| 1. |
- Cagnoli, Patricia, et al.
(author)
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Reduced Insular Glutamine and N-Acetylaspartate in Systemic Lupus Erythematosus: A Single-Voxel H-1-MR Spectroscopy Study
- 2013
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In: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 20:10, s. 1286-1296
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Journal article (peer-reviewed)abstract
- Rationale and Objectives: To investigate for differences in metabolic concentrations and ratios between patients with systemic lupus erythematosus (SLE) without (group SLE) and those with neurological symptoms (group NPSLE) compared to a healthy control (group HC) in three normal-appearing brain regions: the frontal white matter, right insula (RI), and occipital gray matter and whether changes in any of the metabolites or metabolic ratios are correlated to disease activity and other clinical parameters. Materials and Methods: Twenty patients with SLE (18 women and 2 men, age range 23.4-64.6 years, mean age 43.9 years), 23 NPSLE patients (23 women, age range 23.7-69.8 years, mean age 42.4 years), and 21 HC (19 women and 2 men, age range 21.0-65.7 years, mean age 43.4 years) were included. All subjects had conventional brain magnetic resonance imaging and H-1 single-voxel spectroscopy, clinical assessment, and laboratory testing. Results: NPSLE patients had significantly reduced N-acetylaspartate (NAA)/creatine compared to HC (P = .02) and SLE patients (P = .01) in the RI. Lower glutamine/creatine levels were also detected in RI in both patient groups and in frontal white matter in NPSLE patients compared to HC (P = .01, P = .02). NAA/Cr ratio in the RI was significantly negatively correlated with the Systemic Lupus Erythematosus Disease Activity Index (r = -0.41; P = .008), and patients with active SLE symptoms also had a trend toward lower NAA/creatine ratios (1.02 vs 1.12; P = .07). Conclusions: The present data support previous findings of abnormal metabolic changes in normal-appearing regions in the brain of both SLE and NPSLE patients and raise the possibility that especially NAA, glutamine, and glutamate may be additional biomarkers for cerebral disease activity in SLE patients as these early metabolic changes occur in the brain of SLE patients before neurologic and imaging manifestations become apparent.
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| 2. |
- Elias, Augusto E., et al.
(author)
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MR Spectroscopy Using Normalized and Non-normalized Metabolite Ratios for Differentiating Recurrent Brain Tumor from Radiation Injury
- 2011
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In: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 18:9, s. 1101-1108
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Journal article (peer-reviewed)abstract
- Rationale and Objectives: To compare the ability of normalized versus non-normalized metabolite ratios to differentiate recurrent brain tumor from radiation injury using magnetic resonance spectroscopy (MRS) in previously treated patients. Materials and Methods: Twenty-five patients with previous diagnosis of primary intracranial neoplasm confirmed with biopsy/resection, previously treated with radiation therapy (range, 54-70 Gy) with or without chemotherapy and new contrast enhancing lesion on a 1.5 T magnetic resonance imaging at the site of the primary neoplasm participated in this retrospective study. After MRS, clinical, radiological, and histopathology data were used to classify new contrast-enhancing lesions as either recurrent neoplasm or radiation injury. Volume of interest included both the lesion and normal-appearing brain on the contralateral side. Non-normalized metabolic ratios were calculated from choline (Cho), creatine (Cr), and N-acetylaspartate (NAA) spectroscopic values obtained within the contrast-enhancing lesion: Cho/Cr, NAA/Cr, and Cho/NAA. Normalized ratios were calculated using the metabolic values from the contralateral normal side: Cho/normal creatinine (nCr), Cho/normal N-acetylaspartate (nNAA), Cho/normal choline, NAA/nNAA, NAA/nCr, and Cr/nCr. Results were correlated with the final diagnosis by Wilcoxon rank-sum analysis. Results: Two of three non-normalized ratios, Cho/NAA (sensitivity 86%, specificity 90%) and NAA/Cr (sensitivity 93%, specificity 70%) significantly associated with tumor recurrence even after correcting for multiple comparisons. Of the six normalized ratios, only Cho/nNAA significantly correlated with tumor recurrence (sensitivity 73%, specificity 40%), but did not remain significant after correcting for multiple comparisons. Conclusion: Cho/NAA and NAA/Cr were the two ratios with the best discriminating ability and both had better discriminating ability than their corresponding normalized ratios (Area under the curve = 0.92 versus 0.77, AUC= 0.85 vs. 0.66), respectively.
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| 3. |
- Hedner, Charlotta, et al.
(author)
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Associations between Presence of Relevant Information in Referrals to Radiology and Prevalence Rates in Patients with Suspected Pulmonary Embolism.
- 2013
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In: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 20:9, s. 1115-1121
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Journal article (peer-reviewed)abstract
- The purpose of this study was to assess if the presence of information including the pretest probability (Wells score), other known risk factors, and symptoms given on referrals for computed tomography (CT) pulmonary angiography correlated with prevalence rates for pulmonary embolism (PE). Also, to evaluate for differences between a university and a regional hospital setting regarding patient characteristics, amount of relevant information provided on referrals, and prevalence rates for pulmonary embolism.
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| 4. |
- Rohrbach, Daniel J., et al.
(author)
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Preoperative Mapping of Nonmelanoma Skin Cancer Using Spatial Frequency Domain and Ultrasound Imaging
- 2014
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In: Academic Radiology. - : Elsevier. - 1076-6332 .- 1878-4046. ; 21:2, s. 263-270
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Journal article (peer-reviewed)abstract
- Rationale and ObjectivesThe treatment of nonmelanoma skin cancer (NMSC) is usually by surgical excision or Mohs micrographic surgery and alternatively may include photodynamic therapy (PDT). To guide surgery and to optimize PDT, information about the tumor structure, optical parameters, and vasculature is desired.Materials and MethodsSpatial frequency domain imaging (SFDI) can map optical absorption, scattering, and fluorescence parameters that can enhance tumor contrast and quantify light and photosensitizer dose. High frequency ultrasound (HFUS) imaging can provide high-resolution tumor structure and depth, which is useful for both surgery and PDT planning.ResultsHere, we present preliminary results from our recently developed clinical instrument for patients with NMSC. We quantified optical absorption and scattering, blood oxygen saturation (StO2), and total hemoglobin concentration (THC) with SFDI and lesion thickness with ultrasound. These results were compared to histological thickness of excised tumor sections.ConclusionsSFDI quantified optical parameters with high precision, and multiwavelength analysis enabled 2D mappings of tissue StO2 and THC. HFUS quantified tumor thickness that correlated well with histology. The results demonstrate the feasibility of the instrument for noninvasive mapping of optical, physiological, and ultrasound contrasts in human skin tumors for surgery guidance and therapy planning.
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| 5. |
- Sundgren, Pia
(author)
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Mentoring Radiology Residents in Clinical and Translational Research.
- 2012
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In: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 19:9, s. 1110-1113
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Journal article (peer-reviewed)abstract
- To be an effective mentor at any level is always a challenge and requires a dedication to teaching and mentorship and being prepared to devote a significant proportion of one's time. But if you are open-minded and deeply care for your mentee, you have the opportunity to be a successful mentor. This presentation is based on personal experience of mentoring radiology residents, doctoral students, and post doctoral students for several years.
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| 6. |
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| 7. |
- Wang, Page I., et al.
(author)
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Perfusion-weighted MR Imaging in Cerebral Lupus Erythematosus
- 2012
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In: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 19:8, s. 965-970
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Journal article (peer-reviewed)abstract
- Rationale and Objective: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a diagnostically challenging, severe, and life-threatening condition, which is currently lacking a "gold standard." Our aim with this study is to look for magnetic resonance (MR) perfusion differences in NPSLE, SLE, and healthy control (HC) patients and correlate our findings with clinical parameters. Materials and Methods: Twenty-four NPSLE patients, 21 SLE patients, and 21 HC underwent dynamic susceptibility contrast enhanced MR perfusion using a 3-T scanner. Nine prospectively selected intracranial regions of interest were placed in white and gray matter and the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MU) values were calculated. Subjects underwent clinical evaluation with SLEDAI and serum antibodies. Results: The SLE patients had higher CBF and CBV compared to the HC overall (P =.01) and in specific areas (P =.03-.048). SLE patients with signs of active disease (elevated SLEDAI and anti-double-stranded DNA) had significantly elevated CBV, CBF, and MU in the posterior cingulate gyrus (P =.01-.02). No significant difference was seen in the magnetic resonance perfusion measurements of NPSLE patients compared to SLE and HC, although the NPSLE patients also showed higher CBV variability compared to the SLE (P =.0004) and HC cohort (P <.0001). Conclusion: SLE patients have increased CBV and CBF compared to healthy controls. The SLE patients with clinical markers for active disease have elevated CBV, CBF, and MU in the posterior cingulate gyrus. NPSLE patients show increased variability in perfusion measurements, which may explain why susceptibility contrast enhanced MRI has not yet provided a specific target for NPSLE.
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| 10. |
- Johnsson, Åse (Allansdotter), 1966, et al.
(author)
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A Retrospective Study of Chest Tomosynthesis as a Tool for Optimizing the use of Computed Tomography Resources and Reducing Patient Radiation Exposure
- 2014
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In: Academic Radiology. - : Elsevier BV. - 1076-6332. ; 21:11, s. 1427-1433
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Journal article (peer-reviewed)abstract
- Rationale and Objectives: To investigate potential benefits and drawbacks of the clinical use of chest tomosynthesis (CTS), to what extent CTS obviates the need for chest computed tomography (CT), and what reduction in radiation dose thereby can be achieved. Materials and Methods: The Regional Ethical Review Board approved the follow-up study of patients examined with CTS as part of clinical routine. For each case, two radiologists in consensus determined whether CT would have been performed, had CTS not been an option, and whether CTS was an adequate examination. Thereafter, it was determined whether the use of CTS instead of CT in retrospect was beneficial, neutral, or detrimental for the radiological work-up. The radiation dose to the patient population was determined both for the actual clinical situation and for the alternative scenario that would result, had CTS not been available. Results: During 1 month 3.5 years before the survey, 149 patients (74 women, age 18-91 years) had undergone CTS for clinical purposes. It was judged that CT would have been performed in 100 cases, had CTS not been available, and that CTS obviated the need for CT in 80 cases. CTS was judged as beneficial, neutral, and detrimental for the radiological work-up in 85, 13, and two cases, respectively. For the entire study population, the use of CTS decreased the average effective dose from 2.7 to 0.7 mSv. Conclusions: The present study indicates that CTS may have benefits for the radiological work-up as it has the potential to both optimize the use of CT resources and reduce the effective dose to the patient population. A drawback is that CTS examinations may fail to reveal pathology visible with CT and in clinically doubtful cases further investigations including other imaging procedures should be considered.
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| 11. |
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| 12. |
- Persson Osowski, Christine, et al.
(author)
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Teachers' interaction with children in the school meal situation : The example of pedagogic meals in Sweden
- 2013
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In: Journal of nutrition education and behavior. - : Elsevier BV. - 1499-4046 .- 1878-2620. ; 45:5, s. 420-427
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Journal article (peer-reviewed)abstract
- Objective: School meals are also a teaching occasion in which children learn about food and meals, which is referred to as "pedagogic meals" in Sweden. The aim of the present article was to study how the pedagogic meal is practiced in preschool and school settings, with focus on how teachers acted when interacting with the children. Design: Observations, interviews, and focus group interviews. Setting: School canteens. Participants: Three schools. Phenomenon of Interest: Teaching in the school meal situation. Analysis: Social constructionism, new social studies of childhood. Results: The teachers took on 3 different roles. The sociable teacher role entailed turning the school lunch into a social occasion, the educating teacher role involved educating the children, and the evasive teacher role was not associated with the definition of a pedagogic meal. The teacher roles, which ranged from adult-oriented to child-oriented, and which varied in the level of interaction with the children, were summarized in a framework named the Adult-to Child-oriented Teacher Role Framework for School Meals (ACTS). Conclusions and Implications: To realize the potential of pedagogic meals, teachers must be educated and become aware of the effects of their behaviors. In this situation, the ACTS framework can constitute a useful tool.
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