umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Nyholm, Tufve
Alternative names
Publications (10 of 74) Show all publications
Sandgren, K., Johansson, L., Axelsson, J., Jonsson, J., Ögren, M., Ögren, M., . . . Widmark, A. (2019). Radiation dosimetry of [Ga-68]PSMA-11 in low-risk prostate cancer patients. EJNMMI Physics, 6, Article ID 2.
Open this publication in new window or tab >>Radiation dosimetry of [Ga-68]PSMA-11 in low-risk prostate cancer patients
Show others...
2019 (English)In: EJNMMI Physics, ISSN 2197-7364, E-ISSN 2191-219X, Vol. 6, article id 2Article in journal (Refereed) Published
Abstract [en]

Background: 68Ga-labeled Glu-NH-CO-NH-Lys(Ahx)-HBED-CC ([68Ga]PSMA-11) has been increasingly used to image prostate cancer using positron emission tomography (PET)/computed tomography (CT) both during diagnosis and treatment planning. It has been shown to be of clinical value for patients both in the primary and secondary stages of prostate cancer. The aim of this study was to determine the effective dose and organ doses from injection of [68Ga]PSMA-11 in a cohort of low-risk prostate cancer patients.

Methods: Six low-risk prostate cancer patients were injected with 133–178 MBq [68Ga]PSMA-11 and examined with four PET/CT acquisitions from injection to 255 min post-injection. Urine was collected up to 4 h post-injection, and venous blood samples were drawn at 45 min, 85 min, 175 min, and 245 min post-injection. Kidneys, liver, lungs, spleen, salivary and lacrimal glands, and total body where delineated, and cumulated activities and absorbed organ doses calculated. The software IDAC-Dose 2.1 was used to calculate absorbed organ doses according to the International Commission on Radiological Protection (ICRP) publication 107 using specific absorbed fractions published in ICRP 133 and effective dose according to ICRP Publication 103. We also estimated the absorbed dose to the eye lenses using Monte Carlo methods.

Results: [68Ga]PSMA-11 was rapidly cleared from the blood and accumulated preferentially in the kidneys and the liver. The substance has a biological half-life in blood of 6.5 min (91%) and 4.4 h (9%). The effective dose was calculated to 0.022 mSv/MBq. The kidneys received approximately 40 mGy after an injection with 160 MBq [68Ga]PSMA-11 while the lacrimal glands obtained an absorbed dose of 0.12 mGy per administered MBq. Regarding the eye lenses, the absorbed dose was low (0.0051 mGy/MBq).

Conclusion: The effective dose for [68Ga]PSMA-11 is 0.022 mSv/MBq, where the kidneys and lacrimal glands receiving the highest organ dose.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Radiation dosimetry, [Ga-68]PSMA-11, PSMA, PET-tracer, Prostate cancer, Absorbed dose and effective dose, Glu-NH-CO-NH-Lys(Ahx)-HBED-CC
National Category
Cancer and Oncology Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-155760 (URN)10.1186/s40658-018-0239-2 (DOI)000455503100001 ()30631980 (PubMedID)
Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-01-28Bibliographically approved
Engvall, G., Lindh, V., Mullaney, T., Nyholm, T., Lindh, J. & Ångström-Brännström, C. (2018). Children's experiences and responses towards an intervention for psychological preparation for radiotherapy. Radiation Oncology, 13, Article ID 9.
Open this publication in new window or tab >>Children's experiences and responses towards an intervention for psychological preparation for radiotherapy
Show others...
2018 (English)In: Radiation Oncology, ISSN 1748-717X, E-ISSN 1748-717X, Vol. 13, article id 9Article in journal (Refereed) Published
Abstract [en]

Background: Children can experience distress when undergoing radiotherapy as a reaction to being scared of and unfamiliar with the procedure. The aim was to evaluate children's experiences and responses towards an intervention for psychological preparation for radiotherapy.

Methods: A case control design with qualitative content analysis of semi-structured interviews and statistical analysis of anxiety ratings were used for evaluating a strategy for psychological preparation and distraction. Fifty-seven children aged 2 to 18 years and their parents participated - 30 children in the baseline group and 27 in the intervention group. Child interviews were performed and the child and their parents rated the child's anxiety.

Results: The intervention was most appropriate for the younger children, who enjoyed the digital story, the stuffed animal and training with their parents. There were some technical problems and the digital story was not detailed enough to fit exactly with various cancer diagnoses. Children described suggestions for improvement of the intervention. The ratings of the child's anxiety during radiation treatment showed no differences between the baseline group and the intervention group.

Conclusions: The children of all the age groups experienced their interventions as positive. The strength of the intervention was that it encouraged interaction within the family and provided an opportunity for siblings and peers to take part in what the child was going through. Future research on children's experiences to interventions should be encouraged. The intervention and the technical solutions could improve by further development.

Trial registration: The study design was structured as an un-matched case-control study, baseline group vs. intervention group. Trial registration: ClinicalTrials.gov NCT02993978 , Protocol Record 2012-113-31 M. Retrospectively registered - 21 November 2016.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
childhood cancer, children’s experiences, distraction, psychological preparation, radiotherapy
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-144573 (URN)10.1186/s13014-017-0942-5 (DOI)000423350200001 ()29357940 (PubMedID)
Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2018-06-09Bibliographically approved
Garpebring, A., Brynolfsson, P., Kuess, P., Georg, D., Helbich, T. H., Nyholm, T. & Löfstedt, T. (2018). Density Estimation of Grey-Level Co-Occurrence Matrices for Image Texture Analysis. Physics in Medicine and Biology, 63(19), 9-15, Article ID 195017.
Open this publication in new window or tab >>Density Estimation of Grey-Level Co-Occurrence Matrices for Image Texture Analysis
Show others...
2018 (English)In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 63, no 19, p. 9-15, article id 195017Article in journal (Refereed) Published
Abstract [en]

The Haralick texture features are common in the image analysis literature, partly because of their simplicity and because their values can be interpreted. It was recently observed that the Haralick texture features are very sensitive to the size of the GLCM that was used to compute them, which led to a new formulation that is invariant to the GLCM size. However, these new features still depend on the sample size used to compute the GLCM, i.e. the size of the input image region-of-interest (ROI).

The purpose of this work was to investigate the performance of density estimation methods for approximating the GLCM and subsequently the corresponding invariant features.

Three density estimation methods were evaluated, namely a piece-wise constant distribution, the Parzen-windows method, and the Gaussian mixture model. The methods were evaluated on 29 different image textures and 20 invariant Haralick texture features as well as a wide range of different ROI sizes.

The results indicate that there are two types of features: those that have a clear minimum error for a particular GLCM size for each ROI size, and those whose error decreases monotonically with increased GLCM size. For the first type of features, the Gaussian mixture model gave the smallest errors, and in particular for small ROI sizes (less than about 20×20).

In conclusion, the Gaussian mixture model is the preferred method for the first type of features (in particular for small ROIs). For the second type of features, simply using a large GLCM size is preferred.

Place, publisher, year, edition, pages
Institute of Physics and Engineering in Medicine, 2018
Keywords
Haralick features, invariant features, GLCM, density estimation, texture analysis, image analysis
National Category
Computer Vision and Robotics (Autonomous Systems) Other Mathematics
Identifiers
urn:nbn:se:umu:diva-152488 (URN)10.1088/1361-6560/aad8ec (DOI)000446205200005 ()30088815 (PubMedID)
Funder
Västerbotten County CouncilVINNOVA
Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2018-10-31Bibliographically approved
Gronlund, E., Johansson, S., Nyholm, T., Thellenberg, C. & Ahnesjo, A. (2018). Dose painting of prostate cancer based on Gleason score correlations with apparent diffusion coefficients. Acta Oncologica, 57(5), 574-581
Open this publication in new window or tab >>Dose painting of prostate cancer based on Gleason score correlations with apparent diffusion coefficients
Show others...
2018 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 57, no 5, p. 574-581Article in journal (Refereed) Published
Abstract [en]

Background: Gleason scores for prostate cancer correlates with an increased recurrence risk after radiotherapy (RT). Furthermore, higher Gleason scores correlates with decreasing apparent diffusion coefficient (ADC) data from diffusion weighted MRI (DWI-MRI). Based on these observations, we present a formalism for dose painting prescriptions of prostate volumes based on ADC images mapped to Gleason score driven dose-responses.

Methods: The Gleason score driven dose-responses were derived from a learning data set consisting of pre-RT biopsy data and post-RT outcomes for 122 patients treated with a homogeneous dose to the prostate. For a test data set of 18 prostate cancer patients with pre-RT ADC images, we mapped the ADC data to the Gleason driven dose-responses by using probability distributions constructed from published Gleason score correlations with ADC data. We used the Gleason driven dose-responses to optimize dose painting prescriptions that maximize the tumor control probability (TCP) with equal average dose as for the learning sets homogeneous treatment dose.

Results: The dose painting prescriptions increased the estimated TCP compared to the homogeneous dose by 0–51% for the learning set and by 4–30% for the test set. The potential for individual TCP gains with dose painting correlated with increasing Gleason score spread and larger prostate volumes. The TCP gains were also found to be larger for patients with a low expected TCP for the homogeneous dose prescription.

Conclusions: We have from retrospective treatment data demonstrated a formalism that yield ADC driven dose painting prescriptions for prostate volumes that potentially can yield significant TCP increases without increasing dose burdens as compared to a homogeneous treatment dose. This motivates further development of the approach to consider more accurate ADC to Gleason mappings, issues with delivery robustness of heterogeneous dose distributions, and patient selection criteria for design of clinical trials.

National Category
Urology and Nephrology Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-147489 (URN)10.1080/0284186X.2017.1415457 (DOI)000430114000002 ()29260950 (PubMedID)
Funder
Swedish Cancer Society, 130632
Available from: 2018-05-04 Created: 2018-05-04 Last updated: 2018-06-09Bibliographically approved
Fahlström, M., Fransson, S., Blomquist, E., Nyholm, T. & Larsson, E.-M. (2018). Dynamic contrast-enhanced magnetic resonance imaging may act as a biomarker for vascular damage in normal appearing brain tissue after radiotherapy in patients with glioblastoma. Acta Radiologica Open, 7(11), Article ID 2058460118808811.
Open this publication in new window or tab >>Dynamic contrast-enhanced magnetic resonance imaging may act as a biomarker for vascular damage in normal appearing brain tissue after radiotherapy in patients with glioblastoma
Show others...
2018 (English)In: Acta Radiologica Open, ISSN 2058-4601, Vol. 7, no 11, article id 2058460118808811Article in journal (Refereed) Published
Abstract [en]

Background

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a promising perfusion method and may be useful in evaluating radiation-induced changes in normal-appearing brain tissue.

Purpose

To assess whether radiotherapy induces changes in vascular permeability (Ktrans) and the fractional volume of the extravascular extracellular space (Ve) derived from DCE-MRI in normal-appearing brain tissue and possible relationships to radiation dose given.

Material and Methods

Seventeen patients with glioblastoma treated with radiotherapy and chemotherapy were included; five were excluded because of inconsistencies in the radiotherapy protocol or early drop-out. DCE-MRI, contrast-enhanced three-dimensional (3D) T1-weighted (T1W) images and T2-weighted fluid attenuated inversion recovery (T2-FLAIR) images were acquired before and on average 3.3, 30.6, 101.6, and 185.7 days after radiotherapy. Pre-radiotherapy CE T1W and T2-FLAIR images were segmented into white and gray matter, excluding all non-healthy tissue. Ktrans and Ve were calculated using the extended Kety model with the Parker population-based arterial input function. Six radiation dose regions were created for each tissue type, based on each patient’s computed tomography-based dose plan. Mean Ktrans and Ve were calculated over each dose region and tissue type.

Results

Global Ktrans and Ve demonstrated mostly non-significant changes with mean values higher for post-radiotherapy examinations in both gray and white matter compared to pre-radiotherapy. No relationship to radiation dose was found.

Conclusion

Additional studies are needed to validate if Ktrans and Ve derived from DCE-MRI may act as potential biomarkers for acute and early-delayed radiation-induced vascular damages. No dose-response relationship was found.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI, radiation therapy/oncology, radiation effects, normal-appearing brain tissue, glioblastoma
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-154961 (URN)10.1177/2058460118808811 (DOI)000450106500001 ()30542625 (PubMedID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Brynolfsson, P., Löfstedt, T., Asklund, T., Nyholm, T. & Garpebring, A. (2018). Gray-level invariant Haralick texture features. Paper presented at 37th Meeting of the European-Society-for-Radiotherapy-and-Oncology (ESTRO), APR 20-24, 2018, Barcelona, SPAIN. Radiotherapy and Oncology, 127, S279-S280
Open this publication in new window or tab >>Gray-level invariant Haralick texture features
Show others...
2018 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 127, p. S279-S280Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-150493 (URN)10.1016/S0167-8140(18)30837-5 (DOI)000437723401139 ()
Conference
37th Meeting of the European-Society-for-Radiotherapy-and-Oncology (ESTRO), APR 20-24, 2018, Barcelona, SPAIN
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2018-11-01Bibliographically approved
Sandgren, K., Jonsson, J., Nyholm, T., Strandberg, S., Ögren, M., Axelsson, J., . . . Windmark, A. (2018). Histology correlation of in vivo [68Ga]PSMA-PET/MRI data of the prostate. Paper presented at 37th Meeting of the European-Society-for-Radiotherapy-and-Oncology (ESTRO), APR 20-24, 2018, Barcelona, SPAIN. Radiotherapy and Oncology, 127, S541-S541
Open this publication in new window or tab >>Histology correlation of in vivo [68Ga]PSMA-PET/MRI data of the prostate
Show others...
2018 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 127, p. S541-S541Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-150494 (URN)10.1016/S0167-8140(18)31288-X (DOI)000437723402226 ()
Conference
37th Meeting of the European-Society-for-Radiotherapy-and-Oncology (ESTRO), APR 20-24, 2018, Barcelona, SPAIN
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2018-11-01Bibliographically approved
Björeland, U., Jonsson, J., Alm, M., Beckman, L., Nyholm, T. & Thellenberg-Karlsson, C. (2018). Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT. Journal of radiation oncology, 7(4), 357-366
Open this publication in new window or tab >>Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT
Show others...
2018 (English)In: Journal of radiation oncology, ISSN 1948-7894, Vol. 7, no 4, p. 357-366Article in journal (Refereed) Published
Abstract [en]

Objectivities: The aim of this study was to evaluate inter-fraction movements of lymph node regions that are commonly included in the pelvic clinical target volume (CTV) for high-risk prostate cancer patients. We also aimed to evaluate if the movements affect the planning target volumes. Methods: Ten prostate cancer patients were included. The patients underwent six MRI scans, from treatment planning to near end of treatment. The CTV movements were analyzed with deformable registration technique with the CTV divided into sections. The validity of the deformable registration was assessed by comparing the results for individual lymph nodes that were possible to identify in all scans. Results: Using repetitive MRI, measurements showed that areas inside the CTV (lymph nodes) in some extreme cases were as mobile as the prostate and not fixed to the bones. The lymph node volumes closest to the prostate did not tend to follow the prostate motion. The more cranial lymph node volumes moved less, but still independently, and they were not necessarily fixed to the pelvic bones. In 95% of the cases, the lymph node motion in the R-L direction was 2-4mm, in the A-P direction 2-7mm, and in the C-C direction 2-5mm depending on the CTV section. Conclusion: Lymph nodes and prostate were most mobile in the A-P direction, followed by the C-C and R-L directions. This movement should be taken into account when deciding the margins for the planning target volumes (PTV).

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Prostate, Lymph nodes, CTV, Movements
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-154896 (URN)10.1007/s13566-018-0366-3 (DOI)000452890500007 ()30595810 (PubMedID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Nyholm, T., Svensson, S., Andersson, S., Jonsson, J., Sohlin, M., Gustafsson, C., . . . Gunnlaugsson, A. (2018). MR and CT data with multiobserver delineations of organs in the pelvic area: Part of the Gold Atlas project. Medical physics (Lancaster), 45(3), 1295-1300
Open this publication in new window or tab >>MR and CT data with multiobserver delineations of organs in the pelvic area: Part of the Gold Atlas project
Show others...
2018 (English)In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 45, no 3, p. 1295-1300Article in journal (Refereed) Published
Abstract [en]

Purpose: We describe a public dataset with MR and CT images of patients performed in the same position with both multiobserver and expert consensus delineations of relevant organs in the male pelvic region. The purpose was to provide means for training and validation of segmentation algorithms and methods to convert MR to CT like data, i.e., so called synthetic CT (sCT).

Acquisition and validation methods: T1- and T2-weighted MR images as well as CT data were collected for 19 patients at three different departments. Five experts delineated nine organs for each patient based on the T2-weighted MR images. An automatic method was used to fuse the delineations. Starting from each fused delineation, a consensus delineation was agreed upon by the five experts for each organ and patient. Segmentation overlap between user delineations with respect to the consensus delineations was measured to describe the spread of the collected data. Finally, an open-source software was used to create deformation vector fields describing the relation between MR and CT images to further increase the usability of the dataset.

Data format and usage notes: The dataset has been made publically available to be used for academic purposes, and can be accessed from . Potential applicationsThe dataset provides a useful source for training and validation of segmentation algorithms as well as methods to convert MR to CT-like data (sCT). To give some examples: The T2-weighted MR images with their consensus delineations can directly be used as a template in an existing atlas-based segmentation engine; the expert delineations are useful to validate the performance of a segmentation algorithm as they provide a way to measure variability among users which can be compared with the result of an automatic segmentation; and the pairwise deformably registered MR and CT images can be a source for an atlas-based sCT algorithm or for validation of sCT algorithm.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
CT, MRI, open dataset, organs at risk, radiotherapy
National Category
Medical Image Processing
Identifiers
urn:nbn:se:umu:diva-146581 (URN)10.1002/mp.12748 (DOI)000427129700032 ()29322528 (PubMedID)
Available from: 2018-06-26 Created: 2018-06-26 Last updated: 2018-06-26Bibliographically approved
Fahlström, M., Blomquist, E., Nyholm, T. & Larsson, E.-M. (2018). Perfusion magnetic resonance imaging changes in normal appearing brain tissue after radiotherapy in glioblastoma patients may confound longitudinal evaluation of treatment response. Radiology and Oncology, 52(2), 143-151
Open this publication in new window or tab >>Perfusion magnetic resonance imaging changes in normal appearing brain tissue after radiotherapy in glioblastoma patients may confound longitudinal evaluation of treatment response
2018 (English)In: Radiology and Oncology, ISSN 1318-2099, E-ISSN 1581-3207, Vol. 52, no 2, p. 143-151Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was assess acute and early delayed radiation-induced changes in normal-appearing brain tissue perfusion as measured with perfusion magnetic resonance imaging (MRI) and the dependence of these changes on the fractionated radiotherapy (FRT) dose level.

Patients and methods: Seventeen patients with glioma WHO grade III-IV treated with FRT were included in this prospective study, seven were excluded because of inconsistent FRT protocol or missing examinations. Dynamic susceptibility contrast MRI and contrast-enhanced 3D-T1-weighted (3D-T1w) images were acquired prior to and in average (standard deviation): 3.1 (3.3), 34.4 (9.5) and 103.3 (12.9) days after FRT. Pre-FRT 3D-T1w images were segmented into white-and grey matter. Cerebral blood volume (CBV) and cerebral blood flow (CBF) maps were calculated and co-registered patient-wise to pre-FRT 3D-T1w images. Seven radiation dose regions were created for each tissue type: 0-5 Gy, 5-10 Gy, 10-20 Gy, 20-30 Gy, 30-40 Gy, 40-50 Gy and 50-60 Gy. Mean CBV and CBF were calculated in each dose region and normalised (nCBV and nCBF) to the mean CBV and CBF in 0-5 Gy white-and grey matter reference regions, respectively.

Results: Regional and global nCBV and nCBF in white-and grey matter decreased after FRT, followed by a tendency to recover. The response of nCBV and nCBF was dose-dependent in white matter but not in grey matter.

Conclusions: Our data suggest that radiation-induced perfusion changes occur in normal-appearing brain tissue after FRT. This can cause an overestimation of relative tumour perfusion using dynamic susceptibility contrast MRI, and can thus confound tumour treatment evaluation.

Place, publisher, year, edition, pages
Walter de Gruyter, 2018
Keywords
perfusion MRI, radiation-induced changes, normal-appearing brain tissue, malignant gliomas
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-149009 (URN)10.2478/raon-2018-0022 (DOI)000433103400004 ()
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2018-06-15Bibliographically approved
Organisations

Search in DiVA

Show all publications