No Arabic abstract
The impulse response function (IRF) of a localized bolus in cerebral blood flow codes important information on the tissue type. It is indirectly accessible both from MR- and CT-imaging methods, at least in principle. In practice, however, noise and limited signal resolution render standard deconvolution techniques almost useless. Parametric signal descriptions look more promising, and it is the aim of this contribution to develop some improvements along this line.
We tested the hypothesis that simple exercises may significantly increase cerebral blood flow (CBF) and/or cerebral oxygenation. Eighteen subjects ranging in age from nineteen to thirty nine participated in a four-stage study during which measurements of end tidal CO_2 (EtCO2 - by capnometer) and local brain oxygenation (by near-infrared spectroscopy (NIRS) sensor) were taken. The four stages were 1) baseline, 2) breathing exercises, 3) solving an arithmetic problem, and 4) biofeedback. During the breathing exercises there was a significant increase in EtCO2 indicating a significant increase in global CBF. The increase in global CBF was estimated on the basis of a theoretical model. During the arithmetic and biofeedback tasks there was a significant increase in the local (Fp1) oxygenation, but it varied between the different participants. The results may lead to new clinical applications of CBF and brain oxygenation monitoring and behavioral control. We foresee future more detailed investigations in the control of CO2 in brain circulation in specific regions of the brain involved in cognition and memory.
When a blood vessel ruptures or gets inflamed, the human body responds by rapidly forming a clot to restrict the loss of blood. Platelets aggregation at the injury site of the blood vessel occurring via platelet-platelet adhesion, tethering and rolling on the injured endothelium is a critical initial step in blood clot formation. A novel three-dimensional multiscale model is introduced and used in this paper to simulate receptor-mediated adhesion of deformable platelets at the site of vascular injury under different shear rates of blood flow. The novelty of the model is based on a new approach of coupling submodels at three biological scales crucial for the early clot formation: novel hybrid cell membrane submodel to represent physiological elastic properties of a platelet, stochastic receptor-ligand binding submodel to describe cell adhesion kinetics and Lattice Boltzmann submodel for simulating blood flow. The model implementation on the GPUs cluster significantly improved simulation performance. Predictive model simulations revealed that platelet deformation, interactions between platelets in the vicinity of the vessel wall as well as the number of functional GPIb{alpha} platelet receptors played significant roles in the platelet adhesion to the injury site. Variation of the number of functional GPIb{alpha} platelet receptors as well as changes of platelet stiffness can represent effects of specific drugs reducing or enhancing platelet activity. Therefore, predictive simulations can improve the search for new drug targets and help to make treatment of thrombosis patient specific.
Bubbles introduced to the arterial circulation during invasive medical procedures can have devastating consequences for brain function but their effects are currently difficult to quantify. Here we present a Monte-Carlo simulation investigating the impact of gas bubbles on cerebral blood flow. For the first time, this model includes realistic adhesion forces, bubble deformation, fluid dynamical considerations, and bubble dissolution. This allows investigation of the effects of buoyancy, solubility, and blood pressure on embolus clearance. Our results illustrate that blockages depend on several factors, including the number and size distribution of incident emboli, dissolution time and blood pressure. We found it essential to model the deformation of bubbles to avoid overestimation of arterial obstruction. Incorporation of buoyancy effects within our model slightly reduced the overall level of obstruction but did not decrease embolus clearance times. We found that higher blood pressures generate lower levels of obstruction and improve embolus clearance. Finally, we demonstrate the effects of gas solubility and discuss potential clinical applications of the model.
To meet the current need for skeletal tumor-load estimation in prostate cancer (mCRPC), we developed a novel approach, based on adaptive bone segmentation. In this study, we compared the program output with existing estimates and with the radiological outcome. Seventy-six whole-body 99mTc-DPD-SPECT/CT from mCRPC patients were analyzed. The software identified the whole skeletal volume (SVol) and classified it voxels metastases (MVol) or normal bone (BVol). SVol was compared with the estimation of a commercial software. MVol was compared with manual assessment and with PSA-level. Counts/voxel were extracted from MVol and BVol. After six cycles of 223RaCl2-therapy every patient was re-evaluated as progressing (PD), stabilized (SD) or responsive (PR). SVol correlated with the one of the commercial software (R=0,99, p<0,001). MVol correlated with manually-counted lesions (R=0,61, p<0,001) and PSA (R=0,46, p<0.01). PD had a lower counts/voxel in MVol than PR/SD (715 pm 190 Vs. 975 pm 215 and 1058 pm 255, p<0,05 and p<0,01) and in BVol (PD 275 pm 60, PR 515 pm 188 and SD 528 pm 162 counts/voxel, p<0,001). Segmentation-based tumor load correlated with radiological/laboratory indices. Uptake was linked with the clinical outcome, suggesting that metastases in PD patients have a lower affinity for bone-seeking radionuclides and might benefit less from bone-targeted radioisotope therapies.
Infrared light scattering methods have been developed and employed to non-invasively monitor human cerebral blood flow (CBF). However, the number of reflected photons that interact with the brain is low when detecting blood flow in deep tissue. To tackle this photon-starved problem, we present and demonstrate the idea of interferometric speckle visibility spectroscopy (ISVS). In ISVS, an interferometric detection scheme is used to boost the weak signal light. The blood flow dynamics are inferred from the speckle statistics of a single frame speckle pattern. We experimentally demonstrated the improvement of measurement fidelity by introducing interferometric detection when the signal photon number is insufficient. We apply the ISVS system to monitor the human CBF in situations where the light intensity is $sim$100-fold less than that in common diffuse correlation spectroscopy (DCS) implementations. Due to the large number of pixels ($sim 2times 10^5$) used to capture light in the ISVS system, we are able to collect a similar number of photons within one exposure time as in normal DCS implementations. Our system operates at a sampling rate of 100 Hz. At the exposure time of 2 ms, the average signal photon electron number is $sim$0.95 count/pixel, yielding a single pixel interferometric measurement signal-to-noise ratio (SNR) of $sim$0.97. The total $sim 2times 10^5$ pixels provide an expected overall SNR of 436. We successfully demonstrate that the ISVS system is able to monitor the human brain pulsatile blood flow, as well as the blood flow change when a human subject is doing a breath holding task.