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Torkzad, Michael R.
Alternative names
Publications (10 of 27) Show all publications
Torkzad, M. R., Ahlström, H. & Karlbom, U. (2014). Comparison of different magnetic resonance imaging sequences for assessment of fistula-in-ano. World Journal of Radiology, 6(5), 203-209
Open this publication in new window or tab >>Comparison of different magnetic resonance imaging sequences for assessment of fistula-in-ano
2014 (English)In: World Journal of Radiology, ISSN 1949-8470, E-ISSN 1949-8470, Vol. 6, no 5, p. 203-209Article in journal (Refereed) Published
Abstract [en]

AIM:

To assess agreement between different forms of T2 weighted imaging (T2WI), and post-contrast T1WI in the depiction of fistula tracts, inflammation, and internal openings with that of a reference test.

METHODS:

Thirty-nine consecutive prospective cases were enrolled. The following sequences were used for T2WI: 2D turbo-spin-echo (2D T2 TSE); 3D T2 TSE; short tau inversion recovery (STIR); 2D T2 TSE with fat saturation performed in all patients. T1WI were either a 3D T1-weighted prepared gradient echo sequence with fat saturation or a 2D T1 fat saturation [Spectral presaturation with inversion (SPIR)]. Agreement for each sequence for determination of fistula extension, internal openings, and the presence of active inflammation was assessed separately and blindly against a reference test comprised of follow-up, surgery, endoscopic ultrasound, and assessment by an independent experienced radiologist with access to all images.

RESULTS:

Fifty-six fistula tracts were found: 2 inter-sphincteric, 13 trans-sphincteric, and 24 with additional tracts. The best T2 weighted sequence for depiction of fistula tracts was 2D T2 TSE (Cohen's kappa = 1.0), followed by 3D T2 TSE (0.88), T2 with fat saturation (0.54), and STIR (0.19). Internal openings were best seen on 2D T2 TSE (Cohen's kappa = 0.88), followed by 3D T2 TSE (0.70), T2 with fat saturation (0.54), and STIR (0.31). Detection of inflammation showed Cohen's kappa of 0.88 with 2D T2 TSE, 0.62 with 3D T2 TSE, 0.63 with STIR, and 0.54 with T2 with fat saturation. STIR, 3D T2 TSE, and T2 with fat saturation did not make any contributions compared to 2D T2 TSE. Post-contrast 3D T1 weighted prepared gradient echo sequence with fat saturation showed better agreement in the depiction of fistulae (Cohen's kappa = 0.94), finding internal openings (Cohen's kappa = 0.97), and evaluating inflammation (Cohen's kappa = 0.94) compared to post-contrast 2D T1 fat saturation or SPIR where the corresponding figures were 0.71, 0.66, and 0.87, respectively. Comparing the best T1 and T2 sequences showed that, for best results, both sequences were necessary.

CONCLUSION:

3D T1 weighted sequences were best for the depiction of internal openings and active inflammatory components, while 2D T2 TSE provided the best assessment of fistula extension.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-225436 (URN)10.4329/wjr.v6.i5.203 (DOI)24876924 (PubMedID)
Available from: 2014-06-03 Created: 2014-06-03 Last updated: 2017-12-05Bibliographically approved
Beets-Tan, R. G. H., Lambregts, D. M. J., Maas, M., Bipat, S., Barbaro, B., Caseiro-Alves, F., . . . Blomqvist, L. (2013). Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. European Radiology, 23(9), 2522-2531
Open this publication in new window or tab >>Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting
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2013 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 23, no 9, p. 2522-2531Article in journal (Refereed) Published
Abstract [en]

To develop guidelines describing a standardised approach regarding the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. A consensus meeting of 14 abdominal imaging experts from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) was conducted following the RAND-UCLA Appropriateness Method. Two independent (non-voting) chairs facilitated the meeting. Two hundred and thirty-six items were scored by participants for appropriateness and classified subsequently as appropriate or inappropriate (defined by a parts per thousand yen 80 % consensus) or uncertain (defined by < 80 % consensus). Items not reaching 80 % consensus were noted. Consensus was reached for 88 % of items: recommendations regarding hardware, patient preparation, imaging sequences, angulation, criteria for MRI assessment and MRI reporting were constructed from these. These expert consensus recommendations can be used as clinical guidelines for primary staging and restaging of rectal cancer using MRI. These guidelines recommend standardised imaging for staging and restaging of rectal cancer. The guidelines were constructed through consensus amongst 14 abdominal imaging experts. Consensus was reached by in 88 % of 236 items discussed.

Keywords
Rectal cancer, Consensus, Guideline, Magnetic resonance imaging, Tumour staging
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-207504 (URN)10.1007/s00330-013-2864-4 (DOI)000323056600020 ()
Available from: 2013-09-17 Created: 2013-09-16 Last updated: 2017-12-06Bibliographically approved
Torkzad, M. R. (2012). Abdominal and Pelvic Magnetic Resonance Imaging (MRI), the New Frontiers. Current Medical Imaging Reviews, 8(2), 75-75
Open this publication in new window or tab >>Abdominal and Pelvic Magnetic Resonance Imaging (MRI), the New Frontiers
2012 (English)In: Current Medical Imaging Reviews, ISSN 1573-4056, Vol. 8, no 2, p. 75-75Article in journal, Editorial material (Refereed) Published
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-181180 (URN)10.2174/157340512800672162 (DOI)000310573200001 ()
Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2012-12-11Bibliographically approved
Grevfors, N., Torkzad, M. R., Bergman, A. & Påhlman, L. (2012). Can acute abdominal CT prioritise patients with suspected diverticulitis for a subsequent clean colonic examination?. Colorectal Disease, 14(7), 893-896
Open this publication in new window or tab >>Can acute abdominal CT prioritise patients with suspected diverticulitis for a subsequent clean colonic examination?
2012 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 14, no 7, p. 893-896Article in journal (Refereed) Published
Abstract [en]

Aim: 

The aim of this study was to investigate whether patients with diverticulitis can be prioritised with higher urgency for a subsequent full colonic examination based upon the emergency abdominal computerised tomography (CT) at the time of presentation.

Method:

All patients with a diagnosis of diverticulitis hospitalized during 2006 having CT on admission and a subsequent 'clean colon' examination were reviewed. The CT was reviewed by two independent and blinded senior radiologists (A and B) for signs inconsistent with diverticulitis and suggestive of malignancy. The patients were classified on CT into group 1 (normal findings, non-tumour pathology or benign polyps < 1 cm) and group 2 (benign polyps ≥ 1 cm and cancer).

Results: 

93 patients were reviewed with 83 in group 1and 10 in group 2. Radiologist A suggested high priority colonic examination in 18% and 50% of groups 1 and 2, and Radiologist B in 63% and 90%. There was a statically significant inter-observer difference and also lower accuracy of Radiologist B than Radiologist A in predicting a subsequent 'clean colon' examination.

Conclusion: 

Using an emergency acute CT scan at the time of diagnosis of diverticulitis to predict a clean colon examination for neoplasia is not reliable since there is considerable degree of inter-observer difference between rediologista.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-160756 (URN)10.1111/j.1463-1318.2011.02814.x (DOI)000304994100032 ()21899711 (PubMedID)
Available from: 2011-10-31 Created: 2011-10-31 Last updated: 2017-12-08Bibliographically approved
Torkzad, M. R., Ullberg, U., Nyström, N., Blomqvist, L., Hellström, P. M. & Fagerberg, U. L. (2012). Manifestations of small bowel disease in pediatric Crohn's disease on magnetic resonance enterography. Inflammatory Bowel Diseases, 18(3), 520-528
Open this publication in new window or tab >>Manifestations of small bowel disease in pediatric Crohn's disease on magnetic resonance enterography
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2012 (English)In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 18, no 3, p. 520-528Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

We report the manifestations of Crohn's disease (CD) observed on magnetic resonance enterography (MRE) in a pediatric population at the time of CD diagnosis.

METHODS:

MRE of 95 consecutive pediatric patients with inflammatory bowel disease (IBD) examined in 2006-2009 were retrospectively analyzed, with documentation of findings based on type and location of the small bowel (SB) disease.

RESULTS:

In all, 51 were boys and 44 girls. 54 had CD, 31 non-CD IBD, and 10 no IBD. The most common site of SB involvement in CD was the terminal ileum seen in 29 (53.7%) patients, followed by ileum in 10 (18.5%) and jejunum in 9 (16.7%) patients. Solitary jejunal inflammation (3.7%), SB stenoses (1.9%), fistula formation (0.95%), and abscess (0.95%) were much less common. Perienteric lymphadenopathy was seen in 30 (55.6%) patients and fatty proliferation in 9 (16.7%). The most common manifestation of SB inflammation was increased contrast enhancement of bowel wall (93.5%), thickening of the bowel wall (90.3%), and derangement of bowel shape with saccular formations (25.8%).

CONCLUSIONS:

MRE in the pediatric population often demonstrates increased contrast uptake, bowel wall thickening, and perienteral lymphadenopathy in CD. More chronic small bowel changes seen commonly in adults and solitary jejunal involvements are less commonly seen.

National Category
Gastroenterology and Hepatology
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-160755 (URN)10.1002/ibd.21725 (DOI)000300682100016 ()21538711 (PubMedID)
Available from: 2011-10-31 Created: 2011-10-31 Last updated: 2017-12-08Bibliographically approved
Arakelian, E., Torkzad, M. R., Bergman, A., Rubertsson, S. & Mahteme, H. (2012). Pulmonary influences on early post-operative recovery in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: a retrospective study. World Journal of Surgical Oncology, 10, 258
Open this publication in new window or tab >>Pulmonary influences on early post-operative recovery in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: a retrospective study
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2012 (English)In: World Journal of Surgical Oncology, ISSN 1477-7819, E-ISSN 1477-7819, Vol. 10, p. 258-Article in journal (Refereed) Published
Abstract [en]

Background: The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a curative treatment option for peritoneal carcinomatosis (PC). There have been few studies on the pulmonary adverse events (AEs) affecting patient recovery after this treatment, thus this study investigated these factors. Methods: Between January 2005 and December 2006, clinical data on all pulmonary AEs and the recovery progress were reviewed for 76 patients with after CRS and HIPEC. Patients with pulmonary interventions (thoracocenthesis and chest tubes) were compared with the non-intervention patients. Two senior radiologists, blinded to the post-operative clinical course, separately graded the occurrence of pulmonary AEs. Results: Of the 76 patients, 6 had needed thoracocentesis and another 6 needed chest tubes. There were no differences in post-operative recovery between the intervention and non-intervention groups. The total number of days on mechanical ventilation, the length of stay in the intensive care unit, total length of hospital stay, tumor burden, and an American Society of Anesthesiologists (ASA) grade of greater than 2 were correlated with the occurrence of atelectasis and pleural effusion. Extensive atelectasis (grade 3 or higher) was seen in six patients, major pleural effusion (grade 3) in seven patients, and signs of heart failure (grade 1-2) in nine patients. Conclusions: Clinical and radiological post-operative pulmonary AEs are common after CRS and HIPEC. However, most of the pulmonary AEs did not affect post-operative recovery.

Keywords
Peritoneal carcinomatosis, CRS, HIPEC, Post-operative recovery, Pulmonary influences, Radiological assessment
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-193642 (URN)10.1186/1477-7819-10-258 (DOI)000313158500001 ()
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2017-12-06Bibliographically approved
Torkzad, M. R., Norén, A. & Kullberg, J. (2012). Stereology: a novel technique for rapid assessment of liver volume. Insight into Imaging, 3(4), 387-393
Open this publication in new window or tab >>Stereology: a novel technique for rapid assessment of liver volume
2012 (English)In: Insight into Imaging, ISSN 1869-4101, E-ISSN 1869-4101, Vol. 3, no 4, p. 387-393Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The purpose of this study was to test the stereology method using several grid sizes for measuring liver volume and to find which grid provides an accurate estimate of liver volume.

MATERIALS AND METHODS:

Liver volume was measured by volumetry in 41 sets of liver MRI. MRI was performed before and after different weight-reducing regimens. Grids of 3, 4, 5, and 6 cm were used to measure liver volume on different occasions by stereology. The liver volume and the changes in volume before and after treatment were compared between stereology and volumetry.

RESULTS:

There was no significant difference in measurements between stereology methods and volumetry (p > 0.05). The mean differences in liver volume between stereology based on 3-, 4-, 5-, and 6-cm grids and volumetry were 37, 3, 132, and 23 mL, respectively, and the differences in measurement of liver volume change were 21, 2, 19, and 76 mL, respectively. The mean time required for measurement by stereology was 59-190 s.

CONCLUSION:

Stereology employing 3- and 4-cm grids can rapidly provide accurate results for measuring liver volume and changes in liver volume.

MAIN MESSAGES:

• Statistical methods can be used for measuring area/volume in radiology.

• Measuring liver volume by stereology by 4-cm grids can be done in less than two minutes.

• Follow-up of liver volume is highly accurate with stereological methods.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-181183 (URN)10.1007/s13244-012-0166-z (DOI)22695947 (PubMedID)
Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2017-12-07Bibliographically approved
Torkzad, M. R., Wikström, J., Hansen, T., Bergman, A., Bjerner, T. & Ahlström, H. (2012). The Clinical Perspective on Value of 3D, Thin Slice T2-Weighted Images in 3T Pelvic MRI for Tumors. Current Medical Imaging Reviews, 8(2), 76-81(6)
Open this publication in new window or tab >>The Clinical Perspective on Value of 3D, Thin Slice T2-Weighted Images in 3T Pelvic MRI for Tumors
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2012 (English)In: Current Medical Imaging Reviews, ISSN 1573-4056, Vol. 8, no 2, p. 76-81(6)Article in journal (Refereed) Published
Abstract [en]

Pelvic imaging is undergoing rapid changes due to increased use of 3-Tesla (3T) magnetic resonance imaging (3T MRI). One of the advantages of 3T could be the possibility for thin section 3-dimensional (3D) imaging which could improve accuracy and at the same time reduce the need for multi-planar imaging needed for conventional T2 imaging (TSE). In the following text we review the advantages of 3D thin section imaging for assessment of pelvic tumors.

Keywords
MRI, pelvic neoplasms, imaging three-dimensional
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-181181 (URN)10.2174/157340512800672243 (DOI)000310573200002 ()
Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2012-12-11Bibliographically approved
Latifi, A., Labruto, F., Kaiser, S., Ullberg, U., Sundin, A. & Torkzad, M. R. (2011). Does enteral contrast increase the accuracy of appendicitis diagnosis?. Radiologic Technology, 82(4), 294-299
Open this publication in new window or tab >>Does enteral contrast increase the accuracy of appendicitis diagnosis?
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2011 (English)In: Radiologic Technology, ISSN 0033-8397, E-ISSN 1943-5657, Vol. 82, no 4, p. 294-299Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Several approaches traditionally have helped opacify the bowel when computed tomography (CT) is used to diagnose appendicitis. With the development of multidetector row CT (MDCT), the need for enteral contrast agents is less obvious. Purpose The objective of this study was to evaluate retrospectively the accuracy of MDCT demonstration of appendicitis using enteral contrast agents.

METHODS: We reviewed radiologic reports of all 246 adult patients with suspected appendicitis who underwent 16-slice MDCT during 2005-2006 at our department. The use of enteral contrast agents and the route of administration were documented by one investigator. A radiologist evaluated whether the responses in the reports were consistent with diagnosis of appendicitis. The accuracy of the radiologic reports was assessed using the results of surgery, histopathology and 3 to 21 months of follow-up.

RESULTS: Of patients studied, 14.6% received no enteral contrast agent, 8.5% received both oral contrast and rectal contrast (enema), 46.7% received oral contrast and 30.1% received rectal contrast enemas. The accuracies for the CT diagnosis of appendicitis with different combinations of agents ranged from 95% to 100%, with no significant difference among groups.

CONCLUSION: Our study shows that the accuracy for diagnosis of appendicitis by abdominal 16-slice MDCT is high regardless of enteral contrast use. Therefore, further use of enteral contrast agents for CT diagnosis of appendicitis in adults cannot be recommended.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-160754 (URN)21406706 (PubMedID)
Available from: 2011-10-31 Created: 2011-10-31 Last updated: 2017-12-08Bibliographically approved
Torkzad, M. R. (2011). Nyheter inom lever-MRT.
Open this publication in new window or tab >>Nyheter inom lever-MRT
2011 (Swedish)Other (Other academic)
Keywords
Lever, MRT
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-162668 (URN)
Available from: 2011-12-05 Created: 2011-12-05 Last updated: 2012-03-21
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