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- Pálsdóttir, K, et al.
(författare)
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Inter-observer agreement of transvaginal ultrasound and magnetic resonance imaging in local staging of cervical cancer.
- 2021
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 58:5, s. 773-779
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the inter-observer agreement in relation to observer experience for the assessment of local tumor extension in women with cervical cancer, using transvaginal ultrasound (US) and magnetic resonance imaging (MRI).METHODS: The observers comprised six US specialists with, and seven without previous experience of cervical cancer assessment, five experienced radiologists in pelvic MRI, and four less experienced radiology residents without previous MRI experience. The less experienced US observers, and all MRI observers underwent comprehensive training on assessment of cervical tumor extension while experienced US observers received written directives. All observers were assigned the same images from cervical cancer patients of all stages (n=60) for off-line evaluation on tumor detection, cervical stromal- (>1/3), and parametrial invasion. Inter-observer agreement was measured using Fleiss kappa, with 95% CI.RESULTS: Experienced and less experienced US observers had moderate agreement regarding tumor detection Fleiss κ [95% CI] (0.46 [0.40-0.53], and 0.46 [0.41-0.52]), stromal invasion (0.45 [0.38-0.51] and 0.53 [0.40-0.58]) and parametrial invasion (0.57 [0.51-0.64], and 0.44 [0.39-0.50]), respectively. Experienced and less experienced MRI observers had good κ [95% CI] (0.70 [0.62-0.78]) and moderate agreement (0.51 [0.41-0.62]), regarding tumor detection, good agreement regarding stromal invasion (0.80 [0.72-0.88] and 0.71 [0.61-0.81]) and parametrial invasion (0.69 [0.61-0.77] and 0.71[0.61-0.81]), respectively.CONCLUSION: The inter-observer agreement was moderate for US, and moderate - good for MRI regarding the assessment of local tumor extension. The level of inter-observer agreement was only associated with experience among US observers regarding parametrial invasion. This article is protected by copyright. All rights reserved.
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- Silvestri, M., et al.
(författare)
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Fine specificity and neutralizing activity of human serum antibodies directed to the major antigenic region on gp 116 of human cytomegalovirus
- 1993
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Ingår i: Serodiagnosis and Immunotherapy in Infectious Disease. - 0888-0786. ; 5:4, s. 209-216
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Tidskriftsartikel (refereegranskat)abstract
- The human antibody response to the conserved neutralization-related site on the gp 116 of human cytomegalovirus (HCMV) was investigated in healthy blood donors by the use of synthetic peptides. Anti-HCMV positive sera investigated in ELISA gave a reactivity of 48-56% with the peptide T7-13 (amino acids (aa) 67-86). Though epitope mapping revealed several individual fine specificities within this region, the average reactivity pattern was similar to that of the human monoclonal antibody (MAb) ITC88, the binding of which has been localized to aa 69-80. By the use of superparamagnetic Dynabeads coated with the peptide T7-13, serum antibodies were affinity isolated and the neutralizing activity was investigated. A clear reduction in infectivity was seen only with antibodies from one out of four sera and this serum exhibited a fine specificity nearly identical to that of MAb ITC88. A complete adsorption of antibodies to this site was not achieved, yet the results imply that antibodies against this region do not constitute a major part of the HCMV-neutralizing activity in human serum. The potent complement-independent neutralizing activity of antibodies directed to this site nevertheless suggests that it will contribute beneficially to a subunit vaccine.
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- Stranne, Johan, 1970, et al.
(författare)
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SPCG-15 : a prospective randomized study comparing primary radical prostatectomy and primary radiotherapy plus androgen deprivation therapy for locally advanced prostate cancer
- 2018
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Ingår i: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 52:5-6, s. 313-320
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe study design and procedures for a prospective randomized trial investigating whether radical prostatectomy (RP) ± radiation improves cause-specific survival in comparison with primary radiation treatment (RT) and androgen deprivation treatment (ADT) in patients with locally advanced prostate cancer (LAPC).Materials and methods: SPCG-15 is a prospective, multi-centre, open randomized phase III trial. Patients are randomized to either standard (RT + ADT) or experimental (RP with extended pelvic lymph-node dissection and with addition of adjuvant or salvage RT and/or ADT if deemed necessary) treatment. Each centre follows guidelines regarding the timing and dosing of postoperative RT and adjuvant treatment such as ADT The primary endpoint is cause-specific survival. Secondary endpoints include metastasis-free and overall survival, quality-of-life, functional outcomes and health-services requirements. Each subject will be followed up for a minimum of 10 years.Results: Twenty-three centres in Denmark, Finland, Norway and Sweden, well established in performing RP and RT for prostate cancer participated. Each country’s sites were coordinated by national coordinating investigators and sub-investigators for urology and oncology. Almost 400 men have been randomized of the stipulated 1200, with an increasing rate of accrual.Conclusions: The SPCG-15 trial aims to compare the two curatively intended techniques supplying new knowledge to support future decisions in treatment strategies for patients with LAPC The Scandinavian healthcare context is well suited for performing multi-centre long-term prospective randomized clinical trials. Similar care protocols and a history of entirely tax-funded healthcare facilitate joint trials.
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