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Träfflista för sökning "AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Radiology, Nuclear Medicine and Medical Imaging) "

Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Radiology, Nuclear Medicine and Medical Imaging)

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  • Khoshnood, Ardavan (författare)
  • Prehospital Diagnosis and Oxygen Treatment in ST Elevation Myocardial Infarction
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • IntroductionPaper I: An Artificial Neural Network (ANN) was constructed to identify ST Elevation Myocardial Infarction (STEMI) and predict the need for Percutaneous Coronary Intervention (PCI). Paper II, III and IV: Studies suggest that O2 therapy may be harmful in STEMI patients. We therefore conducted the SOCCER study to evaluate the effects of O2 therapy in STEMI patients.MethodsPaper I: 560 ambulance ECGs sent to the Cardiac Care Unit (CCU), was together with the CCU physicians interpretation and decision of conducting an acute PCI or not collected, and compared with the interpretation and PCI decision of the ANN. Paper II, III, IV: Normoxic (≥94%) STEMI patients accepted for acute PCI were in the ambulance randomized to standard care with 10 L/min O2 or room air. A subset of the patients underwent echocardiography for determination of the Left Ventricular Ejection Fraction (LVEF) and the Wall Motion Score Index (WMSI). All patients had a Cardiac Magnetic Resonance Imaging (CMRI) to evaluate Myocardial area at Risk (MaR), Infarct Size (IS) and Myocardial Salvage Index (MSI).ResultsPaper I: The area under the ANN’s receiver operating characteristics curve for STEMI detection as well as predicting the need of acute PCI were very good.Paper II, III, IV: No significant differences could be shown in discussing MaR, MSI or IS between the O2 group (n=46) and the air group (n=49). Neither could any differences be shown for LVEF and WMSI at the index visit as well after six months between the O2 group (n=46) and the air group (n=41)ConclusionsPaper I: The results indicate that the number of ECGs sent to the CCU could be reduced with 2/3 as the ANN would safely identify ECGs not being STEMI.Paper II, III, IV: The results suggest that it is safe to withhold O2 therapy in normoxic, stable STEMI patients.
  • Ahlander, Britt-Marie, 1954-, et al. (författare)
  • Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging : the Magnetic Resonance Imaging- Anxiety Questionnaire (MRI-AQ)
  • 2016
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 72:6, s. 1368-1380
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To develop and validate a new instrument measuring patient anxiety during Magnetic Resonance Imaging examinations, Magnetic Resonance Imaging-Anxiety Questionnaire.Background: Questionnaires measuring patients’ anxiety during Magnetic Resonance Imaging examinations have been the same as used in a wide range of conditions. To learn about patients’ experience during examination and to evaluate interventions, a specific questionnaire measuring patient anxiety during Magnetic Resonance Imaging is needed.Design: Psychometric cross-sectional study with test-retest design.Methods: A new questionnaire, Magnetic Resonance Imaging-Anxiety Questionnaire, was designed from patient expressions of anxiety in Magnetic Resonance Imagingscanners. The sample was recruited between October 2012–October 2014. Factor structure was evaluated with exploratory factor analysis and internal consistency with Cronbach’s alpha. Criterion-related validity, known-group validity and test-retest was calculated.Results: Patients referred for Magnetic Resonance Imaging of either the spine or the heart, were invited to participate. The development and validation of Magnetic Resonance Imaging-Anxiety Questionnaire resulted in 15 items consisting of two factors. Cronbach’s alpha was found to be high. Magnetic Resonance Imaging-Anxiety Questionnaire correlated higher with instruments measuring anxiety than with depression scales. Known-group validity demonstrated a higher level of anxiety for patients undergoing Magnetic Resonance Imaging scan of the heart than for those examining the spine. Test-retest reliability demonstrated acceptable level for the scale.Conclusion: Magnetic Resonance Imaging-Anxiety Questionnaire bridges a gap among existing questionnaires, making it a simple and useful tool for measuring patient anxiety during Magnetic Resonance Imaging examinations.
  • Arnoldussen, Ilse A. C., et al. (författare)
  • Adiposity is related to cerebrovascular and brain volumetry outcomes in the RUN DMC study
  • 2019
  • Ingår i: Neurology. - : Wolters Kluwer. - 0028-3878 .- 1526-632X. ; 93:9, s. e864-e878
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Adiposity predictors, body mass index (BMI), waist circumference (WC), and blood leptin and total adiponectin levels were associated with components of cerebral small vessel disease (CSVD) and brain volumetry in 503 adults with CSVD who were ≥50 years of age and enrolled in the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort (RUN DMC).METHODS: RUN DMC participants were followed up for 9 years (2006-2015). BMI, WC, brain imaging, and dementia diagnoses were evaluated at baseline and follow-up. Adipokines were measured at baseline. Brain imaging outcomes included CSVD components, white matter hyperintensities, lacunes, microbleeds, gray and white matter, hippocampal, total brain, and intracranial volumes.RESULTS: Cross-sectionally among men at baseline, higher BMI, WC, and leptin were associated with lower gray matter and total brain volumes, and higher BMI and WC were associated with lower hippocampal volume. At follow-up 9 years later, higher BMI was cross-sectionally associated with lower gray matter volume, and an obese WC (>102 cm) was protective for ≥1 lacune or ≥1 microbleed in men. In women, increasing BMI and overweight or obesity (BMI ≥25 kg/m2 or WC >88 cm) were associated with ≥1 lacune. Longitudinally, over 9 years, a baseline obese WC was associated with decreasing hippocampal volume, particularly in men, and increasing white matter hyperintensity volume in women and men.CONCLUSIONS: Anthropometric and metabolic adiposity predictors were differentially associated with CSVD components and brain volumetry outcomes by sex. Higher adiposity is associated with a vascular-neurodegenerative spectrum among adults at risk for vascular forms of cognitive impairment and dementias.
  • Ahlander, Britt-Marie, et al. (författare)
  • An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion
  • 2017
  • Ingår i: Clinical Physiology and Functional Imaging. - : John Wiley & Sons. - 1475-0961 .- 1475-097X. ; 37:1, s. 52-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Background To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference. Methods Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study. Results Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI). Conclusion GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.
  • Grubb, Anders, et al. (författare)
  • Cystatin C, a marker for successful aging and glomerular filtration rate, is not influenced by inflammation.
  • 2011
  • Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa Healthcare. - 1502-7686. ; 71, s. 145-149
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background. The plasma level of cystatin C is a better marker than plasma creatinine for successful aging. It has been assumed that the advantage of cystatin C is not only due to it being a better marker for glomerular filtration rate (GFR) than creatinine, but also because an inflammatory state of a patient induces a raised cystatin C level. However, the observations of an association between cystatin C level and inflammation stem from large cohort studies. The present work concerns the cystatin C levels and degree of inflammation in longitudinal studies of individual subjects without inflammation, who undergo elective surgery. Methods. Cystatin C, creatinine, and the inflammatory markers CRP, serum amyloid A (SAA), haptoglobin and orosomucoid were measured in plasma samples from 35 patients the day before elective surgery and subsequently during seven consecutive days. Results. Twenty patients had CRP-levels below 1 mg/L before surgery and low levels of the additional inflammatory markers. Surgery caused marked inflammation with high peak values of CRP and SAA on the second day after the operation. The cystatin C level did not change significantly during the observation period and did not correlate significantly with the level of any of the four inflammatory markers. The creatinine level was significantly reduced on the first postoperative day but reached the preoperative level towards the end of the observation period. Conclusion. The inflammatory status of a patient does not influence the role of cystatin C as a marker of successful aging, nor of GFR.
  • Reza, Salim, 1985-, et al. (författare)
  • Smart dosimetry by pattern recognition using a single photon counting detector system in time over threshold mode
  • 2012
  • Ingår i: Journal of Instrumentation. - 1748-0221 .- 1748-0221. ; 7:1, s. Art. no. C01027-
  • Tidskriftsartikel (refereegranskat)abstract
    • The function of a dosimeter is to determine the absorbed dose of radiation, for those cases in which, generally, the particular type of radiation is already known. Lately, a number of applications have emerged in which all kinds of radiation are absorbed and are sorted by pattern recognition, such as the Medipix2 application in [1]. This form of smart dosimetry enables measurements where not only the total dosage is measured, but also the contributions of different types of radiation impacting upon the detector surface. Furthermore, the use of a photon counting system, where the energy deposition can be measured in each individual pixel, ensures measurements with a high degree of accuracy in relation to the pattern recognition. In this article a Timepix [2] detector system has been used in the creation of a smart dosimeter for Alpha, Beta and Gamma radiation. When a radioactive particle hits the detector surface it generates charge clusters and those impacting upon the detector surface are read out and image processing algorithms are then used to classify each charge cluster. The individual clusters are calculated and as a result, the dosage for each type of radiation is given. In some cases, several particles can impact in roughly the same place, forming overlapping clusters. In order to handle this problem, a cluster separation method has been added to the pattern recognition algorithm. When the clusters have been separated, they are classified by shape and sorted into the correct type of radiation. The algorithms and methods used in this dosimeter have been developed so as to be simple and computationally effective, in order to enable implementation on a portable device. © 2012 IOP Publishing Ltd and SISSA.
  • Andersson, J., et al. (författare)
  • Artificial intelligence and the medical physics profession-A Swedish perspective
  • 2021
  • Ingår i: Physica Medica-European Journal of Medical Physics. - : Elsevier. - 1120-1797 .- 1724-191X. ; 88, s. 218-225
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is a continuous and dynamic discussion on artificial intelligence (AI) in present-day society. AI is expected to impact on healthcare processes and could contribute to a more sustainable use of resources allocated to healthcare in the future. The aim for this work was to establish a foundation for a Swedish perspective on the potential effect of AI on the medical physics profession. Materials and methods: We designed a survey to gauge viewpoints regarding AI in the Swedish medical physics community. Based on the survey results and present-day situation in Sweden, a SWOT analysis was performed on the implications of AI for the medical physics profession. Results: Out of 411 survey recipients, 163 responded (40%). The Swedish medical physicists with a professional license believed (90%) that AI would change the practice of medical physics but did not foresee (81%) that AI would pose a risk to their practice and career. The respondents were largely positive to the inclusion of AI in educational programmes. According to self-assessment, the respondents' knowledge of and workplace preparedness for AI was generally low. Conclusions: From the survey and SWOT analysis we conclude that AI will change the medical physics profession and that there are opportunities for the profession associated with the adoption of AI in healthcare. To overcome the weakness of limited AI knowledge, potentially threatening the role of medical physicists, and build upon the strong position in Swedish healthcare, medical physics education and training should include learning objectives on AI.
  • Wang, Chunliang, 1980-, et al. (författare)
  • An interactive software module for visualizing coronary arteries in CT angiography
  • 2008
  • Ingår i: International Journal of Computer Assisted Radiology and Surgery. - Heidelberg/Berlin : Springer. - 1861-6410 .- 1861-6429. ; 3:1-2, s. 11-18
  • Tidskriftsartikel (refereegranskat)abstract
    • A new software module for coronary artery segmentation and visualization in CT angiography (CTA) datasets is presented, which aims to interactively segment coronary arteries and visualize them in 3D with maximum intensity projection (MIP) and volume rendering (VRT).Materials and Methods:  The software was built as a plug-in for the open-source PACS workstation OsiriX. The main segmentation function is based an optimized “virtual contrast injection” algorithm, which uses fuzzy connectedness of the vessel lumen to separate the contrast-filled structures from each other. The software was evaluated in 42 clinical coronary CTA datasets acquired with 64-slice CT using isotropic voxels of 0.3–0.5 mm.Results:  The median processing time was 6.4 min, and 100% of main branches (right coronary artery, left circumflex artery and left anterior descending artery) and 86.9% (219/252) of visible minor branches were intact. Visually correct centerlines were obtained automatically in 94.7% (321/339) of the intact branches.Conclusion:  The new software is a promising tool for coronary CTA post-processing providing good overviews of the coronary artery with limited user interaction on low-end hardware, and the coronary CTA diagnosis procedure could potentially be more time-efficient than using thin-slab technique.
  • Fredenberg, Erik, PhD, 1979-, et al. (författare)
  • Contrast-enhanced spectral mammography with a photon-counting detector
  • 2010
  • Ingår i: Medical physics (Lancaster). - 0094-2405. ; 37:5, s. 2017-2029
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Spectral imaging is a method in medical x-ray imaging to extract information about the object constituents by the material-specific energy dependence of x-ray attenuation. In particular, the detectability of a contrast agent can be improved over a lumpy background. We have investigated a photon-counting spectral imaging system with two energy bins for contrast-enhanced mammography. System optimization and the potential benefit compared to conventional non-energy-resolved imaging was studied.Methods: A framework for system characterization was set up that included quantum and anatomical noise, and a theoretical model of the system was benchmarked to phantom measurements.Results: It was found that optimal combination of the energy-resolved images corresponded approximately to minimization of the anatomical noise, and an ideal-observer detectability index could be improved more than a factor of two compared to absorption imaging in the phantom study. In the clinical case, an improvement close to 80% was predicted for an average glandularity breast, and a factor of eight for dense breast tissue. Another 70% was found to be within reach for an optimized system.Conclusions: Contrast-enhanced spectral mammography is feasible and beneficial with the current system, and there is room for additional improvements.
  • Andersson, Elisabeth, et al. (författare)
  • Surveillance of indeterminate pulmonary nodules detected with CT in a Swedish population-based study (SCAPIS) : Psychosocial consequences and impact on health-related quality of life - A multicentre prospective cross-sectional study
  • 2021
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055 .- 2044-6055. ; 11:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To investigate whether surveillance of pulmonary nodules detected with low-dose CT (LDCT) impacted health-related quality of life and psychosocial consequences in the Swedish population-based study, Swedish CArdioPulmonary bioImage Study (SCAPIS).Design: A prospective cross-sectional study.Settings and participants: This multicentre (five sites) observational study, which included a cohort from SCAPIS, consisted of 632 participants with indeterminate pulmonary nodules detected with LDCT. These participants continued surveillance for up to 36 months, during which lung cancer was not detected (surveillance group). Additionally, 972 participants with a negative pulmonary LDCT scan were included as a control group. Matching criteria were LDCT date (±2 weeks), gender and site.Outcome measures: All participants completed a health-related quality of life questionnaire (RAND-36) and the Consequences of Screening (COS) questionnaire, an average of 3 years after LDCT was conducted at entry into SCAPIS.Results: Participants were 51-70 years old at study commencement. Overall, the two groups did not differ in demographic or psychosocial variables, smoking habits or pulmonary medical history. Individuals from countries other than Sweden and those with low socioeconomic status were less likely to participate (p<0.001). No effects on health-related quality of life were observed via RAND-36. In COS, the surveillance group demonstrated a higher OR for anxiety about lung cancer (OR 3.96, 95% CI 2.35 to 6.66, p<0.001), experiencing a sense of dejection (OR 1.35, 95% CI 1.06 to 1.72, p=0.015) and thoughts about existential values (OR 1.30, 95% CI 1.04 to 1.60, p=0.018).Conclusions: Lung surveillance with LDCT contributed to significant experiences of sense of dejection, anxiety about lung cancer and development of thoughts about existential values among participants in the surveillance group compared with the controls. The risk of side effects should be communicated for informed decision-making about (non-)attendance in lung cancer screening.
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