| 1. |
- Almén, A, et al.
(författare)
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The radiation dose to children from X-ray examinations of the pelvis and the urinary tract
- 1995
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 68:810, s. 13-604
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Tidskriftsartikel (refereegranskat)abstract
- X-ray examinations of the pelvis and the urinary tract are frequent examinations of children, in which a large part of the trunk is irradiated. The irradiated volume contains many of the most radiation sensitive organs and tissues. The absorbed dose to children during the examination was estimated from measurements with a dose-area product meter and thermoluminescent dosemeters (TLDs). Entrance surface dose and the dose-area product results are presented. Conversion factors between the entrance surface dose and the organ dose were derived. The energy imparted, organ dose and effective dose were determined. The entrance surface dose for one single exposure varied between 0.32 mGy and 8.6 mGy for the urinary tract examination and between 0.26 mGy and 2.89 mGy per exposure for the pelvis examination. These variations are mainly influenced by the body size of the patient. The number of images taken during one examination varied. For the urinary tract investigation, the average number of exposures was six, while the corresponding number for the pelvis examination was two. The average effective dose for a typical urinary tract investigation ranged from 0.9 mSv to 8.5 mSv and from 0.3 mSv to 1.4 mSv for the pelvis examination. The radiation dose depends greatly on the body size. The recommendations to present the results in relation to age have been followed; however, the variation of body size even within each specified age range is significant. It is suggested that doses should be quoted in relation to a more critical parameter than age.
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| 2. |
- Sundgren, P, et al.
(författare)
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Elevation of the larynx on normal and abnormal cineradiogram
- 1993
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 66:789, s. 72-768
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between bolus volume (2.5, 5, 10 and 20 ml) and larynx elevation during swallowing was assessed in 10 non-dysphagic and 10 dysphagic individuals without pharyngeal dysfunction. Laryngeal elevation in different types of pharyngeal dysfunction was assessed in 60 non-dysphagic and 75 dysphagic patients. All subjects were examined with liquid barium and cineradiography at 50 frames/s. The laryngeal elevation was measured at the moment when the bolus reached the level of the valleculae and at maximum elevation. Elevation of the larynx, both the initial and maximal, was not influenced by sex, age or presence of dysphagia. Elevation of the larynx at the moment when the bolus reached the valleculae, when expressed in per cent of maximum elevation, was lower with 10 and 20 ml bolus volumes compared with 2.5 ml bolus volume (p < 0.05) in the 10 dysphagic individuals. Pharyngeal dysfunction was associated with significantly lower initial elevation of the larynx, at the moment when the bolus reached the level of the valleculae, although the maximal laryngeal elevation was normal. Initial elevation was 30% lower (p = 0.03) in patients with aspiration of bolus material into the trachea, 22% lower (p = 0.007) in those with defective closure of the laryngeal vestibule without aspiration and 16% lower (p = 0.06) in those with incoordination of the cricopharyngeal muscle compared with patients without dysfunction.
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| 3. |
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| 4. |
- Sandborg, Michael, 1961-, et al.
(författare)
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Monte Carlo study of grid performance in diagnostic radiology: factors which affect the selection of tube potential and grid ratio
- 1993
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 66, s. 1164-1176
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Tidskriftsartikel (refereegranskat)abstract
- A Monte Carlo computational model has been developed for the study of the performance of anti-scatter grids in diagnostic radiology. It is used here to estimate the scatter in the image plane from soft tissue phantoms (representing the patient) and to calculate image contrast and the mean absorbed dose in the phantom. Different scattering conditions, representative of various examinations, have been investigated: adult lumbar spine; small field radiography and fluoroscopy; adult chest and paediatric pelvis and chest. For each scattering condition, the combinations of tube potential and grid ratio have been found which, for a well designed grid, result in the lowest mean absorbed dose in the phantom for a fixed contrast level. In examinations which generate large amounts of scatter, the use of high grid ratios in combination with high tube potentials is favourable with regard to both mean absorbed dose in the phantom and tube charge. When less scatter is generated, either the grid ratio or the tube potential can be varied to achieve the desired contrast level. High grid ratios require shorter exposure times, but need careful alignment in the beam to prevent primary radiation cut-off. It is shown that the air gap technique can be used to reduce patient dose in examinations with small amounts of scatter, but in combinations with a lower tube potential than when a grid is used.
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| 5. |
- Sandborg, Michael, 1961-, et al.
(författare)
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Monte Carlo study of grid performance in diagnostic radiology: task dependent optimisation for screen-film imaging
- 1994
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 67, s. 76-85
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Tidskriftsartikel (refereegranskat)abstract
- An optimization of anti-scatter grid design using Monte Carlo techniques in diagnostic radiology is presented. The criterion for optimization was to find the combinations of the grid parameters (lead strip width, grid ratio and strip density) and tube potential which result in the lowest mean absorbed dose in the patient at fixed image contrast. The optimization was performed in three irradiation geometries, representing different scattering conditions (paediatric examinations, and two adult lumbar spine examinations) and was restricted to grids using fibre materials in covers and interspaces. Grid designs currently available were studied, as were designs which use thinner strips (< 30 µm) and higher grid ratios (> 18). It was found that grids with widely different strip densities (strips cm–1) and grid ratios can have good performance provided that they are used with appropriate strip width and tube potential. With increasing amounts of scatter, the optimal grid requires thicker strips and higher grid ratios. Increasing the strip density and using thinner strips and higher grid ratios are generally required. Grids with low strip density (25 strips cm–1) were found to be less sensitive to alterations in strip width. Optimal grids for paediatric radiology require thinner strips (10–20 µm) than those in currently available grids. Grids on the market are best suited for examinations of the adult body in anteroposterior (AP) view. In the adult lateral view, representing the largest scattering volume, higher grid ratios (> 18) than those in existing grids would be optimal. Examples of good grid designs are given for each examination.
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| 6. |
- Sandborg, Michael, 1961-, et al.
(författare)
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Selection of anti-scatter grids for different imaging tasks: the advantage of low atomic number cover and interspace materials
- 1993
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 66, s. 1151-1163
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Tidskriftsartikel (refereegranskat)abstract
- A Monte Carlo computer program has been developed for the study of anti-scatter grids used in diagnostic radiology. The program estimates the scatter from soft tissue phantoms representative of either adult or paediatric examinations and uses dose increase, signal-to-noise ratio improvement and contrast improvement factors to study grid performance. It has been used to quantify the advantage of replacing grids with aluminium covers and interspaces by grids using materials of low atomic number for these components. Two approaches are used. First, the aluminium and low atomic number alternatives are compared for five grid ratios at fixed strip density and width and for tube potentials of 50, 70, 100 and 150 kV. Second, 44 commercially available grids are compared for three different imaging situations (lumbar spine, chest and paediatric). The results demonstrate that grids made with carbon fibre cover and cotton fibre interspace result in greater improvements in contrast and signal-to-noise ratio, and lower dose increase factors, than do grids made with aluminium. The dose reduction varies with irradiation conditions and is generally larger at lower tube potentials, higher grid ratios and lower strip densities. A typical reduction in mean absorbed dose in the patient is 30% in an adult lumbar spine (AP view) at 70 kV with a grid with 36 strips per centimetre and ratio 12.
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| 7. |
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| 8. |
- Adrian, Gabriel, et al.
(författare)
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The FLASH effect depends on oxygen concentration
- 2019
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 93:1106
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Recent in vivo results have shown prominent tissue sparing effect of radiotherapy with ultra-high dose rates (FLASH) compared to conventional dose rates (CONV). Oxygen depletion has been proposed as the underlying mechanism, but in vitro data to support this have been lacking. The aim of the current study was to compare FLASH to CONV irradiation under different oxygen concentrations in vitro. METHODS: Prostate cancer cells were irradiated at different oxygen concentrations (relative partial pressure ranging between 1.6 and 20%) with a 10 MeV electron beam at a dose rate of either 600 Gy/s (FLASH) or 14 Gy/min (CONV), using a modified clinical linear accelerator. We evaluated the surviving fraction of cells using clonogenic assays after irradiation with doses ranging from 0 to 25 Gy. RESULTS: Under normoxic conditions, no differences between FLASH and CONV irradiation were found. For hypoxic cells (1.6%), the radiation response was similar up to a dose of about 5-10 Gy, above which increased survival was shown for FLASH compared to CONV irradiation. The increased survival was shown to be significant at 18 Gy, and the effect was shown to depend on oxygen concentration. CONCLUSION: The in vitro FLASH effect depends on oxygen concentration. Further studies to characterize and optimize the use of FLASH in order to widen the therapeutic window are indicated. ADVANCES IN KNOWLEDGE: This paper shows in vitro evidence for the role of oxygen concentration underlying the difference between FLASH and CONV irradiation.
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| 9. |
- Al-Okshi, Ayman, et al.
(författare)
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A meta-review of effective doses in dental and maxillofacial cone beam CT using the ROBIS tool.
- 2021
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 94:1123
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To apply the ROBIS tool for assessment of risk of bias (RoB) in systematic reviews (SRs) in a meta-review on effective doses (EDs) in dental and maxillofacial cone beam CT.METHODS: Three electronic databases and reference lists of included SRs were searched. Eligible SRs were classified as having low, high or unclear RoB. Findings of SRs were synthesised and data from primary studies combined to relate ED to field of view (FOV) and operating potential (kV).RESULTS: Seven SRs were included: three displayed low RoB, three high and one had unclear RoB. Only one SR related ED to image quality. Deficiencies in reporting of eligibility criteria, study selection and synthesis of results in SRs were identified. FOV height had a significant relationship with ED, explaining 27.2% of its variability. Median ED for three FOV categories differed significantly. Operating potential had a weak relationship with ED, with no significant difference in median ED between three operating potential groups.CONCLUSION: The ROBIS tool should have a role for meta-reviews of different aspects of radiology. The disappointing results for RoB might be remedied by developing standards to improve the quality of reporting of primary dosimetry studies and of SRs. Future dosimetry studies should always relate ED to image quality or diagnostic accuracy.ADVANCES IN KNOWLEDGE: This meta-review is the first to implement ROBIS for SRs of ED and identified that trustworthiness of some SRs is questionable. The percentage change in average ED per cm increase in FOV height could be calculated, emphasizing the importance of FOV as a determinant of ED in CBCT.
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| 10. |
- Al-Okshi, Ayman, et al.
(författare)
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Effective dose of cone beam computed tomography (CBCT) of the facial skeleton : a systematic review
- 2015
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 88:1045
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Forskningsöversikt (refereegranskat)abstract
- Objective: To estimate effective dose of cone beam CT (CBCT) of the facial skeleton with focus on measurement methods and scanning protocols. Methods: A systematic review, which adhered to the preferred reporting items for systematic reviews (PRISMA) Statement, of the literature up to April 2014 was conducted. Data sources included MEDLINE®, The Cochrane Library and Web of Science. A model was developed to underpin data extraction from 38 included studies. Results: Technical specifications of the CBCT units were insufficiently described. Heterogeneity in measurement methods and scanning protocols between studies made comparisons of effective doses of different CBCT units and scanning protocols difficult. Few studies related doses to image quality. Reported effective dose varied across studies, ranging between 9.7 and 197.0 mSv for field of views (FOVs) with height #5cm, between 3.9 and 674.0 mSv for FOVs of heights 5.1–10.0 cm and between 8.8 and 1073.0 mSv for FOVs .10 cm. There was an inconsistency regarding reported effective dose of studies of the same CBCT unit with the same FOV dimensions. Conclusion: The review reveals a need for studies on radiation dosages related to image quality. Reporting quality of future studies has to be improved to facilitate comparison of effective doses obtained from examinations with different CBCT units and scanning protocols. A model with minimum data set on important parameters based on this observation is proposed. Advances in knowledge: Data important when estimating effective dose were insufficiently reported in most studies. A model with minimum data based on this observation is proposed. Few studies related effective dose to image quality.
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| 11. |
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| 12. |
- Almén, Anja, et al.
(författare)
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Paediatric diagnostic reference levels for common radiological examinations using the European guidelines
- 2022
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 95:1130
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to explore the feasibility to determine regional diagnostic reference levels (RDRLs) for paediatric conventional and CT examinations using the European guidelines and to compare RDRLs derived from weight and age groups, respectively. Methods: Data were collected from 31 hospitals in 4 countries, for 7 examination types for a total of 2978 patients. RDRLs were derived for each weight and age group, respectively, when the total number of patients exceeded 15. Results: It was possible to derive RDRLs for most, but not all, weight-based and age-based groups for the seven examinations. The result using weight-based and age-based groups differed substantially. The RDRLs were lower than or equal to the European and recently published national DRLs. Conclusion: It is feasible to derive RDRLs. However, a thorough review of the clinical indications and methodologies has to be performed previous to data collection. This study does not support the notion that DRLs derived using age and weight groups are exchangeable. Advances in knowledge: Paediatric DRLs should be derived using weight-based groups with access to the actual weight of the patients. DRLs developed using weight differ markedly from those developed with the use of age. There is still a need to harmonize the method to derive solid DRLs for paediatric radiological examinations.
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| 13. |
- Alobeidi, Hanan, et al.
(författare)
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Minimizing contrast media dose in CT pulmonary angiography with high-pitch technique
- 2020
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Ingår i: British Journal of Radiology. - : John Wiley & Sons. - 0007-1285 .- 1748-880X. ; 93:1111
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To perform CT pulmonary angiography (CTPA) using a minimal amount of iodinated contrast media.METHODS: 47 patients (25 females) with mean age 69 years (range 41-82 years) referred for contrast-enhanced chest CT were prospectively included in this Phase IV clinical drug trial. All participants underwent a study specific CTPA in addition to the chest CT. The participants received 80 mg I/kg body weight Iohexol contrast media using a preparatory saline bolus, a dual flow contrast/saline bolus and a saline flush, and a scanner protocol with 80 kVp dual source high-pitch mode. Three readers independently assessed the image quality on the 3-point scale non-diagnostic, adequate or good-excellent image quality. Additionally, the pulmonary arterial contrast opacification was measured.RESULTS: On average, the patients received 16.8 ml Iohexol 350 mg I/mL (range 12-20 ml). Mean patient weight was 71 kg (range 50-85 kg). Identically for all readers, pulmonary embolism (PE) was detected in 1/47 participants. The median number of examinations visually scored concerning pulmonary embolism as good-excellent was 47/47 (range 44-47); adequate 0/47 (0-3) and non-diagnostic 0/47 (range 0-0). The proportion adequate or better examinations was for all readers 47/47, 100% [95% confidence interval 92-100%]. The mean attenuation ± standard deviation in the pulmonary trunk was 325 ± 72 Hounsfield unit (range 165-531 Hounsfield unit).CONCLUSIONS: Diagnostic CTPA with 17 ml contrast media is possible in non-obese patients using low kVp, high pitch and carefully designed contrast media administration.ADVANCES IN KNOWLEDGE: By combining several procedures in a CTPA protocol, the contrast media dose can be minimized.
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| 14. |
- Andersson, Karin M., 1989-, et al.
(författare)
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Metal artefact reduction in CT imaging of hip prostheses-an evaluation of commercial techniques provided by four vendors
- 2015
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 88:1052
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to evaluate commercial metal artefact reduction (MAR) techniques in X-ray CT imaging of hip prostheses.Methods: Monoenergetic reconstructions of dual-energy CT (DECT) data and several different MAR algorithms, combined with single-energy CT or DECT, were evaluated by imaging a bilateral hip prosthesis phantom. The MAR images were compared with uncorrected images based on CT number accuracy and noise in different regions of interest.Results: The three MAR algorithms studied implied a general noise reduction (up to 67%, 74% and 77%) and an improvement in CT number accuracy, both in regions close to the prostheses and between the two prostheses. The application of monoenergetic reconstruction, without any MAR algorithm, did not decrease the noise in the regions close to the prostheses to the same extent as did the MAR algorithms and even increased the noise in the region between the prostheses.Conclusion: The MAR algorithms evaluated generally improved CT number accuracy and substantially reduced the noise in the hip prostheses phantom images, both close to the prostheses and between the two prostheses. The study showed that the monoenergetic reconstructions evaluated did not sufficiently reduce the severe metal artefact caused by large orthopaedic implants.Advances in knowledge: This study evaluates several commercially available MAR techniques in CT imaging of large orthopaedic implants.
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| 15. |
- Andersson, Karin M., 1989-, et al.
(författare)
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Visual grading evaluation of commercially available metal artefact reduction techniques in hip prosthesis computed tomography
- 2016
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Ingår i: British Journal of Radiology. - London, United Kingdom : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 89:1063
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate metal artefact reduction (MAR) techniques from four computed tomography (CT) vendors in hip prosthesis imaging.Methods: Bilateral hip prosthesis phantom images, obtained by using MAR algorithms for single energy CT data or dual energy CT (DECT) data and by monoenergetic reconstructions of DECT data, were visually graded by five radiologists using ten image quality criteria. Comparisons between the MAR images and a reference image were performed for each scanner separately. Ordinal probit regression analysis was used.Results: The MAR algorithms in general improved the image quality based on the majority of the criteria (up to between 8/10 and 10/10) with a statistically improvement in overall image quality (P<0.001). However, degradation of image quality, such as new artefacts, was seen in some cases. A few monoenergetic reconstruction series improved the image quality (P<0.004) for one of the DECT scanners, but it was only improved for some of the criteria (up to 5/10). Monoenergetic reconstructions resulted in worse image quality for the majority of the criteria (up to 7/10) for the other DECT scanner.Conclusions: The MAR algorithms improved the image quality of the hip prosthesis CT images. However, since additional artefacts and degradation of image quality were seen in some cases, all algorithms should be carefully evaluated for every clinical situation. Monoenergetic reconstructions were in general concluded to be insufficient for reducing metal artifacts. Advances in knowledge: Qualitative evaluation of the usefulness of several MAR techniques from different vendors in CT imaging of hip prosthesis.
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| 16. |
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| 17. |
- Aznar, MC, et al.
(författare)
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In vivo absorbed dose measurements in mammography using a new real-time luminescence technique
- 2005
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 78:928, s. 328-334
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Tidskriftsartikel (refereegranskat)abstract
- A dosimetry system based on radioluminescence (RL) and optically stimulated luminescence (OSL) from carbon doped aluminium oxide (Al2O3:C) crystals was developed for in vivo absorbed dose measurements in mammography. A small cylindrical crystal of Al2O3:C (diameter 0.48 mm and length 2 mm) was coupled to the end of a 1 mm diameter optical fibre cable. Owing to their small size and characteristic shape, these probes can be placed on the body surface in the field of view during the examination, without compromising the reading of the mammogram. Our new technique was tested with a mammography unit (Siemens Mammomat 3000) and screen-film technique over a range of clinically relevant X-ray energies. The results were compared with those obtained from an ionization chamber usually used for the determination of absorbed dose in mammography. The reproducibility of measurements was around 3% (1 standard deviation) at 4.5 mGy for both RL and OSL data. The dose response was found to be linear between 4.5 mGy and 30 mGy. The energy dependence of the system is around 18% between 23 kV and 35 kV. In vivo measurements were performed during three patient examinations. It was shown that entrance and exit doses could be measured. The presence of the small probes did not significantly interfere with the diagnostic quality of the images. Entrance doses estimated by RL/OSL results agreed within 3% with entrance surface dose values calculated from the ionization chamber measurements. These results indicate a considerable potential for use in routine control and in vivo dose measurements in mammography.
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| 18. |
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| 19. |
- Borga, Magnus, 1965-
(författare)
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MRI adipose tissue and muscle composition analysis : a review of automation techniques
- 2018
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Ingår i: British Journal of Radiology. - London, United Kingdom : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 91:1089
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Forskningsöversikt (refereegranskat)abstract
- MRI is becoming more frequently used in studies involving measurements of adipose tissue and volume and composition of skeletal muscles. The large amount of data generated by MRI calls for automated analysis methods. This review article presents a summary of automated and semi-automated techniques published between 2013 and 2017. Technical aspects and clinical applications for MRI-based adipose tissue and muscle composition analysis are discussed based on recently published studies. The conclusion is that very few clinical studies have used highly automated analysis methods, despite the rapidly increasing use of MRI for body composition analysis. Possible reasons for this are that the availability of highly automated methods has been limited for non-imaging experts, and also that there is a limited number of studies investigating the reproducibility of automated methods for MRI-based body composition analysis.
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| 20. |
- Brandberg, John, 1966, et al.
(författare)
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Accurate tissue area measurements with considerably reduced radiation dose achieved by patient-specific CT scan parameters
- 2008
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 81:970, s. 801-8
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Tidskriftsartikel (refereegranskat)abstract
- A low-dose technique was compared with a standard diagnostic technique for measuring areas of adipose and muscle tissue and CT numbers for muscles in a body composition application. The low-dose technique was intended to keep the expected deviation in the measured area of adipose and muscle tissue to <1% of the total tissue area. The largest diameter of the patient determined the parameters for the low-dose technique. 17 patients - chosen to cover a wide range of diameters (31-47 cm) for both abdomen and thighs - were examined using both techniques. Tissue areas were compared, as were CT numbers for muscle tissue. Image noise was quantified by standard deviation measurements. The area deviation was <1%, except in the smallest subjects, in whom it was <2%. The integral radiation dose of the low-dose technique was reduced to 2-3% for diameters of 31-35 cm and to 7.5-50% for diameters of 36-47 cm as compared with the integral dose by the standard diagnostic technique. The CT numbers of muscle tissue remained unchanged with reduced radiation dose. Image noise was on average 20.9 HU (Hounsfield units) for subjects with diameters of 31-35 cm and 11.2 HU for subjects with diameters in the range of 36-47 cm. In conclusion, for body composition studies with CT, scan protocols can be adjusted so that the integral dose is lowered to 2-60% of the standard diagnostic technique at our centre without adversely altering area measurements of adipose and muscle tissue and without altering CT numbers of muscle tissue.
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| 21. |
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| 22. |
- Båth, Magnus, 1974, et al.
(författare)
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Visual grading characteristics (VGC) analysis: a non-parametric rank-invariant statistical method for image quality evaluation.
- 2007
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 80:951, s. 169-76
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Tidskriftsartikel (refereegranskat)abstract
- Visual grading of the reproduction of important anatomical structures is often used to determine clinical image quality in radiography. However, many visual grading methods incorrectly use statistical methods that require data belonging to an interval scale. The rating data from the observers in a visual grading study with multiple ratings is ordinal, meaning that non-parametric rank-invariant statistical methods are required. This paper describes such a method for determining the difference in image quality between two modalities called visual grading characteristics (VGC) analysis. In a VGC study, the task of the observer is to rate his confidence about the fulfilment of image quality criteria. The rating data for the two modalities are then analysed in a manner similar to that used in receiver operating characteristics (ROC) analysis. The resulting measure of image quality is the VGC curve, which--for all possible thresholds of the observer for a fulfilled criterion--describes the relationship between the proportions of fulfilled image criteria for the two compared modalities. The area under the VGC curve is proposed as a single measure of the difference in image quality between two compared modalities. It is also described how VGC analysis can be applied to data from an absolute visual grading analysis study.
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| 23. |
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| 24. |
- Chakwizira, Arthur, et al.
(författare)
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Mathematical modelling of the synergistic combination of radiotherapy and indoleamine-2,3-dioxygenase (IDO) inhibitory immunotherapy against glioblastoma
- 2018
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 91:1087
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Recent research has shown that combining radiotherapy and immunotherapy can counteract the ability of cancer to evade and suppress the native immune system. To optimise the synergy of the combined therapies, factors such as radiation dose and fractionation must be considered, alongside numerous parameters resulting from the complexity of cancer-immune system interactions. It is instructive to use mathematical models to tackle this problem. Methods: In this work, we adapted a model primarily to describe the synergistic effect between single-fraction radiotherapy and immunotherapy (1-methyl tryptophan) observed in previous experiments with glioblastoma-carrying rats. We also showed how the model can be used to generate hypotheses on the outcome of other treatment fractionation schemes. Results: The model successfully reproduced the results of the experiments. Moreover, it provided support for the hypothesis that, for a given biologically effective dose, the efficacy of the combination therapy and the synergy between the two therapies are favoured by the administration of radiotherapy in a hypofractionated regime. Furthermore, for a double-fraction irradiation regimen, the synergy is favoured by a short time interval between the treatment fractions. Conclusion: It was concluded that the model could be fitted to reproduce the experimental data well within its uncertainties. It was also demonstrated that the fitted model can be used to form hypotheses to be validated by further pre-clinical experiments. Advances in knowledge: The results of this work support the hypothesis that the synergetic action of combined radiotherapy and immunotherapy is favoured by using a hypofractionated radiation treatment regimen, given over a short time interval.
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| 25. |
- Cooper, Christian R, et al.
(författare)
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FLASH irradiation induces lower levels of DNA damage ex vivo, an effect modulated by oxygen tension, dose, and dose rate
- 2022
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 95:1133
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: FLASH irradiation reportedly produces less normal tissue toxicity, while maintaining tumour response. To investigate oxygen's role in the 'FLASH effect', we assessed DNA damage levels following irradiation at different oxygen tensions, doses and dose rates.METHODS: Samples of whole blood were irradiated (20 Gy) at various oxygen tensions (0.25-21%) with 6 MeV electrons at dose rates of either 2 kGy/s (FLASH) or 0.1 Gy/s (CONV), and subsequently with various doses (0-40 Gy) and intermediate dose rates (0.3-1000 Gy/s). DNA damage of peripheral blood lymphocytes (PBL) were assessed by the alkaline comet assay.RESULTS: Following 20 Gy irradiation, lower levels of DNA damage were induced for FLASH, the difference being significant at 0.25% (p < 0.05) and 0.5% O2 (p < 0.01). The differential in DNA damage at 0.5% O2 was found to increase with total dose and dose rate, becoming significant for doses ≥20 Gy and dose rates ≥30 Gy/s.CONCLUSION: This study shows, using the alkaline comet assay, that lower levels of DNA damage are induced following FLASH irradiation, an effect that is modulated by the oxygen tension, and increases with the total dose and dose rate of irradiation, indicating that an oxygen related mechanism, e.g. transient radiation-induced oxygen depletion, may contribute to the tissue sparing effect of FLASH irradiation.ADVANCES IN KNOWLEDGE: This paper is first to directly show that FLASH-induced DNA damage is modulated by oxygen tension, total dose and dose rate, with FLASH inducing significantly lower levels of DNA damage for doses ≥20 Gy and dose rates ≥30 Gy/s, at 0.5% O2.
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| 26. |
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| 27. |
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| 28. |
- Dance, David, et al.
(författare)
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The use of carbon fibre material in radiographic cassettes: estimation of the dose and contrast advantages
- 1997
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Ingår i: British Journal of Radiology. - 0007-1285 .- 1748-880X. ; 70, s. 383-390
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Tidskriftsartikel (refereegranskat)abstract
- A Monte Carlo simulation has been used to estimate the dose and contrast advantages of replacing radiographic cassette fronts fabricated from aluminium with cassette fronts fabricated from low atomic number material (carbon fibre). The simulation used a realistic imaging geometry and calculations were made both with and without an anti-scatter grid. Account was taken of the scatter generated in the cassette front and the effect of beam hardening on primary contrast. Dose and contrast were evaluated for a range of cassette front thicknesses and tube potentials (60-150 kV) as well as for four examinations representative of situations with varying amounts of scatter. The results with an anti-scatter grid show a clear dose and contrast advantage in all cases when an aluminium cassette front is replaced with a low attenuation cassette front. The contrast advantage is dependent upon the examination and is generally greater for imaging bony structures than for imaging soft tissue. If a 1.74 mm aluminium cassette front is compared with a 1.1 mm carbon fibre cassette front, then the dose advantages are 16%, 9%, 8% and 6% and the contrast advantages are 10%, 7%, 4% and 5% for the AP paediatric pelvis examination at 60 kV, the anteroposterior (AP) lumbar spine examination at 80 kV, the lateral lumbar spine examination at 100 kV and the posteroanterior (PA) chest examination at 150 kV, respectively. The results without an anti-scatter grid show an increased dose advantage when a low attenuation cassette front is used, but the contrast advantage is small and in some situations negative.
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| 29. |
- Darkeh, M. H. S. E., et al.
(författare)
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The minimum number of target lesions that need to be measured to be representative of the total number of target lesions (according to RECIST)
- 2009
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 82:980, s. 681-6
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Tidskriftsartikel (refereegranskat)abstract
- Response evaluation criteria in solid tumours (RECIST) were introduced as a means to classify tumour response with no definition of the minimum number of lesions. This study was conducted in order to evaluate discrepancies between full assessments based on either all target lesions or fewer lesions. RECIST evaluation was performed on separate occasions based on between one and seven of the target lesions, with simultaneous assessment of non-target lesions. 99 patients were included. 38 patients demonstrated progressive disease, in 61% of whom it was a result of the appearance of new lesions or unequivocal progress in non-target lesions. 32 patients showed stable disease, with 8 having results that differed when 1-3 target lesions were measured. 22 cases were considered as having partial regression, with only 1 case differing when performing 1-3 target lesion assessments. Seven cases demonstrated complete response. The number of discordant cases increased gradually from measuring three lesions to one target lesion. The average number of available target lesions among those with discrepancies was 7.1, which was significantly higher than those demonstrating concordance (4.1 lesions; p<0.05). In conclusion, measuring fewer than four target lesions might cause discrepancies when more than five target lesions are present.
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| 30. |
- Dasu, Alexandru, et al.
(författare)
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Will intrafraction repair have negative consequences on extreme hypofractionation in prostate radiation therapy?
- 2015
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 88:1056, s. Article ID 20150588-
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present study was to investigate the impact of increasing fraction delivery time on the outcome of hypofractionated radiation therapy for prostate cancer.Methods: Monoexponential and biexponential repair models have been used for patients with prostate cancer to study the loss of biochemical control at 5 years for several clinically relevant irradiation times. The theoretical predictions were compared with newly reported clinical results from 4607 patients undergoing conventionally fractionated and hypofractionated prostate radiation therapy.Results: Time-demanding irradiation techniques appear to lead to biochemical control rates that sometimes are about 10–20 percentage points below predictions that neglect intrafraction repair. This difference appears to be of the same order of magnitude as that predicted by moderately slow to slow repair taking place during the irradiation time. The impact is largest for the patient risk groups receiving doses corresponding to the steepest part of the dose–response curve. By contrast, for treatment techniques requiring irradiation times shorter than about 20 min, the impact of intrafraction repair appears to be much smaller and probably difficult to be observed in the light of other sources of uncertainty in clinical data.Conclusion: Neglecting intrafraction repair might overestimate the effectiveness of some treatment schedules and could also influence any subsequent estimations of fractionation sensitivity for prostate tumours.Advances in knowledge: The effect of intrafraction repair for prostate cancer should be taken into account for long irradiation sessions as might be expected from scanned beams and/or from multiple intrafraction imaging sessions to check the positioning of the patient.
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| 31. |
- Delgado, Anna Falk, et al.
(författare)
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Discrimination between primary low-grade and high-grade glioma with 11C-methionine PET : a bivariate diagnostic test accuracy meta-analysis
- 2018
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 91:1082
-
Forskningsöversikt (refereegranskat)abstract
- Objective: To perform a meta-analysis evaluating the diagnostic accuracy of 11C-methionine (MET) positron emission tomography (PET) to discriminate between primary low-grade glioma (LGG) and high-grade glioma (HGG).Methods: A systematic database search was performed by a librarian in relevant databases with the latest search on 07 November 2016. Hits were assessed for inclusion independently by two authors. Individual patient data on relative MET uptake was extracted on patients examined pre-operatively with MET PET and subsequent neuropathological diagnosis of astrocytoma or oligodendroglioma. Individual patient data were analysed for diagnostic accuracy using a bivariate diagnostic random-effects meta-analysis model with restricted maximum likelihood estimation method. Bivariate meta-regression and subgroup analyses assessed study heterogeneity and validity. This study is registered with PROSPERO, number CRD42016050747.Results: Out of 1828 hits, 13 studies comprising of 241 individuals were included in the quantitative and qualitative analysis. MET PET had an area under the bivariate summary receiver operating characteristics curve of 0.78 to discriminate between LGG and HGG and a summary sensitivity of 0.80 with 95% confidence interval (CI) (0.66–0.88) and a summary false positive rate of 0.28, 95% CI (0.19–0.38). Heterogeneity was described by; bias in patient inclusion, study quality, and ratio method. Optimal cutoff for relative MET uptake was 2.21.Conclusion: MET PET had a moderately high diagnostic accuracy for the discrimination between primary LGG and HGG.Advances in knowledge: MET PET can be used as a clinical tool for the non-invasive discrimination between LGG and HGG with a moderately high accuracy at cut-off 2.21.
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| 32. |
- Fägerstam, Patrik, et al.
(författare)
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Similar inhibition of platelet adhesion, P-selectin expression and plasma coagulation by ioversol, iodixanol and ioxaglate
- 2010
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Ingår i: The British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 83:989, s. 401-410
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Tidskriftsartikel (refereegranskat)abstract
- Contrast media (CM) are reported to possess both pro-thrombotic and anticoagulant properties. The mechanisms are not clearly understood and early reports are contradictory. To study the effects of CM on haemostasis, we analysed the ex vivo effects of ioversol and iodixanol on platelet adhesion and P-selectin expression, and the in vitro effects of ioversol, iodixanol and ioxaglate on platelet adhesion, P-selectin expression and plasma coagulation. A novel enzymatic assay was used to measure platelet adhesion to protein surfaces and an enzyme-linked immunosorbent assay was used to measure platelet P-selectin surface expression. Pro-thrombin time (PT) and activated partial thromboplastin time (APTT) were used to measure plasma coagulation. The ex vivo study consisted of blood from 27 outpatients administered ioversol and 9 patients administered iodixanol intravenously. Samples were collected before and 5 min after CM administration. Healthy donors were used for the in vitro studies on the effects of CM. The ex vivo study showed significantly (p<0.05) decreased platelet adhesion and P-selectin expression after administration of ioversol and iodixanol. Adhesion was more affected than P-selectin expression. The in vitro study showed that ioversol, iodixanol and ioaxaglate significantly (p<0.05) and dose dependently (beginning at 3 mg ml(-1)) decreased platelet adhesion and P-selectin expression. APTT and PT were significantly (p<0.01) prolonged at concentrations of 10 mg ml(-1) and 30 mg ml(-1), respectively. In conclusion, ioversol, iodixanol and ioxaglate inhibit platelet adhesion and P-selectin expression, as well as plasma coagulation. Platelets are more sensitive in relation to the inhibiting effect on plasma coagulation.
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| 33. |
- Geijer, Håkan, et al.
(författare)
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Optimizing the tube potential for lumbar spine radiography with a flat-pane digital detector
- 2009
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 82:973, s. 62-68
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to find the optimal settings for lumbar spine radiography with a flat-panel detector. A CDRAD contrast-detail phantom was imaged at various tube potentials, system speeds and filtration settings. Factorial experiments yielded a range of optimized exposure settings, which were submitted to visual grading analysis with images of an Alderson phantom. The first optimized settings involved a system speed increase from 400 to 800. For anteroposterior projection, the optimal tube potential was reduced from the default of 77 kV to 60 kV to give the best image quality without increasing the effective dose, or to 66 kV to give the lowest dose without reducing image quality. For lateral projection, the tube potential was similarly reduced from the default of 90 kV to 70 kV or 77 W. Visual grading analysis confirmed the results, with significantly better image quality when optimizing for image quality. The study thus shows that the tube potential can be reduced as long as the system speed is increased simultaneously. This leads to a lower effective dose and/or increased image quality depending on the settings chosen. The factorial experiments provided a powerful way to evaluate several parameters concomitantly.
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| 34. |
- Geraets, Wil, et al.
(författare)
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Sparseness of the trabecular pattern on dental radiographs : visual assessment compared with semi-automated measurements
- 2012
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 85:1016, s. e455-e460
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Tidskriftsartikel (refereegranskat)abstract
- Abstract OBJECTIVE: In diagnostic imaging; human perception is the most prominent, yet least studied, source of error. A better understanding of image perception will help to improve diagnostic performance. This study focuses on the perception of coarseness of trabecular patterns on dental radiographs. Comparison of human vision with machine vision should yield knowledge on human perception. METHOD: In a study on identifying osteoporotic patients, dental radiographs were made from 505 post-menopausal women aged 45-70 years. Intra-oral radiographs of the lower and upper jaws were made. Five observers graded the trabecular pattern as dense, sparse or mixed. The five gradings were combined into a single averaged observer score per jaw. The radiographs were scanned and a region of interest (ROI) was indicated on each. The ROIs were processed with image analysis software measuring 25 image features. Pearson correlation and multiple linear regression were used to compare the averaged observer score with the image features. RESULTS: 14 image features correlated significantly with the observer judgement for both jaws. The strongest correlation was found for the average grey value in the ROI. Other features, describing that osteoporotic patients have fewer but bigger marrow spaces than controls, correlated less with the sparseness of the trabecular pattern than a rather crude measure for structure such as the average grey value. CONCLUSION: Human perception of the sparseness of trabecular patterns is based more on average grey values of the ROI than on geometric details within the ROI.
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| 35. |
- Granlund, Christina, et al.
(författare)
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Absorbed organ and effective doses from digital intra-oral and panoramic radiography applying the ICRP 103 recommendations for effective dose estimations
- 2016
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 89:1066
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Tidskriftsartikel (refereegranskat)abstract
- Objective: During dental radiography, the salivary and thyroid glands are at radiation risk. In 2007, the International Commission on Radiological Protection (ICRP) updated the methodology for determining the effective dose, and the salivary glands were assigned tissue-specific weighting factors for the first time. The aims of this study were to determine the absorbed dose to the organs and to calculate, applying the ICRP publication 103 tissue-weighting factors, the effective doses delivered during digital intraoral and panoramic radiography. Methods: Thermoluminescent dosemeter measurements were performed on an anthropomorphic head and neck phantom. The organ-absorbed doses were measured at 30 locations, representing different radiosensitive organs in the head and neck, and the effective dose was calculated according to the ICRP recommendations. Results: The salivary glands and the oral mucosa received the highest absorbed doses from both intraoral and panoramic radiography. The effective dose from a fullmouth intraoral examination was 15mSv and for panoramic radiography, the effective dose was in the range of 19-75 mSv, depending on the panoramic equipment used. Conclusion: The effective dose from a full-mouth intraoral examination is lower and that frompanoramic radiography is higher than previously reported. Clinicians should be aware of the higher effective dose delivered during panoramic radiography and the risk-benefit profile of this technique must be assessed for the individual patient.
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| 36. |
- Gunnarsson, Mikael, et al.
(författare)
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No radiation protection reasons for restrictions on C-14 urea breath tests in children.
- 2002
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 75:900, s. 982-986
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Tidskriftsartikel (refereegranskat)abstract
- Traditional 14C urea breath tests are normally not used for younger children because the radiation exposure is unknown. High sensitivity accelerator mass spectrometry and an ultra-low amount (440 Bq) of 14C urea were therefore used both to diagnose Helicobacter pylori (HP) infection in seven children, aged 3–6 years, and to make radiation dose estimates. The activity used was 125 times lower than the amount normally used for older children and 250 times lower than that used for adults. Results were compared with previously reported biokinetic and dosimetric data for adults and older children aged 7–14 years. 14C activity concentrations in urine and exhaled air per unit administered activity for younger children (3–6 years) correspond well with those for older children (7–14 years). For a child aged 3–6 years who is HP negative, the urinary bladder wall receives the highest absorbed dose, 0.3 mGy MBq-1. The effective dose is 0.1 mSv MBq-1 for the 3-year-old child and 0.07 mSv MBq-1 for the 6-year-old child. For two children, the 10 min and 20 min post-14C administration samples of exhaled air showed a significantly higher amount of 14C activity than for the rest of the children, that is 6% and 19% of administered activity exhaled per hour compared with 0.3–0.9% (mean 0.5%) of administered activity exhaled per hour indicating that these two children that is were HP positive. For a 3-year-old HP positive child, absorbed dose to the urinary bladder wall was 0.3 mGy MBq-1 and effective dose per unit of administered activity was 0.4 mSv MBq-1. Using 55 kBq, which is a normal amount for older children when liquid scintillation counters are used for measurement, the effective dose will be approximately 6 µSv to a 3-year-old HP negative child and 20 µSv to a HP positive child. Thus there is no reason for restrictions on performing a normal 14C urea breath test, even on young children.
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| 37. |
- Haraldsson, P, et al.
(författare)
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Dose response characteristics and basic dose distribution data for a polymerization-based dosemeter gel evaluated using MR
- 2000
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 73:865, s. 58-65
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Tidskriftsartikel (refereegranskat)abstract
- A safe and reproducible mixing procedure for the manufacture of a polymerization-based dosemeter gel evaluated using MRI (PoMRI) is presented. The dose response, obtained by irradiating gel-filled vials with absorbed doses in the interval 0-20 Gy and evaluated with respect to 1/T2, was found to be linear in the interval 0-8 Gy, with a sensitivity of 0.211 s-1Gy-1 (r2 = 0.998) at 1.5 T. Evaluation of the same set of vials with respect to 1/T1 gave a sensitivity of 0.018 s-1Gy-1 (r2 = 0.960). PoMRI and diode data were compared for standard photon and electron treatment beams. A deviation of less than 3% was found between the two methods for central depth dose curves as well as dose profiles (2 mm for electrons in the steep dose gradient regions). The importance of the method used for background correction for the reliability of the results was also evaluated. Barex (with a wall thickness of 1.5 mm) was investigated for use as phantom material and found to be favourable compared with glass. The results obtained in this study show that PoMRI has excellent potential as a 3D detector.
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| 38. |
- Hedman, Mattias, et al.
(författare)
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Predictive value of modelled tumour control probability based on individual measurements of in vitro radiosensitivity and potential doubling time
- 2013
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 86:1025
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to compare patient-specific radiobiological parameters to population averages in predicting clinical outcome after radiotherapy using a tumor control probability (TCP) model based on BED.Methods: A previously published material of forty-six head and neck carcinomas with individually identified radiobiological parameters; SF2 and Tpot, and known tumor size was investigated. These patients had all been treated with external beam radiotherapy and the majority had also received brachytherapy. TCP for each individual based on BED using patient-specific radiobiological parameters was compared to TCP based on BED using average radiobiological parameters (α = 0.3 Gy-1 and Tpot = 3 days).Results: Forty-three patients remained in the final analysis. There was only a weak trend for increasing local tumor control with increasing BED in both groups. However, when TCP was calculated the use of patient-specific parameters was better to identify local control correctly. Sensitivity and specificity for tumor-specific parameters were 63% and 80%, respectively. The corresponding values for population-based averages were 0% and 91%, respectively. Positive predictive value was 92% when tumor-specific parameters were used compared to 0 % for population-based. A receiver operating characteristic (ROC) curve confirmed the superiority of patient-specific parameters over population averages in predicting local control.Conclusions: Individual radiobiological parameters are better than population derived averages when used in a mathematical model to predict tumor control probability after curative radiotherapy in head and neck carcinomas.Advances in knowledge: TCP based on individual radiobiological parameters are better than TCP based on population based averages.
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| 39. |
- Hilman, S, et al.
(författare)
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Gastrointestinal stromal tumour with a KIT exon 11 mutation presenting as a paratesticular mass.
- 2009
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 82:977
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Tidskriftsartikel (refereegranskat)abstract
- Gastrointestinal stromal tumours (GISTs) are sarcomas arising in the gastrointestinal tract. They are characterised by a gain in function mutation of the KIT oncogene and the majority express the receptor tyrosine kinase KIT, which can be detected by the immunohistochemical stain CD117. Patients with a GIST present with symptoms such as abdominal pain or gastrointestinal bleeding, or may be asymptomatic. We describe the clinical history and pathological features of a patient with a GIST who presented with a paratesticular mass which, to our knowledge, has never previously been reported. With the development of new drugs to treat GISTs, the knowledge of the type of mutations may in the future prove helpful in determining optimal treatment strategies and prognosis.
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| 40. |
- Jadidi, M., et al.
(författare)
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Dependency of image quality on acquisition protocol and image processing in chest tomosynthesis-a visual grading study based on clinical data
- 2018
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 91:1087
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the quality of images obtained with two different protocols with different acquisition time and the influence from image post processing in a chest digital tomosynthesis (DTS) system. Methods: 20 patients with suspected lung cancer were imaged with a chest X-ray equipment with tomosynthesis option. Two examination protocols with different acquisition times (6.3 and 12 s) were performed on each patient. Both protocols were presented with two different image post-processing (standard DTS processing and more advanced processing optimised for chest radiography). Thus, 4 series from each patient, altogether 80 series, were presented anonymously and in a random order. Five observers rated the quality of the reconstructed section images according to predefined quality criteria in three different classes. Visual grading characteristics (VGC) was used to analyse the data and the area under the VGC curve (AUC(VGC)) was used as figure-of-merit. The 12 s protocol and the standard DTS processing were used as references in the analyses. Results: The protocol with 6.3s acquisition time had a statistically significant advantage over the vendor-recommended protocol with 12s acquisition time for the classes of criteria, Demarcation (AUC(VGC)= 0.56, p = 0.009) and Disturbance (AUC(VGC) = 0.58, p < 0.001). A similar value of AUC(VGC) was found also for the class Structure (definition of bone structures in the spine) (0.56) but it could not be statistically separated from 0.5 (p = 0.21). For the image processing, the VGC analysis showed a small but statistically significant advantage for the standard DTS processing over the more advanced processing for the classes of criteria Demarcation (AUC vGc = 0.45, p = 0.017) and Disturbance (AUC(VGC) = 0.43, p = 0.005). A similar value of AUC(VGC)was found also for the class Structure (0.46), but it could not be statistically separated from 0.5 (p = 0.31). Conclusion: The study indicates that the protocol with 6.3 s acquisition time yields slightly better image quality than the vender-recommended protocol with acquisition time 12 s for several anatomical structures. Furthermore, the standard gradation processing (the vendor- recommended post-processing for DTS), yields to some extent advantage over the gradation processing/multiobjective frequency processing/flexible noise control processing in terms of image quality for all classes of criteria. Advances In knowledge: The study proves that the image quality may be strongly affected by the selection of DTS protocol and that the vendor-recommended protocol may not always be the optimal choice.
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| 41. |
- Jadidi, M, et al.
(författare)
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Evaluation of a new system for chest tomosynthesis : aspects of image quality of different protocols determined using an anthropomorphic phantom.
- 2015
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 88:1053, s. 20150057-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the image quality obtained with the different protocols in a new chest digital tomosynthesis (DTS) system.METHODS: A chest phantom was imaged with chest X-ray equipment with DTS. 10 protocols were used, and for each protocol, nine acquisitions were performed. Four observers visually rated the quality of the reconstructed section images according to pre-defined quality criteria in four different classes. The data were analysed with visual grading characteristics (VGC) analysis, using the vendor-recommended protocol [12-s acquisition time, source-to-image distance (SID) 180 cm] as reference, and the area under the VGC curve (AUCVGC) was determined for each protocol and class of criteria.RESULTS: Protocols with a smaller swing angle resulted in a lower image quality for the classes of criteria "disturbance" and "homogeneity in nodule" but a higher image quality for the class "structure". The class "demarcation" showed little dependency on the swing angle. All protocols but one (6.3 s, SID 130 cm) obtained an AUCVGC significantly <0.5 (indicating lower quality than reference) for at least one class of criteria.CONCLUSION: The study indicates that the DTS protocol with 6.3 s yields image quality similar to that obtained with the vendor-recommended protocol (12 s) but with the clinically important advantage for patients with respiratory impairment of a shorter acquisition time.ADVANCES IN KNOWLEDGE: The study demonstrates that the image quality may be strongly affected by the choice of protocol and that the vendor-recommended protocol may not be optimal.
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| 42. |
- Jansson, Margareta, et al.
(författare)
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Bowel preparation for excretory urography is not necessary : a randomized trial
- 2007
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 80:956, s. 617-624
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Tidskriftsartikel (refereegranskat)abstract
- Despite the fact that computed tomography is becoming more commonly used to investigate the genitourinary tract, intravenous urography still plays an important role in uroradiology. The aim of this study was to compare bowel purgation and two other preparation methods - dietary restrictions and no preparations at all - in an attempt to find the optimal procedure for uniform practice. 210 consecutive patients were randomised to three preparation groups with 70 in each group. Group 1 received standard bowel purgation, Group 2 was instructed to fast, while Group 3 had no preparation at all. Irrespective of preparation, all patients underwent the same examination procedure. The examining radiographer and evaluating radiologists were unaware of the type of preparation given. Image quality was assessed according to European Commission criteria for excretory urography. The effectiveness of bowel purgation and the amount of residual gas were scored separately. There was no statistically significant difference in the proportions with fulfilled criteria between preparation Groups 1 and 2 and Groups 1 and 3. A criterion was regarded as fulfilled only when all three observers agreed. Assessment of the amount of residual faeces proved the effectiveness of our standard bowel purgation. The results of our study show equality of the evaluated preparation methods and cannot justify further use of bowel purgation before excretory urography.
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| 43. |
- Karambatsakidou, A, et al.
(författare)
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Age-specific and gender-specific radiation risks in paediatric angiography and interventional cardiology: conversion coefficients and risk reference values
- 2020
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 93:1110, s. 20190869-
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Tidskriftsartikel (refereegranskat)abstract
- To estimate risk for exposure-induced cancer death (REID), organ-specific risks of exposure-induced cancer death (REIDHT) and associated conversion coefficients (CCREID:KAP=REID/kerma-area product (KAP), CCREIDHT:KAP=REIDHT/KAP) in paediatric cardiac catheterizations using data from radiation dose structured reports (RDSR). A novel risk surveillance tool consisting of age-specific and gender-specific risk reference values (RRVs) related to population cancer risk is suggested. Methods: The PCXMC v.2.0 code is used together with exposure-related information from RDSR from a cohort of 238 children to assess cancer risks and related conversion coefficients. The KAP corresponding to 1 in 1000 of increased REID is used to define age-specific and gender-specific KAP values to monitor risk in such patient cohorts, here denoted as RRVs. Results: The REID estimates ranged from below 1 up to 300 in 100,000, and the RRVs for the different age groups and gender ranged from 0.77 Gycm2 and 2.1 Gycm2 for neonates (female, male) to 11 Gycm2 and 25 Gycm2 for 15-year-olds (female, male). The CCREID:KAP and CCREIDHT:KAP decreased biexponentially with increased age, being notably higher for female patients. Conclusions: Prominent risk contributing organs were the lungs and the (female) breast. The concept of age-specific and gender-specific RRVs related to population cancer risk is introduced and is intended to be used as a supporting tool for physicians performing such interventions. Advances in knowledge: Age-related and gender-related conversion coefficients for radiation risk, CCREID:KAP and CCREIDHT:KAP, are introduced and a novel risk surveillance concept, the RRV, is suggested for paediatric cardiac catheterizations.
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| 44. |
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| 45. |
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| 46. |
- Krammer, Julia, et al.
(författare)
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Evaluation of a new image reconstruction method for digital breast tomosynthesis : effects on the visibility of breast lesions and breast density
- 2019
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Ingår i: British Journal of Radiology. - : BRITISH INST RADIOLOGY. - 0007-1285 .- 1748-880X. ; 92:1103
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare image quality and breast density of two reconstruction methods, the widely-used filtered-back projection (FBP) reconstruction and the iterative heuristic Bayesian inference reconstruction (Bayesian inference reconstruction plus the method of total variation applied, HBI). Methods: Thirty-two clinical DBT data sets with malignant and benign findings, n = 27 and 17, respectively, were reconstructed using FBP and HBI. Three experienced radiologists evaluated the images independently using a 5-point visual grading scale and classified breast density according to the American College of Radiology Breast Imaging-Reporting And Data System Atlas, fifth edition. Image quality metrics included lesion conspicuity, clarity of lesion borders and spicules, noise level, artifacts surrounding the lesion, visibility of parenchyma and breast density. Results: For masses, the image quality of HBI reconstructions was superior to that of FBP in terms of conspicuity,clarity of lesion borders and spicules (p < 0.01). HBI and FBP were not significantly different in calcification conspicuity. Overall, HBI reduced noise and supressed artifacts surrounding the lesions better (p < 0.01). The visibility of fibroglandular parenchyma increased using the HBI method (p < 0.01). On average, five cases per radiologist were downgraded from BI-RADS breast density category C/D to A/B. Conclusion: HBI significantly improves lesion visibility compared to FBP. HBI-visibility of breast parenchyma increased, leading to a lower breast density rating. Applying the HBIR algorithm should improve the diagnostic performance of DBT and decrease the need for additional imaging in patients with dense breasts. Advances in knowledge: Iterative heuristic Bayesian inference (HBI) image reconstruction substantially improves the image quality of breast tomosynthesis leading to a better visibility of breast carcinomas and reduction of the perceived breast density compared to the widely-used filtered-back projection (FPB) reconstruction. Applying HBI should improve the accuracy of breast tomosynthesis and reduce the number of unnecessary breast biopsies. It may also reduce the radiation dose for the patients, which is especially important in the screening context.
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| 47. |
- Kullberg, Joel, et al.
(författare)
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Whole-body adipose tissue analysis: comparison of MRI, CT and dual energy X-ray absorptiometry.
- 2009
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 82:974, s. 123-30
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to validate a recently proposed MRI-based T(1)-mapping method for analysis of whole-body adipose tissue (AT) using an established CT protocol as reference and to include results from dual energy X-ray absorptiometry (DEXA). 10 subjects, drawn from the Swedish Obese Subjects Sibling-pairs study, were examined using CT, MRI and DEXA. The CT analysis was based on 28 imaged slices. T(1) maps were calculated using contiguous MRI data from two different gradient echo sequences acquired using different flip angles. CT and MRI comparison was performed slice-wise and for the whole-body region. Fat weights were compared between all three modalities. Strong correlations (r > or = 0.977, p<0.0001) were found between MRI and CT whole-body and AT volumes. MRI visceral AT volume was underestimated by 0.79 +/- 0.75 l (p = 0.005), but total AT was not significantly different from that estimated by CT (MRI - CT = -0.61+/-1.17 l; p = 0.114). DEXA underestimated fat weights by 5.23 +/- 1.71 kg (p = 0.005) compared with CT. MRI underestimated whole-body volume by 2.03 +/- 1.61 l (p = 0.005) compared with CT. Weights estimated either by CT or by DEXA were not significantly different from weights measured using scales. In conclusion, strong correlations were found between whole-body AT results from CT, MRI-based T(1) mapping and DEXA. If the differences between the results from T(1)-mapping and CT-based analysis are accepted, the T(1)-mapping method allows fully automated post-processing of whole-body MRI data, allowing longitudinal whole-body studies that are also applicable for children and adolescents.
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| 48. |
- Lanhede, B, et al.
(författare)
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The influence of different technique factors on image quality of chest radiographs as evaluated by modified CEC image quality criteria.
- 2002
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 75:889, s. 38-49
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Tidskriftsartikel (refereegranskat)abstract
- The Commission of the European Communities (CEC) research project "Predictivity and optimisation in medical radiation protection" addressed fundamental operational limitations in existing radiation protection mechanisms. The first part of the project aimed at investigating (1) whether the CEC image quality criteria could be used for optimization of a radiographic process and (2) whether significant differences in image quality based on these criteria could be detected in a controlled project with well known physical and technical parameters. In the present study, chest radiographs on film were produced using healthy volunteers. Four physical/technical parameters were varied in a carefully controlled manner: tube voltage (102 kVp and 141 kVp), nominal speed class (160 and 320), maximum film density (1.3 and 1.8) and method of scatter reduction (grid (R=12) and air gap). The air kerma at the entrance surface was measured for all patients and the risk-related dose H(Golem), based on calculated organ-equivalent dose conversion coefficients and the measured entrance air kerma values, was calculated. Image quality was evaluated by a group of European expert radiologists using a modified version of the CEC quality criteria. For the two density levels, density level 1.8 was significantly better than 1.3 but at the cost of a higher patient radiation exposure. The correlation between the number of fulfilled quality criteria and H(Golem) was generally poor. An air gap technique resulted in lower doses than scatter reduction with a grid but provided comparable image quality. The criteria can be used to highlight optimum radiographic technique in terms of image quality and patient dose, although not unambiguously. A recommendation for good radiographic technique based on a compromise between image quality and risk-related radiation dose to the patient is to use 141 kVp, an air gap, a screen-film system with speed 320 and an optical density of 1.8.
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| 49. |
- Ledenius, Kerstin, 1979, et al.
(författare)
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A method to analyse observer disagreement in visual grading studies: example of assessed image quality in paediatric cerebral multidetector CT images.
- 2010
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 83:991, s. 604-11
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to demonstrate a non-parametric statistical method that can identify and explain the components of observer disagreement in terms of systematic disagreement as well as additional individual variability, in visual grading studies. As an example, the method was applied to a study where the effect of reduced tube current on diagnostic image quality in paediatric cerebral multidetector CT (MDCT) images was investigated. Quantum noise, representing dose reductions equivalent to steps of 20 mA, was artificially added to the raw data of 25 retrospectively selected paediatric cerebral MDCT examinations. Three radiologists, blindly and randomly, assessed the resulting images from two different levels of the brain with regard to the reproduction of high- and low-contrast structures and overall image quality. Images from three patients were assessed twice for the analysis of intra-observer disagreement. The intra-observer disagreement in test-retest assessments could mainly be explained by a systematic change towards lower image quality the second time the image was reviewed. The inter-observer comparisons showed that the paediatric radiologist was more critical of the overall image quality, while the neuroradiologists were more critical of the reproduction of the basal ganglia. Differences between the radiologists regarding the extent to which they used the whole classification scale were also found. The statistical method used was able to identify and separately measure a presence of bias apart from additional individual variability within and between the radiologists which is, at the time of writing, not attainable by any other statistical approach suitable for paired, ordinal data.
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| 50. |
- Ledenius, Kerstin, 1979, et al.
(författare)
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Effect of tube current on diagnostic image quality in paediatric cerebral multidetector CT images.
- 2009
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 1748-880X .- 0007-1285. ; 82:976, s. 313-20
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the effect of tube current on diagnostic image quality in paediatric cerebral multidetector CT (MDCT) images in order to identify the minimum radiation dose required to reproduce acceptable levels of different diagnostic image qualities. Original digital scanning data (raw data) were selected retrospectively from routine MDCT brain examinations of 25 paediatric patients. All examinations had been performed using axial scanning on an eight-slice MDCT (LightSpeed Ultra, GE Healthcare). Their ages ranged from newborn to 15 years. Quantum noise was added artificially to the raw data representing dose reductions equivalent to steps of 20 mA. Patient identification information was removed. Three experienced radiologists blindly and randomly assessed the resulting images from two different levels of the brain with regard to reproduction of structures and overall image quality. Final data were evaluated using the non-parametric statistical approach of inter-scale concordance. The minimum value of tube current-time product (mAs) required to reproduce an image of sufficient diagnostic quality was established in relation to the age of the patient. The corresponding CT dose index values by volume (CTDI(vol) (mGy)) were also established. In conclusion, acceptable reproduction of low-contrast structures was possible at CTDI(vol) values down to 20 mGy (patients 1-5 years old). For acceptable reproduction of high-contrast structures, CTDI(vol) values down to 10 mGy were considered possible (patients 1-5 years old). The original image quality for patients under 6 months of age (15 mGy) was found to be inadequate for acceptable reproduction of low-contrast structures.
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