to evaluate the accuracy of ultrasonography in classification of groin hernias, according to the criteria of the unified classification system. Unified classification divides groin hernias into nine types (grades): type I (indirect, small), II (indirect, medium), III (indirect, large), IV (direct, small), V (direct, medium), VI (direct, large), VII (combined-pantaloon), VIII (femoral), and O (other). Patients and methods: One hundred and twenty-five adult patients with clinically diagnosed or suspected groin hernias were examined. Ultrasonography of both groins was performed with a 5 to 10-MHz linear-array transducer. Preoperative ultrasonographic findings of type of groin hernia were compared with the intraoperative findings, which were considered the gold standard. Results: Total accuracy of ultrasonography in determination of type of groin hernia was 96% (119 of 124 correct predictions of type of groin hernia compared with surgical explorations). All hernias of types I, IV, V, VII, and VIII were correctly identified with ultrasonography (sensitivity and specificity 100%). In the remaining five cases of the 124 (4%), hernia was incorrectly classified with ultrasonography: type VI (direct, large) was misdiagnosed as type III (indirect, large) in three cases, type III as type VI in one case, and type III as type II (indirect, medium) in one case. The sensitivity and the specificity of ultrasonography in classifying type II were 100 and 99%, respectively, for type III, 85 and 97%, and for type VI, 90 and 99%. Conclusion: Ultrasonography of the groin regions could be used with great accuracy for precise classification of groin hernias in adults. Each type of groin hernia, according to the unified classification system that we used for classification, has a characteristic ultrasonographic presentation, which is demonstrated in this study. © Springer-Verlag 2008.