| 1. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 2. |
- Ekblom Bak, Elin, 1981-, et al.
(författare)
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Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis : cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:11
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.DESIGN: Cross-sectional.SETTING: Multisite study at university hospitals.PARTICIPANTS: A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.PRIMARY AND SECONDARY OUTCOMES: Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.RESULTS: High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61-0.67), CACS (OR range 0.71-0.75) and CarA (OR range 0.72-0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).CONCLUSIONS: MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.
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| 3. |
- Oldgren, Jonas, 1964-, et al.
(författare)
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Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study
- 2021
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 28:3, s. 250-259
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Tidskriftsartikel (refereegranskat)abstract
- Background It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis. Design The design of this study was as a cross-sectional analysis from a population-based study cohort. Methods From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined. Results Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)). Conclusion Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.
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| 4. |
- Bornefalk, Hans, et al.
(författare)
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Effect of Temperature Variation on the Energy Response of a Photon Counting Silicon CT Detector
- 2013
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Ingår i: IEEE Transactions on Nuclear Science. - : Institute of Electrical and Electronics Engineers (IEEE). - 0018-9499 .- 1558-1578. ; 60:2, s. 1442-1449
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Tidskriftsartikel (refereegranskat)abstract
- The effect of temperature variation on pulse height determination accuracy is determined for a photon counting multibin silicon detector developed for spectral CT. Theoretical predictions of the temperature coefficient of the gain and offset are similar to values derived from synchrotron radiation measurements in a temperature controlled environment. By means of statistical modeling, we conclude that temperature changes affect all channels equally and with separate effects on gain and threshold offset. The combined effect of a 1 degrees C temperature increase is to decrease the detected energy by 0.1 keV for events depositing 30 keV. For the electronic noise, no statistically significant temperature effect was discernible in the data set, although theory predicts a weak dependence. The method is applicable to all x-ray detectors operating in pulse mode.
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| 5. |
- Engström, Gunnar, et al.
(författare)
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The Swedish CArdioPulmonary BioImage Study : objectives and design
- 2015
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 278:6, s. 645-659
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Tidskriftsartikel (refereegranskat)abstract
- Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.
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| 6. |
- Qin, Leiqiang, et al.
(författare)
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A flexible semitransparent photovoltaic supercapacitor based on water-processed MXene electrodes
- 2020
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Ingår i: Journal of Materials Chemistry A. - : Royal Society of Chemistry. - 2050-7488 .- 2050-7496. ; 8:11, s. 5467-5475
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Tidskriftsartikel (refereegranskat)abstract
- Solar energy, although it has the highest power density available in terms of renewable energy, has the drawback of being erratic. Integrating an energy harvesting and storage device into photovoltaic energy storage modules is a viable route for obtaining self-powered energy systems. Herein, an MXene-based all-solution processed semitransparent flexible photovoltaic supercapacitor (PSC) was fabricated by integrating a flexible organic photovoltaic (OPV) with Ti3C2Tx MXene as the electrode and transparent MXene supercapacitors with an organic ionogel as the electrolyte in the vertical direction, using Ti3C2Tx thin film as a common electrode. In the quest for a semitransparent flexible PSC, Ti3C2Tx MXene was first used as a transparent electrode for OPV with a high power conversion efficiency of 13.6%. The ionogel electrolyte-based transparent MXene supercapacitor shows a high volumetric capacitance of 502 F cm(-3) and excellent stability. Finally, a flexible PSC with a high average transmittance of over 33.5% was successfully constructed by all-solution processing and a remarkable storage efficiency of 88% was achieved. This strategy enables a simple route for fabricating MXene based high-performance all-solution-processed flexible PSCs, which is important for realizing flexible and printable electronics for future technologies.
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| 7. |
- Sundberg, Christel, et al.
(författare)
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1-µm spatial resolution in silicon photon-counting CT detectors
- 2021
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Ingår i: Journal of Medical Imaging. - : SPIE - International Society for Optical Engineering. - 2329-4302 .- 2329-4310. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Spatial resolution for current scintillator-based computed tomography (CT) detectors is limited by the pixel size of about 1 mm. Direct conversion photon-counting detector prototypes with silicon- or cadmium-based detector materials have lately demonstrated spatial resolution equivalent to about 0.3 mm. We propose a development of the deep silicon photon-counting detector which will enable a resolution of 1 ?? µ m , a substantial improvement compared to the state of the art. Approach: With the deep silicon sensor, it is possible to integrate CMOS electronics and reduce the pixel size at the same time as significant on-sensor data processing capability is introduced. A Gaussian curve can then be fitted to the charge cloud created in each interaction.We evaluate the feasibility of measuring the charge cloud shape of Compton interactions for deep silicon to increase the spatial resolution. By combining a Monte Carlo photon simulation with a charge transport model, we study the charge cloud distributions and induced currents as functions of the interaction position. For a simulated deep silicon detector with a pixel size of 12 ?? µ m , we present a method for estimating the interaction position. Results: Using estimations for electronic noise and a lowest threshold of 0.88 keV, we obtain a spatial resolution equivalent to 1.37 ?? µ m in the direction parallel to the silicon wafer and 78.28 ?? µ m in the direction orthogonal to the wafer. Conclusions: We have presented a simulation study of a deep silicon detector with a pixel size of 12 × 500 ?? µ m 2 and a method to estimate the x-ray interaction position with ultra-high resolution. Higher spatial resolution can in general be important to detect smaller details in the image. The very high spatial resolution in one dimension could be a path to a practical implementation of phase contrast imaging in CT.
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| 8. |
- Sundberg, Christel, et al.
(författare)
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1 mu m Spatial Resolution in Silicon Photon-Counting CT Detectors by Measuring Charge Diffusion
- 2020
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Ingår i: MEDICAL IMAGING 2020: PHYSICS OF MEDICAL IMAGING. - : SPIE-INT SOC OPTICAL ENGINEERING. - 9781510633926
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Konferensbidrag (refereegranskat)abstract
- One of the existing prototype detector systems for full-field photon-counting CT is a silicon detector developed by our group. Spatial resolution is clinically important to resolve small details and can enable more efficient phase-contrast imaging. However, improving the resolution is difficult as decreasing the pixel size is associated with technical challenges. By integrating CMOS electronics into the silicon sensor, it is possible to reduce the pixel size drastically while also introducing on-sensor data processing capabilities. In this work, we evaluate the feasibility of measuring the charge cloud shape of Compton interactions in a silicon strip detector to increase the spatial resolution. With an incident spectrum of 140 kVp, Compton interactions constitute 66.2% of the detected interactions. By combining a Monte Carlo photon simulation with a charge transport model, we study the charge cloud distributions and induced currents as functions of the interaction position. For a simulated silicon strip detector with a pixel size of 12x500 mu m(2), we present a method in which the interaction position can be determined. For an ideal case without electronic noise an average absolute error of 0.65 mu m is obtained in the direction along the wafer and 13.08 mu m in the trans-wafer direction. With simulated electronic noise and a lowest threshold of 0.88 keV the corresponding values are 1.38 mu m and 122.83 mu m. Our results show that the proposed method has the potential to very significantly increase the spatial resolution in a full-field photon-counting detector for CT.
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| 9. |
- Sundberg, Christel, et al.
(författare)
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Increased count-rate performance and dose efficiency for silicon photon-counting detectors for full-field CT using an ASIC with adjustable shaping time
- 2019
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Ingår i: MEDICAL IMAGING 2019. - : SPIE-INT SOC OPTICAL ENGINEERING. - 9781510625440
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Konferensbidrag (refereegranskat)abstract
- Photon-counting silicon strip detectors are attracting interest for use in next generation CT scanners. For silicon detectors, a low noise floor is necessary to obtain a good dose efficiency. A low noise floor can be achieved by having a filter with a long shaping time in the readout electronics. This also increases the pulse length, resulting in a long deadtime and thereby a degraded count-rate performance. However, as the flux typically varies greatly during a CT scan, a high count-rate capability is not required for all projection lines. It would therefore be desirable to use more than one shaping time within a single scan. To evaluate the potential benefit of using more than one shaping time, it is of interest to characterize the relation between the shaping time, the noise, and the resulting pulse shape. In this work we present noise and pulse shape measurements on a photon-counting detector with two different shaping times along with a complementary simulation model of the readout electronics. We show that increasing the shaping time from 28.1 ns to 39.4 ns decreases the noise and increases the signal-to-noise ratio (SNR) with 6.5% at low count rates and we also present pulse shapes for each shaping time as measured at a synchrotron source. Our results demonstrate that the shaping time plays an important role in optimizing the dose efficiency in a photon-counting x-ray detector.
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| 10. |
- Sundberg, Christel, et al.
(författare)
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Silicon photon-counting detector for full-field CT usingan ASIC with adjustable shaping time
- 2020
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Ingår i: Journal of Medical Imaging. - : SPIE - International Society for Optical Engineering. - 2329-4302 .- 2329-4310. ; 7:5
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Photon-counting silicon strip detectors are attracting interest for use in next-generation CT scanners. For CT detectors in a clinical environment, it is desirable to have a low power consumption. However, decreasing the power consumption leads to higher noise. This is particularly detrimental for silicon detectors, which require a low noise floor to obtain a good dose efficiency. The increase in noise can be mitigated using a longer shaping time in the readout electronics. This also results in longer pulses, which requires an increased deadtime, thereby degrading the count-rate performance. However, as the photon flux varies greatly during a typical CT scan, not all projection lines require a high count-rate capability. We propose adjusting the shaping time to counteract the increased noise that results from decreasing the power consumption.Approach: To show the potential of increasing the shaping time to decrease the noise level, synchrotron measurements were performed using a detector prototype with two shaping time settings. From the measurements, a simulation model was developed and used to predict the performance of a future channel design.Results: Based on the synchrotron measurements, we show that increasing the shaping time from 28.1 to 39.4 ns decreases the noise and increases the signal-to-noise ratio with 6.5% at low count rates. With the developed simulation model, we predict that a 50% decrease in power can be attained in a proposed future detector design by increasing the shaping time with a factor of 1.875.Conclusion: Our results show that the shaping time can be an important tool to adapt the pulse length and noise level to the photon flux and thereby optimize the dose efficiency of photon-counting silicon detectors.
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