| 1. |
- Blystad, Ida, 1972-
(författare)
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Clinical Applications of Synthetic MRI of the Brain
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Magnetic Resonance Imaging (MRI) has a high soft-tissue contrast with a high sensitivity for detecting pathological changes in the brain. Conventional MRI is a time-consuming method with multiple scans that relies on the visual assessment of the neuroradiologist. Synthetic MRI uses one scan to produce conventional images, but also quantitative maps based on relaxometry, that can be used to quantitatively analyse tissue properties and pathological changes. The studies presented here apply the use of synthetic MRI of the brain in different clinical settings.In the first study, synthetic MR images were compared to conventional MR images in 22 patients. The contrast, the contrast-to-noise ratio, and the diagnostic quality were assessed. Image quality was perceived to be inferior in the synthetic images, but synthetic images agreed with the clinical diagnoses to the same extent as the conventional images.Patients with early multiple sclerosis were analysed in the second study. In patients with multiple sclerosis, contrast-enhancing white matter lesions are a sign of active disease and can indicate a need for a change in therapy. Gadolinium-based contrast agents are used to detect active lesions, but concern has been raised regarding the long-term effects of repeated use of gadolinium. In this study, relaxometry was used to evaluate whether pre-contrast injection tissue-relaxation rates and proton density can identify active lesions without gadolinium. The findings suggest that active lesions often have relaxation times and proton density that differ from non-enhancing lesions, but with some overlap. This makes it difficult to replace gadolinium-based contrast agent injection with synthetic MRI in the monitoring of MS patients.Malignant gliomas are primary brain tumours with contrast enhancement due to a defective blood-brain barrier. However, they also grow in an infiltrative, diffuse manner, making it difficult to clearly delineate them from surrounding normal brain tissue in the diagnostic workup, at surgery, and during follow-up. The contrast-enhancing part of the tumour is easily visualised, but not the diffuse infiltration. In studies three and four, synthetic MRI was used to analyse the peritumoral area of malignant gliomas, and revealed quantitative findings regarding peritumoral relaxation changes and non-visible contrast enhancement suggestive of non-visible infiltrative tumour growth.In conclusion, synthetic MRI provides quantitative information about the brain tissue and this could improve the diagnosis and treatment for patients.
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| 2. |
- DeCarli, Charles, et al.
(författare)
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Measures of brain morphology and infarction in the framingham heart study: establishing what is normal.
- 2005
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Ingår i: Neurobiology of aging. - : Elsevier BV. - 0197-4580. ; 26:4, s. 491-510
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Tidskriftsartikel (refereegranskat)abstract
- Numerous anatomical and brain imaging studies find substantial differences in brain structure between men and women across the span of human aging. The ability to extend the results of many of these studies to the general population is limited, however, due to the generally small sample size and restrictive health criteria of these studies. Moreover, little attention has been paid to the possible impact of brain infarction on age-related differences in regional brain volumes. Given the current lack of normative data on gender and aging related differences in regional brain morphology, particularly with regard to the impact of brain infarctions, we chose to quantify brain MRIs from more than 2200 male and female participants of the Framingham Heart Study who ranged in age from 34 to 97 years. We believe that MRI analysis of the Framingham Heart Study more closely represents the general population enabling more accurate estimates of regional brain changes that occur as the consequence of normal aging. As predicted, men had significantly larger brain volumes than women, but these differences were generally not significant after correcting for gender related differences in head size. Age explained approximately 50% of total cerebral brain volume differences, but age-related differences were generally small prior to age 50, declining substantially thereafter. Frontal lobe volumes showed the greatest decline with age (approximately 12%), whereas smaller differences were found for the temporal lobes (approximately 9%). Age-related differences in occipital and parietal lobe were modest. Age-related gender differences were generally small, except for the frontal lobe where men had significantly smaller lobar brain volumes throughout the age range studied. The prevalence of MRI infarction was common after age 50, increased linearly with age and was associated with significantly larger white matter hyperintensity (WMH) volumes beyond that associated with age-related differences in these measures. Amongst men, the presence of MRI infarction was associated with significant age-related reductions in total brain volume. Finally, statistically significant associations were found between the volume of MRI infarcts in cubic centimeters and all brain measures with the exception of parietal lobe volume for individuals where the volume of MRI infarctions was measured. These data serve to define age and gender differences in brain morphology for the Framingham Heart Study. To the degree participants of the Framingham Heart Study are representative the general population, these data can serve as norms for comparison with morphological brain changes associated with aging and disease. In this regard, these cross-sectional quantitative estimates suggest that age-related tissue loss differs quantitatively and qualitatively across brain regions with only minor differences between men and women. In addition, MRI evidence of cerebrovascular disease is common to the aging process and associated with smaller regional brain volumes for a given age, particularly for men. We believe quantitative MRI studies of the Framingham community enables exploration of numerous issues ranging from understanding normal neurobiology of brain aging to assessing the impact of various health factors, particularly those related to cerebrovascular disease, that appear important to maintaining brain health for the general population.
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| 3. |
- Emblem, Kyrre E, et al.
(författare)
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Glioma grading by using histogram analysis of blood volume heterogeneity from MR-derived cerebral blood volume maps.
- 2008
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Ingår i: Radiology. - : Radiological Society of North America (RSNA). - 0033-8419 .- 1527-1315. ; 247:3, s. 808-17
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To retrospectively compare the diagnostic accuracy of an alternative method used to grade gliomas that is based on histogram analysis of normalized cerebral blood volume (CBV) values from the entire tumor volume (obtained with the histogram method) with that of the hot-spot method, with histologic analysis as the reference standard.MATERIALS AND METHODS: The medical ethics committee approved this study, and all patients provided informed consent. Fifty-three patients (24 female, 29 male; mean age, 48 years; age range, 14-76 years) with histologically confirmed gliomas were examined with dynamic contrast material-enhanced 1.5-T magnetic resonance (MR) imaging. CBV maps were created and normalized to unaffected white matter (normalized CBV maps). Four neuroradiologists independently measured the distribution of whole-tumor normalized CBVs and analyzed this distribution by classifying the values into area-normalized bins. Glioma grading was performed by assessing the normalized peak height of the histogram distributions. Logistic regression analysis and interobserver agreement were used to compare the proposed method with a hot-spot method in which only the maximum normalized CBV was used.RESULTS: For the histogram method, diagnostic accuracy was independent of the observer. Interobserver agreement was almost perfect for the histogram method (kappa = 0.923) and moderate for the hot-spot method (kappa = 0.559). For all observers, sensitivity was higher with the histogram method (90%) than with the hot-spot method (55%-76%).CONCLUSION: Glioma grading based on histogram analysis of normalized CBV heterogeneity is an alternative to the established hot-spot method, as it offers increased diagnostic accuracy and interobserver agreement.
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| 4. |
- Falk Delgado, Anna
(författare)
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Preoperative MRI and PET in suspected low-grade gliomas : Radiological, neuropathological and clinical intersections
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Gliomas are neuroepithelial tumours classified by cell type and grade. In adults, low-grade gliomas are comprised mainly of astrocytomas and oligodendrogliomas grade II. The aim was to non-invasively characterise suspected low-grade gliomas through use of 11C-methionine-PET and physiological MRI in order to facilitate treatment decisions.Materials and methods: Patients with suspected low-grade glioma were prospectively and consecutively included after referral to the Neurosurgical Department, Uppsala University Hospital, between February 2010 and February 2014. All patients underwent morphological MRI, perfusion MRI, diffusion MRI and 11C-methionine PET. The institutional review board approved the study, and written informed consent was obtained prior to participation from each patient.Results: 11C-methionine PET hot spot regions corresponded spatially with regions of maximum relative cerebral blood volume in dynamic susceptibility contrast (DSC) perfusion MRI. The skewness of the transfer constantin dynamic contrast-enhanced (DCE) perfusion MRI, and the standard deviation of relative cerebral blood flow in DSC perfusion MRI could most efficiently discriminate between glioma grades II and III. In diffusion MRI, tumour fractional anisotropy differed between suspected low-grade gliomas of different neuropathological types. Quantitative diffusion tensor tractography was applicable for the evaluation of tract segment infiltration.Conclusion: PET and physiological MRI are able to characterise low-grade gliomas and are promising tools for guiding therapy and clinical decisions before neuropathological diagnosis has been obtained.
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| 5. |
- Fedorova, Irina, et al.
(författare)
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Analyzing Boron in 9-12% Chromium Steels Using Atom Probe Tomography
- 2019
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Ingår i: Microscopy and Microanalysis. - 1435-8115 .- 1431-9276. ; 25:2, s. 462-469
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Tidskriftsartikel (refereegranskat)abstract
- Microscopy Society of America 2019. Small additions of boron can remarkably improve the long-term creep resistance of 9-12% Cr steels. The improvement has been attributed to boron segregation to grain boundaries during quenching, and subsequent boron incorporation into certain families of precipitates during tempering. However, the detailed mechanisms are not yet fully understood. Atom probe tomography (APT) is an excellent technique for gaining insights into boron distribution, however, in order to acquire accurate analysis of boron in 9-12% Cr steels using APT, there are several key challenges. In order to better understand and address these challenges, we developed a novel method for site-specific APT specimen preparation, which enables convenient preparation of specimens containing specifically selected grain boundaries positioned approximately perpendicular to the axis of the APT tip. Additionally, when analyzing boron at boundaries and in carbides (as diluted solute) and borides, a widening of the profile of boron distribution compared to other elements was repeatedly observed. This phenomenon is particularly analyzed and discussed in light of the evaporation field of different elements. Finally, the possible effects of detector dead-time on quantitative analysis of boron in metal borides are discussed. A simple method using 10B correction was used to obtain good quantification.
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| 6. |
- Fedorova, I., et al.
(författare)
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Fine (Cr,Fe)2B borides on grain boundaries in a 10Cr–0.01B martensitic steel
- 2018
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Ingår i: Scripta Materialia. - : Elsevier BV. - 1359-6462. ; 156, s. 124-128
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Tidskriftsartikel (refereegranskat)abstract
- A 10Cr creep resistant martensitic steel with 108 ppm B was normalized at 1100 °C for 1 h and air cooled. Fine (Cr,Fe)2B borides were observed on the majority of prior austenite grain boundaries, all of which were high angle boundaries, as revealed by EBSD-based reconstruction of parent austenite grains. Some high angle boundaries including twin boundaries were boride-free. Segregation of boron to austenite grain boundaries during slow cooling from 1100 °C led to boride nucleation and growth. Their size increased with decreasing cooling rate. Borides were verified by atom probe tomography, auger spectroscopy, transmission and scanning electron microscopy.
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| 7. |
- Fougner, Stine L, et al.
(författare)
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The clinical response to somatostatin analogues in acromegaly correlates to the somatostatin receptor subtype 2a protein expression of the adenoma.
- 2008
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Ingår i: Clinical Endocrinology. - : Wiley. - 0300-0664 .- 1365-2265. ; 68:3, s. 458-65
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Reduced expression of the somatostatin receptor subtype 2 (SSTR2) has been suggested as an explanation for the poor response to octreotide in acromegaly, but studies correlating levels of SSTR2 mRNA to octreotide efficacy have been contradictory. Some studies have found better responses to somatostatin analogues in G-protein alpha subunit (Gsalpha) mutation (gsp oncogene)-positive adenomas. The aim of this study was to determine adenoma SSTR2a protein expression and gsp status in a large group of patients with acromegaly, and relate this to the clinical effect of octreotide.PATIENTS: Seventy-one patients were included. All underwent transsphenoidal surgery, 23 patients after preoperative octreotide treatment.MEASUREMENTS: The adenoma SSTR2a expression was examined by immunohistochemistry and Western blot analysis, and gsp status determined. An acute octreotide test was performed, and the change in IGF-1 level after 6 months preoperative octreotide treatment was recorded.RESULTS: The acute octreotide response in non-pretreated patients and the preoperative long-term octreotide response were significantly better in patients with adenomas containing a large proportion of cells that stained positively for SSTR2a by immunohistochemistry. However, the SSTR2a protein level assessed by Western blot did not correlate with the octreotide response. The preoperatively treated group had lower SSTR2a protein levels and fewer adenomas with a large percentage of positively stained cells. The gsp oncogene was detected in 43% of the adenomas but did not correlate to the octreotide response.CONCLUSION: The clinical effect of octreotide correlates with the proportion of cells positive for SSTR2a in immunohistochemical staining, rather than the adenoma SSTR2a protein level. There may be a down-regulation of SSTR2a during octreotide treatment.
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| 8. |
- Fougner, Stine Lyngvi, et al.
(författare)
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The expression of E-cadherin in somatotroph pituitary adenomas is related to tumor size, invasiveness, and somatostatin analog response
- 2010
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 95:5, s. 2334-2342
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Appropriate cell-to-cell adhesion is fundamental for the epithelial phenotype of pituitary cells. Loss of the adhesion protein E-cadherin has been associated with invasiveness, metastasis, and poor prognosis in cancers of epithelial origin. In somatotroph adenomas, a variable and reduced expression of E-cadherin has been demonstrated. In addition, nuclear translocation of E-cadherin was found to correlate with pituitary tumor invasion.OBJECTIVE: The objective was to examine the protein expression of E-cadherin in somatotroph pituitary adenomas in relation to adenoma size, invasiveness, and somatostatin analog (SMS) efficacy.PATIENTS AND METHODS: Eighty-three patients were included, and 29 were treated preoperatively with SMS. Adenoma E-cadherin protein expression was analyzed by Western blot (61 patients) and immunohistochemistry (IHC) (80 patients) with antibodies directed against both extracellular and intracellular domains (IHC). The acute (direct surgery group) and long-term (preoperatively treated group) SMS responses were evaluated. Baseline tumor volume and invasiveness were measured on magnetic resonance imaging scans.RESULTS: Membranous E-cadherin was lost in several adenomas. Nine of these were nuclear E-cadherin positive. The E-cadherin protein expression correlated negatively to tumor size and positively to acute SMS response. Low E-cadherin levels (preoperatively treated group only) and loss of membranous E-cadherin correlated to tumor invasiveness. The E-cadherin level correlated positively to tumor reduction after SMS treatment, and adenomas with nuclear E-cadherin staining had lower IGF-I reduction and tumor shrinkage. Preoperatively treated adenomas had reduced E-cadherin protein levels, but the IHC expression was unaltered.CONCLUSION: Reduced E-cadherin expression may correlate to a dedifferentiated phenotype in the somatotroph pituitary adenomas.
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| 9. |
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| 10. |
- Liu, Fang, 1975, et al.
(författare)
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A new 12% chromium steel strengthened by Z-phase precipitates
- 2016
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Ingår i: Scripta Materialia. - : Elsevier BV. - 1359-6462. ; 113, s. 93-96
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Tidskriftsartikel (refereegranskat)abstract
- In order to increase the corrosion resistance and simultaneously maintain the creep resistance of 9–12% Cr steels at 650 °C, a new alloy design concept was proposed, using thermodynamically stable Z-phase (CrTaN) precipi- tates to strengthen the steel. A new trial Z-phase strengthened 12% Cr steel was produced and creep tested. The steel exhibited good long-term creep resistance. Dense nano-sized Z-phase precipitates were formed at an early stage, and coarsened slowly. They remained small after more than 10,000 h.
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