| 1. |
- Ansari, Daniel, et al.
(författare)
-
Pancreatic cancer : Yesterday, today and tomorrow
- 2016
-
Ingår i: Future Oncology. - : Future Medicine Ltd. - 1479-6694 .- 1744-8301. ; 12:16, s. 1929-1946
-
Tidskriftsartikel (refereegranskat)abstract
- Pancreatic cancer is one of our most lethal malignancies. Despite substantial improvements in the survival rates for other major cancer forms, pancreatic cancer survival rates have remained relatively unchanged since the 1960s. Pancreatic cancer is usually detected at an advanced stage and most treatment regimens are ineffective, contributing to the poor overall prognosis. Herein, we review the current understanding of pancreatic cancer, focusing on central aspects of disease management from radiology, surgery and pathology to oncology.
|
|
| 2. |
|
|
| 3. |
- Baubeta, Erik, et al.
(författare)
-
No gadolinium K‐edge detected on the first clinical photon‐counting computed tomography scanner
-
Ingår i: Journal of Applied Clinical Medical Physics. - 1526-9914. ; , s. 1-7
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThis study aimed to elucidate whether gadolinium contrast in clinically relevant doses can be used with photon-counting computed tomography (PCCT) as an alternative contrast agent in clinical applications.Material/methodsA CTDI phantom with 3D printed rods filled with different concentrations of gadolinium and iodine contrast was scanned in a PCCT and an energy-integrated computed tomography (EICT). Attenuation values at different monoenergetic steps were extracted for each contrast concentration.ResultsFor PCCT, gadolinium reached an attenuation >100 HU (103 HU) at 40 keV with a concentration 5 mmol/L whereas the same level was reached at 50 keV (118 HU) for 10 mmol/L and 90 keV (114 HU) for 25 mmol/L. For iodine, the same level of attenuation was reached at 100 keV (106 HU) with a concentration 8.75 mg I/mL.For EICT the lowest gadolinium contrast concentration needed to reach >100 HU (108 HU) was 10 mmol/L at 50 keV. For 25 mmol/L 100 HU was reached at 100 keV. For iodine contrast 108 HU was reached at 110 keV for 8.75 mg I/mL.ConclusionNo K-edge potential or difference in attenuation curves between iodine and gadolinium contrast is detected on the first clinical available PCCT. Clinically relevant attenuation levels were barely achieved in this setting with gadolinium concentrations approved for human use. The results of this study suggest that, given current scanning technology, gadolinium is not a clinically useful contrast agent for computed tomography because no K-edge was detected.
|
|
| 4. |
- Björk, Dennis, et al.
(författare)
-
Portal vein embolization with N-butyl-cyanoacrylate improves liver hypertrophy compared to microparticles – A Swedish multicenter cohort study
- 2023
-
Ingår i: Heliyon. - : CELL PRESS. - 2405-8440. ; 9:11
-
Tidskriftsartikel (refereegranskat)abstract
- Background: An adequate future liver remnant (FLR) is fundamental for major liver resections. To achieve sufficient FLR, portal vein embolization (PVE) may be used. The most effective material for PVE has yet to be determined. The aim of this study was to investigate the differences in FLR growth between n-butyl-cyanoacrylate glue (NBCA) and microparticles. Material/methodsa: retrospective study was performed at three Swedish hepatobiliary centers and included patients who underwent PVE 2013–2021. Electronic medical records were reviewed, and procedure-related data were collected. Data were analyzed with respect to embolizing material. Results: A total of 265 patients were included: 160 in the NBCA group and 105 in the microparticle group. The NBCA group had a higher degree of hypertrophy (12.1 vs. 9.4 % points, p = 0.003) and a higher resection rate (68 vs. 59 %, p = 0.01) than the microparticle group. Procedure-related data all indicated the superiority of NBCA. No difference in inducing hypertrophy was observed when comparing patients who received chemotherapy before PVE with those who received chemotherapy before and after PVE within the NBCA group. Discussion/conclusion: This retrospective multicenter study supports the superiority of NBCA compared to microparticles in the setting of PVE. Chemotherapy after PVE does not seem to negatively affect hypertrophy.
|
|
| 5. |
- Frühling, Petter, et al.
(författare)
-
Change in tissue resistance after irreversible electroporation in liver tumors as an indicator of treatment success : A multi-center analysis with long term follow-up
- 2024
-
Ingår i: European Journal of Surgical Oncology. - : Elsevier. - 0748-7983 .- 1532-2157. ; 50:9
-
Tidskriftsartikel (refereegranskat)abstract
- IntroductionA nationwide multicenter study was performed to examine whether there is a correlation between decrease in tissue resistance and time to local tumor recurrence after irreversible electroporation (IRE) in patients with hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRCLM).MethodsAll patients treated with IRE for liver tumors in Sweden from 2011 until 2018 were included. Patient characteristics and recurrence patterns were obtained from medical records and radiological imaging. All procedural data from the IRE hardware at the three hospitals performing IRE were retrieved. The resistance during each pulse and the change during each treatment were calculated. The electrode pair with the smallest decrease in tissue resistance was used and compared with the time to LTP.Results149 patients with 206 tumors were treated. Exclusion due to missing and inaccurate data resulted in 124 patients with 170 tumors for the analyses. In a multivariable Cox regression model, a smaller decrease in tissue resistance and larger tumor size were associated with shorter time to local tumor recurrence for CRCLM, but not for HCC.ConclusionThere was an association between a decrease in tissue resistance and time to local tumor recurrence for CRCLM. The decrease in resistance, in combination with a rise in current, may be the parameters the interventionist should use during IRE to decide if the treatment is successful.
|
|
| 6. |
- Frühling, Petter, et al.
(författare)
-
Irreversible electroporation of hepatocellular carcinoma and colorectal cancer liver metastases : A nationwide multicenter study with short- and long-term follow-up
- 2023
-
Ingår i: European Journal of Surgical Oncology. - : Elsevier. - 0748-7983 .- 1532-2157. ; 49:11
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: A nationwide multicenter study was performed to examine short- and long-term effects of irreversible electroporation (IRE) for hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRCLM). IRE is an alternative method when thermal ablation is contraindicated because of risk for serious thermal complications.Methods: All consecutive patients in Sweden treated with IRE because of HCC or CRCLM, were included between 2011 and 2018. We evaluated medical records and radiological imaging to obtain information regarding patient-, tumor-, and treatment characteristics. We also assessed local tumor progression, and survival.Results: In total 206 tumors in 149 patients were treated with IRE. Eighty-seven patients (58.4%) had colorectal cancer liver metastases, and 62 patients (41.6%) had hepatocellular carcinoma. Median tumor size was 20 mm (i. q.r. 14-26 mm). Median overall survival for CRCLM and HCC, were 27.0 months (95% CI 22.2-31.8 months), and 35.0 months (95% CI 13.8-56.2 months), respectively. Median follow-up time was 58 months (95% CI 50.6-65.4). Local ablation success at six and twelve months for HCC was 58.3% and 40.3%, and for CRCLM 37.7% and 25.4%. The median time to local tumor progression (LTP) for HCC was 21.0 months (95% CI: 9.5-32.5 months), and for CRCLM 6.0 months (95% CI: 4.5-7.5 months). At 30-day follow-up, 15.4% (n = 23) of patients suffered from a complication rated as Clavien-Dindo grade 1-3a. Three patients (2.0%) had grade 3b-5 with one death in a thromboembolic event.Conclusion: IRE is a safe ablation modality for patients with liver tumors that are located in such a way that other treatment options are unsuitable.
|
|
| 7. |
- Gadsbøll, Eva Laurin, et al.
(författare)
-
Virtual non-contrast images in photon-counting computed tomography: impact of different contrast phases
-
Ingår i: Acta Radiologica. - 1600-0455.
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPhoton-counting computed tomography (PCCT) enables new ways of image reconstruction, e.g. material decomposition and creation of virtual non-contrast (VNC) series with higher resolution and lower radiation dose than standard computed tomography (CT). Clinical experiences of this are limited.PurposeTo compare true non-contrast (TNC) series with VNC series derived from non-enhanced (VNCu), arterial phase (VNCa) and portal venous phase (VNCv) in clinically approved PCCT.Material and MethodsA total of 45 clinical, tri-phasic abdominal CT scans from the PCCT Naetom Alpha, between February 2022 and November 2022, were retrospectively assessed. Placing a region of interest in six different locations in each VNC series – right liver parenchyma, left liver parenchyma, spleen, aorta, erector spinae muscle, and in the subcutaneous fat – absolute Hounsfield values (HU) and standard deviations (SD) were collected. Differences in HU (ΔHU) were compared and statistically analyzed.ResultsStatistically significant differences between VNC and TNC were seen in all measurements, with the largest difference in the subcutaneous fat and the smallest difference in the erector spinae muscle. Only small differences were seen between VNCa and VNCv, where the largest differences were seen in the left and right liver lobes.ConclusionVNC images from the first-generation clinically approved PCCT showed a significant difference between VNC and TNC images. The differences vary with the type of tissue. Only small differences were seen depending from which contrast phase the VNC was derived.
|
|
| 8. |
- Gisselsson Nord, David, et al.
(författare)
-
Generation of trisomies in cancer cells by multipolar mitosis and incomplete cytokinesis.
- 2010
-
Ingår i: Proceedings of the National Academy of Sciences. - : Proceedings of the National Academy of Sciences. - 1091-6490 .- 0027-8424. ; 107:47, s. 20489-20493
-
Tidskriftsartikel (refereegranskat)abstract
- One extra chromosome copy (i.e., trisomy) is the most common type of chromosome aberration in cancer cells. The mechanisms behind the generation of trisomies in tumor cells are largely unknown, although it has been suggested that dysfunction of the spindle assembly checkpoint (SAC) leads to an accumulation of trisomies through failure to correctly segregate sister chromatids in successive cell divisions. By using Wilms tumor as a model for cancers with trisomies, we now show that trisomic cells can form even in the presence of a functional SAC through tripolar cell divisions in which sister chromatid separation proceeds in a regular fashion, but cytokinesis failure nevertheless leads to an asymmetrical segregation of chromosomes into two daughter cells. A model for the generation of trisomies by such asymmetrical cell division accurately predicted several features of clones having extra chromosomes in vivo, including the ratio between trisomies and tetrasomies and the observation that different trisomies found in the same tumor occupy identical proportions of cells and colocalize in tumor tissue. Our findings provide an experimentally validated model explaining how multiple trisomies can occur in tumor cells that still maintain accurate sister chromatid separation at metaphase-anaphase transition and thereby physiologically satisfy the SAC.
|
|
| 9. |
- Holmquist, Fredrik, et al.
(författare)
-
80-kV(p) hepatic CT to reduce contrast medium dose in azotemic patients: a feasibility study
- 2020
-
Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 61:4, s. 441-449
-
Tidskriftsartikel (refereegranskat)abstract
- Background Low peak kilovoltage (kV(p)) computed tomography (CT) may be used to reduce contrast medium doses in patients at risk of contrast medium-induced acute kidney injury if image noise can be controlled by increasing X-ray tube loading (mAs). Purpose To evaluate objective and subjective image quality in 80-kV(p) CT with reduced contrast medium dose and compensated mAs for unchanged image noise in patients with estimated glomerular filtration rate Material and Methods 80-kV(p) CT with 300 mg I/kg in 40 patients (body mass index 18-32 kg/m(2), glomerular filtration rate <45 mL/min) and 120-kV(p) CT with 500 mg I/kg in 40 patients (body mass index = 17-30 kg/m(2), glomerular filtration rate >= 45 mL/min) was compared on mean hepatic attenuation, image noise, contrast medium enhancement, signal-to-noise ratio, contrast-to-noise ratio, effective radiation dose, and subjective image quality. Results There were no significant differences regarding median hepatic post-contrast attenuation, image noise, contrast medium enhancement, signal-to-noise ratio, contrast-to-noise ratio, or effective dose between the 80-kV(p) and 120-kV(p) cohorts: 114/110 HU; 14/14 HU; 57/53 HU; 8.0/7.4; 3.8/3.5; and 5.3/5.9 mSv, respectively. However, subjective image visual grading showed statistically significantly inferior scores for 80 kV(p) for six of eight items. After exclusion of seven inferior examinations not caused by the chosen kV(p) technique, only three items showed inferior scores for 80 kV(p). Only 5% of gradings regarding overall image quality were Conclusion Despite lower subjective image quality, objective data indicate that 80-kV(p) CT with reduced contrast medium doses and compensated mAs may have the potential to provide satisfactory diagnostic quality in patients with body mass index <30 kg/m(2), which could benefit patients at risk of contrast medium-induced acute kidney injury.
|
|
| 10. |
- Holmquist, Fredrik, et al.
(författare)
-
Can iterative reconstruction algorithms replace tube loading compensation in low kVp hepatic CT? Subjective versus objective image quality
- 2020
-
Ingår i: Acta Radiologica Open. - : SAGE Publications. - 2058-4601 .- 2058-4601. ; 9:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Hepatic computed tomography (CT) with decreased peak kilovoltage (kVp) may be used to reduce contrast medium doses in patients at risk of contrast-induced acute kidney injury (CI-AKI); however, it increases image noise. To preserve image quality, noise has been controlled by X-ray tube loading (mAs) compensation (TLC), i.e. increased mAs. Another option to control image noise would be to use iterative reconstructions (IR) algorithms without TLC (No-TLC). It is unclear whether this may preserve image quality or only reduce image noise. Purpose: To evaluate image quality of 80 kVp hepatic CT with TLC and filtered back projection (FBP) compared with 80 kVp with No-TLC and IR algorithms (SAFIRE 3 and 5) in patients with eGFR <45 mL/min. Material and Methods: Forty patients (BMI 18-32 kg/m(2)) were examined with both protocols following injection of 300 mg I/kg. Hepatic attenuation, image noise, enhancement, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality were evaluated for each patient. Results: Comparing TLC/FBP with No-TLC/IR-S5, there were no significant differences regarding hepatic attenuation, image noise, enhancement, SNR and CNR: 114 vs. 115 HU, 14 vs. 14 HU, 55 vs. 57 HU, 8.0 vs. 8.4, and 3.8 vs. 4.0 in median, respectively. No-TLC/IR-S3 resulted in higher image noise and lower SNR and CNR than TLC/FBP. Subjective image quality scoring with visual grading showed statistically significantly inferior scores for IR-S5 images. Conclusion: CT of 80 kVp to reduce contrast medium dose in patients at risk of CI-AKI combined with IR algorithms with unchanged tube loading to control image noise does not provide sufficient diagnostic quality.
|
|
