| 1. |
- Wagrell, Sofia
(författare)
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Drivers and Hindrances to Med-Tech Innovation : A device's guide to the Swedish healthcare galaxy
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Today, the expectations on new medical technology solutions are substantial. On the one hand, healthcare policy expects new technologies both to improve the quality of people’s life and to reduce the burgeoning healthcare costs. On the other hand, innovation policy expects new med-tech solutions to stimulate economic growth, with large emphasis on the production of new solutions. However, despite the growing importance of med-tech innovations it is cumbersome to embed these innovative promising products into use in the Swedish healthcare sector.This thesis investigates med-tech innovation by following a microwave-based device in the treatment of the common disease BPH, Benign Prostatic Enlargement. This is an empirically based longitudinal study where the microwave device is used as a probe to capture a med-tech innovation journey. We follow the device through the efforts of technological and scientific development, through complex industrial production structures and foremost inits struggles to achieve widespread use in Swedish public healthcare.This study identifies a number of hindrances and drivers and, importantly, how they are interconnected in the innovation process. By applying the different settings of development, production and use of this device, a central finding is that the very same mechanisms can have contradicting effects in the different settings. Moreover, what functions as a trigger to innovation during development, can become later a hindrance to use. The study also shows that, whereas drivers prevail over hindrances in the development and production of med-tech solutions, hindrances clearly prevail in their use, which involves the provision of healthcare services. Not only has the use setting a generally weak financial support, but its organisational structures and regulations do also have a negative impact on the spread of new solutions in healthcare.
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| 2. |
- Axelsson, Jeanette, 1978-
(författare)
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Differentiation of Brain and Reproductive Organs in Birds : Effects of Environmental Contaminants
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The first objective of this thesis was to investigate effects of endocrine disruptors on the developing brain and gonads of bird embryos. The substances studied were the insecticide methoxychlor, and nine UV-filters (3-benzylidene camphor (3BC), 4 methyl benzylidene camphor (4MBC), benzophenone (BP) 1,2 and 3, 4 hydroxy benzophenone (4 HB), 4 dihydroxy benzophenone (4DHB), benzyl salicylate (BS), and ethyl-4-aminobenzoate Et-PABA)), commonly used in cosmetic products. Some of these substances have no estrogenic effect in vitro, but have been shown to be estrogenic in vivo. The PCB-mixture Clophen A50 is a well-known inducer of biotransformation enzymes and was co-administered with methoxychlor and the UV-filters 3BC and 4MBC. Exposure to 3BC or 4MBC caused ovotestis formation and malformations of the Müllerian ducts in Japanese quail embryos. Co-exposure to one of these compounds and Clophen A50 enhanced the effects, indicating that Clophen A50 potentiates the effects of the UV-filters. Embryonic co-exposure to Clophen A50 and methoxychlor caused a disturbed male sexual behaviour. The metabolites of methoxychlor are estrogen receptor (ER)α-selective, which indicates that the effects on behaviour following embryonic treatment were mediated by ERα. Another objective in this thesis was to localize estrogen receptors (ERs) in the brain of adult and embryonic Japanese quail. The ER localization provides a basis for mechanistic studies on effects of endocrine disruptors, by the identification of estrogen-responsive areas in the brain. We found that ERβ, not previously implicated in sex-differentiation of the brain, was the only ER-subtype present in a sexually dimorphic brain area during differentiation. In conclusion, the estrogenic effects of 3BC, 4MBC and methoxychlor were increased by co-exposure to PCB. These results raise concern since many wildlife species, as well as humans, carry large body burdens of persistent organic pollutants like PCBs, which potentially can interact and enhance the effects of other endocrine disruptors.
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| 3. |
- Eslami, Mohammad Hossein
(författare)
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Knowledge Integration in Buyer-Supplier Collaboration in Product Development
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Recent research in the field of buyer-supplier collaboration has found that product innovation increases if suppliers and their buyers exchange what they know. From a knowledge-based view, it is argued that both buyers and suppliers are important sources of knowledge. Still, the field lacks a comprehensive understanding of: 1) knowledge integration with buyers in terms of what the buyer’s contribution specifically consists of, 2) the timing of this contribution, and 3) how exactly this buyer knowledge integrates in a collaborative product development project. Therefore, the purpose of this thesis is to investigate how suppliers integrate knowledge with buyers in collaborative product development projects.This study examines six case studies in three industrial sectors, and examines an extensive collection of literature based on interviews, workshops and focused group meetings. The thesis also includes a compiled summary and three appended papers.The first of these three papers identifies knowledge content and timing of knowledge integration with buyers. The second paper highlights the mechanisms that suppliers use to integrate knowledge with buyers. The third and final paper describes internal integration approaches that enhance and facilitate the knowledge integration between buyers and suppliers.A principal contribution of this thesis is its demonstration of the dynamism of knowledge integration, specifically in understanding how knowledge integration is used in different phases of product development and how this integration may change over time. The study reveals that knowledge content, which need to be integrated with the buyer, must align with the requirements of each phase of the product development process. Moreover, different knowledge integration mechanisms may be used between the buyer and suppliers during each phase of the project.
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| 4. |
- Molin, Jonas, 1972-
(författare)
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Business Streamlining : Toward a Substantive Theory of the Streamlining of Outsourced Business Processes
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Research comparing public-private services outsourcing applying a longitudinal approach including the production/delivery processes (life after purchase) in services sourcing contexts is scarce. In addition, prior studies on service sourcing tend be under conceptualized.To address the above this licentiate thesis presents the results of a comparative and grounded theory inspired case study of two major Swedish FM services outsourcing projects, a public and a private case of operational partnering. Client-provider interaction processes on management level have been followed regularly over time utilizing participant observation as a core element combined with interviews and documentary studies. Observed variations in relational orientation over time, are problematized and discussed. A substantive theory – Business streamlining - of Facility Management outsourcing processes, including the seldom-researched life after purchase processes, is outlined and contextualized. It is argued that existing relational classifications, such as operational partnering, do not capture the life after purchase dynamics of the studied relationships. Business streamlining rests on four main categories, which have major influence on how Facility Management relationships evolve over time.
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| 5. |
- Hansson, Magnus, 1972-
(författare)
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On closedowns : towards a pattern of explanations to the closedown effect
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Productivity effects under uncertainty and threat is the topic of this thesis. It comprises a synthesis and four papers on closedown – focusing a phenomenon where there is an overall productivity increase during the closedown process. Productivity effects are the primary focus of this work’s case closedown studies, and uncertainty and threat the common denominator of the cases. This thesis contributes a theoretical foundation for analysis of closedowns. It identifies explanatory contributing factors and patterns which enable a better understanding of the Closedown effect.The theoretical foundation for this thesis is outlined in the first paper. It recontextualizes the Hawthorne experiments by applying a closedown perspective to them. This new perspective identifies several similarities between the Hawthorne experiments and situations where closedown is threatened or decided. Originally the Hawthorne experiments were viewed as a closed system, laboratory experiments instead of actions on daily operations. The new perspective analyzed the prevalent threat implicit in the context that the Hawthorne experiments were conducted in. Such threat was identified in other earlier work on the Horndal and Closedown effect, situations where productivity also increased. Threat can act as a motivator or de-motivator. With the recontextualized perspective, it was found that employees become sensitive to their managerial and informational context, and so productivity patterns fluctuate. A productivity increase is observed overall when closedown is threatened. It is this phenomenon we term the Closedown effect.In the second paper, a case study of the closure of a plant tracks productivity fluctuations and fine-tunes analysis of critical events that occur during a closedown process. It builds on the previous papers theoretical foundations and outlines a theoretical model for explaining the Closedown effect. Productivity development depends on workers’ interpretations of management information, and actions and reactions to the prevalent closedown. The dialectics between management and workers change during the closedown period – there were fewer conflicts, speeder conflict resolution, increased formal and informal worker autonomy, and more workers’ work design initiatives. A HRM-program initially had a positive effect on workers, but its importance diminished during the closedown period. The closedown decision generated structural changes: management control over daily operations diminished, informal leadership evolved and individualization grew stronger as the importance of informal groups deteriorated.In the third paper a multiple case-study is presented. Lack of social responsibility characterizes the managerial setting in these cases, in contrast to the case study presented in the second paper. That is, here there was a lack of management support for worker activities in this particular closedown process. The Closedown effect was found to be statistically significant in three of the four cases. This paper also contributes a theoretical elaboration of the Closedown effect, including distinguishing the key aspects needed in a detailed analysis of the closedown process.In the fourth paper the productivity paradox is examined with a holistic approach, which draws on Buckley’s (1967) modern systems theory. This holistic perspective considers changes in the initial economic and institutional structure, and assesses the dynamics that are triggered by the closedown decision. A closedown decision evidently reorders the equilibrium between management and the workers. The main holistic pattern that emerges is a new order, where worker self management replaces management control at plant level and workplace psychology is based on the apprehension of unfairness.An empirically-close analysis approach is a recognized method for highlighting puzzling phenomenon and developing explanatory patterns. This empirically-close analysis of the empirical data generated in this thesis enabled identification of key factors to explain the appearance of the Closedown effect. Moreover, it was a means for generating a more rigorous theoretical understanding of the Closedown effect, and developing a pattern of explanations to this productivity increase effect.A key theoretical contribution of this thesis is the identification of a range of concepts that form antecedent explanations to the Closedown effect’s occurrence. These antecedents are aggregated in themes: managerial actions, counter-institutional actions, conflict context, worker autonomy, perceived threat of job loss, collective action, economic and institutional reordering, and institutional restrictions. The following describes the influence of these aggregates and their temporal dynamics, in relationship to the Closedown effect.The identification above factors and the generation of a theoretical framework to assess closedowns is the contribution this thesis makes. The significance of these for future research is also critically assessed.
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| 6. |
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| 7. |
- Melin, Ulf, 1968-
(författare)
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Koordination och informationssystem i företag och nätverk
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Organisatorisk koordination, informationssystem och IT-system är nyckelord i denna avhandling. Att koordinera är en grundläggande del av verksamhet eftersom denna handling syftar till att öka sannolikheten för att nå mål. Att förstå koordination har engagerat forskare från olika ämnesområden under en längre tid. Trots detta finns, med utgångspunkt i både teori och praktik, behov att studera koordination i både företag och nätverk tillsammans med användning av IT-system. Frågor som behandlas i avhandlingen är följande: hur ser samspelet ut mellan koordination inom företag och mellan företag (relationer i nätverk)? Vilken roll har informations-/kommunikationshantering och informationssystem/IT-system vid koordination? Huvudsyftet är att utifrån ett kombinerat företags- och nätverksperspektiv, beskriva och analysera koordination av handlingar inom, och av, affärsrelationer samt användning av informations- och IT-system. Exempel på teorier och perspektiv som används för att förstå koordination är organisationsteori, inter-organisatorisk teori, nätverksansatsen samt teori om informationssystem och IT-system. Aktörer, handling och kommunikation som handling betonas också. Den empiriska delen av arbetet utgörs av två nätverk; ett inom träindustrin och ett inom verkstadsindustrin. Nätverken innehåller både likheter och skillnader och dessa nyttjas för att förstå koordination och informationssystem. De IT-system som studeras och analyseras är företagsinterna och inter-organisatoriska. Systemen används exempelvis för konstruktion (CAD-system), hantering av order, lager och fakturering. Dessutom har ett affärssystem studerats. Det empiriska arbetet är longitudinellt, kvalitativt inriktat och utgörs av 70 intervjuer, viss deltagande observation samt studier av dokument, IT-system och dess användning. Medverkande företag och privata konsumenter är 23 och antalet analyserade affärsrelationer är 20. Kunskapsutvecklingsprocessen kännetecknas av en aktiv användning av både teori och empiri. Teori är en initial guide till datainsamling, en del av en iterativ process av datainsamling och analys samt en del av slutmålet. Växlingen mellan fallstudier, etablerad kunskap, förförståelse och framväxande teori är tydlig både i tillämpning och i beskrivning. Resultatet av studien visar bland annat att befintliga koordinationsmekanismer från teori har en otillräcklig förståelse- och förklaringskraft vid studier av koordination i företag och nätverk, med och utan bruk av IT-system, och behöver därför kompletteras. Otillräcklig hänsyn tas också till mänskliga aktörer och deras handlingar, företagsextern påverkan, emergenta och dynamiska processer, samtidighet och variation samt kommunikation, IT-system och information. Koordination är ett komplext fenomen som kan betraktas utifrån olika vyer. En uppsättning vyer, ett centralt resultat av arbetet, visar att handling, anpassning, organisering, medel, roller, subjekt/objekt och kommunikation samt information är viktigt att inkludera för att förstå koordination. IT-systemens alltmer framträdande roll vid organisering, både som reellt stöd och hinder vid koordination, diskuteras och problematiseras. En viktig tes i avhandlingen är att genom en utvecklad förståelse för koordinationsprinciper och -mönster i företag och nätverk stöds utveckling av verksamhetsnyttiga informationssystem. Rika empiriska beskrivningar tillsammans med en kombinerad ansats vid analys av affärsrelationer samt analys och jämförelse av teorier är också viktiga resultat av arbetet. Vidare finns en avslutande reflektion över den eklektiska forskningsansatsen i arbetet tillsammans med reflektion över utgångspunkter, datagenerering och kunskapsbidrag.
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| 8. |
- Olofsson, Jenny, 1980-
(författare)
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Amoebae as Hosts and Vectors for Spread of Campylobacter jejuni
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Campylobacter jejuni is the leading bacterial cause of gastrointestinal diarrheal disease in humans worldwide. This zoonotic pathogen has a complex epidemiology due to its presence in many different host organisms. The overall aim of this thesis was to explore the role of amoebae of the genus Acanthamoeba as an intermediate host and vector for survival and dissemination of C. jejuni. Earlier studies have shown that C. jejuni can enter, survive and replicate within Acanthamoebae spp. In this thesis, I have shown that C. jejuni actively invades Acanthamoeba polyphaga. Once inside, C. jejuni could survive within the amoebae by avoiding localization to degradative lysosomes. We also found that A. polyphaga could protect C. jejuni in acid environments with pH levels far below the range in which the bacterium normally survives. Furthermore, low pH triggered C. jejuni motility and invasion of A. polyphaga. In an applied study I found that A. polyphaga also could increase the survival of C. jejuni in milk and juice both at room temperature and at +4ºC, but not during heating to recommended pasteurization temperatures. In the last study we found that forty environmental C. jejuni isolates with low bacterial concentrations could be successfully enriched using the Acanthamoeba-Campylobacter coculture (ACC) method. Molecular genetic analysis using multilocus sequence typing (MLST) and sequencing of the flaA gene, showed no genetic changes during coculture. The results of this thesis have increased our knowledge on the mechanisms behind C. jejuni invasion and intracellular survival in amoebae of the genus Acanthamoeba. By protecting C. jejuni from acid environments, Acanthamoebae could serve as important reservoirs for C. jejuni e.g. during acid sanitation of chicken stables and possibly as vectors during passage through the stomach of host animals. Furthermore, Acanthamoeba spp. could serve as a vehicle and reservoir introducing and protecting C. jejuni in beverages such as milk and juice. Validation of the ACC method suggests that it is robust and could be used even in outbreak investigations where genetic fingerprints are compared between isolates. In conclusion, Acanthamoeba spp. are good candidates for being natural hosts and vectors of C. jejuni.
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| 9. |
- Parment, Anders, 1972-
(författare)
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Car distribution organization : strategic issues in four configurations
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study is concerned with car distribution organization, a context characterized by overcapacity, intense competition, and manufacturers heavily focusing on brands. In the study, different distribution solutions are investigated through applying a framework of four strategic issues. First, the pressure to keep distribution costs low while conveying a clear brand message gives rise to decisions on solus or multi franchising; second, the choice of either selling through one channel that is likely to be committed to the brand, or through multi channels competing with each other; third, the choice of selling the products through own outlets or through independent dealers, the latter giving rise to conflicting interests; fourth, the choice of mechanisms for coordinating channel members' efforts and knowledge exchange.The empirical part of the study contains slightly more than 100 interviews with manufacturers, importers, dealers and experts in Sweden, Germany, the UK, Spain and Australia.The study reveals that, among other forces in the distribution setting, industry overcapacity appears to undermine efforts to create constructive relationships between channel members. Order-to-delivery systems and systems to feed back market knowledge are superseded by the pressure to sell pre-produced cars. Particularly volume brands suffer from fierce competition, while a premium brand provides some protection from competitive forces.The findings of the study are synthesized as four distribution chain configurations. In the brand-based chain, channel members' efforts create a consistent brand experience throughout the chain. The efficiency-based chain is focused on keeping costs low without neglecting other demands, e.g. the ability to handle industry overcapacity. The flexibility-based chain is led by a powerful dealer group who manages a portfolio of brands and dealerships. As new opportunities in the market emerge, the dealer group restructures the portfolio accordingly. The premium aspiration chain, finally, represents an inferior strategy by trying to be a premium brand while lacking an attractive product, thus creating a situation of confused customers and excessive distribution costs.
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| 10. |
- Renman, David, et al.
(författare)
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Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer
- 2023
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Ingår i: International Journal of Colorectal Disease. - : Springer Nature. - 0179-1958 .- 1432-1262. ; 38:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Sarcopenia and myosteatosis, quantified via computed tomography (CT), are associated with poor colorectal cancer outcomes. These body composition estimates can be influenced by physical exercise. We explored the correlation between pre-diagnostic physical exercise, body composition close to diagnosis, and the combined prognosis impact of these factors.Methods: We studied 519 stage I–III colorectal cancer (CRC) cases diagnosed 2000–2016 with pre-diagnostic self-reported recreational physical exercise data collected in the prospective, population-based Northern Sweden Health and Disease Study, and CT-estimated skeletal muscle index (SMI) or skeletal muscle density (SMD). Risk estimates were calculated by multivariable logistic regression and Cox proportional hazards models.Results: No association was seen between low pre-diagnostic physical exercise and sarcopenia/myosteatosis in the multivariable model adjusted for age, sex, educational level, tumor stage, and tumor location. In multivariable Cox regression models, the combination of low pre-diagnostic physical exercise and either sarcopenia or myosteatosis at the time of diagnosis was associated with cancer-specific mortality compared to the reference group of high physical exercise combined with no sarcopenia/myosteatosis (adjusted HR 1.94 95% CI 1.00–3.76 for sarcopenia and adjusted HR 2.39 95% CI 1.16–4.94 for myosteatosis).Conclusions: The combined presence of low pre-diagnostic physical exercise and sarcopenia or myosteatosis was associated with increased CRC-specific mortality. Despite the positive effect on prognosis, physical exercise did not alter body composition estimates at diagnosis, which could indicate attenuation from other factors.
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| 11. |
- Shirdel, Mona, et al.
(författare)
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Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease
- 2020
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 59:7, s. 799-808
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators.Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival.Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.
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| 12. |
- Unéus, Erica Irene, et al.
(författare)
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Cerebellar and Cerebral Amyloid Visualized by [18F]flutemetamol PET in Long-Term Hereditary V30M (p.V50M) Transthyretin Amyloidosis Survivors
- 2022
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Ingår i: Frontiers in Neurology. - : Frontiers Media S.A.. - 1664-2295. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hereditary transthyretin (ATTRv) amyloidosis caused by the V30M (p. V50M) mutation is a fatal, neuropathic systemic amyloidosis. Liver transplantation has prolonged the survival of patients and central nervous system (CNS) complications, attributed to amyloid angiopathy caused by CNS synthesis of variant transthyretin, have emerged. The study aimed to ascertain amyloid deposition within the brain in long-term ATTRv amyloidosis survivors with neurological symptoms from the CNS.Methods: A total of 20 patients with ATTR V30M having symptoms from the CNS and a median disease duration of 16 years (8–25 years) were included in this study. The cognitive and peripheral nervous functions were determined for 18 patients cross-sectionally at the time of the investigation. Amyloid brain deposits were examined by [18F]flutemetamol PET/CT. Five patients with Alzheimer's disease (AD) served as positive controls.Result: 60% of the patients with ATTRv had a pathological Z-score in the cerebellum, compared to only 20% in the patients with AD. 75% of the patients with transient focal neurological episodes (TFNEs) displayed a pathological uptake only in the cerebellum. Increased cerebellar uptake was related to an early age of onset of the ATTRv disease. 55% of the patients with ATTRv had a pathological Z-score in the global cerebral region compared to 100% of the patients with AD.Conclusion: Amyloid deposition within the brain after long-standing ATTRv amyloidosis is common, especially in the cerebellum. A cerebellar amyloid uptake profile seems to be related to TFNE symptoms.
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| 13. |
- Zarei, Maryam, et al.
(författare)
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Accuracy of gross tumour volume delineation with [68Ga]-PSMA-PET compared to histopathology for high-risk prostate cancer
- 2024
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Ingår i: Acta Oncologica. - : MJS Publishing, Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 503-510
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The delineation of intraprostatic lesions is vital for correct delivery of focal radiotherapy boost in patients with prostate cancer (PC). Errors in the delineation could translate into reduced tumour control and potentially increase the side effects. The purpose of this study is to compare PET-based delineation methods with histopathology.MATERIALS AND METHODS: The study population consisted of 15 patients with confirmed high-risk PC intended for prostatectomy. [68Ga]-PSMA-PET/MR was performed prior to surgery. Prostate lesions identified in histopathology were transferred to the in vivo [68Ga]-PSMA-PET/MR coordinate system. Four radiation oncologists manually delineated intraprostatic lesions based on PET data. Various semi-automatic segmentation methods were employed, including absolute and relative thresholds, adaptive threshold, and multi-level Otsu threshold.RESULTS: The gross tumour volumes (GTVs) delineated by the oncologists showed a moderate level of interobserver agreement with Dice similarity coefficient (DSC) of 0.68. In comparison with histopathology, manual delineations exhibited the highest median DSC and the lowest false discovery rate (FDR) among all approaches. Among semi-automatic approaches, GTVs generated using standardized uptake value (SUV) thresholds above 4 (SUV > 4) demonstrated the highest median DSC (0.41), with 0.51 median lesion coverage ratio, FDR of 0.66 and the 95th percentile of the Hausdorff distance (HD95%) of 8.22 mm.INTERPRETATION: Manual delineations showed a moderate level of interobserver agreement. Compared to histopathology, manual delineations and SUV > 4 exhibited the highest DSC and the lowest HD95% values. The methods that resulted in a high lesion coverage were associated with a large overestimation of the size of the lesions.
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