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Sökning: FÖRF:(Jonas Widell)

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1.
  • Lidén, Mats, 1976-, et al. (författare)
  • Quantitative T2* imaging of iron overload in a non-dedicated center - Normal variation, repeatability and reader variation
  • 2021
  • Ingår i: European journal of radiology open. - : Elsevier. - 2352-0477. ; 8
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patients with transfusion dependent anemia are at risk of complications from iron overload. Quantitative T2* magnetic resonance imaging (MRI) is the best non-invasive method to assess iron deposition in the liver and heart and to guide chelation therapy.Purpose: To investigate the image quality and inter-observer variations in T2* measurements of the myocardium and the liver, and to obtain the lower limit of cardiac and hepatic quantitative T2* values in patients without suspicion of iron overload.Material and methods: Thirty-eight patients referred for cardiac MRI were prospectively included in the study. Three patients were referred with, and 35 without suspicion of iron overload. Quantitative T2* parametric maps were obtained on a 1.5 T MRI system in the cardiac short axis and liver axial view. Two readers independently assessed the image quality and the representative and the lowest T2* value in the myocardium and the liver.Results: The normal range of representative T2* values in the myocardium and liver was 24-45 ms and 14-37 ms, respectively. None of the 35 participants (0 %, 95 % confidence interval 0-11 %) in the normal reference group demonstrated representative T2* values below previously reported lower limits in the myocardium (20 ms) or the liver (8 ms). Focal myocardial areas with T2* values near the lower normal range, 19-20 ms, were seen in two patients. The readers generally reported good image quality.Conclusion: T2* imaging for assessing iron overload can be performed in a non-dedicated center with sufficient image quality.
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2.
  • Alobeidi, Hanan, et al. (författare)
  • Minimizing contrast media dose in CT pulmonary angiography with high-pitch technique
  • 2020
  • Ingår i: British Journal of Radiology. - : John Wiley & Sons. - 0007-1285 .- 1748-880X. ; 93:1111
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To perform CT pulmonary angiography (CTPA) using a minimal amount of iodinated contrast media.METHODS: 47 patients (25 females) with mean age 69 years (range 41-82 years) referred for contrast-enhanced chest CT were prospectively included in this Phase IV clinical drug trial. All participants underwent a study specific CTPA in addition to the chest CT. The participants received 80 mg I/kg body weight Iohexol contrast media using a preparatory saline bolus, a dual flow contrast/saline bolus and a saline flush, and a scanner protocol with 80 kVp dual source high-pitch mode. Three readers independently assessed the image quality on the 3-point scale non-diagnostic, adequate or good-excellent image quality. Additionally, the pulmonary arterial contrast opacification was measured.RESULTS: On average, the patients received 16.8 ml Iohexol 350 mg I/mL (range 12-20 ml). Mean patient weight was 71 kg (range 50-85 kg). Identically for all readers, pulmonary embolism (PE) was detected in 1/47 participants. The median number of examinations visually scored concerning pulmonary embolism as good-excellent was 47/47 (range 44-47); adequate 0/47 (0-3) and non-diagnostic 0/47 (range 0-0). The proportion adequate or better examinations was for all readers 47/47, 100% [95% confidence interval 92-100%]. The mean attenuation ± standard deviation in the pulmonary trunk was 325 ± 72 Hounsfield unit (range 165-531 Hounsfield unit).CONCLUSIONS: Diagnostic CTPA with 17 ml contrast media is possible in non-obese patients using low kVp, high pitch and carefully designed contrast media administration.ADVANCES IN KNOWLEDGE: By combining several procedures in a CTPA protocol, the contrast media dose can be minimized.
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3.
  • Widell, Jonas, et al. (författare)
  • Interobserver variability in high-resolution CT of the lungs
  • 2020
  • Ingår i: European Journal of Radiology Open. - : Elsevier. - 2352-0477. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To quantify the interobserver variability among the most frequently encountered parenchymal patterns in High Resolution CT (HRCT) and to compare the interobserver variability in the application of the 2011 and 2018 usual interstitial pneumonia (UIP) criteria according to the joint guidelines from international thoracic and respiratory societies.Material and methods: Two observers independently evaluated 126 HRCT, with examples of most common parenchymal patterns, and noted the presence of each pattern. The readers also noted whether the findings met the 2011 criteria for UIP. In a second reading, the same readers noted whether the HRCT met the UIP criteria according to the 2018 UIP update.Results: The kappa values for interobserver variability for the different patterns ranged from 0.28 (intralobular lines) to 0.85 (tree-in-bud nodules). The kappa value for UIP pattern was similar for 2011 and 2018 criteria, 0.58 and 0.69, respectively. Compared to the 2011 UIP criteria, there was no statistically significant difference in the number of HRCT classified as UIP using the 2018 criteria.Conclusions: There is a substantial variation in interobserver agreement between the different parenchymal patterns, which suggests that some patterns a more easily identified than others. There is also a considerable reader variation in the assessment of UIP applying the 2011 UIP criteria as well as applying the 2018 UIP update.
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