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  • 1. Aguilar, Carlos
    et al.
    Edholm, Kaijsa
    Simmons, Andrew
    Cavallin, Lena
    Muller, Susanne
    Skoog, Ingmar
    Larsson, Elna-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Axelsson, Rimma
    Wahlund, Lars-Olof
    Westman, Eric
    Automated CT-based segmentation and quantification of total intracranial volume2015Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 25, nr 11, s. 3151-3160Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To develop an algorithm to segment and obtain an estimate of total intracranial volume (tICV) from computed tomography (CT) images.

    MATERIALS AND METHODS: Thirty-six CT examinations from 18 patients were included. Ten patients were examined twice the same day and eight patients twice six months apart (these patients also underwent MRI). The algorithm combines morphological operations, intensity thresholding and mixture modelling. The method was validated against manual delineation and its robustness assessed from repeated imaging examinations. Using automated MRI software, the comparability with MRI was investigated. Volumes were compared based on average relative volume differences and their magnitudes; agreement was shown by a Bland-Altman analysis graph.

    RESULTS: We observed good agreement between our algorithm and manual delineation of a trained radiologist: the Pearson's correlation coefficient was r = 0.94, tICVml[manual] = 1.05 × tICVml[automated] - 33.78 (R(2) = 0.88). Bland-Altman analysis showed a bias of 31 mL and a standard deviation of 30 mL over a range of 1265 to 1526 mL.

    CONCLUSIONS: tICV measurements derived from CT using our proposed algorithm have shown to be reliable and consistent compared to manual delineation. However, it appears difficult to directly compare tICV measures between CT and MRI.

    KEY POINTS: • Automated estimation of tICV is in good agreement with manual tracing. • Consistent tICV estimations from repeated measurements demonstrate the robustness of the algorithm. • Automatically segmented volumes seem less variable than those from manual tracing. • Unbiased and automated tlCV estimation is possible from CT.

  • 2.
    Ahlström, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    MultiHance in body MR angiography: personal experiences2004Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 14 Suppl 7, s. O52-O54Artikel i tidskrift (Refereegranskat)
  • 3. Aurell, Y
    et al.
    Johansson, A
    Hansson, G
    Wallander, H
    Jonsson, K
    Ultrasound anatomy in the normal neonatal and infant foot: an anatomic introduction to ultrasound assessment of foot deformities.2002Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 12, nr 9, s. 2306-12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to establish guidelines for US assessment of the talo-crural, the talo-navicular and the calcaneo-cuboid joints during the first year of life, which could serve as a reference while studying foot deformities. The feet of 54 healthy children were examined at birth and at the age of 4, 7 and 12 months by using three easily defined and reproducible US projections. With a medial projection the relation of the navicular in relation to the medial malleolus and the head of the talus was studied. A lateral projection revealed the calcaneo-cuboid relationship and a dorsal projection the talo-navicular alignment in the sagittal plane. Normal values for measurements of these cartilaginous relationships were established for the different age groups. Intra- and inter-observer reliability was assessed and found to be acceptable ( r=0.53-0.90, Pearson correlation coefficient). With US it is possible to obtain reproducible planes of investigation that give reliable information about the talo-crural, the talo-navicular and the calcaneo-cuboid relationships during the first year of life.

  • 4.
    Bajic, Dragan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Kumlien, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Mattsson, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Lundberg, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wang, Chen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Raininko, Raili
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Incomplete hippocampal inversion-is there a relation to epilepsy?2009Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 19, nr 10, s. 2544-2550Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Incomplete hippocampal inversion (IHI) has been described in patients with epilepsy or severe midline malformations but also in nonepileptic subjects without obvious developmental anomalies. We studied the frequency of IHI in different epilepsy syndromes to evaluate their relationship. Three hundred patients were drawn from the regional epilepsy register. Of these, 99 were excluded because of a disease or condition affecting the temporal lobes or incomplete data. Controls were 150 subjects without epilepsy or obvious intracranial developmental anomalies. The coronal MR images were analysed without knowledge of the clinical data. Among epilepsy patients, 30% had IHI (40 left-sided, 4 right-sided, 16 bilateral). Of controls, 18% had IHI (20 left-sided, 8 bilateral). The difference was statistically significant (P < 0.05). Of temporal lobe epilepsy (TLE) patients, 25% had IHI, which was not a significantly higher frequency than in controls (P = 0.34). There was no correlation between EEG and IHI laterality. A total of 44% of Rolandic epilepsy patients and 57% of cryptogenic generalised epilepsy patients had IHI. The IHI frequency was very high in some epileptic syndromes, but not significantly higher in TLE compared to controls. No causality between TLE and IHI could be found. IHI can be a sign of disturbed cerebral development affecting other parts of the brain, maybe leading to epilepsy.

  • 5.
    Bajic, Dragan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Wang, Cheng
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Kumlien, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Mattsson, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Lundberg, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Eeg-Olofsson, Orvar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Raininko, Raili
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Incomplete inversion of the hippocampus: a common developmental anomaly2008Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 18, nr 1, s. 138-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Incomplete inversion of the hippocampus, an imperfect fetal development, has been described in patients with epilepsy or severe midline malformations. We studied this condition in a nonepileptic population without obvious developmental anomalies. We analyzed the coronal MR images of 50 women and 50 men who did not have epilepsy. Twenty of them were healthy volunteers and 80 were patients without obvious intracranial developmental anomalies, intracranial masses, hydrocephalus or any condition affecting the temporal lobes. If the entire hippocampus (the head could not be evaluated) were affected, the incomplete inversion was classified as total, otherwise as partial. Incomplete inversion of the hippocampus was found in 19/100 subjects (9 women, 10 men). It was unilateral, always on the left side, in 13 subjects (4 women, 9 men): 9 were of the total type, 4 were partial. It was bilateral in six subjects (five women, one man): four subjects had total types bilaterally, two had a combination of total and partial types. The collateral sulcus was vertically oriented in all subjects with a deviating hippocampal shape. We conclude that incomplete inversion of the hippocampus is not an unusual morphologic variety in a nonepileptic population without other obvious intracranial developmental anomalies.

  • 6. Balleyguier, Corinne
    et al.
    Sala, E.
    Da Cunha, T.
    Bergman, Antonina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Brkljacic, B.
    Danza, F.
    Forstner, R.
    Hamm, B.
    Kubik-Huch, R.
    Lopez, C.
    Manfredi, R.
    McHugo, J.
    Oleaga, L.
    Togashi, K.
    Kinkel, K.
    Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology2011Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 21, nr 5, s. 1102-1110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To design clear guidelines for the staging and follow-up of patients with uterine cervical cancer, and to provide the radiologist with a framework for use in multidisciplinary conferences. Methods: Guidelines for uterine cervical cancer staging and follow-up were defined by the female imaging subcommittee of the ESUR (European Society of Urogenital Radiology) based on the expert consensus of imaging protocols of 11 leading institutions and a critical review of the literature. Results: The results indicated that high field Magnetic Resonance Imaging (MRI) should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine cervix) of the pelvic content. Axial T1-weighted sequence is useful to detect suspicious pelvic and abdominal lymph nodes, and images from symphysis to the left renal vein are required. The intravenous administration of Gadolinium-chelates is optional but is often required for small lesions (< 2 cm) and for follow-up after treatment. Diffusion-weighted sequences are optional but are recommended to help evaluate lymph nodes and to detect a residual lesion after chemoradiotherapy. Conclusions: Expert consensus and literature review lead to an optimized MRI protocol to stage uterine cervical cancer. MRI is the imaging modality of choice for preoperative staging and follow-up in patients with uterine cervical cancer.

  • 7. Beets-Tan, Regina G. H.
    et al.
    Lambregts, Doenja M. J.
    Maas, Monique
    Bipat, Shandra
    Barbaro, Brunella
    Caseiro-Alves, Filipe
    Curvo-Semedo, Luis
    Fenlon, Helen M.
    Gollub, Marc J.
    Gourtsoyianni, Sofia
    Halligan, Steve
    Hoeffel, Christine
    Kim, Seung Ho
    Laghi, Andrea
    Maier, Andrea
    Rafaelsen, Soren R.
    Stoker, Jaap
    Taylor, Stuart A.
    Torkzad, Michael R.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Blomqvist, Lennart
    Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting2013Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 23, nr 9, s. 2522-2531Artikel i tidskrift (Refereegranskat)
    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.

  • 8.
    Berglund, Felix
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Eilertz, Ebba
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Nimmersjö, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Wolf, Adam
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Nordlander, Christopher
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Palm, Fredrik
    Parenmark, Fredric
    Westerbergh, Johan
    Liss, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Frithiof, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Acute and long-term renal effects after iodine contrast media-enhanced computerised tomography in the critically ill-a retrospective bi-centre cohort study.2024Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 34, nr 3, s. 1736-1745Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To determine if current clinical use of iodine contrast media (ICM) for computerised tomography (CT) increases the risk of acute kidney injury (AKI) and long-term decline in renal function in patients treated in intensive care.

    METHODS: A retrospective bi-centre cohort study was performed with critically ill subjects undergoing either ICM-enhanced or unenhanced CT. AKI was defined and staged based on the Kidney Disease Improve Global Outcome AKI criteria, using both creatinine and urine output criteria. Follow-up plasma creatinine was recorded three to six months after CT to assess any long-term effects of ICM on renal function.

    RESULTS: In total, 611 patients were included in the final analysis, median age was 65.0 years (48.0-73.0, quartile 1-quartile 3 (IQR)) and 62.5% were male. Renal replacement therapy was used post-CT in 12.9% and 180-day mortality was 31.2%. Plasma creatinine level on day of CT was 100.0 µmol/L (66.0-166.5, IQR) for non-ICM group and 77.0 µmol/L (59.0-109.0, IQR) for the ICM group. The adjusted odds ratio for developing AKI if the patient received ICM was 1.03 (95% confidence interval 0.64-1.66, p = 0.90). No significant association between ICM and increase in plasma creatinine at long-term follow-up was found, with an adjusted effect size of 2.92 (95% confidence interval - 6.52-12.36, p = 0.543).

    CONCLUSIONS: The results of this study do not indicate an increased risk of AKI or long-term decline in renal function when ICM is used for enhanced CT in patients treated at intensive care units.

    CLINICAL RELEVANCE STATEMENT: Patients treated in intensive care units had no increased risk of acute kidney injury or persistent decline in renal function after contrast-enhanced CT. This information underlines the need for a proper risk-reward assessment before denying patients a contrast-enhanced CT.

    KEY POINTS: • Iodine contrast media is considered a risk factor for the development of acute kidney injury. • Patients receiving iodine contrast media did not have an increased incidence of acute kidney injury or persistent decline in renal function. • A more clearly defined risk of iodine contrast media helps guide clinical decisions whether to perform contrast-enhanced CTs or not.

  • 9. Elvin, A
    et al.
    Andersson, T
    Ericsson, A
    Eriksson, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Öberg, Kjell
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Hemmingsson, A
    Therapy evaluation of neuroendocine liver metastases with contrast-enhanced MR imaging1993Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 3, s. 19-25Artikel i tidskrift (Refereegranskat)
  • 10.
    Elvin, A
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Andersson, T
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Eriksson, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Öberg, Kjell
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Duplex Doppler ultrasound in carcinoid metastases1991Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 1, nr 2, s. 108-112Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In a prospective study, the role of duplex Doppler ultrasound in monitoring interferon treatment-related changes in carcinoid metastases was evaluated. The Doppler findings from the tumours were correlated to the clinical and laboratory status of the patients to test the hypothesis that successful treatment results in increased vascular resistance. The patients were divided into 4 groups: untreated (n = 10), progressive disease (n = 17), stable disease (n = 20) and objective response (n = 18). In 7 cases Doppler evaluation was made before and after treatment. No significant difference in Doppler values were found between the groups, and at present duplex Doppler ultrasound does not seem to play a role in the evaluation of tumour therapy in carcinoid patients.

  • 11.
    Fällmar, David
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Haller, Sven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi. Univ Med Ctr Freiburg, Dept Neuroradiol, Freiburg, Germany.; Univ Geneva, Fac Med, Geneva, Switzerland.; Affidea CDRC Ctr Diagnost Radiol Carouge, Carouge, Switzerland..
    Lilja, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. Hermes Med Solut, Stockholm, Sweden.
    Danfors, Torsten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Kilander, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Tolboom, Nelleke
    Vrije Univ Amsterdam, Dept Radiol & Nucl Med, Med Ctr, Neurosci Campus, Amsterdam, Netherlands.
    Egger, Karl
    Univ Med Ctr Freiburg, Dept Neuroradiol, Freiburg, Germany.
    Kellner, Elias
    Univ Freiburg, Dept Radiol, Med Ctr, Fac Med,Med Phys, Freiburg, Germany.
    Croon, Philip M
    Vrije Univ Amsterdam, Dept Radiol & Nucl Med, Med Ctr, Neurosci Campus, Amsterdam, Netherlands.
    Verfaillie, Sander C J
    Vrije Univ Amsterdam, Alzheimer Ctr Amsterdam, Dept Neurol, Med Ctr, Amsterdam, Netherlands.
    van Berckel, Bart N M
    Vrije Univ Amsterdam, Dept Radiol & Nucl Med, Med Ctr, Neurosci Campus, Amsterdam, Netherlands.
    Ossenkoppele, Rik
    Vrije Univ Amsterdam, Alzheimer Ctr Amsterdam, Dept Neurol, Med Ctr, Amsterdam, Netherlands.
    Barkhof, Frederik
    Vrije Univ Amsterdam, Dept Radiol & Nucl Med, Med Ctr, Neurosci Campus, Amsterdam, Netherlands.; UCL, Inst Neurol & Healthcare Engn, London, England..
    Larsson, Elna-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Arterial spin labeling-based Z-maps have high specificity and positive predictive value for neurodegenerative dementia compared to FDG-PET.2017Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 27, nr 10, s. 4237-4246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Cerebral perfusion analysis based on arterial spin labeling (ASL) MRI has been proposed as an alternative to FDG-PET in patients with neurodegenerative disease. Z-maps show normal distribution values relating an image to a database of controls. They are routinely used for FDG-PET to demonstrate disease-specific patterns of hypometabolism at the individual level. This study aimed to compare the performance of Z-maps based on ASL to FDG-PET.

    METHODS: Data were combined from two separate sites, each cohort consisting of patients with Alzheimer's disease (n = 18 + 7), frontotemporal dementia (n = 12 + 8) and controls (n = 9 + 29). Subjects underwent pseudocontinuous ASL and FDG-PET. Z-maps were created for each subject and modality. Four experienced physicians visually assessed the 166 Z-maps in random order, blinded to modality and diagnosis.

    RESULTS: Discrimination of patients versus controls using ASL-based Z-maps yielded high specificity (84%) and positive predictive value (80%), but significantly lower sensitivity compared to FDG-PET-based Z-maps (53% vs. 96%, p < 0.001). Among true-positive cases, correct diagnoses were made in 76% (ASL) and 84% (FDG-PET) (p = 0.168).

    CONCLUSION: ASL-based Z-maps can be used for visual assessment of neurodegenerative dementia with high specificity and positive predictive value, but with inferior sensitivity compared to FDG-PET.

    KEY POINTS: • ASL-based Z-maps yielded high specificity and positive predictive value in neurodegenerative dementia. • ASL-based Z-maps had significantly lower sensitivity compared to FDG-PET-based Z-maps. • FDG-PET might be reserved for ASL-negative cases where clinical suspicion persists. • Findings were similar at two study sites.

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  • 12. Giannakopoulos, Panteleimon
    et al.
    Montandon, Marie-Louise
    Herrmann, François R
    Hedderich, Dennis
    Gaser, Christian
    Kellner, Elias
    Rodriguez, Cristelle
    Haller, Sven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Alzheimer resemblance atrophy index, BrainAGE, and normal pressure hydrocephalus score in the prediction of subtle cognitive decline: added value compared to existing MR imaging markers.2022Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 32, nr 11, s. 7833-7842Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Established visual brain MRI markers for dementia include hippocampal atrophy (mesio-temporal atrophy MTA), white matter lesions (Fazekas score), and number of cerebral microbleeds (CMBs). We assessed whether novel quantitative, artificial intelligence (AI)-based volumetric scores provide additional value in predicting subsequent cognitive decline in elderly controls.

    METHODS: A prospective study including 80 individuals (46 females, mean age 73.4 ± 3.5 years). 3T MR imaging was performed at baseline. Extensive neuropsychological assessment was performed at baseline and at 4.5-year follow-up. AI-based volumetric scores were derived from 3DT1: Alzheimer Disease Resemblance Atrophy Index (AD-RAI), Brain Age Gap Estimate (BrainAGE), and normal pressure hydrocephalus (NPH) index. Analyses included regression models between cognitive scores and imaging markers.

    RESULTS: AD-RAI score at baseline was associated with Corsi (visuospatial memory) decline (10.6% of cognitive variability in multiple regression models). After inclusion of MTA, CMB, and Fazekas scores simultaneously, the AD-RAI score remained as the sole valid predictor of the cognitive outcome explaining 16.7% of its variability. Its percentage reached 21.4% when amyloid positivity was considered an additional explanatory factor. BrainAGE score was associated with Trail Making B (executive functions) decrease (8.5% of cognitive variability). Among the conventional MRI markers, only the Fazekas score at baseline was positively related to the cognitive outcome (8.7% of cognitive variability). The addition of the BrainAGE score as an independent variable significantly increased the percentage of cognitive variability explained by the regression model (from 8.7 to 14%). The addition of amyloid positivity led to a further increase in this percentage reaching 21.8%.

    CONCLUSIONS: The AI-based AD-RAI index and BrainAGE scores have limited but significant added value in predicting the subsequent cognitive decline in elderly controls when compared to the established visual MRI markers of brain aging, notably MTA, Fazekas score, and number of CMBs.

    KEY POINTS: • AD-RAI score at baseline was associated with Corsi score (visuospatial memory) decline. • BrainAGE score was associated with Trail Making B (executive functions) decrease. • AD-RAI index and BrainAGE scores have limited but significant added value in predicting the subsequent cognitive decline in elderly controls when compared to the established visual MRI markers of brain aging, notably MTA, Fazekas score, and number of CMBs.

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  • 13.
    Hansen, Tomas
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Ahlström, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Wikström, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Johansson, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    A total atherosclerotic score for whole-body MRA and its relation to traditional cardiovascular risk factors2008Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 18, nr 6, s. 1174-1180Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to create a scoring system for whole-body magnetic resonance angiography (WBMRA) that allows estimation of atherosclerotic induced luminal narrowing, and determine whether the traditional cardiovascular (CV) risk factors included in the Framingham risk score (FRS) were related to this total atherosclerotic score (TAS) in an elderly population. A group of 306 subjects, aged 70, were recruited from the general population and underwent WBMRA in a 1.5-T scanner. Three-dimensional sequences were acquired after administration of one i.v. injection of 40 ml gadodiamide. The arterial tree was divided into five territories (carotid, aorta, renal, upper and lower leg) comprising 26 vessel segments, and assessed according to its degree of stenosis or occlusion. FRS correlated to TAS (r=0.30, P < 0.0001), as well as to the atherosclerotic score for the five individual territories. Of the parameters included in the FRS, male gender (P < 0.0001), systolic blood pressure (P=0.0002), cigarette pack-years (P=0.0008) and HDL cholesterol (P=0.008) contributed to the significance. A scoring system for WBMRA was created. The significant relation towards traditional CV risk factors indicates that the proposed scoring system could be of value for assessing atherosclerotically induced luminal narrowing.

  • 14.
    Helenius, Malin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Dahlman, Pär
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Lönnemark, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Brekkan, Einar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Urologkirurgi.
    Wernroth, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Magnusson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Comparison of post contrast CT urography phases in bladder cancer detection2016Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 26, nr 2, s. 585-591Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives The aim of this study was to investigate which post-contrast phase(s) in a four-phase CT urography protocol is (are) most suitable for bladder cancer detection. Methods The medical records of 106 patients with visible haematuria who underwent a CT urography examination, including unenhanced, enhancement-triggered corticomedullary (CMP), nephrographic (NP) and excretory (EP) phases, were reviewed. The post-contrast phases (n = 318 different phases) were randomized into an evaluation order and blindly reviewed by two uroradiologists. Results Twenty-one patients were diagnosed with bladder cancer. Sensitivity for bladder cancer detection was 0.95 in CMP, 0.83 in NP and 0.81 in EP. Negative predictive value (NPV) was 0.99 in CMP, 0.96 in NP and 0.95 in EP. The sensitivity was higher in CMP than in both NP (p-value 0.016) and EP (p-value 0.0003). NPV was higher in CMP than in NP (p-value 0.024) and EP (p-value 0.002). Conclusion In the CT urography protocol with enhancement-triggered scan, sensitivity and NPV were highest in the corticomedullary phase, and this phase should be used for bladder assessment.

  • 15. Hemke, Robert
    et al.
    Herregods, Nele
    Jaremko, Jacob L
    Åström, Gunnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Avenarius, Derk
    Becce, Fabio
    Bielecki, Dennis K
    Boesen, Mikael
    Dalili, Danoob
    Giraudo, Chiara
    Hermann, Kay-Geert
    Humphries, Paul
    Isaac, Amanda
    Jurik, Anne Grethe
    Klauser, Andrea S
    Kvist, Ola
    Laloo, Frederiek
    Maas, Mario
    Mester, Adam
    Oei, Edwin
    Offiah, Amaka C
    Omoumi, Patrick
    Papakonstantinou, Olympia
    Plagou, Athena
    Shelmerdine, Susan
    Simoni, Paolo
    Sudoł-Szopińska, Iwona
    Tanturri de Horatio, Laura
    Teh, James
    Jans, Lennart
    Rosendahl, Karen
    Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis: ESSR-ESPR points to consider.2020Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 30, nr 10, s. 5237-5249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatic disease. It represents a group of heterogenous inflammatory disorders with unknown origin and is a diagnosis of exclusion in which imaging plays an important role. JIA is defined as arthritis of one or more joints that begins before the age of 16 years, persists for more than 6 weeks and is of unknown aetiology and pathophysiology. The clinical goal is early suppression of inflammation to prevent irreversible joint damage which has shifted the emphasis from detecting established joint damage to proactively detecting inflammatory change. This drives the need for imaging techniques that are more sensitive than conventional radiography in the evaluation of inflammatory processes as well as early osteochondral change. Physical examination has limited reliability, even if performed by an experienced clinician, emphasising the importance of imaging to aid in clinical decision-making. On behalf of the European Society of Musculoskeletal Radiology (ESSR) arthritis subcommittee and the European Society of Paediatric Radiology (ESPR) musculoskeletal imaging taskforce, based on literature review and/or expert opinion, we discuss paediatric-specific imaging characteristics of the most commonly involved, in literature best documented and clinically important joints in JIA, namely the temporomandibular joints (TMJs), spine, sacroiliac (SI) joints, wrists, hips and knees, followed by a clinically applicable point to consider for each joint. We will also touch upon controversies in the current literature that remain to be resolved with ongoing research. KEY POINTS: • Juvenile idiopathic arthritis (JIA) is the most common chronic paediatric rheumatic disease and, in JIA imaging, is increasingly important to aid in clinical decision-making. • Conventional radiographs have a lower sensitivity and specificity for detection of disease activity and early destructive change, as compared to MRI or ultrasound. Nonetheless, radiography remains important, particularly in narrowing the differential diagnosis and evaluating growth disturbances. • Mainly in peripheral joints, ultrasound can be helpful for assessment of inflammation and guiding joint injections. In JIA, MRI is the most validated technique. MRI should be considered as the modality of choice to assess the axial skeleton or where the clinical presentation overlaps with JIA.

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  • 16. Kinkel, K.
    et al.
    Forstner, R.
    Danza, F. M.
    Oleaga, L.
    Cunha, T. M.
    Bergman, Antonia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Barentsz, J. O.
    Balleyguier, C.
    Brkljacic, B.
    Spencer, J. A.
    Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging2009Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 19, nr 7, s. 1565-1574Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2 min +/- 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer.

  • 17.
    Lambregts, Doenja M. J.
    et al.
    Netherlands Canc Inst, Dept Radiol, POB 90203, NL-1006 BE Amsterdam, Netherlands..
    Bogveradze, Nino
    Netherlands Canc Inst, Dept Radiol, POB 90203, NL-1006 BE Amsterdam, Netherlands.;Maastricht Univ, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.;Amer Hosp Tbilisi, Dept Radiol, Tbilisi, Georgia..
    Blomqvist, Lennart K.
    Karolinska Univ Hosp, Dept Imaging & Physiol, Stockholm, Sweden..
    Fokas, Emmanouil
    Goethe Univ Frankfurt am Main, Univ Hosp, Dept Radiooncol, Frankfurt, Germany.;Goethe Univ Frankfurt am Main, Univ Hosp, Frankfurt Canc Inst FCI, Frankfurt, Germany..
    Garcia-Aguilar, Julio
    Mem Sloan Kettering Canc Ctr, Dept Surg, Colorectal Serv, Benno C Schmidt Chair Surg Oncol, New York, NY 10021 USA..
    Glimelius, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Cancerprecisionsmedicin.
    Gollub, Marc J.
    Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA..
    Konishi, Tsuyoshi
    Univ Texas MD Anderson Canc Ctr, Dept Colon & Rectal Surg, Houston, TX USA..
    Marijnen, Corrie A. M.
    Netherlands Canc Inst, Dept Radiat Oncol, Amsterdam, Netherlands.;Leiden Univ Med Ctr, Dept Radiat Oncol, Leiden, Netherlands..
    Nagtegaal, Iris D.
    Radboud Univ Nijmegen Med Ctr, Dept Pathol, Nijmegen, Netherlands..
    Nilsson, Per J.
    Karolinska Univ Hosp, Pelv Canc Ctr, Karolinska Inst, Dept Mol Med & Surg,Div Coloproctol, Stockholm, Sweden..
    Perez, Rodrigo O.
    Hosp Alemao Oswaldo Cruz, Sao Paulo, Brazil.;Hosp Beneficencia Portuguesa Sao Paulo, Sao Paulo, Brazil..
    Snaebjornsson, Petur
    Netherlands Canc Inst, Dept Pathol, Amsterdam, Netherlands..
    Taylor, Stuart A.
    Univ Coll London Hosp, Ctr Med Imaging, London, England..
    Tolan, Damian J. M.
    Leeds Teaching Hosp NHS Trust, Dept Radiol, Leeds, W Yorkshire, England..
    Valentini, Vincenzo
    Univ Cattolica S Cuore, Fdn Policlin Univ A Gemelli IRCCS, Dept Bioimaging Radiat Oncol & Hematol, Rome, Italy..
    West, Nicholas P.
    Univ Leeds, Pathol & Data Analyt, Leeds Inst Med Res St Jamess, Leeds, W Yorkshire, England..
    Wolthuis, Albert
    Univ Hosp Leuven, Dept Abdominal Surg, Leuven, Belgium..
    Lahaye, Max J.
    Netherlands Canc Inst, Dept Radiol, POB 90203, NL-1006 BE Amsterdam, Netherlands..
    Maas, Monique
    Netherlands Canc Inst, Dept Radiol, POB 90203, NL-1006 BE Amsterdam, Netherlands..
    Beets, Geerard L.
    Maastricht Univ, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.;Netherlands Canc Inst, Dept Surg, Amsterdam, Netherlands..
    Beets-Tan, Regina G. H.
    Netherlands Canc Inst, Dept Radiol, POB 90203, NL-1006 BE Amsterdam, Netherlands.;Maastricht Univ, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.;Univ Southern Denmark, Inst Reg Hlth Res, Odense, Denmark..
    Current controversies in TNM for the radiological staging of rectal cancer and how to deal with them: results of a global online survey and multidisciplinary expert consensus2022Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 32, nr 7, s. 4991-5003Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To identify the main problem areas in the applicability of the current TNM staging system (8(th) ed.) for the radiological staging and reporting of rectal cancer and provide practice recommendations on how to handle them. Methods A global case-based online survey was conducted including 41 image-based rectal cancer cases focusing on various items included in the TNM system. Cases reaching < 80% agreement among survey respondents were identified as problem areas and discussed among an international expert panel, including 5 radiologists, 6 colorectal surgeons, 4 radiation oncologists, and 3 pathologists. Results Three hundred twenty-one respondents (from 32 countries) completed the survey. Sixteen problem areas were identified, related to cT staging in low-rectal cancers, definitions for cT4b and cM1a disease, definitions for mesorectal fascia (MRF) involvement, evaluation of lymph nodes versus tumor deposits, and staging of lateral lymph nodes. The expert panel recommended strategies on how to handle these, including advice on cT-stage categorization in case of involvement of different layers of the anal canal, specifications on which structures to include in the definition of cT4b disease, how to define MRF involvement by the primary tumor and other tumor-bearing structures, how to differentiate and report lymph nodes and tumor deposits on MRI, and how to anatomically localize and stage lateral lymph nodes. Conclusions The recommendations derived from this global survey and expert panel discussion may serve as a practice guide and support tool for radiologists (and other clinicians) involved in the staging of rectal cancer and may contribute to improved consistency in radiological staging and reporting.

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  • 18.
    Loizou, L.
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
    Albiin, N.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; Ersta Hosp, Dept Radiol, S-11691 Stockholm, Sweden.
    Leidner, B.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
    Axelsson, E.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
    Fischer, M. A.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
    Grigoriadis, A.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
    Del Chiaro, M.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, S-14186 Stockholm, Sweden; Karolinska Univ Hosp Huddinge, Ctr Digest Dis, S-14186 Stockholm, Sweden.
    Segersvärd, R.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, S-14186 Stockholm, Sweden; Karolinska Univ Hosp Huddinge, Ctr Digest Dis, S-14186 Stockholm, Sweden.
    Verbeke, C.
    Karolinska Inst, Dept Lab Med, Div Pathol, S-14186 Stockholm, Sweden; Karolinska Univ Hosp Huddinge, S-14186 Stockholm, Sweden.
    Sundin, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi. Univ Uppsala Hosp, Dept Radiol, S-75185 Uppsala, Sweden.
    Kartalis, N.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
    Multidetector CT of pancreatic ductal adenocarcinoma: Effect of tube voltage and iodine load on tumour conspicuity and image quality2016Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 26, nr 11, s. 4021-4029Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To compare a low-tube-voltage with or without high-iodine-load multidetector CT (MDCT) protocol with a normal-tube-voltage, normal-iodine-load (standard) protocol in patients with pancreatic ductal adenocarcinoma (PDAC) with respect to tumour conspicuity and image quality.

    METHODS: Thirty consecutive patients (mean age: 66 years, men/women: 14/16) preoperatively underwent triple-phase 64-channel MDCT examinations twice according to: (i) 120-kV standard protocol (PS; 0.75 g iodine (I)/kg body weight, n = 30) and (ii) 80-kV protocol A (PA; 0.75 g I/kg, n = 14) or protocol B (PB; 1 g I/kg, n = 16). Two independent readers evaluated tumour delineation and image quality blindly for all protocols. A third reader estimated the pancreas-to-tumour contrast-to-noise ratio (CNR). Statistical analysis was performed with the Chi-square test.

    RESULTS: Tumour delineation was significantly better in PB and PA compared with PS (P = 0.02). The evaluation of image quality was similar for the three protocols (all, P > 0.05). The highest CNR was observed with PB and was significantly better compared to PA (P = 0.02) and PS (P = 0.0002).

    CONCLUSION: In patients with PDAC, a low-tube-voltage, high-iodine-load protocol improves tumour delineation and CNR leading to higher tumour conspicuity compared to standard protocol MDCT.

    KEY POINTS: • Low-tube-voltage high-iodine-load MDCT improves pancreatic cancer conspicuity compared to a standard protocol. • The pancreas-to-tumour attenuation difference increases significantly by reducing the tube voltage. • The radiation exposure dose decreases by reducing the tube voltage.

  • 19.
    Nyman, Ulf
    et al.
    Lund Univ, Dept Translat Med, Div Med Radiol, Malmo, Sweden.
    Ahlkvist, Joanna
    Nykoping Hosp, Dept Radiol, Nykoping, Sweden.
    Aspelin, Peter
    Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, Stockholm, Sweden.
    Brismar, Torkel
    Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, Stockholm, Sweden;Karolinska Univ Hosp Huddinge, Dept Radiol, Stockholm, Sweden.
    Frid, Anders
    Skane Univ Hosp, Dept Diabetol, Malmo, Sweden.
    Hellström, Mikael
    Gothenburg Univ, Sahlgrenska Univ Hosp, Dept Radiol, Gothenburg, Sweden;Gothenburg Univ, Sahlgrenska Acad, Gothenburg, Sweden.
    Liss, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Sterner, Gunnar
    Skane Univ Hosp, Dept Nephrol, Malmo, Sweden.
    Leander, Peter
    Lund Univ, Dept Translat Med, Div Med Radiol, Malmo, Sweden.
    Preventing contrast medium-induced acute kidney injury: Side-by-side comparison of Swedish-ESUR guidelines2018Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 28, nr 12, s. 5384-5395Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A side-by-side comparison of updated guidelines regarding contrast medium-induced acute kidney injury (CI-AKI) from the Swedish Society of Uroradiology (SSUR) and the European Society of Urogenital Radiology (ESUR) is presented. The major discrepancies include a higher glomerular filtration rate (GFR) threshold as a risk factor for CI-AKI and for discontinuation of metformin by SSUR, i.e., < 45 ml/min versus < 30 ml/min/1.73 m(2) by ESUR, when intravenous or intra-arterial contrast media (CM) with second-pass renal exposure is administered. SSUR also continues to recommend consideration of traditional non-renal risk factors such as diabetes and congestive heart failure, while ESUR considers these factors as non-specific for CI-AKI and does not recommend anyconsideration. Contrary to ESUR, SSUR also recommends discontinuation of NSAID and nephrotoxic medication if possible. Insufficient evidence at the present time motivates the more cautionary attitude taken by SSUR. Furthermore, SSUR expresses GFR thresholds in absolute values in ml/min as recommended by the National Kidney Foundation for drugs excreted by glomerular filtration, while ESUR uses the relative GFR normalised to body surface area in ml/min/1.73 m(2). CM dose/GFR ratio thresholds established for coronary angiography/interventions are also applied as recommendations for CM-enhanced CT by SSUR, since SSUR regards coronary procedures as a second-pass renal exposure of CM with no obvious difference in the incidence of AKI compared withIV CM administration. Finally, SSUR recommends reducing the gram-iodine dose/GFR ratio from < 1.0 in patients not at risk to < 0.5 in patients at risk of CI-AKI, while ESUR has no such recommendation.Key Points center dot The more cautionary attitude taken by SSUR compared with that of ESUR is motivated by insufficient evidence regarding risk for contrast medium-induced acute kidney injuries (CI-AKI).center dot SSUR recommends that absolute and not relative GFR should be used when dosing drugs eliminated by the kidneys such as contrast media.center dot According to SSUR the gram-iodine dose/GFR ratio should be < 0.5 in patients at risk of CI-AKI, while ESUR has no such recommendation.

  • 20. Nyman, Ulf
    et al.
    Leander, Peter
    Liss, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Sterner, Gunnar
    Brismar, Torkel
    Absolute and relative GFR and contrast medium dose/GFR ratio: cornerstones when predicting the risk of acute kidney injury.2024Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 31, nr 1, s. 612-621Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Glomerular filtration rate (GFR) is considered the best overall index of kidney function in health and disease and its use is recommended to evaluate the risk of iodine contrast medium-induced acute kidney injury (CI-AKI) either as a single parameter or as a ratio between the total contrast medium dose (gram iodine) and GFR. GFR may be expressed in absolute terms (mL/min) or adjusted/indexed to body surface area, relative GFR (mL/min/1.73 m2). Absolute and relative GFR have been used interchangeably to evaluate the risk of CI-AKI, which may be confusing and a potential source of errors. Relative GFR should be used to assess the GFR category of renal function as a sign of the degree of kidney damage and sensitivity for CI-AKI. Absolute GFR represents the excretion capacity of the individual and may be used to calculate the gram-iodine/absolute GFR ratio, an index of systemic drug exposure (amount of contrast medium in the body) that relates to toxicity. It has been found to be an independent predictor of AKI following percutaneous coronary angiography and interventions but has not yet been fully validated for computed tomography (CT). Prospective studies are warranted to evaluate the optimal gram-iodine/absolute GFR ratio to predict AKI at various stages of renal function at CT. Only GFR estimation (eGFR) equations based on standardized creatinine and/or cystatin C assays should be used. eGFRcystatin C/eGFRcreatinine ratio < 0.6 indicating selective glomerular hypofiltration syndrome may have a stronger predictive power for postcontrast AKI than creatinine-based eGFR. CLINICAL RELEVANCE STATEMENT: Once the degree of kidney damage is established by estimating relative GFR (mL/min/1.73 m2), contrast dose in relation to renal excretion capacity [gram-iodine/absolute GFR (mL/min)] may be the best index to evaluate the risk of contrast-induced kidney injury. KEY POINTS: • Relative glomerular filtration rate (GFR; mL/min/1.73 m2) should be used to assess the GFR category as a sign of the degree of kidney damage and sensitivity to contrast medium-induced acute kidney injury (CI-AKI). • Absolute GFR (mL/min) is the individual's actual excretion capacity and the contrast-dose/absolute GFR ratio is a measure of systemic exposure (amount of contrast medium in the body), relates to toxicity and should be expressed in gram-iodine/absolute GFR (mL/min). • Prospective studies are warranted to evaluate the optimal contrast medium dose/GFR ratio predicting the risk of CI-AKI at CT and intra-arterial examinations.

  • 21. Nyman, Ulf
    et al.
    Leander, Peter
    Liss, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Sterner, Gunnar
    Brismar, Torkel
    Correction: Absolute and relative GFR and contrast medium dose/GFR ratio2024Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 34, nr 3, s. 2123-2124Artikel i tidskrift (Refereegranskat)
  • 22.
    Pemberton, Hugh G.
    et al.
    UCL, Ctr Med Image Comp CMIC, Dept Med Phys & Bioengn, London, England.;UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Goodkin, Olivia
    UCL, Ctr Med Image Comp CMIC, Dept Med Phys & Bioengn, London, England.;UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England..
    Prados, Ferran
    UCL, Ctr Med Image Comp CMIC, Dept Med Phys & Bioengn, London, England.;Univ Oberta Catalunya, Barcelona, Spain..
    Das, Ravi K.
    UCL, Clin Educ & Hlth Psychol, London, England..
    Vos, Sjoerd B.
    UCL, Ctr Med Image Comp CMIC, Dept Med Phys & Bioengn, London, England.;UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England..
    Moggridge, James
    UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCLH NHS Fdn Trust, Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England..
    Coath, William
    UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Gordon, Elizabeth
    UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Barrett, Ryan
    Brighton & Sussex Univ Hosp, Dept Neuroradiol, Brighton, E Sussex, England..
    Schmitt, Anne
    UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCLH NHS Fdn Trust, Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England..
    Whiteley-Jones, Hefina
    Brighton & Sussex Univ Hosp, Dept Neuroradiol, Brighton, E Sussex, England..
    Burd, Christian
    Guys & St Thomas NHS Fdn Trust, London, England..
    Wattjes, Mike P.
    Hannover Med Sch, Dept Diagnost & Intervent Neuroradiol, Hannover, Germany..
    Haller, Sven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Vernooij, Meike W.
    Erasmus MC Univ, Dept Radiol & Nucl Med, Med Ctr, Rotterdam, Netherlands.;Erasmus MC Univ, Dept Epidemiol, Med Ctr, Rotterdam, Netherlands..
    Harper, Lorna
    UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Fox, Nick C.
    UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Paterson, Ross W.
    UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Schott, Jonathan M.
    UCL, Dementia Res Ctr, UCL Queen Sq Inst Neurol, London, England..
    Bisdas, Sotirios
    UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCLH NHS Fdn Trust, Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England..
    White, Mark
    Univ Coll London Hosp, Digital Serv, London, England..
    Ourselin, Sebastien
    Kings Coll London, Sch Biomed Engn & Imaging Sci, London, England..
    Thornton, John S.
    UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCLH NHS Fdn Trust, Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England..
    Yousry, Tarek A.
    UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCLH NHS Fdn Trust, Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England..
    Cardoso, M. Jorge
    Kings Coll London, Sch Biomed Engn & Imaging Sci, London, England..
    Barkhof, Frederik
    UCL, Ctr Med Image Comp CMIC, Dept Med Phys & Bioengn, London, England.;UCL, Neuroradiol Acad Unit, UCL Queen Sq Inst Neurol, London, England.;UCLH NHS Fdn Trust, Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England.;Vrije Univ Amsterdam, Radiol & Nucl Med, Med Ctr, Amsterdam, Netherlands..
    Automated quantitative MRI volumetry reports support diagnostic interpretation in dementia: a multi-rater, clinical accuracy study2021Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 31, nr 7, s. 5312-5323Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives We examined whether providing a quantitative report (QReport) of regional brain volumes improves radiologists' accuracy and confidence in detecting volume loss, and in differentiating Alzheimer's disease (AD) and frontotemporal dementia (FTD), compared with visual assessment alone. Methods Our forced-choice multi-rater clinical accuracy study used MRI from 16 AD patients, 14 FTD patients, and 15 healthy controls; age range 52-81. Our QReport was presented to raters with regional grey matter volumes plotted as percentiles against data from a normative population (n = 461). Nine raters with varying radiological experience (3 each: consultants, registrars, 'non-clinical image analysts') assessed each case twice (with and without the QReport). Raters were blinded to clinical and demographic information; they classified scans as 'normal' or 'abnormal' and if 'abnormal' as 'AD' or 'FTD'. Results The QReport improved sensitivity for detecting volume loss and AD across all raters combined (p = 0.015* and p = 0.002*, respectively). Only the consultant group's accuracy increased significantly when using the QReport (p = 0.02*). Overall, raters' agreement (Cohen's kappa) with the 'gold standard' was not significantly affected by the QReport; only the consultant group improved significantly (kappa(s) 0.41 -> 0.55, p = 0.04*). Cronbach's alpha for interrater agreement improved from 0.886 to 0.925, corresponding to an improvement from 'good' to 'excellent'. Conclusion Our QReport referencing single-subject results to normative data alongside visual assessment improved sensitivity, accuracy, and interrater agreement for detecting volume loss. The QReport was most effective in the consultants, suggesting that experience is needed to fully benefit from the additional information provided by quantitative analyses.

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  • 23.
    Smedby, Ö.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Rostad, H.
    Klaastad, Ö.
    Lilleås, F.
    Tillung, T.
    Fosse, E.
    Functional imaging of the thoracic outlet syndrome in an open MR scanner2000Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 10, nr 4, s. 597-600Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Symptoms due to thoracic outlet syndrome may present only in abduction, a position that cannot be investigated in conventional MR scanners. Therefore, this study was initiated to test MRI in an open magnet as a method for diagnosis of thoracic outlet syndrome. Ten volunteers and 7 patients with a clinical suspicion of thoracic outlet syndrome were investigated at 0.5 T in an open MR scanner. Sagittal 3D SPGR acquisitions were made in 0 and 90 degrees abduction. In the patients, a similar data set was also obtained in maximal abduction. To assess compression, the minimum distance between the first rib and the clavicle, measured in a sagittal plane, was determined. In the neutral position, no significant difference was found between patients and controls. In 90 degrees abduction, the patients had significantly smaller distance between rib and clavicle than the controls (14 vs 29 mm; p < 0.01). On coronal reformatted images, the compression of the brachial plexus could often be visualised in abduction. Functional MR examination seems to be a useful diagnostic tool in thoracic outlet syndrome. Examination in abduction, which is feasible in an open scanner, is essential for the diagnosis.

  • 24.
    Smedby, Örjan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Riesenfeld, Vendela
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Carlson, Britt-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Jacobson, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Löfberg, Anne-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Lindgren, P. G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Ahlström, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Magnetic resonance angiography in the resectability assessment of suspected pancreatic tumours1997Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 7, nr 5, s. 649-653Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this prospective study was to evaluate MRI, including MR angiography (MRA), in the preoperative assessment of the resectability of suspected malignancy of the pancreas. A total of 17 patients with suspected pancreatic carcinoma and planned surgery were investigated with conventional angiography, ultrasonography with Doppler technique, MRI and MRA. The MRA protocol included both 2D inflow angiography and 3D phase-contrast angiography. Surgery was carried out in 13 patients. The image quality of MRA was judged satisfactory in all cases. The findings with respect to vascular involvement agreed between the radiological methods in all but 3 cases. When the findings were correlated with the final diagnosis, one false-negative case was found for each of the three methods. The results suggest that MRI with MRA, including both the phase-contrast and inflow techniques, has a similar diagnostic value to that of conventional angiography and ultrasonography in the preoperative assessment of the portal venous system in patients with pancreatic carcinoma. Further studies are needed to establish the optimal diagnostic procedure.

  • 25.
    Svahn, Tony M.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Sjöberg, Tommy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Ast, Jennifer C.
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Biologiska sektionen, Institutionen för organismbiologi, Systematisk biologi.
    Dose estimation of ultra-low-dose chest CT to different sized adult patients2019Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 29, nr 8, s. 4315-4323Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To evaluate the effect of patient size on radiation dose for standard CT (SD-CT), ultra-low-dose CT (ULD-CT) and two-view digital radiography (DR).

    Methods: Dosimeters were distributed within the lungs of chest phantoms representing males of 65kg and 82kg (body mass indices 23 and 29). In contrast to SD-CT and DR which include automatic exposure control (AEC), the ULD scan employs a fixed mAs value. The phantoms were exposed to SD, ULD and DR while recording lung doses. Projected dose data were calculated from the phantoms. The resulting exposure settings were used in Monte Carlo programs to determine the effective dose for a standard-sized (BMI 24.2) adult male (170cm/70kg) and female (160cm/59kg). Patients previously examined by both ULD- and SD-CT were identified to determine post hoc size-specific dose estimates (SSDEs).

    Results: ULD-CT dose was inversely related to patient size; average lung doses summarised in terms of patient size BMI23/29 are 5.2/8.1 (SD-CT), 0.56/0.35 (ULD-CT) and 0.05/0.13mGy (DR), while the effective doses for these techniques on a standard-sized male were 2.9, 0.16 and 0.03mSv and 2.3, 0.247 and 0.024mSv for a standard-sized female respectively. SSDEs for 15 patients (averages: BMI 26, range 18-37) averaged 5.5mGy (3.6-10) for SD-CT and 0.35mGy (0.42-0.27) for ULD-CT.

    Conclusions: The effective doses for a standard-sized male and female examined by ULD-CT are (respectively) 6%/11% of SD-CT and 5/10 times higher than DR. ULD-CT gave a lower radiation dosage to larger patients than DR. AEC is warranted in ULD-CT for improved dose consistency.

    Key Points: center dot For standard-sized patients, ULD-CT dose level is 6%/11% of SD-CT, and 5/10 times higher than DR. For larger patients, ULD-CT is currently being used clinically at lower dose levels than DR.center dot Using ULD-CT should greatly reduce the risk of late effects from ionising radiation.center dot AEC in ULD-CT is desirable for increased consistency in patient dose.

  • 26.
    Themudo, Raquel
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Johansson, Lars E.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Ebeling Barbier, Charlotte
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Kardiovaskulär epidemiologi.
    Ahlström, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Bjerner, Tomas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    The number of unrecognized myocardial infarction scars detected at DE-MRI increase during a 5-year follow-up2017Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 27, nr 2, s. 715-722Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    In an elderly population, the prevalence of unrecognized myocardial infarction (UMI) scars found via late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging was more frequent than expected. This study investigated whether UMI scars detected with LGE-CMR at age 70 would be detectable at age 75 and whether the scar size changed over time.

    Methods

    From 248 participants that underwent LGE-CMR at age 70, 185 subjects underwent a follow-up scan at age 75. A myocardial infarction (MI) scar was defined as late enhancement involving the subendocardium.

    Results

    In the 185 subjects that underwent follow-up, 42 subjects had a UMI scar at age 70 and 61 subjects had a UMI scar at age 75. Thirty-seven (88 %) of the 42 UMI scars seen at age 70 were seen in the same myocardial segment at age 75. The size of UMI scars did not differ between age 70 and 75.

    Conclusions

    The prevalence of UMI scars detected at LGE-CMR increases with age. During a 5-year follow-up, 88 % (37/42) of the UMI scars were visible in the same myocardial segment, reassuring that UMI scars are a consistent finding. The size of UMI scars detected during LGE-CMR did not change over time.

  • 27.
    Torkzad, Michael R.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Hansson, Karl A.
    Lindholm, Johan
    Martling, Anna
    Blomqvist, Lennart
    Significance of mesorectal volume in staging of rectal cancer with magnetic resonance imaging and the assessment of involvement of the mesorectal fascia2007Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 17, nr 7, s. 1694-1699Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to study the influence of mesorectal volume, as estimated by magnetic resonance imaging (MRI), that is to be removed during total mesorectal excision (TME), on the accuracy of the first preoperative MRI of rectal cancer compared to histopathology, and its correlation to locoregional prognostic factors. A total of 267 rectal cancer patients from a multinational study (MERCURY or MRI equivalence study) had their mesorectal volume retrospectively estimated by researchers without knowledge of the assessments made by the radiologist or the pathologist. The evaluations made by the pathologist and the radiologist were then compared, including T- and N-staging, assessment of extent of extramural tumor invasion (the largest portion of the tumor beyond the muscularis propria or EMI) and distance to mesorectal fascia; the discrepancies in the results were correlated to the mesorectal volume. T- or N-staging accuracy by MRI and the difference between the EMI as measured by the pathologist and the radiologist were not dependent on individual mesorectal volume. There was no correlation between assessment of involvement of mesorectal fascia or local neighboring organs by MRI and histopathology with mesorectal volume. Mesorectal volume does not affect locoregional prognostic factors or the accuracy of local staging of rectal cancer.

  • 28.
    Torkzad, Michael R.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Lauenstein, Thomas C.
    Enterclysis versus enterography: the unsettled issue2009Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 19, nr 1, s. 90-91; discussion 92Artikel i tidskrift (Refereegranskat)
  • 29.
    Torkzad, Michael R.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Lindholm, Johan
    Martling, Anna
    Cedermark, Björn
    Glimelius, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Blomqvist, Lennart
    MRI after preoperative radiotherapy for rectal cancer; correlation with histopathology and the role of volumetry.2007Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 17, nr 6, s. 1566-1573Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective is to assess if tumor size after radiotherapy in patients with rectal cancer can be assessed by a second magnetic resonance imaging (MRI), after radiotherapy prior to surgery and to correlate changes observed on MRI with findings at histopathology at surgery. Twenty-five patients with MRI before and after radiotherapy were included. Variables studied were changes in tumor size, T-staging and distance to the circumferential resection margin (CRM). RVs was measured as tumor volume at surgery (Vs) divided by tumor volume at the initial MRI (Vi) in percent. RVm was defined as the tumor volume at the second MRI (Vm) divided by Vi in percent. The ypT-stage was the same or more favorable than the initial MRI T-stage in 24 of 25 patients. The second MRI was not more accurately predictive than the initial MRI for ypT-staging or distance to CRM (p > 0.05). Vm correlated significantly to Vs, as did RVs to RVm, although the former was always smaller than the latter. Vm and RVm correlated well with ypT-stage (p < 0.001). Volumetry seems to correlate with ypT-stage after preoperative radiotherapy for resectable rectal cancer. The value of a second MRI after radiotherapy for assessment of distance to CRM and ypT-staging is, however, not apparent.

  • 30.
    Torkzad, Michael R.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi, Enheten för radiologi.
    Vargas, Roberto
    Tanaka, Chikako
    Blomqvist, Lennart
    Value of cine MRI for better visualization of the proximal small bowel in normal individuals2007Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 17, nr 11, s. 2964-2968Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    While enteroclysis seems to be the most efficacious method in achieving bowel distension, enterographic methods have become widespread due to the unpleasantness of enteroclysis and the radiation involved with positioning the catheter. Cine images in MRI can be done without radiation. Our aim is to see if and how cine MR imaging can improve visualization of bowel loops by capturing them while distended. Ten healthy individuals were asked to drink up to 2,000 ml of an oral solution made locally over a 60-min period. Then they underwent MRI using coronal balanced fast field echo (b-FFE) covering small bowel loops. If the initial exam revealed collapsed bowel loops an additional 50 mg of erythromycine was given intravenously with the subject still in the scanner and then cine imaging was performed. The degree of distension of different segments of the small bowel was measured before and after cine imaging and compared. The distension score was significantly higher after addition of the cine images as well, being only significant for depiction of the duodenum and jejunum. Our preliminary study suggests that cine MRI can give better image depiction of the proximal small bowel in healthy volunteers, perhaps circumventing the need for enteroclysis in some cases. There is a need for validation of these results in patients with small bowel disease.

  • 31. van der Veldt, Astrid A M
    et al.
    Lubberink, Mark
    Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands.
    Lammertsma, Adriaan A
    Smit, Egbert F
    Comment on Cho et al.: Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction2011Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 21, nr 10, s. 2148-2149; author reply 2150Artikel i tidskrift (Refereegranskat)
  • 32.
    Velickaite, Vilma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Ferreira, D
    Cavallin, L
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Ahlström, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Kilander, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Westman, E
    Larsson, Elna-Marie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Radiologi.
    Medial temporal lobe atrophy ratings in a large 75-year-old population-based cohort: gender-corrected and education-corrected normative data2018Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 28, nr 4, s. 1739-1747Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To find cut-off values for different medial temporal lobe atrophy (MTA) measures (right, left, average, and highest), accounting for gender and education, investigate the association with cognitive performance, and to compare with decline of cognitive function over 5 years in a large population-based cohort.

    METHODS: Three hundred and ninety 75-year-old individuals were examined with magnetic resonance imaging of the brain and cognitive testing. The Scheltens's scale was used to assess visually MTA scores (0-4) in all subjects. Cognitive tests were repeated in 278 of them after 5 years. Normal MTA cut-off values were calculated based on the 10th percentile.

    RESULTS: Most 75-year-old individuals had MTA score ≤2. Men had significantly higher MTA scores than women. Scores for left and average MTA were significantly higher in highly educated individuals. Abnormal MTA was associated with worse results in cognitive test and individuals with abnormal right MTA had faster cognitive decline.

    CONCLUSION: At age 75, gender and education are confounders for MTA grading. A score of ≥2 is abnormal for low-educated women and a score of ≥2.5 is abnormal for men and high-educated women. Subjects with abnormal right MTA, but normal MMSE scores had developed worse MMSE scores 5 years later.

    KEY POINTS: • Gender and education are confounders for MTA grading. • We suggest cut-off values for 75-year-olds, taking gender and education into account. • Males have higher MTA scores than women. • Higher MTA scores are associated with worse cognitive performance.

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    fulltext
  • 33.
    Wikström, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Johansson, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    Karacagil, Sadettin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Ahlström, Håkan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för radiologi.
    The importance of adjusting for differences in proximal and distal contrast bolus arrival times in contrast-enhanced iliac artery magnetic resonance angiography2003Ingår i: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 13, nr 5, s. 957-963Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We tested the hypothesis that differences in proximal and distal contrast bolus arrival times may result in insufficient vascular signal in the distal part of the aortoiliofemoral territory with routinely used timing techniques. The difference in arrival time of the contrast medium bolus between the aorta and the common femoral arteries was measured in 14 patients undergoing magnetic resonance angiography of the aortoiliac arteries. A dual-station test bolus technique adjusting for this difference was evaluated. The variation coefficient of the signal intensity in six defined locations and signal intensities (SI) normalised to fat were calculated. Comparisons were made with findings in 13 patients examined with a fluoroscopically triggered timing technique (BolusTrak, Philips Medical Systems, Best, The Netherlands). The difference in bolus arrival time between proximal and distal vessels was 0-7 s. In 3 of 14 patients it was 5.6-7 s. There was a tendency towards a lower mean variation coefficient in the dual-station group ( p=0.10). With both techniques, significantly lower SIs were measured in the femoral arteries compared with SIs in the superior part of the abdominal aorta. In two cases in the BolusTrak group, a distal vessel could not be delineated but was shown to be patent on a delayed scan. Differences in contrast medium arrival time along the vessel may be large enough to preclude visualisation of distal vessels unless there is compensation. A dual-station test bolus technique taking this into account was found to be feasible.

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