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Imaging techniques used for the real-time assessment of angiogenesis in digestive cancers

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World Journal of Gastroenterology 2011年第1期17卷 7-8页

作者： adrian sǎftoiu Peter Vilmann Research Center of Gastroenterology and Hepatology Gastroenterology DepartmentUniversity of Medicine and Pharmacy CraiovaCraiovaDolj200349Romania Department of surgical Gastroenterology Copenhagen University Hospital HerlevEndoscopic Unit at Gentofte Hospital2900 HellerupDenmark

Angiogenesis has a critical role in primary tumor growth and the development of *** angiogenesis inhibitors were recently developed,being a very attractive target for digestive tumor ***,individualized therapy should not only be based on the pre-treatment imaging evaluation,but also on sensitive monitoring of microvascular changes during ***-of-theart imaging techniques have the potential to visualize and characterize angiogenesis,although the technology and methodologies employed are recent and need further *** aim of this series of reviews was to analyze and enhance current knowledge and future perspectives about the real-time assessment of angiogenesis in digestive cancers,used for the longitudinal monitoring of the effects of chemo-radiotherapy(including anti-angiogenic therapies),as well as for the precise targeting of drugs through molecular-based drug-delivery systems.

关键词： Angiogenesis Digestive cancers Chemoradiotherapy

Imaging tests for accurate diagnosis of acute biliary pancreatitis

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World Journal of Gastroenterology 2014年第44期20卷 16544-16549页

作者： Valeriu surlin adrian s?ftoiu Daniela Dumitrescu 1st Clinic of surgery University of Medicine and Pharmacy of Craiova Research Center of Gastroenterology and Hepatology University of Medicine and Pharmacy of Craiova Department of Radiology University of Medicine and Pharmacy of Craiova

Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis(ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct(CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography(Us) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. sensitivity of transabdominal ultrasonography(TUs) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography(EUs) seems to be a more effectivetool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography(ERCP),which should be performed only for therapeutic *** the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography(MRCP)or EUs,especially for small stones and small diameter of CBD,the later techniques are nowadays preferred for the evaluation of ABP *** has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies,especially after sphincterotomy and balloon extraction of CBD *** ultrasonography is a useful tool for the intraoperative diagnosis of *** exploration of the CBD in cases of patients scheduled for cholecystectomy after an attack of ABP was not proven useful.A significant rate of the so-called idiopathic pancreatitis is actually caused by microlithiasis and/or biliary *** conclusion,the general algorithm for CBD stone detection starts with anamnesis,serum biochemistry and then TUs,followed by EUs or *** the end,bile duct microscopic an

关键词： Biliary Pancreatitis Lithiasis Endoscopic ultrasonography Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiopancreatography

Autofluorescence imaging and magnification endoscopy

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World Journal of Gastroenterology 2011年第1期17卷 9-14页

作者： Monalisa Filip sevastita Iordache adrian sǎftoiu Tudorel Ciurea Research Center of Gastroenterology and Hepatology University of Medicine and PharmacyCraiovaDolj200349Romania

It is well known that angiogenesis is critical in the transition from premalignant to malignant ***,early detection and diagnosis based on morphological changes to the microvessels are *** the last few years,new imaging techniques which utilize the properties of light-tissue interaction have been developed to increase early diagnosis of gastrointestinal(GI) tract *** analyzed several "red-flag" endoscopic techniques used to enhance visualization of the vascular pattern of preneoplastic and neoplastic lesions(*** imaging including autofluorescence imaging,magnifying endoscopy and narrow band imaging).These new endoscopic techniques provide better visualization of mucosal microsurface structure and microvascular architecture and may enhance the diagnosis and characterization of mucosal lesions in the GI *** the near future,it is expected that trimodal imaging endoscopy will be practiced as a standard endoscopy technique as it is quick,safe and accurate for making a precise diagnosis of gastrointestinal pathology,with an emphasis on the diagnosis of early GI tract *** large-scale randomized controlled trials comparing these modalities in different patient subpopulations are warranted before their endorsement in the routine practice of GI endoscopy.

关键词： Angiogenesis Autofluorescence imaging Multiband imaging Narrow band imaging Zoom endoscopy

Optical coherence tomography and Doppler optical coherence tomography in the gastrointestinal tract

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World Journal of Gastroenterology 2011年第1期17卷 15-20页

作者： Eugen Osiac adrian sǎftoiu Dan Ionut Gheonea Ion Mandrila Radu Angelescu Centre for Research in Gastroenterology and Hepatology University of Medicine and Pharmacy200349 CraiovaRomania

Optical coherence tomography(OCT) is a noninvasive,high-resolution,high-potential imaging method that has recently been introduced into medical investigations.A growing number of studies have used this technique in the field of gastroenterology in order to assist classical ***,3D-imaging and Doppler capabilities have been developed in different configurations,which make this type of investigation more *** paper reviews the principles and characteristics of OCT and Doppler-OCT in connection with analyses of the detection of normal and pathological structures,and with the possibility to investigate angiogenesis in the gastrointestinal tract.

关键词： Optical coherence tomography Doppler Gastrointestinal tract Gastrointestinal cancer Angiogenesis

Contrast-enhanced endoscopic ultrasonography

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World Journal of Gastroenterology 2011年第1期17卷 42-48页

作者： Nischita K Reddy Ana Maria Ioncicǎ adrian sǎftoiu Peter Vilmann Manoop s Bhutani Department of Medicine University of Texas Medical BranchGalvestonTX 77555-0144United States Department of Gastroenterology and Hepatology University of Medicine and Pharmacy CraiovaCraiova 200349Romania Department of surgical Gastroenterology Gentofte and Herlev University Hospital2730 HerlevCopenhagenDenmark Department of Gastroenterology Hepatology and Nutrition-Unit 1466University of TexasMD Anderson Cancer CenterHoustonTX 77030-4009United States

Contrast agents are increasingly being used to characterize the vasculature in an organ of interest,to better delineate benign from malignant pathology and to aid in staging and directing therapeutic *** review the mechanisms of action of first,second and third generation contrast agents and their use in various endoscopic procedures in the gastrointestinal *** applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy,assessment of depth of invasion of esophageal,gastric and gall bladder cancers and visualization of the portal venous system and esophageal *** addition,contrast agents can be used to differentiate pancreatic *** use of color Doppler further increases the ability to diagnose and differentiate various pancreatic *** sensitivity of power Doppler sonography to depict tumor neovascularization can be increased by contrast ***-enhanced harmonic imaging is a useful aid in identifying the tumor vasculature and studying pancreatic *** the future,these techniques could potentially be used to quantify tumor perfusion,to assess and monitor the efficacy of antiangiogenic agents,to assist targeted drug delivery and allow molecular imaging.

关键词： Contrast media Endoscopic ultrasonography Gastrointestinal neoplasms Doppler ultrasonography Pancreatic cancer

Real-time sono-elastography in the diagnosis of diffuse liver diseases

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World Journal of Gastroenterology 2010年第14期16卷 1720-1726页

作者： Dan Ionut Gheonea adrian s ǎftoiu Tudorel Ciurea Florin Gorunescu sevastita Iordache Gabriel Lucian Popescu smaranda Belciug Marina Gorunescu Larisa sǎndulescu Research Center of Gastroenterology and Hepatology University of Medicine and Pharmacy Craiova 200349 Romania Department of Biostatistics and Informatics University of Medicine and Pharmacy Craiova 200349 Romania IT Department University of Medicine and Pharmacy Craiova 200349 Romania Faculty of Mathematics of Computer science University of Craiova Craiova 200585 Romania

AIM: To analyze whether computer-enhanced dynamic analysis of elastography movies is able to better characterize and differentiate between different degrees of liver fibrosis. METHODs: The study design was prospective. A total of 132 consecutive patients with chronic liver diseases and healthy volunteers were examined by transabdominal ultrasound elastography. All examinations were done by two ***: Due to the limitations of the method, we obtained high-quality elastography information in only 73.48% of the patients. The κ-means clustering method was applied to assess the inter-observer diagnosis varia- bility, which showed good variability values in accordance with the experience of ultrasound examination of every observer. Cohen’sκ test indicated a moderate agreement between the study observers (κ = 0.4728). Furthermore, we compared the way the two observers clustered the patients, using the test for comparing two proportions (t value, two-sided test). There was no statistically significant difference between the two physicians, regardless of the patients’ real status. CONCLUsION: Transabdominal real-time elastography is certainly a very useful method in depicting liver hard- ness, although it is incompletely tested in large multicenter studies.

关键词： Elastography Ultrasonography Liver steato- sis Viral hepatitis Liver cirrhosis

Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies

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World Journal of Gastroenterology 2011年第1期17卷 21-27页

作者： Dan Ionut Gheonea Tatiana Crtnǎ Tudorel Ciurea Carmen Popescu Anca Bǎdǎrǎu adrian sǎftoiu Research Center of Gastroenterology and Hepatology University of Medicine and Pharmacy CraiovaCraiova 200349Romania Physiology Department University of Medicine and Pharmacy Carol Davila BucharestBucharest 050474Romania Cytology Laboratory Emergency Hospital CraiovaCraiova 200642Romania

Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor *** plays a crucial part in tumor growth and metastasis,with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary *** laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast *** markers of angiogenesis in association with confocal laser endomicroscopic examination(immunoendoscopy),as a future challenge,will add functional analysis to the morphological aspect of the neoplastic *** review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization,resulting in a broad spectrum of potential clinical applications,and also preclinical research that could be translated to human studies.

关键词： Confocal laser endomicroscopy Immunoendoscopy Fluoresceine Acriflavine Cancer

Advances in endoscopic ultrasound imaging of colorectaldiseases

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World Journal of Gastroenterology 2016年第5期22卷 1756-1766页

作者： Elena Tatiana Cârțână Dan IonuțGheonea adrian săftoiu Department of Gastroenterology Research Center of Gastroenterology and Hepatology CraiovaUniversity of Medicine and Pharmacy of Craiova200638 CraiovaRomania Department of Endoscopy Gastrointestinal UnitCopenhagen University Hospital HerlevHerlev Ringvej2730 HerlevDenmark

The development of endoscopic ultrasound(EUs) has had a significant impact for patients with digestive diseases, enabling enhanced diagnostic and therapeutic procedures, with most of the available evidence focusing on upper gastrointestinal(GI) and pancreaticobiliary diseases. For the lower GI tract the main application of EUs has been in staging rectal cancer, as a complementary technique to other cross-sectional imaging methods. EUs can provide highly accurate indepth assessments of tumour infiltration, performing best in the diagnosis of early rectal tumours. In the light of recent developments other EUs applications for colorectal diseases have been also envisaged and are currently under investigation, including beyond-rectum tumour staging by means of the newly developed forward-viewing radial array echoendoscope. Due to its high resolution, EUs might be also regarded as an ideal method for the evaluation of subepithelial lesions. Their differential diagnosis is possible by imaging the originating wall layer and the associated echostructure, and cytological and histological confirmation can be obtained through EUs-guided fine needle aspiration or trucut biopsy. However, reports on the use of EUs in colorectal subepithelial lesions are currently limited. EUs allows detailed examination of perirectal and perianal complications in Crohn's disease and, as a safe and less expensive investigation, can be used to monitor therapeutic response of fistulae, which seems to improve outcomes and reduce the need for additional surgery. Furthermore, EUs image enhancement techniques, such as the use of contrast agents or elastography, have recently been evaluated for colorectal indications as well. Possible applications of contrast enhancement include the assessment of tumour angiogenesis in colorectal cancer, the monitoring of disease activity in inflammatory bowel disease based on quantification of bowel wall vascularization, and differentiating between benign and malignant

关键词： Endoscopic ultrasound Contrast-enhancedendoscopic ultrasound Elastography Colorectal cancer Inflammatory bowel disease Colorectal submucosaltumours Endoscopic ultrasound-guided therapy

Increasing the Maximum Capacity Path in a Network and Its Application for Improving the Connection Between Two Routers

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Tsinghua science and Technology 2024年第3期29卷 753-765页

作者： adrian M.Deaconu Javad Tayyebi Department of Mathematics and Computer science Transilvania University of BrasovBrasov 500036Romania Department of Industrial Engineering Birjand University of TechnologyBirjand 000097Iran

Abstract:This paper addresses the problem of improving the optimal value of the Maximum Capacity Path(MCP)through expansion in a flexible network,and minimizing the involved *** only condition applied to the cost functions is to be non-decreasing *** is a non-restrictive condition,reflecting the reality in practice,and is considered for the first time in the ***,the total cost of expansion is a combination of max-type cost(e.g.,for supervision)and sum-type cost(*** building infrastructures,price of materials,price of labor,etc.).For this purpose,two types of strategies are combined:(l)increasing the capacity of the existing arcs,and(l)adding potential new *** different problems are introduced and *** the problems have immediate applications in Internet routing *** first one is to extend the network,so that the capacity of an McP in the modified network becomes equal to a prescribed value,therefore the cost of modifications is minimized.A strongly polynomial-time algorithm is deduced to solve this *** second problem is a network expansion under a budget constraint,so that the capacity of an McP is maximized.A weakly polynomial-time algorithm is presented to deal with *** the special case when all the costs are linear,a Meggido's parametric search technique is used to develop an algorithm for solving the problem in strongly polynomial *** new approach has a time complexity of O(n^(4)),which is better than the time complexity of O(n4 log(n)of the previously known method from literature.

关键词： Maximum Capacity Path(MCP) network expansion Internet routing polynomial-time algorithms