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11.
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12.
  • Kataria, Bharti, 1955-, et al. (författare)
  • Assessment of image quality in abdominal computed tomography : Effect of model-based iterative reconstruction, multi-planar reconstruction and slice thickness on potential dose reduction
  • 2020
  • Ingår i: European Journal of Radiology. - : Elsevier Ireland Ltd. - 0720-048X .- 1872-7727. ; 122
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To determine the effect of tube load, model-based iterative reconstruction (MBIR) strength and slice thickness in abdominal CT using visual comparison of multi-planar reconstruction images. Method: Five image criteria were assessed independently by four radiologists on two data sets at 42- and 98-mAs tube loads for 25 patients examined on a 192-slice dual-source CT scanner. Effect of tube load, MBIR strength, slice thickness and potential dose reduction was estimated with Visual Grading Regression (VGR). Objective image quality was determined by measuring noise (SD), contrast-to-noise (CNR) ratio and noise-power spectra (NPS). Results: Comparing 42- and 98-mAs tube loads, improved image quality was observed as a strong effect of log tube load regardless of MBIR strength (p < 0.001). Comparing strength 5 to 3, better image quality was obtained for two criteria (p < 0.01), but inferior for liver parenchyma and overall image quality. Image quality was significantly better for slice thicknesses of 2mm and 3mm compared to 1mm, with potential dose reductions between 24%-41%. As expected, with decrease in slice thickness and algorithm strength, the noise power and SD (HU-values) increased, while the CNR decreased. Conclusion: Increasing slice thickness from 1 mm to 2 mm or 3 mm allows for a possible dose reduction. MBIR strength 5 shows improved image quality for three out of five criteria for 1 mm slice thickness. Increasing MBIR strength from 3 to 5 has diverse effects on image quality. Our findings do not support a general recommendation to replace strength 3 by strength 5 in clinical abdominal CT protocols. However, strength 5 may be used in task-based protocols.
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13.
  • Kataria, Bharti, 1955-, et al. (författare)
  • Assessment of image quality in abdominal CT : potential dose reduction with model-based iterative reconstruction
  • 2018
  • Ingår i: European Radiology. - Heidelberg : SPRINGER. - 0938-7994 .- 1432-1084. ; 28:6, s. 2464-2473
  • Tidskriftsartikel (refereegranskat)abstract
    • To estimate potential dose reduction in abdominal CT by visually comparing images reconstructed with filtered back projection (FBP) and strengths of 3 and 5 of a specific MBIR. A dual-source scanner was used to obtain three data sets each for 50 recruited patients with 30, 70 and 100% tube loads (mean CTDIvol 1.9, 3.4 and 6.2 mGy). Six image criteria were assessed independently by five radiologists. Potential dose reduction was estimated with Visual Grading Regression (VGR). Comparing 30 and 70% tube load, improved image quality was observed as a significant strong effect of log tube load and reconstruction method with potential dose reduction relative to FBP of 22-47% for MBIR strength 3 (p < 0.001). For MBIR strength 5 no dose reduction was possible for image criteria 1 (liver parenchyma), but dose reduction between 34 and 74% was achieved for other criteria. Interobserver reliability showed agreement of 71-76% (kappa (w) 0.201-0.286) and intra-observer reliability of 82-96% (kappa (w) 0.525-0.783). MBIR showed improved image quality compared to FBP with positive correlation between MBIR strength and increasing potential dose reduction for all but one image criterion. aEuro cent MBIR's main advantage is its de-noising properties, which facilitates dose reduction. aEuro cent MBIR allows for potential dose reduction in relation to FBP. aEuro cent Visual Grading Regression (VGR) produces direct numerical estimates of potential dose reduction. aEuro cent MBIR strengths 3 and 5 dose reductions were 22-34 and 34-74%. aEuro cent MBIR strength 5 demonstrates inferior performance for liver parenchyma.
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14.
  • Kataria, Bharti, et al. (författare)
  • Image quality and pathology assessment in CT Urography : when is the low-dose series sufficient?
  • 2019
  • Ingår i: BMC Medical Imaging. - : BMC. - 1471-2342 .- 1471-2342. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Our aim was to compare CT images from native, nephrographic and excretory phases using image quality criteria as well as the detection of positive pathological findings in CT Urography, to explore if the radiation burden to the younger group of patients or patients with negative outcomes can be reduced. Methods This is a retrospective study of 40 patients who underwent a CT Urography examination on a 192-slice dual source scanner. Image quality was assessed for four specific renal image criteria from the European guidelines, together with pathological assessment in three categories: renal, other abdominal, and incidental findings without clinical significance. Each phase was assessed individually by three radiologists with varying experience using a graded scale. Certainty scores were derived based on the graded assessments. Statistical analysis was performed using visual grading regression (VGR). The limit for significance was set at p = 0.05. Results For visual reproduction of the renal parenchyma and renal arteries, the image quality was judged better for the nephrogram phase (p < 0.001), whereas renal pelvis/calyces and proximal ureters were better reproduced in the excretory phase compared to the native phase (p < 0.001). Similarly, significantly higher certainty scores were obtained in the nephrogram phase for renal parenchyma and renal arteries, but in the excretory phase for renal pelvis/calyxes and proximal ureters. Assessment of pathology in the three categories showed no statistically significant differences between the three phases. Certainty scores for assessment of pathology, however, showed a significantly higher certainty for renal pathology when comparing the native phase to nephrogram and excretory phase and a significantly higher score for nephrographic phase but only for incidental findings. Conclusion Visualisation of renal anatomy was as expected with each post-contrast phase showing favourable scores compared to the native phase. No statistically significant differences in the assessment of pathology were found between the three phases. The low-dose CT (LDCT) seems to be sufficient in differentiating between normal and pathological examinations. To reduce the radiation burden in certain patient groups, the LDCT could be considered a suitable alternative as a first line imaging method. However, radiologists should be aware of its limitations.
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15.
  • Kataria, Bharti, 1955-, et al. (författare)
  • Image Quality and Potential Dose Reduction Using Advanced Modeled Iterative Reconstruction (Admire) in Abdominal Ct : A Review
  • 2021
  • Ingår i: Radiation Protection Dosimetry. - : Oxford University Press. - 0144-8420 .- 1742-3406. ; 195:3-4, s. 177-187
  • Forskningsöversikt (refereegranskat)abstract
    • Traditional filtered back projection (FBP) reconstruction methods have served the computed tomography (CT) community wellfor over 40 years. With the increased use of CT during the last decades, efforts to minimise patient exposure, while maintainingsufficient or improved image quality, have led to the development of model-based iterative reconstruction (MBIR) algorithms fromseveral vendors. The usefulness of the advanced modeled iterative reconstruction (ADMIRE) (Siemens Healthineers) MBIR inabdominal CT is reviewed and its noise suppression and/or dose reduction possibilities explored. Quantitative and qualitativemethods with phantom and human subjects were used. Assessment of the quality of phantom images will not always correlatepositively with those of patient images, particularly at the higher strength of the ADMIRE algorithm. With few exceptions,ADMIRE Strength 3 typically allows for substantial noise reduction compared to FBP and hence to significant (≈30%) patientdose reductions. The size of the dose reductions depends on the diagnostic task.
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16.
  • Kataria, Bharti, 1955- (författare)
  • Visual grading evaluation of reconstruction methods and dose optimisation in abdominal Computed Tomography
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Since its introduction in the 1970’s CT has emerged as a modality of choice because of its high sensitivity in producing accurate diagnostic images. A third of all Computed Tomography (CT) examinations are abdominal CTs which deliver one of the highest doses among common examinations. An increase in the number of CT examinations has raised concerns about the negative effects of ionising radiation as the dose is cumulative over the life span of the individual. Image quality in CT is closely related to the radiation dose, so that a certain dose with an associated small, but not negligible, risk is a prerequisite for high image quality. Typically, dose reduction in CT results in higher noise and a decrease in low contrast resolution which can be detrimental to the image quality produced. New technology presents a wide range of dose reduction strategies, the latest being iterative reconstruction (IR).The aim of this thesis was to evaluate two different classes of iterative reconstruction algorithms: statistical (SAFIRE) and model-based (ADMIRE) as well as to explore the diagnostic value of a low-dose abdominal CT for optimisation purposes.This thesis included a total of 140 human subjects in four image quality evaluation studies, three of which were prospective studies (Papers I, II and IV) and one retrospective study (Paper III). Visual grading experiments to determine the potential dose reductions, were performed with pairwise comparison of image quality in the same patient at different tube loads (dose) and reconstructed with Filtered back projection (FBP) and SAFIRE strength 1 in a low-dose abdominal CT (Paper I) and FBP and ADMIRE strengths 3 and 5 in a standard dose abdominal CT (Paper II). Paper IV evaluated the impact of slice thicknesses in CT images reconstructed with ADMIRE strengths 3 and 5 when comparing multiplanar reconstruction (MPR) formatted images in a standard dose abdominal CT. Paper III, on the other hand, was an absolute assessment of image quality and pathology between the three phases of a CT Urography (CTU) protocol to explore the diagnostic value of low-dose abdominal CT. The anonymised images were displayed in random order and image quality was assessed by a group of radiologists using image quality criteria from the “European guidelines of quality criteria for CT”. The responses from the reviewer assessment were analysed statistically with ordinal logistic regression i.e. Visual Grading Regression (VGR).Results in Paper I show that a small dose reduction (5-9 %) was possible using SAFIRE strength 1and indicated the need for further research to evaluate the dose reduction potential of higher strengths of the algorithm. In Paper II a 30% dose reduction was possible without change in ADMIRE algorithm strength as no improvement in image quality was observed between tube loads 98- and 140 mAs. When comparing tube loads 42 and 98 mAs, further dose reduction was possible with ADMIRE strength 3 (22-47%). However, for images reconstructed with ADMIRE strength 5, a dose reduction of 34-74% was possible for some, but not all image criteria. Image quality in low-contrast objects such as the liver parenchyma, was affected and a decline in diagnostic confidence was observed. Paper IV showed potential dose reductions are possible with increasing slice thickness from 1 mm to 2 mm (24-35%) and 1 mm to 3mm (25-41%). ADMIRE strength 3 continued to provide diagnostically acceptable images with possible dose reductions for all image criteria assessed. Despite objective evaluations showing a decrease in noise and an increase in contrast to noise ratio, ADMIRE strength 5 had diverse effects on the five image criteria, depending on slice thickness and further dose reductions were limited to certain image criteria. The findings do not support a general recommendation to replace ADMIRE3 with ADMIRE5 in clinical abdominal CT protocols.Paper III studied another aspect of optimisation and results show that visualisation of renal anatomy was as expected in favour of the post-contrast phases when compared to the native phase. Assessment of pathology showed no significant differences between the three phases. Significantly higher diagnostic certainty for renal anatomy was observed for the post-contrast phases when compared to the native phase. Significantly high certainty scores were also seen for the nephrographic phase for incidental findings. The conclusion is that a low-dose series seems to be sufficient as a first-line modality in certain patient groups.This thesis clinically evaluated the effect of IR in abdominal CT imaging and estimated potential dose reductions. The important conclusion from papers I, II and IV is that IR improves image quality in abdominal CT allowing for some dose reductions. However, the clinical utility of the highest strength of the algorithm is limited to certain criteria. The results can be used to optimise the clinical abdominal CT protocol. The conclusion from paper III may increase clinical awareness of the value of the low-dose abdominal protocol when choosing an imaging method for certain patient groups who are more sensitive to radiation.
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17.
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18.
  • Larsson, Martin, et al. (författare)
  • Renal artery stenosis : extracting quantitative parameters with a mathematical model fitted to magnetic resonance blood flow data
  • 2008
  • Ingår i: Journal of Magnetic Resonance Imaging. - : John Wiley & Sons. - 1053-1807 .- 1522-2586. ; 27:1, s. 140-147
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To investigate the feasibility of quantitative parameter extraction from a mathematical model fitted to renal artery magnetic resonance flow data.Material and methods: Sixteen subjects, 8 patients and 8 normal controls, were examined with cine phase-contrast velocity measurements, and blood flow data from the aorta and both renal arteries were extracted by means of contour detection. A mathematical model with eight parameters describing the time, duration and amplitude of the systolic acceleration and the diastolic deceleration was fitted to the aorta and renal artery blood flow data from each subject. The curve fitting was evaluated with R2 values. Statistical analysis was performed with unpaired Wilcoxon tests and stepwise logistic regression.Results: Three data sets out of 48 yielded R2 values below 0.80 and were considered unreliable for parameter estimation. Basal flow was significantly, and systolic peak amplitude almost significantly, lower in stenotic arteries. Logistic regression indicated that two parameters describing basal flow and the duration of acceleration can accurately predict stenosis.Conclusion: The results suggest that it is technically feasible to fit a mathematical model to renal blood flow data, extracting quantitative parameters that may prove useful for quantification and diagnosis of renal artery stenosis.
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19.
  • Löfving, Adam, et al. (författare)
  • Angiographic visualization of the coronary arteries in computed tomography with virtual contrast injection
  • 2006
  • Ingår i: The Internet Journal of Radiology. - : Internet Scientific Publications, Llc.. - 1528-8404. ; 4:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Computed Tomography Angiography (CTA) is a non-invasive alternative to catheter angiography but has had limited use in the coronary arteries due to resolution and visualization problems. Maximum intensity projection (MIP) is difficult to apply in the heart with numerous overlying contrast-filled structures. The study proposes virtual contrast injection, originally introduced for MR angiography, for visualizing the coronaries in CTA. Examination after i.v. contrast injection was made in a 16-slice CT. After virtual contrast injection (concurrent grayscale connectedness) separating the vessels, rendering of the right and left coronary separately was made with MIP and volume rendering (VRT). Images similar to invasive angiography were obtained in all 7 projections used in the clinical routine. The observer also has the possibility to freely select an optimal projection. After validation in larger materials, this may become a clinically useful non-invasive alternative for examining coronary arteries.
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