| 1. |
- Almlöv, Karin, et al.
(författare)
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MRI Lymph Node Evaluation for Prediction of Metastases in Rectal Cancer
- 2020
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Ingår i: Anticancer Research. - : International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 40:5, s. 2757-2763
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore whether the size and characteristics of the largest regional lymph node in patients with rectal cancer, based on magnetic resonance imaging (MRI), following neoadjuvant therapy and before surgery, is able to identify patients at high risk of developing metachronous metastases.Patients and Methods: A retrospective case–control study with data from the Swedish Colo-Rectal Cancer Registry. Forty patients were identified with metachronous metastases (M+), and 40 patients without metastases (M0) were matched as controls.Results: Patients with M+ disease were more likely to have a regional lymph node measuring ≥5 mm than patients with M0. (87% vs. 65%, p=0.02). There was also a significant difference between the groups regarding the presence of an irregular border of the largest lymph node (68% vs. 40%, p=0.01).Conclusion: Lymph nodes measuring ≥5 mm with/without displaying irregular borders at MRI performed after neoadjuvant therapy emerged as risk factors for metachronous metastases in patients with rectal cancer. Intensified follow-up programmes may be indicated in these patients.
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| 2. |
- Björkman, Ann-Sofi, 1983-, et al.
(författare)
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Mobile learning device increased study efficiency for radiology residents but with risk of temporary novelty effect
- 2019
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Ingår i: Acta Radiologica Open. - : Sage Publications. - 2058-4601. ; 8:11, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Digital resources in learning are increasingly available and offer new possibilities in education. Mobile learning devices (MLD) such as tablets provide easy and flexible access for users.Purpose: To investigate whether the introduction of MLDs in radiology education affected time spent on studies over a longer time frame and whether learning behavior and attitudes changed.Material and Methods: The radiology residents employed during 2015–2016 were invited to participate in this 12-month MLD intervention study. Results were evaluated using online questionnaires at six months (6 m) and 12 months (12 m).Results: Thirty-one residents were included, of whom half were in the early stages of residency (<2 years). After the MLD introduction, most participants (91% [6 m] and 83% [12 m]) estimated increased time spent on studies. Of these, 32% stated “a lot more” at 6 m but only 8% at 12 m (P ¼ 0.12). The MLDs showed positive effects on the experience of radiology studies, as a majority of participants stated better quality and effectiveness in their studies (100% [6 m]–92% [12 m]), that MLD facilitated access to educational materials to a high degree (83% [6 m]–75% [12 m]), and that studies had become better and more fun (96% [6 m]–100% [12 m]).Conclusion: The use of MLDs seems to facilitate learning effectively for radiologic residents. However, a larger scale study is required as a trend of decreasing figures in the longer term was seen, but our results did not show a significant reduction of time spent on radiology studies.
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| 3. |
- Kataria, Bharti, 1955-, et al.
(författare)
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Image quality in CT thorax: effect of altering reconstruction algorithm and tube load : Image quality in CT thorax
- 2024
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Ingår i: Radiation Protection Dosimetry. - : Oxford University Press. - 0144-8420 .- 1742-3406. ; 200:5, s. 504-514
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Tidskriftsartikel (refereegranskat)abstract
- Non-linear properties of iterative reconstruction (IR) algorithms can alter image texture. We evaluated the effect of a model-basedIR algorithm (advanced modelled iterative reconstruction; ADMIRE) and dose on computed tomography thorax image quality.Dual-source scanner data were acquired at 20, 45 and 65 reference mAs in 20 patients. Images reconstructed with filteredback projection (FBP) and ADMIRE Strengths 3–5 were assessed independently by six radiologists and analysed using an ordinallogistic regression model. For all image criteria studied, the effects of tube load 20 mAs and all ADMIRE strengths were significant(p < 0.001) when compared to reference categories 65 mAs and FBP. Increase in tube load from 45 to 65 mAs showed imagequality improvement in three of six criteria. Replacing FBP with ADMIRE significantly improves perceived image quality for allcriteria studied, potentially permitting a dose reduction of almost 70% without loss in image quality
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| 4. |
- Kotti, Angeliki, et al.
(författare)
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Computed tomography-measured body composition and survival in rectal cancer patients: a Swedish cohort study
- 2022
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Ingår i: Cancer & Metabolism. - : BMC. - 2049-3002. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The association between body composition and survival in rectal cancer patients is still unclear. Therefore, we aimed to evaluate the impact of computed tomography (CT)-measured body composition on survival in rectal cancer patients, stratifying our analyses by sex, tumour location, tumour stage and radiotherapy. Methods This retrospective cohort study included 173 patients with rectal adenocarcinoma. CT colonography scans at the time of diagnosis were used to assess the skeletal muscle index (SMI) and the visceral adipose tissue area (VAT). The patients were divided into a low or high SMI group and a low or high VAT group according to previously defined cutoff values. Endpoints included cancer-specific survival (CSS) and overall survival (OS). Results In all patients, low SMI was associated with worse CSS (HR, 2.63; 95% CI, 1.35-5.12; P = 0.004) and OS (HR, 3.57; 95% CI, 2.01-6.34; P < 0.001) compared to high SMI. The differences remained significant after adjusting for potential confounders (CSS: adjusted HR, 2.28; 95% CI, 1.13-4.58; P = 0.021; OS: adjusted HR, 3.17; 95% CI, 1.73-5.82; P < 0.001). Low SMI was still related to a poor prognosis after stratifying by sex, tumour location, stage and radiotherapy (P < 0.05). High VAT was associated with better CSS (HR, 0.31; 95% CI, 0.11-0.84; P = 0.022) and OS (HR, 0.40; 95% CI, 0.17-0.97; P = 0.044) compared to low VAT among men with rectal cancer <= 10 cm from the anal verge. High VAT was associated with worse CSS (HR, 4.15; 95% CI, 1.10-15.66; P = 0.036) in women with rectal cancer <= 10 cm from the anal verge. Conclusions Low SMI was associated with worse survival. High VAT predicted better survival in men but worse survival in women. The results suggest that CT-measured body composition is a useful tool for evaluating the prognosis of rectal cancer patients and demonstrate the need to include the sex and the tumour location in the analyses.
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| 5. |
- Mohammadi, A., et al.
(författare)
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Comparison of multiphase data from CT perfusion vs clinical 4-phase CT scans with respect to image quality, lesion detection, and LI-RADS classification in HCC patients
- 2022
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Ingår i: Heliyon. - : Elsevier Science Ltd. - 2405-8440. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to assess the image quality and diagnostic performance of reconstructed arterial (A) and portal venous (PV) phases in computed tomography perfusion (CTP) scans compared to the corresponding phases in standard 4-phase CT and to assess the utility for LI-RADS classification using CTP and 4-phase 4CT. Methods: A total of 26 scans with each method (CTP and 4-phase CT) from 19 hepatocellular carcinoma patients were analyzed and compared. Arterial and PV phases reconstructed by advanced modeled iterative reconstruction at strength 4 (ADMIRE 4) from raw CTP data were compared with image sets from arterial and PV phases of 4-phase CT (ADMIRE 3) in the same patient with respect to image quality. Results: Quantitative image analysis showed that reconstructed CTP datasets were equivalent to 4-phase CT image sets. Qualitative image analysis revealed similar lesion detection rates with the 2 methods for patients with an abdominal diameter <= 36 cm and body weight <90 kg, but lower detection rates with CTP for patients with an abdominal diameter >37 cm. There was no difference in Liver Imaging Reporting and Data System (LI-RADS) classifications between the 2 methods. Conclusion: Reconstructed CTP images can potentially replace 4-phase CT images in patients weighing <90 kg and with a body diameter <37 cm, as the 2 methods are comparable in terms of quantitative image quality and ability to detect and classify lesions based on LI-RADS criteria.
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| 6. |
- Spångeus, Anna, 1975-, et al.
(författare)
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DENUSOMAB PERSISTENCE DURING THE COVID PANDEMIC (Poster 883)
- 2021
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To investigate the effect of the COVID-19 pandemic on denosumab persistence. Methods: All patients who initiated denosumab treatment at our outpatient care (osteoporosis/endocrinology unit) between 2016-2019 were included and date of injections were recorded from case records. Persistence was analyzed regarding 2-y persistence and 1-y persistence. Persistence was defined as a maximum interval of either 1) 8 months (m) [6+2m], or 2) 9m [6+3m]. Results: In total 171 patients were included. Mean age was 74.3+10.2 y (range 35-93 y) and 87% were women. Age and gender distribution did not differ significantly between the year of denosumab initiation. The 2-y persistence rate (8-m interval permitted) was lower in patients starting denosumab 2019 than those starting 2016-1018, i.e., 69% vs. 83%, p=0.044. No significant difference was seen analyzing 1-y persistence in the same groups (87 vs. 91%, p=0.410). When using a more liberal persistence definition, i.e., 9+m interval permitted, no difference was seen between 2 y persistence, 77 vs. 83%, p=0.341. Conclusion: The present study indicates that a higher number of patients got their injection later than recommended during the pandemic, but despite high pressure on our healthcare system and health concerns in the general population, no significant influence on denosumab persistence using a more liberal interval allowance was seen in this outpatient osteoporosis group.
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| 7. |
- Spångeus, Anna, Bitr Professor, 1975-, et al.
(författare)
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Prevalence of denosumab-induced hypocalcemia: a retrospective observational study of patients routinely monitored with ionized calcium post-injection
- 2024
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Ingår i: Osteoporosis International. - : SPRINGER LONDON LTD. - 0937-941X .- 1433-2965. ; 35:1, s. 173-180
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Tidskriftsartikel (refereegranskat)abstract
- Summary: We assessed the prevalence of hypocalcemia after denosumab injections in a real-world cohort routinely monitored for calcium during up to 7.5 years of treatment. Among 1096 injections in 242 patients, 6.3% resulted in hypocalcemia, and was independent of the injection number. Severe hypocalcemia was rare (1%).Purpose: To assess the prevalence of and risk factors for hypocalcemia after administration of denosumab in a patient cohort routinely monitored for ionized calcium after each dose.Methods: In this retrospective observational study, we analyzed denosumab-induced hypocalcemia in a real-world cohort who were routinely followed up with ionized calcium pre- and post-injection (within 31 days after injection) during the period 2011 to 2020.Results: In total, we included data from 1096 denosumab injections in 242 individuals (1–15 injections per patient). The mean age for the first injection was 74 ± 10 years, and 88% were female. Post-injection hypocalcemia occurred after 6.3% of all injections (4.6% mild, 0.6% moderate, and 1.1% severe) and was independent of the number of injections (rate of hypocalcemia varied from 3–8%). Risk factors for hypocalcemia were male sex, severe renal failure, pre-injection hypocalcemia, hypomagnesemia, hypophosphatemia, and vitamin D insufficiency. Furthermore, older age was not associated with an increased hypocalcemia risk.Conclusions: Denosumab-induced hypocalcemia is a prevalent adverse event, which occurs independently of the number of injections. However, severe hypocalcemia is a rare occurrence, and severe renal failure and nutritional status appear to be important predictive factors. Magnesium and phosphate might add value in the pre-injection risk assessment; however, this observation needs to be confirmed in larger cohorts.
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| 8. |
- Woisetschläger, Mischa, 1974-, et al.
(författare)
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Dual energy 4D-CT of parathyroid adenomas not clearly localized by sestamibi scintigraphy and ultrasonography - a retrospective study
- 2020
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Ingår i: European Journal of Radiology. - : Elsevier. - 0720-048X .- 1872-7727. ; 124
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: At present, the gold standard for diagnosing PAs includes ultrasonography of the neck and sestamibi scans of the parathyroid. The objective of this study was to evaluate scans performed in 4D-DECT (4D-dualenergy mode) at three different time points, in order to analyze spectral information from PAs, lymph nodes (LNs), and thyroid gland (Thy).Method: Fifteen patients (mean age: 57 +/- 18.9 years) with primary hyperparathyroidism, in which previous ultrasound and sestamibi scanning proved to be negative or equivocal, underwent 4D-DECT in three different phases. Hounsfield units (HU), dual-energy information (electron density [Rho], atomic number [Z], dual-energy index [DEW, and spectral information (keV) were determined.Results: For all energies, PAs exhibited significantly lower HU-values than the Thy in non-contrast images, and higher HU-values than LNs in the arterial phase (p < 0.05). All three tissues differed significantly in HU in the venous phase at 90 kV, 150 kV, and mixed 0.8 images; the Thy showed significantly higher HU-values than PAs or LNs in non-contrast images at 90 kV, 150 kV, mixed 0.8 images, and [Rho] (p < 0.05). LNs exhibited significantly lower HU-values than PAs and Thy in the arterial phase at 90 kV, 150 kV, mixed 0.8, Rho, Z, and DEI (p < 0.05). With regards to spectral information, lower energies showed greater HU differences between the three tissues. During the venous phase, there were significant differences between all three tissues up to 100 keV (p < 0.05).Conclusions: We identified significant differences in HU-values and spectral information between PAs, LNs, and Thy at different energies and contrast phases.
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| 9. |
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| 10. |
- Woisetschläger, Mischa, 1974-, et al.
(författare)
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Model for improved correlation of BMD values between abdominal routine dual-energy CT data and DXA scans
- 2018
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Ingår i: European Journal of Radiology. - : Elsevier BV. - 0720-048X .- 1872-7727. ; 99, s. 76-81
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background:Osteoporosis is a common but underdiagnosed and undertreated disease causing severe morbidity and economic burden. The gold standard for detection of osteoporosis is DXA (dual energy x-ray absorptiometry), which is a dedicated examination for osteoporosis. Dual energy CT (DECT) examinations are increasingly used in daily routine for a wide variety of diagnoses. In the present study, we wanted to examine whether vBMD (volume bone mass density) could be evaluated as a side product in non-contrast as well as contrast phases as well as to evaluate a correction model taking known shortcomings for DXA into account. Methods:A total of 20 patients, i.e. 79 vertebrae (one excluded due to vertebral fracture), mean age 71 years (range 43 – 85) with a mean BMI (body mass index) of 26 (range 17 – 33) were examined with both abdominal/pelvic DECT as well as DXA. Furthermore, aortic calcium was measured as well as the presence of osteoarthritis of the spine (OAS) and osteoarthritis in facet joints (OAF) with a 5-grade scaling system. Results:A significant correlation was found between DXA BMD and vBMD from DECT without with no contrast (WNC) (r=0.424, p=0.001), and with venous contrast (WVC) (r=0.402, p<0.001), but no significant correlation was found with arterial contrast (WAC). Using multivariate linear regression with DXA BMD as dependent, two models were created combining DECT WNC, aortic calciumscore (ACS), OAS and BMI yielding an R2 = 0.616 (model 1) and replacement of WNC to WVC a R2 = 0.612 (model 2). The Pearson correlation between DXA and predictive DXA BMD value of model 1 was r = 0.785 (p<0.001) and model 2 r = 0.782 (p<0.001).Conclusion:There is a correlation between DXA BMD and DECT in non-contrast and venous contrast scans but not in arterial scans. The correlation is further improved by quantifying the degree of different confounding factors (osteoarthritis of the spine, body mass index and aortic calcium score) and taking these into account in an explanatory model. Future software solutions with DECT data as input data might be able to automatically measure the BMD in the trabecular bone as well as measuring the confounding factors automatically in order to obtain spinal DXA comparable BMD values.
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