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- Ásgeirsdóttir, Helga, et al.
(författare)
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Depiction of anatomic structures of relevance for scoring of cystic fibrosis changes by chest tomosynthesis and computed tomography
- 2014
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Ingår i: Journal of Cystic Fibrosis. 37th European Cystic Fibrosis Conference, 11-14 June 2014, Gothenburg, Sweden. ; 13:Suppl. 2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Chest radiography (CR) and computed tomography (CT) are commonly used for imaging of patients with cystic fibrosis, and scoring is applied to assess disease severity. Chest tomosynthesis (CTS) is a new imaging modality providing better anatomic visualization than CR at radiation doses and costs lower than CT. Objective: To compare visibility and size of anatomic structures of relevance for scoring in CTS and CT images. Methods: 21 adult patients with cystic fibrosis were examined both with CTS (VolumeRAD; GE Healthcare) and volumetric CT (LightSpeed Pro 16, LightSpeed VCT, Discovery CT750HD; GE healthcare and Somatom Definition, Siemens Medical Solutions). The average effective dose for a standard patient was 0.13 and 4.5 mSv for CTS and CT, respectively. Comparison of visibility and manual measurements of diameters of the central and peripheral bronchi and their accompanying artery, as well as bronchial wall thickness (BWT), were performed in a non-blinded fashion. Results: All central structures could be evaluated. Mean difference in diameter of central bronchi, accompanying artery and BWT between CTS and CT was −0.6 (SD 0.6), −0.7 (SD 0.7) and −0.4 (SD 0.2) mm, respectively. Peripheral structures were more difficult to assess by CTS. Peripheral bronchial diameter, BWT and diameter of accompanying artery could be assessed by CTS in 20, 15 and 4 cases, respectively and mean difference between measurements was −0.5 (SD 0.5), −0.3 (SD 0.3) and −0.4 (SD 0.4) mm, respectively. Conclusion: This study indicates that peripheral structures are more difficult to evaluate by CTS and that CTS slightly underestimate size of structures in comparison to CT
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- Caragounis, Eva Corina, et al.
(författare)
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CT-lung volume estimates in trauma patients undergoing stabilizing surgery for flail chest.
- 2019
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Ingår i: Injury. - : Elsevier BV. - 1879-0267 .- 0020-1383. ; 50:1, s. 101-8
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Tidskriftsartikel (refereegranskat)abstract
- To estimate and compare lung volumes from pre- and post-operative computed tomography (CT) images and correlate findings with post-operative lung function tests in trauma patients with flail chest undergoing stabilizing surgery.Pre- and post-operative CT images of the thorax were used to estimate lung volumes in 37 patients who had undergone rib plate fixation at least 6 months before inclusion for flail chest due to blunt thoracic trauma. Computed tomography lung volumes were estimated from airway distal to each lung hilum by outlining air-filled lung tissue either manually in images of 5mm slice thickness or automatically in images of 0.6mm slice thickness. Demographics, pain, range of motion in the thorax, breathing movements and Forced Vital Capacity (FVC) were assessed. Total Lung Capacity (TLC) measurements were also made in a subgroup of patients (n=17) who had not been intubated at time of the initial CT. Post-operative CT lung volumes were correlated to FVC and TLC.Patients with a median age of 62 (19-90) years, a median Injury Severity Score (ISS) of 20 (9-54), and a median New Injury Severity Score (NISS) of 27 (17-66) were enrolled in the study. Median follow-up time was 3.9 (0.5-5.6) years. Two patients complained of pain at rest and when breathing. Pre-operative CT lung volumes were significantly different (p<0.0001) from post-operative CT lung volumes, 3.51l (1.50-6.05) vs. 5.59l (2.18-7.78), respectively. At follow-up, median FVC was 3.76l (1.48-5.84) and median TLC was 6.93l (4.21-8.42). Post-operative CT lung volumes correlated highly with both FVC [rs=0.75 (95% CI 0.57‒0.87, p<0.0001)] and TLC [rs=0.90 (95% CI 0.73‒0.96, p<0.0001)]. The operated thoracic side showed decreased breathing movements. Range of motion in the lower thorax showed a low correlation with FVC [rs=0.48 (95% CI 0.19‒0.70, p=0.002)] and a high correlation with TLC [rs=0.80 (95% CI 0.51‒0.92, p<0.0001)].Post-operative CT-lung volume estimates improve compared to pre-operative values in trauma patients undergoing stabilizing surgery for flail chest, and can be used as a marker for lung function when deciding which patient with chest wall injuries can benefit from surgery.
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- Hadesi, Parsa, et al.
(författare)
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Injury pattern and clinical outcome in patients with and without chest wall injury after cardiopulmonary resuscitation
- 2023
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Ingår i: Journal of Trauma and Acute Care Surgery. - 2163-0755 .- 2163-0763. ; 95:6, s. 855-860
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Cardiopulmonary resuscitation (CPR), although lifesaving may cause chest wall injury (CWI) because of the physical force exerted on the thorax. The impact of CWI on clinical outcome in this patient group is unclear. The primary aim of this study was to investigate the incidence of CPR-related CWI and the secondary aim to study injury pattern, length of stay (LOS), and mortality in patients with and without CWI. METHODS This is a retrospective study of adult patients who were admitted to our hospital due to cardiac arrest (CA) during 2012 to 2020. Patients were identified in the Swedish CPR Registry and those undergoing CT of the thorax within 2 weeks after CPR were included. Patients with traumatic CA, chest wall surgery prior or after CA were excluded. Demographic data, type and length of CPR, type of CWI, LOS on mechanical ventilator (MV), in intensive care unit (ICU) and in hospital (H), and mortality were studied. RESULTS Of 1,715 CA patients, 245 met the criteria for inclusion. The majority (79%) of the patients suffered from CWI. Chondral injuries and rib fractures were more common than sternum fractures (95% vs. 57%), and 14% had a radiological flail segment. Patients with CWI were older (66.5 ± 15.4 vs. 52.5 ± 15.2, p < 0.001). No difference was seen in MV-LOS (3 [0-43] vs. 3 [0-22]; p = 0.430), ICU-LOS (3 [0-48] vs. 3 [0-24]; p = 0.427), and H-LOS (5.5 [0-85] vs. 9.0 [1-53]; p = 0.306) in patients with or without CWI. Overall mortality within 30 days was higher with CWI (68% vs. 47%, p = 0.007). CONCLUSION Chest wall injuries are common after CPR and 14% of patients had a flail segment on CT. Elderly patients have an increased risk of CWI, and a higher overall mortality is seen in patients with CWI. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.
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- Larsson, Anne, et al.
(författare)
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Methods for estimating uptake and absorbed dose in tumours from I-125 labelled monoclonal antibodies, based on scintigraphic imaging of mice.
- 1999
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 38:3, s. 361-365
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Tidskriftsartikel (refereegranskat)abstract
- Monoclonal antibodies for radioimmunotargeting are often tested in tumour bearing nude mice. In vivo determination of the uptake of the monoclonal antibody in the tumour requires quantitative scintigraphy, and this in turn requires an adequate method for subtraction of radiation from the normal tissue. For this reason, two different methods for background subtraction were evaluated, a contralateral background region of interest or an irregular one, surrounding the tumour. A pinhole collimator was used for the scintigraphy and the monoclonal antibodies were labelled with 125I. Furthermore, a method was developed for estimation of the mean absorbed dose in the tumour from these repeated quantitative scintigraphic measurements. This requires that the tumour mass can be accurately estimated in vivo. Finally, the results were compared with in vitro measurements of the uptake.
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- Meltzer, Carin, et al.
(författare)
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Detection and Characterization of Solid Pulmonary Nodules at Digital Chest Tomosynthesis: Data from a Cohort of the Pilot Swedish Cardiopulmonary Bioimage Study
- 2018
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Ingår i: Radiology. - : Radiological Society of North America (RSNA). - 0033-8419 .- 1527-1315. ; 287:3, s. 1018-1027
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the performance of digital tomosynthesis (DTS) for detection and characterization of incidental solid lung nodules. Materials and Methods: This prospective study was based on a population study with 1111 randomly selected participants (age range, 50-64 years) who underwent a medical evaluation that included chest computed tomography (CT). Among these, 125 participants with incidental nodules 5 mm or larger were included in this study, which added DTS in conjunction with the follow-up CT and was performed between March 2012 and October 2014. DTS images were assessed by four thoracic radiologists blinded to the true number of nodules in two separate sessions according to the 5-mm (125 participants) and 6-mm (55 participants) cut-off for follow-up of incidental nodules. Pulmonary nodules were directly marked on the images by the readers and graded regarding confidence of presence and recommendation for follow-up. Statistical analyses included jackknife free-response receiver operating characteristic, receiver operating characteristic, and Cohen k coefficient. Results: Overall detection rate ranges of CT-proven nodules 5 mm or larger and 6 mm or larger were, respectively, 49%58% and 48%-62%. Jackknife free-response receiver operating characteristics figure of merit for detection of CT-proven nodules 5 mm or larger and 6 mm or larger was 0.47 and 0.51, respectively, and area under the receiver operating characteristic curve regarding recommendation for follow-up was 0.62 and 0.65, respectively. Conclusion: Routine use of DTS would result in lower detection rates and reduced number of small nodules recommended for follow-up. (C) RSNA, 2018.
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- Meltzer, Carin, et al.
(författare)
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Nodule mimics in chest tomosynthesis
- 2017
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Ingår i: World Congress of Thoracic Imaging. June 18-21, 2017, Boston, Massachusetts.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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- Mirzai, Maral, et al.
(författare)
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The Effect of Dose Reduction on Overall Image Quality in Clinical Chest Tomosynthesis
- 2021
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Ingår i: Academic Radiology. - : Elsevier BV. - 1076-6332. ; 28:10, s. 289-296
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Tidskriftsartikel (refereegranskat)abstract
- Rationale and Objectives: To evaluate the effect of reduction in effective dose on the reproduction of anatomical structures in chest tomosynthesis (CTS). Materials and Methods: Twenty-four CTS examinations acquired at exposure settings resulting in an effective dose of 0.12 mSv for an average sized patient were included in the study. The examinations underwent simulated dose reduction to dose levels corresponding to 32%, 50%, and 70% of the original dose using a previously described and validated method. The image quality was evaluated by five thoracic radiologists who rated the fulfillment of specified image quality criteria in a visual grading study. The ratings for each image quality criterion in the dose-reduced images were compared to the corresponding ratings for the full-dose examinations using visual grading characteristics (VGC) analysis. The area under the resulting VGC curve (AUCVGC) provides a measure of the difference between the ratings, where an AUCVGC of 0.5 indicates no difference. Results: The dose reductions resulted in inferior reproduction of structures compared to the original dose level (AUCVGC <0.5). Structures in the central region of the lung obtained the lowest AUCVGC for each dose level whereas the reproduction of structures in the parenchyma was least affected by the dose reduction. Conclusion: Although previous studies have shown that dose reduction in CTS is possible without affecting the performance of certain clinical tasks, the reproduction of normal anatomical structures is significantly degraded even at small reductions. It is therefore important to consider the clinical purpose of the CTS examinations before deciding on a permanent dose reduction. © 2020 The Association of University Radiologists
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