| 1. |
- Aliukonyte, Ieva, et al.
(författare)
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Unlocking the potential of photon counting detector CT for paediatric imaging: a pictorial essay
- 2024
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Ingår i: BJR OPEN. - : BRITISH INST RADIOLOGY. - 2513-9878. ; 6:1
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Forskningsöversikt (refereegranskat)abstract
- Recent advancements in CT technology have introduced a revolutionary innovation to practice known as the Photon-Counting detector (PCD) CT imaging. The pivotal hardware enhancement of the PCD-CT scanner lies in its detectors, which consist of smaller pixels than standard detectors and allow direct conversion of individual X-rays to electrical signals. As a result, CT images are reconstructed at higher spatial resolution (as low as 0.2 mm) and reduced overall noise, at no expense of an increased radiation dose. These features are crucial for paediatric imaging, especially for infants and young children, where anatomical structures are notably smaller than in adults and in whom keeping dose as low as possible is especially relevant. Since January 2022, our hospital has had the opportunity to work with PCD-CT technology for paediatric imaging. This pictorial review will showcase clinical examples of PCD-CT imaging in children. The aim of this pictorial review is to outline the potential paediatric applications of PCD-CT across different anatomical regions, as well as to discuss the benefits in utilizing PCD-CT in comparison to conventional standard energy integrating detector CT.
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| 2. |
- Booij, Ronald, et al.
(författare)
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Assessment of visibility of bone structures in the wrist using normal and half of the radiation dose with photon-counting detector CT
- 2023
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Ingår i: European Journal of Radiology. - : ELSEVIER IRELAND LTD. - 0720-048X .- 1872-7727. ; 159
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To quantitatively and qualitatively assess the visibility of bone structures in the wrist on photon-counting detector computed tomography (PCD-CT) images compared to state-of-the-art energy-integrating de-tector CT (EID-CT).Method: Four human cadaveric wrist specimens were scanned with EID-CT and PCD-CT at identical CTDIvolof 12.2 mGy and with 6.1 mGy (half dose PCD-CT). Axial images were reconstructed using the thinnest possible slice thickness, i.e. 0.4 mm on EID-CT and 0.2 mm on PCD-CT, with the largest image matrix size possible using reconstruction kernels optimized for bone (EID-CT: Ur68, PCD-CT: Br92). Quantitative evaluation was performed to determine contrast-noise ratio (CNR) of bone/ fat, cortical and trabecular sharpness. An observer study using visual grading characteristics (VGC) analysis was performed by six observers to assess the visibility of nutrient canals, trabecular architecture, cortical bone and the general image quality.Results: At equal dose, images obtained with PCD-CT had 39 +/- 6 % lower CNR (p = 0.001), 71 +/- 57 % higher trabecular sharpness in the radius (p = 0.02) and 42 +/- 8 % (p < 0.05) sharper cortical edges than those obtained with EID-CT. This was confirmed by VGC analysis showing a superior visibility of nutrient canals, trabeculae and cortical bone area under the curve (AUC) > 0.89) for PCD-CT, even at half dose.Conclusions: Despite a lower CNR and increased noise, the trabecular and cortical sharpness were twofold higher with PCD-CT. Visual grading analysis demonstrated superior visibility of cortical bone, trabeculae, nutrient canals and an overall improved image quality with PCD-CT over EID-CT. At half dose, PCD-CT also yielded superior image quality, both in quantitative measures and as evaluated by radiologists.
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| 3. |
- Emin, Sevgi, et al.
(författare)
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Imaging-based assessment of fatty acid composition in human bone marrow adipose tissue at 7 T : Method comparison and in vivo feasibility
- 2023
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Ingår i: Magnetic Resonance in Medicine. - : Wiley. - 0740-3194 .- 1522-2594. ; 90:1, s. 240-249
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To demonstrate the feasibility and accuracy of chemical shift–encoded imaging of the fatty acid composition (FAC) of human bone marrow adipose tissue at 7 T, and to determine suitable image-acquisition parameters using simulations. Methods: The noise performance of FAC estimation was investigated using simulations with a range of inter-echo time, and accuracy was assessed using a phantom experiment. Furthermore, one knee of 8 knee-healthy subjects (ages 35–54 years) was imaged, and the fractions of saturated fatty acids (SFA) and polyunsaturated fatty acids (PUFA) were mapped. Values were compared between reconstruction methods, and between anatomical regions. Results: Based on simulations, ΔTE = 0.6 ms was chosen. The phantom experiment demonstrated high accuracy of especially SFA using a constrained reconstruction model (slope = 1.1, average bias = −0.2%). The lowest accuracy was seen for PUFA using a free model (slope = 2.0, average bias = 9.0%). For in vivo images, the constrained model resulted in lower intersubject variation compared with the free model (e.g., in the femoral shaft, the SFA percent-point range was within 1.0% [vs. 3.0%]). Furthermore, significant regional FAC differences were detected. For example, using the constrained approach, the femoral SFA in the medial condyle was lower compared with the shaft (median [range]: 27.9% [27.1%, 28.4%] vs. 32.5% [31.8%, 32.8%]). Conclusion: Bone marrow adipose tissue FAC quantification using chemical-shift encoding is feasible at 7 T. Both the noise performance and accuracy of the technique are superior using a constrained signal model.
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| 4. |
- Mourad, Charbel, et al.
(författare)
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Chances and challenges of photon-counting CT in musculoskeletal imaging
- 2024
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Ingår i: Skeletal Radiology. - : SPRINGER. - 0364-2348 .- 1432-2161.
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Forskningsöversikt (refereegranskat)abstract
- In musculoskeletal imaging, CT is used in a wide range of indications, either alone or in a synergistic approach with MRI. While MRI is the preferred modality for the assessment of soft tissues and bone marrow, CT excels in the imaging of high-contrast structures, such as mineralized tissue. Additionally, the introduction of dual-energy CT in clinical practice two decades ago opened the door for spectral imaging applications. Recently, the advent of photon-counting detectors (PCDs) has further advanced the potential of CT, at least in theory. Compared to conventional energy-integrating detectors (EIDs), PCDs provide superior spatial resolution, reduced noise, and intrinsic spectral imaging capabilities. This review briefly describes the technical advantages of PCDs. For each technical feature, the corresponding applications in musculoskeletal imaging will be discussed, including high-spatial resolution imaging for the assessment of bone and crystal deposits, low-dose applications such as whole-body CT, as well as spectral imaging applications including the characterization of crystal deposits and imaging of metal hardware. Finally, we will highlight the potential of PCD-CT in emerging applications, underscoring the need for further preclinical and clinical validation to unleash its full clinical potential.
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| 5. |
- Rio, Ebonie Kendra, et al.
(författare)
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ICON PART-T 2019-International Scientific Tendinopathy Symposium Consensus : recommended standards for reporting participant characteristics in tendinopathy research (PART-T)
- 2020
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 54:11, s. 627-630
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to establish consensus for reporting recommendations relating to participant characteristics in tendon research. A scoping literature review of tendinopathy studies (Achilles, patellar, hamstring, gluteal and elbow) was followed by an online survey and face-to-face consensus meeting with expert healthcare professionals (HCPs) at the International Scientific Tendon Symposium, Groningen 2018. We reviewed 263 papers to form statements for consensus and invited 30 HCPs from different disciplines and geographical locations; 28 completed the survey and 15 attended the meeting. There was consensus that the following data should be reported for cases and controls: sex, age, standing height, body mass, history of tendinopathy, whether imaging was used to confirm pathology, loading tests, pain location, symptom duration and severity, level of disability, comorbidities, physical activity level, recruitment source and strategies, and medication use history. Standardised reporting of participant characteristics aims to benefit patients and clinicians by guiding researchers in the conduct of their studies. We provide free resources to facilitate researchers adopting our recommendations.
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| 6. |
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| 7. |
- Sudol-Szopinska, Iwona, et al.
(författare)
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Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases
- 2015
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Ingår i: Seminars in Musculoskeletal Radiology. - : Georg Thieme Verlag KG. - 1089-7860 .- 1098-898X. ; 19:4, s. 396-411
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Tidskriftsartikel (refereegranskat)abstract
- This article presents the recommendations of the European Society of Muscloskeletal Radiology Arthritis Subcommittee regarding the standards of the use of MRI in the diagnosis of musculoskeletal rheumatic diseases. The recommendations discuss (1) the role of MRI in current classification criteria of musculoskeletal rheumatic diseases (including early diagnosis of inflammation, disease follow-up, and identification of disease complications); (2) the impact of MRI on the diagnosis of axial and peripheral spondyloarthritis, rheumatoid arthritis, and juvenile spondyloarthritis; (3) MRI protocols for the axial and peripheral joints; (4) MRI interpretation and reporting for axial and peripheral joints; and finally, (5) methods for assessing MR images including quantitative, semiquantitative, and dynamic contrast-enhanced MRI studies.
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| 8. |
- Vicenzino, Bill, et al.
(författare)
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ICON 2019-International Scientific Tendinopathy Symposium Consensus : There are nine core health-related domains for tendinopathy (CORE DOMAINS): Delphi study of healthcare professionals and patients
- 2020
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 54:8, s. 444-451
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe absence of any agreed-upon tendon health-related domains hampers advances in clinical tendinopathy research. This void means that researchers report a very wide range of outcome measures inconsistently. As a result, substantial synthesis/meta-analysis of tendon research findings is almost futile despite researchers publishing busily. We aimed to determine options for, and then define, core health-related domains for tendinopathy.MethodsWe conducted a Delphi study of healthcare professionals (HCP) and patients in a three-stage process. In stage 1, we extracted candidate domains from clinical trial reports and developed an online survey. Survey items took the form: 'The 'candidate domain' is important enough to be included as a core health-related domain of tendinopathy'; response options were: agree, disagree, or unsure. In stage 2, we administered the online survey and reported the findings. Stage 3 consisted of discussions of the findings of the survey at the ICON (International Scientific Tendinopathy Symposium Consensus) meeting. We set 70% participant agreement as the level required for a domain to be considered 'core'; similarly, 70% agreement was required for a domain to be relegated to 'not core' (see Results next).ResultsTwenty-eight HCP (92% of whom had >10 years of tendinopathy experience, 71% consulted >10 cases per month) and 32 patients completed the online survey. Fifteen HCP and two patients attended the consensus meeting. Of an original set of 24 candidate domains, the ICON group deemed nine domains to be core. These were: (1) patient rating of condition, (2) participation in life activities (day to day, work, sport), (3) pain on activity/loading, (4) function, (5) psychological factors, (6) physical function capacity, (7) disability, (8) quality of life and (9) pain over a specified time. Two of these (2, 6) were an amalgamation of five candidate domains. We agreed that seven other candidate domains were not core domains: range of motion, pain on clinician applied test, clinical examination, palpation, drop out, sensory modality pain and pain without other specification. We were undecided on the other five candidate domains of physical activity, structure, medication use, adverse effects and economic impact.ConclusionNine core domains for tendon research should guide reporting of outcomes in clinical trials. Further research should determine the best outcome measures for each specific tendinopathy (ie, core outcome sets).
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| 9. |
- Woisetschläger, Mischa, et al.
(författare)
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Improved visualization of the bone-implant interface and osseointegration in ex vivo acetabular cup implants using photon-counting detector CT
- 2023
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Ingår i: EUROPEAN RADIOLOGY EXPERIMENTAL. - : SPRINGERNATURE. - 2509-9280. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSuccessful osseointegration of joint replacement implants is required for long-term implant survival. Accurate assessment of osseointegration could enable clinical discrimination of failed implants from other sources of pain avoiding unnecessary surgeries. Photon-counting detector computed tomography (PCD-CT) provides improvements in image resolution compared to conventional energy-integrating detector CT (EID-CT), possibly allowing better visualization of bone-implant-interfaces and osseointegration. The aim of this study was to assess the quality of visualization of bone-implant-interfaces and osseointegration in acetabular cup implants, using PCD-CT compared with EID-CT.MethodsTwo acetabular implants (one cemented, one uncemented) retrieved during revision surgery were scanned using PCD-CT and EID-CT at equal radiation dose. Images were reconstructed using different reconstruction kernels and iterative strengths. Delineation of the bone-implant and bone-cement-interface as an indicator of osseointegration was scored subjectively for image quality by four radiologists on a Likert scale and assessed quantitatively.ResultsDelineation of bone-implant and bone-cement-interfaces was better with PCD-CT compared with EID-CT (p <= 0.030). The highest ratings were given for PCD-CT at sharper kernels for the cemented cup (PCD-CT, median 5, interquartile range 4.25-5.00 versus EID-CT, 3, 2.00-3.75, p < 0.001) and the uncemented cup (5, 4.00-5.00 versus 2, 2-2, respectively, p < 0.001). The bone-implant-interface was 35-42% sharper and the bone-cement-interface was 28-43% sharper with PCD-CT compared with EID-CT, depending on the reconstruction kernel.ConclusionsPCD-CT might enable a more accurate assessment of osseointegration of orthopedic joint replacement implants.
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| 10. |
- Zhang, Fan, et al.
(författare)
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The association between meniscal body extrusion and the development/enlargement of bone marrow lesions on knee MRI in overweight and obese women
- 2020
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Ingår i: Osteoarthritis and Cartilage Open. - : Elsevier BV. - 2665-9131. ; 1:3-4
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the association between meniscal body extrusion and bone marrow lesion (BML) development/enlargement in overweight and obese women at high risk of knee osteoarthritis (OA). Design: We used baseline and 30 months follow-up data of the PROOF study, Netherlands, comprising overweight or obese women aged 50–60 years, free of clinical knee OA. All subjects (n = 395) completed a questionnaire on knee complaints and physical activity, underwent physical examination, radiography, and repeated 1.5 T MRI of both knees. Using the mid-coronal MRI slice, one observer measured tibial plateau width and meniscal body extrusion of both menisci in both knees. BMLs and meniscal damage were read using the semi-quantitative MOAKS scoring system by another observer. The association between BML development and meniscal extrusion was primarily analyzed with a random-effects logistic regression model adjusted for age, body weight, body height, physical activity, meniscus damage, knee alignment, and tibia width. In addition, we used a fixed-effect regression model for evaluation of knee-specific factors. Results: In our primary model, there was about 24% increased risk of BML incidence/enlargement per 1 mm extrusion (95% confidence interval [CI] 0.99, 1.57) for medial compartments and 69% risk increase (95% confidence interval [CI] 1.27, 2.25) for the lateral compartments. Results from the fixed-effects regression model were similar, strengthening the validity of the findings. Conclusions: Meniscal body extrusion is an important factor influencing BML development/enlargement, and thus may be a potential treatment target in knee OA development.
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