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- Hesse, B., et al.
(författare)
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EANM/ESC Guidelines for Radionuclide Imaging of Cardiac function
- 2008
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 35:4, s. 851-885
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Tidskriftsartikel (refereegranskat)abstract
- Radionuclide imaging of cardiac function represents a number of well-validated techniques for accurate determination of right (RV) and left ventricular (LV) ejection fraction (EF) and LV volumes. These first European guidelines give recommendations for how and when to use first-pass and equilibrium radionuclide ventriculography, gated myocardial perfusion scintigraphy, gated PET, and studies with non-imaging devices for the evaluation of cardiac function. The items covered are presented in 11 sections: clinical indications, radiopharmaceuticals and dosimetry, study acquisition, RV EF, LV EF, LV volumes, LV regional function, LV diastolic function, reports and image display and reference values from the literature of RVEF, LVEF and LV volumes. If specific recommendations given cannot be based on evidence from original, scientific studies, referral is given to "prevailing or general consensus". The guidelines are designed to assist in the practice of referral to, performance, interpretation and reporting of nuclear cardiology studies for the evaluation of cardiac performance.
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| 2. |
- Hesse, B, et al.
(författare)
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EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology
- 2005
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 32:7, s. 855-897
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Tidskriftsartikel (refereegranskat)abstract
- The European procedural guidelines for radionuclide imaging of myocardial perfusion and viability are presented in 13 sections covering patient information, radiopharmaceuticals, injected activities and dosimetry, stress tests, imaging protocols and acquisition, quality control and reconstruction methods, gated studies and attenuation-scatter compensation, data analysis, reports and image display, and positron emission tomography. If the specific recommendations given could not be based on evidence from original, scientific studies, we tried to express this state-of-art. The guidelines are designed to assist in the practice of performing, interpreting and reporting myocardial perfusion SPET. The guidelines do not discuss clinical indications, benefits or drawbacks of radionuclide myocardial imaging compared to non-nuclear techniques, nor do they cover cost benefit or cost effectiveness.
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| 3. |
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| 4. |
- Josephson Hesse, Kristina, 1958-
(författare)
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Contacts and Trade at Late Bronze Age Hazor : Aspects of Intercultural Relationships and Identity in the Eastern Mediterranean
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hazor’s role in an international Late Bronze Age context has long been indicated but never thoroughly investigated. This role, I believe, was more crucial than previously stressed. My assumption is based on the very large size of this flourishing city which, according to documents, possessed ancient traditions of diplomatic connections and trade with Mesopotamia in the Middle Bronze Age. Its strategic position along the most important N-S and E-W main trade routes, which connected Egypt with Syria-Mesopotamia and the Mediterranean Sea with the city and beyond, promoted contacts. Hazor was a city-state in Canaan, a province under Egyptian domination and exploitation during this period, a position that also influenced the city’s international relations. Methodologically the thesis examines areas of the earlier and the renewed excavations at Hazor, with the aim of discussing the city’s interregional relations and cultural belonging based on external influences in architectural structures (mainly temples), imported pottery and artistic expressions in small finds, supported by written evidence. Cultic influences are also considered. Various origin and find contexts of the imported and culturally influenced material can be recognized, which imply three concepts in the field of interaction studies found within the framework of a modified World Systems Theory and also according to C. Renfrew’s Peer Polity Interaction model: 1) The northern influenced material at Hazor should be understood in the context of cultural identity. It continues from earlier periods and is maintained through external trade and the regional interaction between Canaanite city-states in the north, resulting in certain cultural homogeneity. 2) A core-periphery approach is used to explain the special unequal relation between Canaan and Egypt, in which Hazor might have possessed an integrating semi-peripheral role, a kind of diplomatic position between Egypt and its northern enemies. The city’s loyalty to Egypt is hinted at in documents and in the increasing evidences of emulation in elite contexts appearing on the site. 3) A model of ‘interregional interaction networks’ describes the organization of the trade which provided certain consumers at Hazor with the Aegean and Cypriote pottery and its desirable content. The cargo of the Ulu Burun and Cape Gelidonya ships and documents show that luxury items were transited from afar through Canaan. Such long-distance trade / exchange require professional traders that established networks along the main trade routes. The thesis suggests that Hazor possessed a node position in such a network.
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| 5. |
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| 6. |
- Tägil, Kristina, et al.
(författare)
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A decision support system improves the interpretation of myocardial perfusion imaging.
- 2008
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 35:9, s. 1602-1607
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to investigate the influence of a computer-based decision support system (DSS) on performance and inter-observer variability of interpretations regarding ischaemia and infarction in myocardial perfusion scintigraphy (MPS). METHODS: Seven physicians independently interpreted 97 MPS studies, first without and then with the advice of a DSS. Four physicians had long experience and three had limited experience in the interpretation of MPS. Each study was interpreted regarding myocardial ischaemia and infarction in five myocardial regions. The patients had undergone a gated MPS using a 2-day stress/gated rest (99m)Tc sestamibi protocol. The gold standard used was the interpretations made by one experienced nuclear medicine specialist on the basis of all available clinical and image information. RESULTS: The sensitivity for ischaemia of the seven readers increased from 81% without the DSS to 86% with the DSS (p = 0.01). The increase in sensitivity was higher for the three inexperienced physicians (9%) than for the four experienced physicians (2%). There was no significant change in specificity between the interpretations. The interpretations of ischaemia made with the advice of the DSS showed less inter-observer variability than those made without advice. CONCLUSION: This study shows that a DSS can improve performance and reduces the inter-observer variability of interpretations in myocardial perfusion imaging. Both experienced and, especially, inexperienced physicians can improve their interpretation with the advice from such a system.
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| 7. |
- Tägil, Kristina, et al.
(författare)
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Use of neural networks to improve quality control of interpretations in myocardial perfusion imaging
- 2008
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Ingår i: International Journal of Cardiovascular Imaging. - : Springer Science and Business Media LLC. - 1875-8312 .- 1569-5794 .- 1573-0743. ; 24:8, s. 841-848
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to explore the feasibility of using a technique based on artificial neural networks for quality assurance of image reporting. The networks were used to identify potentially suboptimal or erroneous interpretations of myocardial perfusion scintigrams (MPS). Methods: Reversible perfusion defects (ischaemia) in each of five myocardial regions, as interpreted by one experienced nuclear medicine physician during his daily routine of clinical reporting, were assessed by artificial neural networks in 316 consecutive patients undergoing stress/rest 99mTc-sestamibi myocardial perfusion scintigraphy. After a training process, the networks were used to select the 20 cases in each region that were more likely to have a false clinical interpretation. These cases, together with 20 control cases in which the networks detected no likelihood of false clinical interpretation, were presented in random order to a group of three experienced physicians for a consensus re-interpretation; no information regarding clinical or neural network interpretations was provided to the re-evaluation panel. Results: The clinical interpretation and the re-evaluation differed in 53 of the 200 cases. Forty-six of the 53 cases (87%) came from the group selected by the neural networks, and only seven (13%) were control cases (P < 0.001). The disagreements between clinical routine interpretation by an experienced nuclear medicine expert and artificial networks were related to small and mild perfusion defects and localization of defects. Conclusion: The results demonstrate that artificial neural networks can identify those myocardial perfusion scintigrams that may have suboptimal image interpretations. This is a potentially highly cost-effective technique, which could be of great value, both in daily practice as a clinical decision support tool and as a tool in quality assurance.
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| 8. |
- Wang, YZ, et al.
(författare)
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Effect of mobilization of bone marrow stem cells by granulocyte colony stimulating factor on clinical symptoms, left ventricular perfusion and function in patients with severe chronic ischemic heart disease
- 2005
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 100:3, s. 477-483
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: A phase I safety and efficacy study with granulocyte colony stimulating factor (G-CSF) mobilization of bone marrow stem cells to induce vasculogenesis in patients with severe ischemic heart disease (IHD) was conducted. Design, patients and results: 29 patients with IHD participated in the study. Thirteen patients were treated with G-CSF for 6 days and 16 patients served as controls. G-CSF treatment was without any serious adverse events. Four patients were "poor mobilizers" with a maximal increase in CD34+ cells to 5,000 +/- 700/mL blood (mean +/- S.D.) compared to 28,900 +/- 5,100/mL blood in "mobilizers". At the follow-up, G-CSF treated had improved in CCS classification, NTG consumption and angina attacks, but the controls only in CCS classification. No difference was seen between the two groups. The decline in NTG consumption tended to be significant in "mobilizers" compared to controls. Myocardial perfusion was unchanged at adenosine stress single photon emission computerized tomography (SPECT) or magnetic resonance images (MRI). Left ventricular ejection fraction decreased from 57% to 52% (p < 0.01, MRI) and from 48% to 44% (p=0.07, SPECT) in G-CSF treated, but was unchanged measured with echocardiography. Conclusions: Treatment by G-CSF improved symptoms but not signs of myocardial ischemia in patients with severe IHD. The effects seemed related to mobilization of stem cells. An adverse effect on ejection fraction could not be excluded. (c) 2005 Published by Elsevier Ireland Ltd.
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