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| 4. |
- Al Nouh, Micheline, et al.
(författare)
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Favourable outcome in survivors of CPR-related chest wall injuries
- 2024
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Ingår i: INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED. - 0020-1383 .- 1879-0267. ; 55:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a lack of studies focusing on long -term chest function after chest wall injury due to cardiopulmonary resuscitation (CPR). The purpose of this cross-sectional study was to investigate long -term pain, lung function, physical function, and fracture healing after manual or mechanical CPR and in patients with and without flail chest. Methods: Patients experiencing out -of -hospital cardiac arrest between 2013 and 2020 and transported to Sahlgrenska University Hospital were identified. Survivors who had undergone a computed tomography (CT) showing chest wall injury were contacted. Thirty-five patients answered a questionnaire regarding pain, physical function, and quality of life and 25 also attended a clinical examination to measure the respiratory and physical functions 3.9 (SD 1.7, min 2 -max 8) years after the CPR. In addition, 22 patients underwent an additional CT scan to evaluate fracture healing. Results: The initial CT showed bilateral rib fractures in all but one patient and sternum fracture in 69 %. At the time of the follow-up none of the patients had persistent pain, however, two patients were experiencing local discomfort in the chest wall. Lung function and thoracic expansion were significantly lower compared to reference values (FVC 14 %, FEV1 18 %, PEF 10 % and thoracic expansion 63 %) ( p < 0.05). Three of the patients had remaining unhealed injuries. Patients who had received mechanical CPR in additional to manual CPR had a lower peak expiratory flow (80 vs 98 % of predicted values) ( p =0.030) =0.030) and those having flail chest had less range of motion in the thoracic spine (84 vs 127 % of predicted) ( p = 0.019) otherwise the results were similar between the groups. Conclusion: None of the survivors had long -term pain after CPR-related chest wall injuries. Despite decreased lower lung function and thoracic expansion, most patients had no limitations in physical mobility. Only minor differences were seen after manual vs. mechanical CPR or with and without flail chest.
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| 5. |
- 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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| 6. |
- 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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| 7. |
- 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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| 8. |
- 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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| 9. |
- 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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| 10. |
- 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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| 11. |
- 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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| 12. |
- Norlén, Alexander, 1988, et al.
(författare)
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Automatic pericardium segmentation and quantification of epicardial fat from computed tomography angiography
- 2016
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Ingår i: Journal of Mecial Imaging. - 2329-4302 .- 2329-4310. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- Recent findings indicate a strong correlation between the risk of future heart disease and the volume ofadipose tissue inside of the pericardium. So far, large-scale studies have been hindered by the fact that manual delin-eation of the pericardium is extremely time-consuming and that existing methods for automatic delineation strugglewith accuracy. In this paper, an efficient and fully automatic approach to pericardium segmentation and epicardial fatvolume estimation is presented, based on a variant of multi-atlas segmentation for spatial initialization and a randomforest classifier for accurate pericardium detection. Experimental validation on a set of 30 manually delineated Com-puter Tomography Angiography (CTA) volumes shows a significant improvement on state-of-the-art in terms of EFVestimation (mean absolute epicardial fat volume difference: 3.8 ml (4.7%), Pearson correlation: 0.99) with run-timessuitable for large-scale studies (52 s). Further, the results compare favorably to inter-observer variability measured on10 volumes.
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| 16. |
- Rossi-Norrlund, Rauni, 1962, et al.
(författare)
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EVALUATION OF TWO CHEST TOMOSYNTHESIS CYSTIC FIBROSIS SCORING SYSTEMS USING HIGH-RESOLUTION COMPUTED TOMOGRAPHY BRODY SCORING AS REFERENCE
- 2021
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Ingår i: Radiation Protection Dosimetry. - : Oxford University Press (OUP). - 0144-8420 .- 1742-3406. ; 195:3-4, s. 443-453
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate two chest tomosynthesis (CTS) scoring systems for cystic fibrosis (CF), one system developed by Vult von Steyern et al. (VvS) and one system based on the Brody scoring system for high-resolution computed tomography (HRCT) (modified Brody (mB)). Brody scoring of HRCT was used as reference. Methods: In conjunction with routine control HRCT at clinical follow-up, 10 consecutive adult CF patients underwent CTS for research purposes. Four radiologists scored the CTS examinations using the mB and VvS scoring systems. All scores were compared to the Brody HRCT scores. The agreement between the evaluated CTS scoring systems and the reference HRCT scoring system was determined using Spearman's rank correlation coefficient and the intraclass correlation coefficient (ICC). Major findings: Spearman's rank correlation coefficient showed strong correlations between HRCT score and both the mB and the VvS CTS total scores (median r(s) = 0.81 and 0.85, respectively). The ICC showed strong correlation between the CTS scoring systems and the reference: 0.88 for mB and 0.85 for VvS scoring. The median time for scoring was 20 and 10 minutes for the mB and VvS scoring systems, respectively. Conclusions: Both evaluated CTS scoring systems correlate well with the reference standard Brody HRCT scoring. The VvS CTS scoring system has a shorter reading time, suggesting its advantage in clinical practice.
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| 17. |
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| 18. |
- Rylander, Christian, 1960, et al.
(författare)
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Uneven distribution of ventilation in acute respiratory distress syndrome
- 2005
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Ingår i: Crit Care. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The aim of this study was to assess the volume of gas being poorly ventilated or non-ventilated within the lungs of patients treated with mechanical ventilation and suffering from acute respiratory distress syndrome (ARDS). METHODS: A prospective, descriptive study was performed of 25 sedated and paralysed ARDS patients, mechanically ventilated with a positive end-expiratory pressure (PEEP) of 5 cmH2O in a multidisciplinary intensive care unit of a tertiary university hospital. The volume of poorly ventilated or non-ventilated gas was assumed to correspond to a difference between the ventilated gas volume, determined as the end-expiratory lung volume by rebreathing of sulphur hexafluoride (EELVSF6), and the total gas volume, calculated from computed tomography images in the end-expiratory position (EELVCT). The methods used were validated by similar measurements in 20 healthy subjects in whom no poorly ventilated or non-ventilated gas is expected to be found. RESULTS: EELVSF6 was 66% of EELVCT, corresponding to a mean difference of 0.71 litre. EELVSF6 and EELVCT were significantly correlated (r2 = 0.72; P < 0.001). In the healthy subjects, the two methods yielded almost identical results. CONCLUSION: About one-third of the total pulmonary gas volume seems poorly ventilated or non-ventilated in sedated and paralysed ARDS patients when mechanically ventilated with a PEEP of 5 cmH2O. Uneven distribution of ventilation due to airway closure and/or obstruction is likely to be involved.
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| 19. |
- Sinderholm Sposato, Niklas, 1977, et al.
(författare)
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Thoracic configuration in patients ageing with cystic fibrosis: A retrospective single-blinded cohort study.
- 2023
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Ingår i: Respiratory physiology & neurobiology. - : Elsevier BV. - 1569-9048 .- 1878-1519. ; 307
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Tidskriftsartikel (refereegranskat)abstract
- In patients with cystic fibrosis (CF), thoracic morphology and its role in respiratory function is conditioned by anthropometric factors, as well as by pathological changes. While the lungs are continuously monitored, examinations of potential thoracic cage adaptations to the disease are rare. Hence, the aim of this study was to investigate thoracic configuration, and its correlation to spirometry measures over time.In total, 344 high-resolution computed tomography (HRCT) examinations from 90 patients were assessed and analysed. Those results were subsequently related to spirometry measurements performed within the same period.The cohort displayed no homogenous change in thoracic configuration over time, and correlation between thoracic area and spirometry variables could not be supported statistically.Although the current study included a larger cohort of patients with CF compared to previous studies on thoracic morphology, no patient group-specific changes in thoracic configuration were revealed. Furthermore, no correlations between structural findings and functional respiratory measurements were found.
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| 20. |
- Svalkvist, Angelica, et al.
(författare)
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Evaluation of deep-learning image reconstruction for chest CT examinations at two different dose levels.
- 2023
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Ingår i: Journal of applied clinical medical physics. - : Wiley. - 1526-9914. ; 24:3
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to, for both a full-dose protocol and an ultra-low dose (ULD) protocol, compare the image quality of chest CT examinations reconstructed using TrueFidelity (Standard kernel) with corresponding examinations reconstructed using ASIR-V (Lung kernel) and to evaluate if post-processing using an edge-enhancement filter affects the noise level, spatial resolution and subjective image quality of clinical images reconstructed using TrueFidelity.A total of 25 patients were examined with both a full-dose protocol and an ULD protocol using a GE Revolution APEX CT system (GE Healthcare, Milwaukee, USA). Three different reconstructions were included in the study: ASIR-V 40%, DLIR-H, and DLIR-H with additional post-processing using an edge-enhancement filter (DLIR-H + E2). Five observers assessed image quality in two separate visual grading characteristics (VGC) studies. The results from the studies were statistically analyzed using VGC Analyzer. Quantitative evaluations were based on determination of two-dimensional power spectrum (PS), contrast-to-noise ratio (CNR), and spatial resolution in the reconstructed patient images.For both protocols, examinations reconstructed using TrueFidelity were statistically rated equal to or significantly higher than examinations reconstructed using ASIR-V 40%, but the ULD protocol benefitted more from TrueFidelity. In general, no differences in observer ratings were found between DLIR-H and DLIR-H + E2. For the three investigated image reconstruction methods, ASIR-V 40% showed highest noise and spatial resolution and DLIR-H the lowest, while the CNR was highest in DLIR-H and lowest in ASIR-V 40%.The use of TrueFidelity for image reconstruction resulted in higher ratings on subjective image quality than ASIR-V 40%. The benefit of using TrueFidelity was larger for the ULD protocol than for the full-dose protocol. Post-processing of the TrueFidelity images using an edge-enhancement filter resulted in higher image noise and spatial resolution but did not affect the subjective image quality.
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| 21. |
- Svensson, Frida, et al.
(författare)
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Evaluation of a corrected implementation of a method of simulating pulmonary nodules in chest tomosynthesis.
- 2017
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Ingår i: Acta radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 58:4, s. 408-413
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Tidskriftsartikel (refereegranskat)abstract
- A method of simulating pulmonary nodules in tomosynthesis images has previously been developed and evaluated. An unknown feature of a rounding function included in the computer code was later found to introduce an artifact, affecting simulated nodules in low-signal regions of the images. The computer code has now been corrected.To perform a thorough evaluation of the corrected nodule-simulation method, comparing the detection rate and visual appearance of artificial nodules with those of real nodules in an observer performance experiment.A cohort of 64 patients with a total of 129 pulmonary nodules was used in the study. Artificial nodules, each matching a corresponding real nodule by size, attenuation, and anatomical location, were generated and simulated into the tomosynthesis images of the different patients. The detection rate and visual appearance of artificial nodules generated using both the corrected and uncorrected computer code were compared to those of real nodules. The results were evaluated using modified receiver operating characteristic (ROC) analyses.The difference in detection rate between artificial and real nodules slightly increased using the corrected computer code (uncorrected code: area under the curve [AUC], 0.47; 95% CI, 0.43-0.51; corrected code: AUC, 0.42; 95% CI, 0.38-0.46). The visual appearance was however substantially improved using the corrected computer code (uncorrected code: AUC, 0.70; 95% CI, 0.63-0.76; corrected code: AUC, 0.49; 95% CI, 0.29-0.65).The computer code including a correct rounding function generates simulated nodules that are more visually realistic than simulated nodules generated using the uncorrected computer code, but have a slightly different detection rate compared to real nodules.
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| 22. |
- Svensson, Frida, 1979, et al.
(författare)
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Evaluation of an improved implementation of a method of simulating pulmonary nodules in chest tomosynthesis
- 2015
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Ingår i: Optimisation in X-ray and Molecular Imaging 2015 - the Fourth Malmö Conference on Medical Imaging, Gothenburg, Sweden, 28-30 May 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: At the previous Malmö Conference on Medical Imaging, Svalkvist et al presented a method of simulating the presence of pulmonary nodules in chest tomosynthesis images through using computer simulations. The method was later evaluated in an observer study that revealed that although the artificial lung nodules had similar detectability as real nodules, experienced thoracic radiologists to some extent were able to distinguish them from real nodules. Recently, an error was found in the code used to generate the simulated nodules in the evaluation study. This error has now been corrected. The purpose of the present work was to perform a thorough evaluation of the corrected implementation of the nodule simulation method for chest tomosynthesis, comparing the detection rate and appearance of the artificial nodules with those of real nodules in an observer performance experiment. Material and methods: A cohort consisting of 64 patients, 38 patients with a total of 129 identified pulmonary nodules and 26 patients without identified pulmonary nodules, was used in the study. Simulated nodules, matching the real clinically found pulmonary nodules by size, attenuation, and location, were created and randomly inserted into the tomosynthesis section images of the patients. Three thoracic radiologists reviewed the images in an observer performance study divided into two parts. The first part included nodule detection and the second part included rating of the visual appearance of the nodules. The results were evaluated using a modified receiver-operating characteristic (ROC) analysis. Results and conclusions: The data collection is not complete and the final results will be presented at the conference. A preliminary analysis indicates that the corrected code increases the similarity between the artificial nodules and real nodules and that the validity of the implemented method thus has increased.
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| 23. |
- Swärd, Christina, 1967, et al.
(författare)
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[(177)Lu-DOTA(0)-Tyr (3)]-Octreotate Treatment in Patients with Disseminated Gastroenteropancreatic Neuroendocrine Tumors: The Value of Measuring Absorbed Dose to the Kidney.
- 2010
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Ingår i: World journal of surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 34, s. 1368-1372
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Peptide receptor radiation therapy (PRRT) using [(177)Lu-DOTA(0)-Tyr(3)]-octreotate is a new, promising option for treatment of disseminated gastroenteropancreatic neuroendocrine tumors (GEPNETs). METHODS: During 2006-2008, 26 patients with disseminated GEPNETs were treated with (177)Lu-octreotate. Radiologic response (RECIST), biochemical response [plasma chromogranin-A (P-CgA)], hematologic toxicity [Common Toxicity Criteria (CTC)], absorbed dose to the kidneys (conjugate view method), and glomerular filtration rate (GFR) were analyzed. RESULTS: (177)Lu-octreotate (8 GBq) was given one to five times (median = 3) with a 6-week interval between each. Sixteen of the 26 patients were evaluated radiologically; 6 (38%) had partial response (PR), 8 (50%) had stable disease (SD), and 2 (13%) had progressive disease (PD). Seventeen of the 26 patients were evaluated biochemically; 6 (35%) showed a >/=30% decrease, 8 (47%) showed a >/=20% increase, and 3 (18%) showed neither a >/=30% decrease nor a >/=20% increase. The mean absorbed dose to the kidneys was 24 Gy. With a dose limit of 27 Gy to the kidneys, 10 patients did not receive the planned four treatments, while four patients had the potential to receive additional treatment. A significant reduction (p = 0.0013) of GFR was observed at follow-up. Three patients experienced CTC grade 3 hematologic toxicity. CONCLUSIONS: By using the absorbed dose to the kidneys as a limiting factor, treatment with (177)Lu-octreotate can be individualized, e.g., overtreatment can be avoided and patients with the potential to receive additional treatment can be identified. Further studies are needed to define tolerance doses to the kidneys so that treatment can be optimized.
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| 24. |
- Söderman, Christina, et al.
(författare)
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Accuracy of pulmonary nodule size measurement on chest tomosynthesis
- 2013
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Ingår i: Nationellt möte om sjukhusfysik 2013, 13-14 november 2013, Varberg.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Incidentally detected pulmonary nodules are common secondary findings from chest CT examinations. In order to detect nodule growth, which is an indicator of malignancy for these lesions, it is common to perform repeated chest CT examinations at certain time intervals. The diameter of the nodule is manually measured in the images by the radiologist and if a significant size increase over time is detected, further diagnostic investigations are initiated. As CT resources at the clinic are often under pressure and since repeated CT examinations introduce patient dose concern, chest tomosynthesis has emerged as an interesting alternative for the task of pulmonary nodule monitoring. Previous studies have shown that the visibility of known nodules is relatively high on chest tomosynthesis images, and that manual nodule measurements are comparable between CT and tomosynthesis. Results will be presented from a study investigating the accuracy of manual pulmonary nodule measurements on chest tomosynthesis images and its dependence on nodule size and examination dose. Data consist of measurements of the longest diameter of artificial ellipsoid shaped nodules, with known dimensions, inserted in to clinical chest tomosynthesis images. The measurements were performed by thoracic radiologists. Inter- and intraobserver variability was analysed. To simulate different examination doses, a previously developed method for noise addition was applied on the images.
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| 25. |
- Söderman, Christina, et al.
(författare)
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Application of a computed tomography based cystic fibrosis scoring system to chest tomosynthesis
- 2013
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Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 8673
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In the monitoring of progression of lung disease in patients with cystic fibrosis (CF), recurrent computed tomography (CT) examinations are often used. The relatively new imaging technique chest tomosynthesis (CTS) may be an interesting alternative in the follow-up of these patients due to its visualization of the chest in slices at radiation doses and costs significantly lower than is the case with CT. A first step towards introducing CTS imaging in the diagnostics of CF patients is to establish a scoring system appropriate for evaluating the severity of CF pulmonary disease based on findings in CTS images. Previously, several such CF scoring systems based on CT imaging have been published. The purpose of the present study was to develop a CF scoring system for CTS, by starting from an existing scoring system dedicated for CT images and making modifications regarded necessary to make it appropriate for use with CTS images. In order to determine any necessary changes, three thoracic radiologists independently used a scoring system dedicated for CT on both CT and CTS images from CF patients. The results of the scoring were jointly evaluated by all the observers, which lead to suggestions for changes to the scoring system. Suggested modifications include excluding the scoring of air trapping and doing the scoring of the findings in quadrants of the image instead of in each lung lobe. © 2013 SPIE.
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