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  • 1. Abat, Ferran
    et al.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Campos, Jocelio
    Planells, Gabriel
    Torras, Jordi
    Madruga-Parera, Marc
    Rodriguez-Baeza, Alfonso
    Ultrasound-guided versus blind interventions in patellar tendon lesions: a cadaveric study2021In: Skeletal Radiology, ISSN 0364-2348, E-ISSN 1432-2161, Vol. 50, no 5, p. 967-972Article in journal (Refereed)
    Abstract [en]

    Purpose: The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon "target point" in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections.

    Methods: A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis.

    Results: Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The "unguided" injections were considered to have been performed on average 10 mm away from the target point compared to the "ultrasound-guided" injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the "non-ultrasound-guided" injections obtained an accuracy of 11.54% (p < 0.0001).

    Conclusion: The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment.

  • 2. Adams, D.
    et al.
    Coelho, T.
    Conceicao, E.
    Waddington-Cruz, M.
    Schmidt, H.
    Buades, J.
    Campistol, J. M.
    Pouget, J.
    Berk, J. L.
    Polydefkis, M.
    Ziyadeh, N.
    Partisano, A. M.
    Chen, J.
    Gollob, J.
    Suhr, Ole B.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    PHASE 2 OPEN-LABEL EXTENSION (OLE) STUDY OF PATISIRAN, AN INVESTIGATIONAL RNA INTERFERENCE (RNAI) THERAPEUTIC FOR THE TREATMENT OF HEREDITARY ATTR AMYLOIDOSIS WITH POLYNEUROPATHY2017In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 20, no 5, p. A211-A212Article in journal (Other academic)
  • 3.
    Adjeiwaah, Mary
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Quality assurance for magnetic resonance imaging (MRI) in radiotherapy2017Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Magnetic resonance imaging (MRI) utilizes the magnetic properties of tissues to generate image-forming signals. MRI has exquisite soft-tissue contrast and since tumors are mainly soft-tissues, it offers improved delineation of the target volume and nearby organs at risk. The proposed Magnetic Resonance-only Radiotherapy (MR-only RT) work flow allows for the use of MRI as the sole imaging modality in the radiotherapy (RT) treatment planning of cancer. There are, however, issues with geometric distortions inherent with MR image acquisition processes. These distortions result from imperfections in the main magnetic field, nonlinear gradients, as well as field disturbances introduced by the imaged object. In this thesis, we quantified the effect of system related and patient-induced susceptibility geometric distortions on dose distributions for prostate as well as head and neck cancers. Methods to mitigate these distortions were also studied.

    In Study I, mean worst system related residual distortions of 3.19, 2.52 and 2.08 mm at bandwidths (BW) of 122, 244 and 488 Hz/pixel up to a radial distance of 25 cm from a 3T PET/MR scanner was measured with a large field of view (FoV) phantom. Subsequently, we estimated maximum shifts of 5.8, 2.9 and 1.5 mm due to patient-induced susceptibility distortions. VMAT-optimized treatment plans initially performed on distorted CT (dCT) images and recalculated on real CT datasets resulted in a dose difference of less than 0.5%.

     The magnetic susceptibility differences at tissue-metallic,-air and -bone interfaces result in local B0 magnetic field inhomogeneities. The distortion shifts caused by these field inhomogeneities can be reduced by shimming.  Study II aimed to investigate the use of shimming to improve the homogeneity of local  B0 magnetic field which will be beneficial for radiotherapy applications. A shimming simulation based on spherical harmonics modeling was developed. The spinal cord, an organ at risk is surrounded by bone and in close proximity to the lungs may have high susceptibility differences. In this region, mean pixel shifts caused by local B0 field inhomogeneities were reduced from 3.47±1.22 mm to 1.35±0.44 mm and 0.99±0.30 mm using first and second order shimming respectively. This was for a bandwidth of 122 Hz/pixel and an in-plane voxel size of 1×1 mm2.  Also examined in Study II as in Study I was the dosimetric effect of geometric distortions on 21 Head and Neck cancer treatment plans. The dose difference in D50 at the PTV between distorted CT and real CT plans was less than 1.0%.

    In conclusion, the effect of MR geometric distortions on dose plans was small. Generally, we found patient-induced susceptibility distortions were larger compared with residual system distortions at all delineated structures except the external contour. This information will be relevant when setting margins for treatment volumes and organs at risk.  

    The current practice of characterizing MR geometric distortions utilizing spatial accuracy phantoms alone may not be enough for an MR-only radiotherapy workflow. Therefore, measures to mitigate patient-induced susceptibility effects in clinical practice such as patient-specific correction algorithms are needed to complement existing distortion reduction methods such as high acquisition bandwidth and shimming.

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  • 4.
    Adjeiwaah, Mary
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Quality assurance for magnetic resonance imaging (MRI) in radiotherapy2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The use of Magnetic Resonance Imaging (MRI) in the radiotherapy (RT) treatment planning workflow is increasing. MRI offers superior soft-tissue contrast compared to Computed Tomography (CT) and therefore improves the accuracy in target volume definitions. There are, however concerns with inherent geometric distortions from system- (gradient nonlinearities and main magnetic field inhomogeneities) and patient-related sources (magnetic susceptibility effect and chemical shift). The lack of clearly defined quality assurance (QA) procedures has also raised questions on the ability of current QA protocols to detect common image quality degradations under radiotherapy settings. To fully implement and take advantage of the benefits of MRI in radiotherapy, these concerns need to be addressed.

    In Papers I and II, the dosimetric impact of MR distortions was investigated. Patient CTs (CT) were deformed with MR distortion vector fields (from the residual system distortions after correcting for gradient nonlinearities and patient-induced susceptibility distortions) to create distorted CT (dCT) images. Field parameters from volumetric modulated arc therapy (VMAT) treatment plans initially optimized on dCT data sets were transferred to CT data to compute new treatment plans. Data from 19 prostate and 21 head and neck patients were used for the treatment planning. The dCT and CT treatment plans were compared to determine the impact of distortions on dose distributions. No clinically relevant dose differences between distorted CT and original CT treatment plans were found. Mean dose differences were < 1.0% and < 0.5% at the planning target volume (PTV) for the head and neck, and prostate treatment plans, respectively. 

    Strategies to reduce geometric distortions were also evaluated in Papers I and II. Using the vendor-supplied gradient non-linearity correction algorithm reduced overall distortions to less than half of the original value. A high acquisition bandwidth of 488 Hz/pixel (Paper I) and 488 Hz/mm (Paper II) kept the mean geometric distortions at the delineated structures below 1 mm. Furthermore, a patient-specific active shimming method implemented in Paper II significantly reduced the number of voxels with distortion shifts > 2 mm from 15.4% to 2.0%.

    B0 maps from patient-induced magnetic field inhomogeneities obtained through direct measurements and by simulations that used MR-generated synthetic CT (sCT) data were compared in Paper III. The validation showed excellent agreement between the simulated and measured B0 maps.

    In Paper IV, the ability of current QA methods to detect common MR image quality degradations under radiotherapy settings were investigated. By evaluating key image quality parameters, the QA protocols were found to be sensitive to some of the introduced degradations. However, image quality issues such as those caused by RF coil failures could not be adequately detected.

    In conclusion, this work has shown the feasibility of using MRI data for radiotherapy treatment planning as distortions resulted in a dose difference of less than 1% between distorted and undistorted images. The simulation software can be used to produce accurate B0 maps, which could then be used as the basis for the effective correction of patient-induced field inhomogeneity distortions and for the QA verification of sCT data. Furthermore, the analysis of the strengths and weaknesses in current QA tools for MRI in RT contribute to finding better methods to efficiently identify image quality errors.

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  • 5.
    Adjeiwaah, Mary
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bylund, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundman, Josef A.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Söderström, Karin
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Zackrisson, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Jonsson, Joakim H.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Dosimetric Impact of MRI Distortions: A Study on Head and Neck Cancers2019In: International Journal of Radiation Oncology, Biology, Physics, ISSN 0360-3016, E-ISSN 1879-355X, Vol. 103, no 4, p. 994-1003Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate the effect of magnetic resonance (MR) imaging (MRI) geometric distortions on head and neck radiation therapy treatment planning (RTP) for an MRI-only RTP. We also assessed the potential benefits of patient-specific shimming to reduce the magnitude of MR distortions for a 3-T scanner.

    Methods and Materials: Using an in-house Matlab algorithm, shimming within entire imaging volumes and user-defined regions of interest were simulated. We deformed 21 patient computed tomography (CT) images with MR distortion fields (gradient nonlinearity and patient-induced susceptibility effects) to create distorted CT (dCT) images using bandwidths of 122 and 488 Hz/mm at 3 T. Field parameters from volumetric modulated arc therapy plans initially optimized on dCT data sets were transferred to CT data to compute a new plan. Both plans were compared to determine the impact of distortions on dose distributions.

    Results: Shimming across entire patient volumes decreased the percentage of voxels with distortions of more than 2 mm from 15.4% to 2.0%. Using the user-defined region of interest (ROI) shimming strategy, (here the Planning target volume (PTV) was the chosen ROI volume) led to increased geometric for volumes outside the PTV, as such voxels within the spinal cord with geometric shifts above 2 mm increased from 11.5% to 32.3%. The worst phantom-measured residual system distortions after 3-dimensional gradient nonlinearity correction within a radial distance of 200 mm from the isocenter was 2.17 mm. For all patients, voxels with distortion shifts of more than 2 mm resulting from patient-induced susceptibility effects were 15.4% and 0.0% using bandwidths of 122 Hz/mm and 488 Hz/mm at 3 T. Dose differences between dCT and CT treatment plans in D-50 at the planning target volume were 0.4% +/- 0.6% and 0.3% +/- 0.5% at 122 and 488 Hz/mm, respectively.

    Conclusions: The overall effect of MRI geometric distortions on data used for RTP was minimal. Shimming over entire imaging volumes decreased distortions, but user-defined subvolume shimming introduced significant errors in nearby organs and should probably be avoided.

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  • 6.
    Adjeiwaah, Mary
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bylund, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundman, Josef A.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Thellenberg Karlsson, Camilla
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Jonsson, Joakim H.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Medical Radiation Physics, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
    Quantifying the Effect of 3T Magnetic Resonance Imaging Residual System Distortions and Patient-Induced Susceptibility Distortions on Radiation Therapy Treatment Planning for Prostate Cancer2018In: International Journal of Radiation Oncology, Biology, Physics, ISSN 0360-3016, E-ISSN 1879-355X, Vol. 100, no 2, p. 317-324Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effect of magnetic resonance system- and patient-induced susceptibility distortions from a 3T scanner on dose distributions for prostate cancers.

    Methods and Materials: Combined displacement fields from the residual system and patient-induced susceptibility distortions were used to distort 17 prostate patient CT images. VMAT dose plans were initially optimized on distorted CT images and the plan parameters transferred to the original patient CT images to calculate a new dose distribution.

    Results: Maximum residual mean distortions of 3.19 mm at a radial distance of 25 cm and maximum mean patient-induced susceptibility shifts of 5.8 mm were found using the lowest bandwidth of 122 Hz per pixel. There was a dose difference of <0.5% between distorted and undistorted treatment plans. The 90% confidence intervals of the mean difference between the dCT and CT treatment plans were all within an equivalence interval of (−0.5, 0.5) for all investigated plan quality measures.

    Conclusions: Patient-induced susceptibility distortions at high field strengths in closed bore magnetic resonance scanners are larger than residual system distortions after using vendor-supplied 3-dimensional correction for the delineated regions studied. However, errors in dose due to disturbed patient outline and shifts caused by patient-induced susceptibility effects are below 0.5%.

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  • 7.
    Adjeiwaah, Mary
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Quality Assurance for MRI in Radiotherapy: Sensitivity Analysis of Current MethodsManuscript (preprint) (Other academic)
  • 8.
    Adjeiwaah, Mary
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lundman, Josef A.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bylund, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Technical Note: Comparison between simulated and measured B0 field maps of head and neck MRIManuscript (preprint) (Other academic)
  • 9.
    Adjez, Timor
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Torshage, Wilhelm
    Umeå University, Faculty of Medicine, Department of Odontology.
    Comparison of image quality in radiographs acquired with different panoramic machines in Västerbotten2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 10.
    af Bjerkén, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
    Axelsson, Jan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Flygare, Carolina
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Remes, Jussi
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Strandberg, Sara
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Eriksson, Linda
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
    Bäckström, David C.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
    Jakobson Mo, Susanna
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Reliability and validity of visual analysis of [18F]FE-PE2I PET/CT in early Parkinsonian disease2023In: Nuclear medicine communications, ISSN 0143-3636, E-ISSN 1473-5628, Vol. 44, no 5, p. 397-406Article in journal (Refereed)
    Abstract [en]

    Objective: [18F]FE-PE2I (FE-PE2I) is a new radiotracer for dopamine transporter (DAT) imaging with PET. The aim of this study was to evaluate the visual interpretation of FE-PE2I images for the diagnosis of idiopathic Parkinsonian syndrome (IPS). The inter-rater variability, sensitivity, specificity, and diagnostic accuracy for visual interpretation of striatal FE-PE2I compared to [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) was evaluated.

    Methods: Thirty patients with newly onset parkinsonism and 32 healthy controls with both an FE-PE2I and FP-CIT were included in the study. Four patients had normal DAT imaging, of which three did not fulfil the IPS criteria at the clinical reassessment after 2 years. Six raters evaluated the DAT images blinded to the clinical diagnosis, interpreting the image as being ‘normal’ or ‘pathological’, and assessed the degree of DAT-reduction in the caudate and putamen. The inter-rater agreement was assessed with intra-class correlation and Cronbach’s α. For calculation of sensitivity and specificity, DAT images were defined as correctly classified if categorized as normal or pathological by ≥4/6 raters.

    Results: The overall agreement in visual evaluation of the FE-PE2I- and FP-CIT images was high for the IPS patients (α = 0.960 and 0.898, respectively), but lower in healthy controls (FE-PE2I: α = 0.693, FP-CIT: α = 0.657). Visual interpretation gave high sensitivity (both 0.96) but lower specificity (FE-PE2I: 0.86, FP-CIT: 0.63) with an accuracy of 90% for FE-PE2I and 77% for FP-CIT.

    Conclusion: Visual evaluation of FE-PE2I PET imaging demonstrates high reliability and diagnostic accuracy for IPS.

  • 11.
    Ahlgren, Ulf
    Umeå University, Faculty of Medicine, Umeå Centre for Molecular Medicine (UCMM).
    Exploring the pancreas with optical projection tomography2012In: Imaging in Medicine, ISSN 1755-5191, Vol. 4, no 1, p. 5-7Article in journal (Refereed)
  • 12.
    Ahmed, Maghfoor
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Antibiotikaanvändning före diagnos och överlevnad vidkolorektalcancer stadium IV.2022Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 13.
    Akhtari, Mohammad Mehdi
    Umeå University, Faculty of Science and Technology, Department of Physics. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    3D Structural similarity check between CT and SCT2014Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of the current work was to develop and test a method for comparing the geometrical representation of a patient using computed tomography (CT), and CT like images derived from magnetic resonance images (MRI). It would be beneficial to use MRI alone for both target delineation and treatment planning to save time and costs. This was first investigated in Umea university Hospital by introducing substitute computed tomography (SCT) obtained from MRI images and which can be used as CT equivalent information. The data that is used in this report are from five patients with intracranial tumors; A MATLAB code has been developed to compare DDRs based on s-CT data with CT based DRR’s for these five patients.

  • 14. Akram, Harith
    et al.
    Hariz, Marwan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Zrinzo, Ludvic
    Connectivity derived thalamic segmentation: Separating myth from reality2019In: NeuroImage: Clinical, E-ISSN 2213-1582, Vol. 22, article id 101758Article in journal (Refereed)
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  • 15. Aksnessaether, Bjorg Y.
    et al.
    Myklebus, Tor Age
    Solberg, Arne
    Klepp, Olbjorn H.
    Skovlund, Eva
    Hoff, Solveig Roth
    Fossa, Sophie D.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Lund, Jo-Asmund
    In Reply to Sari et al2020In: International Journal of Radiation Oncology, Biology, Physics, ISSN 0360-3016, E-ISSN 1879-355X, Vol. 107, no 2, p. 388-389Article in journal (Refereed)
  • 16.
    Aksu, Fatih
    et al.
    Humanitas University, Department of Biomedical Sciences, Milan, Italy.
    Gelardi, Fabrizia
    Humanitas University, Department of Biomedical Sciences, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy.
    Chiti, Arturo
    Humanitas University, Department of Biomedical Sciences, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy.
    Soda, Paolo
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Humanitas University, Department of Biomedical Sciences, Milan, Italy; Campus Bio-Medico University of Rome, Research Unit of Computer Systems and Bioinformatics, Rome, Italy.
    Early Experiences on using Triplet Networks for Histological Subtype Classification in Non-Small Cell Lung Cancer2023In: 2023 IEEE 36th International Symposium on Computer-Based Medical Systems (CBMS): Proceedings / [ed] João Rafael Almeida; Myra Spiliopoulou; Jose Alberto Benitez Andrades; Giuseppe Placidi; Alejandro Rodríguez González; Rosa Sicilia; Bridget Kane, IEEE, 2023, p. 832-837Conference paper (Refereed)
    Abstract [en]

    Lung cancer has the highest mortality rate among tumours and an accurate pathological assessment is crucial to deliver personalized treatments to patients. The gold standard for pathological assessment requires invasive procedures, which are not always possible and might cause clinical complications. Therefore, in the last years, efforts have been directed towards the development of machine and deep learning approaches for virtual biopsy, which leverage routinely collected CT scans. However, in many cases, the available datasets are limited in size, an issue that limits the training of any model. In this paper, we investigate if triplet networks can cope with this limitation: they are a class of neural networks that uses the same weights while working in tandem on three different input vectors to minimize the loss function. In particular, on a dataset including 87 CT scans collected from patients suffering from non-small cell lung cancer, we experimentally compare triplet networks against plain deep networks when performing histological subtype classification. The results show that the former outperforms the latter in almost all experiments.

  • 17.
    Al-Amiry, Bariq
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Pantelakis, Georgios
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Mahmood, Sarwar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Kadum, Bakir
    Brismar, Torkel B.
    Sayed-Noor, Arkan S.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Does body mass index affect restoration of femoral offset, leg length and cup positioning after total hip arthroplasty?: a prospective cohort study2019In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 20, article id 422Article in journal (Refereed)
    Abstract [en]

    Background: In obese patients, total hip arthroplasty (THA) can be technically demanding with increased perioperative risks. The aim of this prospective cohort study is to evaluate the effect of body mass index (BMI) on radiological restoration of femoral offset (FO) and leg length as well as acetabular cup positioning.

    Methods: In this prospective study, patients with unilateral primary osteoarthritis (OA) treated with THA between September 2010 and December 2013 were considered for inclusion. The perioperative plain radiographs were standardised and used to measure the preoperative degree of hip osteoarthritis, postoperative FO, leg length discrepancy (LLD), acetabular component inclination and anteversion.

    Results: We included 213 patients (74.5% of those considered for inclusion) with a mean BMI of 27.7 (SD 4.5) in the final analysis. The postoperative FO was improper in 55% and the LLD in 15%, while the cup inclination and anteversion were improper in 13 and 23% of patients respectively. A multivariable logistic regression model identified BMI as the only factor that affected LLD. Increased BMI increased the risk of LLD (OR 1.14, 95% CI 1.04 to 1.25). No other factors included in the model affected any of the primary or secondary outcomes.

    Conclusion: Increased BMI showed a negative effect on restoration of post-THA leg length but not on restoration of FO or positioning of the acetabular cup. Age, gender, OA duration or radiological severity and surgeon’s experience showed no relation to post-THA restoration of FO, leg length or cup positioning.

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  • 18.
    Ala-Prinkkilä, Aleksi
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Explorativ analys av motorisk aktivitet under sömn på3-åriga barn2022Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 19.
    Ali, Hazrat
    et al.
    College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
    Shah, Zubair
    College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
    Alam, Tanvir
    College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar.
    Wijayatunga, Priyantha
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Elyan, Eyad
    School of Computing Science and Digital Media, Robert Gordon University, Aberdeen, United Kingdom.
    Editorial: recent advances in multimodal artificial intelligence for disease diagnosis, prognosis, and prevention2024In: Frontiers in Radiology, ISSN 2673-8740, Vol. 3, article id 1349830Article in journal (Other academic)
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  • 20.
    Ali, Hazrat
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Department of Electrical and Computer Engineering, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan.
    Umander, Johannes
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Rohlén, Robin
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Röhrle, Oliver
    Stuttgart Center for Simulation Technology (SC SimTech), University of Stuttgart, Stuttgart, Germany; Institute for Modelling and Simulation of Biomechanical Systems, Chair for Computational Biophysics and Biorobotics, University of Stuttgart, Stuttgart, Germany.
    Grönlund, Christer
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Modelling intra-muscular contraction dynamics using in silico to in vivo domain translation2022In: Biomedical engineering online, E-ISSN 1475-925X, Vol. 21, no 1, article id 46Article in journal (Refereed)
    Abstract [en]

    Background: Advances in sports medicine, rehabilitation applications and diagnostics of neuromuscular disorders are based on the analysis of skeletal muscle contractions. Recently, medical imaging techniques have transformed the study of muscle contractions, by allowing identifcation of individual motor units’ activity, within the whole studied muscle. However, appropriate image-based simulation models, which would assist the continued development of these new imaging methods are missing. This is mainly due to a lack of models that describe the complex interaction between tissues within a muscle and its surroundings, e.g., muscle fbres, fascia, vasculature, bone, skin, and subcutaneous fat. Herein, we propose a new approach to overcome this limitation.

    Methods: In this work, we propose to use deep learning to model the authentic intramuscular skeletal muscle contraction pattern using domain-to-domain translation between in silico (simulated) and in vivo (experimental) image sequences of skeletal muscle contraction dynamics. For this purpose, the 3D cycle generative adversarial network (cycleGAN) models were evaluated on several hyperparameter settings and modifcations. The results show that there were large diferences between the spatial features of in silico and in vivo data, and that a model could be trained to generate authentic spatio-temporal features similar to those obtained from in vivo experimental data. In addition, we used diference maps between input and output of the trained model generator to study the translated characteristics of in vivo data.

    Results: This work provides a model to generate authentic intra-muscular skeletal muscle contraction dynamics that could be used to gain further and much needed physiological and pathological insights and assess and overcome limitations within the newly developed research feld of neuromuscular imaging.

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  • 21.
    Alkner, Sara
    et al.
    Department of Oncology, Faculty of Medicine, Institute of Clinical Sciences Lund, Lund University, Lund, Sweden; Skåne University Hospital Lund, Department of Hematology, Oncology and Radiation Physics, Lund, Sweden.
    Wieslander, Elinore
    Skåne University Hospital Lund, Department of Hematology, Oncology and Radiation Physics, Lund, Sweden.
    Lundstedt, Dan
    Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Oncology at, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Berg, Martin
    Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
    Kristensen, Ingrid
    Skåne University Hospital Lund, Department of Hematology, Oncology and Radiation Physics, Lund, Sweden.
    Andersson, Yvette
    Department of Surgery, Vastmanland Hospital Västerås, Västerås, Sweden; Centre for Clinical Research, Uppsala University and Region Vastmanland, Vastmanland Hospital Västerås, Sweden.
    Bergkvist, Leif
    Centre for Clinical Research, Uppsala University and Region Vastmanland, Vastmanland Hospital Västerås, Sweden.
    Frisell, Jan
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Breast Center Karolinska, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden.
    Olofsson Bagge, Roger
    Sahlgrenska Center for Cancer Research, Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
    Sund, Malin
    Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Department of Surgery, University of Helsinki and Helsinki University Hospital, Finland.
    Christiansen, Peer
    Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
    Davide Gentilini, Oreste
    Breast Surgery, IRCCS Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
    Kontos, Michalis
    1st Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece.
    Kühn, Thorsten
    Die Filderklinik, Breast Center, Filderstadt, Germany; Department of Gynecology and Obstetrics, University of Ulm, Germany.
    Reimer, Toralf
    Department of Obstetrics and Gynecology, University of Rostock, Rostock, Germany.
    Rydén, Lisa
    Department of Oncology, Faculty of Medicine, Institute of Clinical Sciences Lund, Lund University, Lund, Sweden; Skåne University Hospital, Department of Gastroenterology and Surgery, Malmö, Sweden.
    Filtenborg Tvedskov, Tove
    Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Breast Surgery, Gentofte Hospital, Gentofte, Denmark.
    Vrou Offersen, Birgitte
    Department of Oncology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark; Department of Experimental Clinical Oncology, Danish Center for Particle Therapy, Aarhus, Denmark.
    Dahl Nissen, Henrik
    Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, Vejle, Denmark.
    de Boniface, Jana
    Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Capio St. Goran's Hospital, Stockholm, Sweden.
    Quality assessment of radiotherapy in the prospective randomized SENOMAC trial2024In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 197, article id 110372Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Recommendations for regional radiotherapy (RT) of sentinel lymph node (SLN)-positive breast cancer are debated. We here report a RT quality assessment of the SENOMAC trial.

    Materials and Methods: The SENOMAC trial randomized clinically node-negative breast cancer patients with 1–2 SLN macrometastases to completion axillary lymph node dissection (cALND) or SLN biopsy only between 2015–2021. Adjuvant RT followed national guidelines. RT plans for patients included in Sweden and Denmark until June 2019 were collected (N = 1176) and compared to case report forms (CRF). Dose to level I (N = 270) and the humeral head (N = 321) was analyzed in detail.

    Results: CRF-data and RT plans agreed in 99.3 % (breast/chest wall) and in 96.6 % of patients (regional RT). Congruence for whether level I was an intended RT target was lower (78 %). In accordance with Danish national guidelines, level I was more often an intended target in the SLN biopsy only arm (N = 334/611, 55 %,) than in the cALND arm (N = 174/565, 31 %,). When an intended target, level I received prescribed dose to 100 % (IQR 98–100 %) of the volume. However, even when not an intended target, full dose was delivered to > 80 % of level I (IQR 75–90 %). The intentional inclusion of level I in the target volume more than doubled the dose received by ≥ 50 % of the humeral head.

    Conclusion: Congruence between CRF data and RT plans was excellent. Level I received a high dose coverage even when not intentionally included in the target. Including level I in target significantly increased dose to the humeral head.

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  • 22. Anand, Aseem
    et al.
    Tragardh, Elin
    Edenbrandt, Lars
    Beckman, Lars
    Svensson, Jan-Henry
    Thellenberg-Karlsson, Camilla
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Kindblom, Jon
    Ullen, Anders
    Bjartell, Anders
    Assessing Radiographic Response to 223Ra with an Automated Bone Scan Index in Metastatic Castration-Resistant Prostate Cancer Patients2020In: Journal of Nuclear Medicine, ISSN 0161-5505, E-ISSN 1535-5667, Vol. 61, no 5, p. 671-675Article in journal (Refereed)
    Abstract [en]

    For effective clinical management of patients being treated with 223Ra, there is a need for radiographic response biomarkers to minimize disease progression and to stratify patients for subsequent treatment options. The objective of this study was to evaluate an automated bone scan index (aBSI) as a quantitative assessment of bone scans for radiographic response in patients with metastatic castration-resistant prostate cancer (mCRPC). 

    Methods: In a multicenter retrospective study, bone scans from patients with mCRPC treated with monthly injections of 223Ra were collected from 7 hospitals in Sweden. Patients with available bone scans before treatment with 223Ra and at treatment discontinuation were eligible for the study. The aBSI was generated at baseline and at treatment discontinuation. The Spearman rank correlation was used to correlate aBSI with the baseline covariates: alkaline phosphatase (ALP) and prostate-specific antigen (PSA). The Cox proportional-hazards model and Kaplan–Meier curve were used to evaluate the association of covariates at baseline and their change at treatment discontinuation with overall survival (OS). The concordance index (C-index) was used to evaluate the discriminating strength of covariates in predicting OS. 

    Results: Bone scan images at baseline were available from 156 patients, and 67 patients had both a baseline and a treatment discontinuation bone scan (median, 5 doses; interquartile range, 3–6 doses). Baseline aBSI (median, 4.5; interquartile range, 2.4–6.5) was moderately correlated with ALP (r = 0.60, P < 0.0001) and with PSA (r = 0.38, P = 0.003). Among baseline covariates, aBSI (P = 0.01) and ALP (P = 0.001) were significantly associated with OS, whereas PSA values were not (P = 0.059). After treatment discontinuation, 36% (24/67), 80% (54/67), and 13% (9/67) of patients demonstrated a decline in aBSI, ALP, and PSA, respectively. As a continuous variable, the relative change in aBSI after treatment, compared with baseline, was significantly associated with OS (P < 0.0001), with a C-index of 0.67. Median OS in patients with both aBSI and ALP decline (median, 134 wk) was significantly longer than in patients with ALP decline only (median, 77 wk; P = 0.029). 

    Conclusion: Both aBSI at baseline and its change at treatment discontinuation were significant parameters associated with OS. The study warrants prospective validation of aBSI as a quantitative imaging response biomarker to predict OS in patients with mCRPC treated with 223Ra.

  • 23. Andersson, Elisabeth
    et al.
    Dai Ydrefelt, Ying
    Johannesson, Marit
    Lundbäck, Maria
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Mannila, Maria
    Persson, Margaretha
    Swahn, Eva
    Bolejko, Anetta
    Surveillance of indeterminate pulmonary nodules detected with CT in a Swedish population-based study (SCAPIS): Psychosocial consequences and impact on health-related quality of life - A multicentre prospective cross-sectional study2021In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 9, article id e048721Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate whether surveillance of pulmonary nodules detected with low-dose CT (LDCT) impacted health-related quality of life and psychosocial consequences in the Swedish population-based study, Swedish CArdioPulmonary bioImage Study (SCAPIS).

    Design: A prospective cross-sectional study.

    Settings and participants: This multicentre (five sites) observational study, which included a cohort from SCAPIS, consisted of 632 participants with indeterminate pulmonary nodules detected with LDCT. These participants continued surveillance for up to 36 months, during which lung cancer was not detected (surveillance group). Additionally, 972 participants with a negative pulmonary LDCT scan were included as a control group. Matching criteria were LDCT date (±2 weeks), gender and site.

    Outcome measures: All participants completed a health-related quality of life questionnaire (RAND-36) and the Consequences of Screening (COS) questionnaire, an average of 3 years after LDCT was conducted at entry into SCAPIS.

    Results: Participants were 51-70 years old at study commencement. Overall, the two groups did not differ in demographic or psychosocial variables, smoking habits or pulmonary medical history. Individuals from countries other than Sweden and those with low socioeconomic status were less likely to participate (p<0.001). No effects on health-related quality of life were observed via RAND-36. In COS, the surveillance group demonstrated a higher OR for anxiety about lung cancer (OR 3.96, 95% CI 2.35 to 6.66, p<0.001), experiencing a sense of dejection (OR 1.35, 95% CI 1.06 to 1.72, p=0.015) and thoughts about existential values (OR 1.30, 95% CI 1.04 to 1.60, p=0.018).

    Conclusions: Lung surveillance with LDCT contributed to significant experiences of sense of dejection, anxiety about lung cancer and development of thoughts about existential values among participants in the surveillance group compared with the controls. The risk of side effects should be communicated for informed decision-making about (non-)attendance in lung cancer screening.

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  • 24.
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    [Book review] The Physics of CT Dosimetry – CTDI and Beyond, by Robert L. Dixon2020In: Physica medica (Testo stampato), ISSN 1120-1797, E-ISSN 1724-191X, Vol. 69, p. 126-126Article, book review (Other academic)
  • 25.
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Norrlands universitetssjukhus.
    Fysik och teknik: konventionell planar röntgen2013In: Nuklearmedicin / [ed] Sven-Ola Hietala, Katrine Åhlström Riklund, Lund: Studentlitteratur AB, 2013, 2, p. 40-46Chapter in book (Other academic)
  • 26.
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ion recombination in liquid ionization chambers: development of an experimental method to quantify general recombination2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    An experimental method (the two-dose-rate method) for the correction of general recombination losses in liquid ionization chambers has been developed and employed in experiments with different liquids and radiation qualities. The method is based on a disassociation of initial and general recombination, since an ionized liquid is simultaneously affected by both of these processes.

    The two-dose-rate method has been compared to an existing method for general recombination correction for liquid ionization chambers, and has been found to be the most robust method presently available.

    The soundness of modelling general recombination in liquids on existing theory for gases has been evaluated, and experiments indicate that the process of general recombination is similar in a gas and a liquid. It is thus reasonable to employ theory for gases in the two-dose-rate method to achieve experimental corrections for general recombination in liquids. There are uncertainties in the disassociation of initial and general recombination in the two-dose-rate method for low applied voltages, where initial recombination has been found to cause deviating results for different liquids and radiation qualities.

    Sensitivity to ambient electric fields has been identified in the microLion liquid ionization chamber (PTW, Germany). Experimental data may thus be perturbed if measurements are conducted in the presence of ambient electric fields, and the sensitivity has been found to increase with an increase in the applied voltage. This can prove to be experimentally limiting since general recombination may be too severe for accurate corrections if the applied voltage is low.

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    Ion recombination in liquid ionization chambers (kappa)
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    Ion recombination in liquid ionization chambers (omslag)
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    Ion recombination in liquid ionization chambers (spikblad)
  • 27.
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    TG246 On Patient Dose From Diagnostic Radiation: Acceptance Testing and Dose Measurements with CT2014In: 56th AAPM Annual Meeting and Exhibition 2014, Austin, TX, USA, July 20-24 (2014), 2014Conference paper (Refereed)
    Abstract [en]

    Radiation dose from diagnostic and interventional use of ionizing radiation continues to be a focus of the regulatory, accreditation and standards organizations in the US and Europe. A Joint AAPM/EFOMP effort has been underway in the past year – having the goal to assist the clinical medical physicist with communicating optional and varied approaches in estimating (and validating) patient dose. In particular, the tools provided by DICOM Radiation Dose Structured Reports, either by themselves or as part of a networked data repository of dose related information are a rich source of actionable information. The tools of the medical physicist have evolved to include using DICOM data in meaningful ways to look at patient dose with respect to imaging practices. In addition to how accurate or reproducible a dose value is (totally necessary and our traditional workspace) it is now being asked how reproducible (patient to patient, device to device) are the delivered doses? Clinical medical physicists are best equipped to assist our radiology and technologist colleagues with this effort. The purpose of this session is to review the efforts of TG246 - bringing forward a summary content of the TG246 Report including specific dose descriptors for CT and Fluoroscopy – particularly in a focus of leveraging the RDSR as a means for monitoring good practices according to the ALARA principle. Additionally, rapidly evolving technologies for more refined dose estimates are now in use. These will be presented as they look to having highly patient specific dose estimates in automated use.

  • 28.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bednarek, Daniel R.
    State University of New York, 875 Ellicott St, NY, Buffalo, United States.
    Bolch, Wesley
    University of Florida, 1275 Center Drive, FL, Gainesville, United States.
    Boltz, Thomas
    Orange Factor Imaging Physicists, 4035 E Captain Dreyfus Ave, AZ, Phoenix, United States.
    Bosmans, Hilde
    University of Leuven, Herestraat 49, Leuven, Belgium.
    Gislason-Lee, Amber J.
    University of Leeds, Worsley Building, Clarendon Way, Leeds, United Kingdom.
    Granberg, Christoffer
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Hellström, Max
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Kanal, Kalpana
    University of Washington Medical Center, 1959 NE Pacific Street, WA, Seattle, United States.
    McDonagh, Ed
    Joint Department of Physics, The Royal Marsden NHS Foundation Trust, Fulham Road, London, United Kingdom.
    Paden, Robert
    Mayo Clinic, 5777 East Mayo Blvd, AZ, Phoenix, United States.
    Pavlicek, William
    Mayo Clinic, 13400 E Shea Blvd., AZ, Scottsdale, United States.
    Khodadadegan, Yasaman
    Progressive Insurance, Customer Relation Management, 6300 Wilson Mills Rd., Mayfield Village, OH, United States.
    Torresin, Alberto
    Niguarda Ca'Granda Hospital, Via Leon Battista Alberti 5, Milano, Italy.
    Trianni, Annalisa
    Udine University Hospital, Piazzale S. Maria Della Misericordia, n. 15, Udine, Italy.
    Zamora, David
    University of Washington Medical Center, 6852 31st Ave NE, WA, Seattle, United States.
    Estimation of patient skin dose in fluoroscopy: summary of a joint report by AAPM TG357 and EFOMP2021In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 48, no 7, p. e671-e696Article in journal (Refereed)
    Abstract [en]

    Background: Physicians use fixed C-arm fluoroscopy equipment with many interventional radiological and cardiological procedures. The associated effective dose to a patient is generally considered low risk, as the benefit-risk ratio is almost certainly highly favorable. However, X-ray-induced skin injuries may occur due to high absorbed patient skin doses from complex fluoroscopically guided interventions (FGI). Suitable action levels for patient-specific follow-up could improve the clinical practice. There is a need for a refined metric regarding follow-up of X-ray-induced patient injuries and the knowledge gap regarding skin dose-related patient information from fluoroscopy devices must be filled. The most useful metric to indicate a risk of erythema, epilation or greater skin injury that also includes actionable information is the peak skin dose, that is, the largest dose to a region of skin.

    Materials and Methods: The report is based on a comprehensive review of best practices and methods to estimate peak skin dose found in the scientific literature and situates the importance of the Digital Imaging and Communication in Medicine (DICOM) standard detailing pertinent information contained in the Radiation Dose Structured Report (RDSR) and DICOM image headers for FGI devices. Furthermore, the expertise of the task group members and consultants have been used to bridge and discuss different methods and associated available DICOM information for peak skin dose estimation.

    Results: The report contributes an extensive summary and discussion of the current state of the art in estimating peak skin dose with FGI procedures with regard to methodology and DICOM information. Improvements in skin dose estimation efforts with more refined DICOM information are suggested and discussed.

    Conclusions: The endeavor of skin dose estimation is greatly aided by the continuing efforts of the scientific medical physics community, the numerous technology enhancements, the dose-controlling features provided by the FGI device manufacturers, and the emergence and greater availability of the DICOM RDSR. Refined and new dosimetry systems continue to evolve and form the infrastructure for further improvements in accuracy. Dose-related content and information systems capable of handling big data are emerging for patient dose monitoring and quality assurance tools for large-scale multihospital enterprises.

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  • 29.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Kaiser, Franz-Joachim
    Gómez, Faustino
    Jäkel, Oliver
    Pardo-Montero, Juan
    Tölli, Heikki
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A comparison of different experimental methods for general recombination correction for liquid ionization chambers2012In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 57, no 21, p. 7161-7175Article in journal (Refereed)
    Abstract [en]

    Radiation dosimetry of highly modulated dose distributions requires a detector with a high spatial resolution. Liquid filled ionization chambers (LICs) have the potential to become a valuable tool for the characterization of such radiation fields. However, the effect of an increased recombination of the charge carriers, as compared to using air as the sensitive medium has to be corrected for. Due to the presence of initial recombination in LICs, the correction for general recombination losses is more complicated than for air-filled ionization chambers. In the present work, recently published experimental methods for general recombination correction for LICs are compared and investigated for both pulsed and continuous beams. The experimental methods are all based on one of two approaches, either measurements at two different dose rates (two-dose-rate methods), or measurements at three different LIC polarizing voltages (three-voltage methods). In a comparison with the two-dose-rate methods, the three-voltage methods fail to achieve accurate corrections in several instances, predominantly at low polarizing voltages and dose rates. However, for continuous beams in the range of polarizing voltages recommended by the manufacturer of the LICs used, the agreement between the different methods is generally within the experimental uncertainties. For pulsed beams, the agreement between the methods is poor. The inaccuracies found in the results from the three-voltage methods are associated with numerical difficulties in solving the resulting equation systems, which also make these methods sensitive to small variations in the experimental data. These issues are more pronounced for the case of pulsed beams. Furthermore, the results suggest that the theoretical modelling of initial recombination used in the three-voltage methods may be a contributing factor to the deviating results observed.

  • 30.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ceberg, Crister
    Almén, Anja
    Bernhardt, Peter
    Fransson, Annette
    Olsson, Lars E.
    Artificial intelligence and the medical physics profession - A Swedish perspective2021In: Physica medica (Testo stampato), ISSN 1120-1797, E-ISSN 1724-191X, Vol. 88, p. 218-225Article in journal (Refereed)
    Abstract [en]

    Background: There is a continuous and dynamic discussion on artificial intelligence (AI) in present-day society. AI is expected to impact on healthcare processes and could contribute to a more sustainable use of resources allocated to healthcare in the future. The aim for this work was to establish a foundation for a Swedish perspective on the potential effect of AI on the medical physics profession.

    Materials and methods: We designed a survey to gauge viewpoints regarding AI in the Swedish medical physics community. Based on the survey results and present-day situation in Sweden, a SWOT analysis was performed on the implications of AI for the medical physics profession.

    Results: Out of 411 survey recipients, 163 responded (40%). The Swedish medical physicists with a professional license believed (90%) that AI would change the practice of medical physics but did not foresee (81%) that AI would pose a risk to their practice and career. The respondents were largely positive to the inclusion of AI in educational programmes. According to self-assessment, the respondents’ knowledge of and workplace preparedness for AI was generally low.

    Conclusions: From the survey and SWOT analysis we conclude that AI will change the medical physics profession and that there are opportunities for the profession associated with the adoption of AI in healthcare. To overcome the weakness of limited AI knowledge, potentially threatening the role of medical physicists, and build upon the strong position in Swedish healthcare, medical physics education and training should include learning objectives on AI.

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  • 31.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Tölli, Heikki
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Application of the two-dose-rate method for general recombination correction for liquid ionization chambers in continuous beams2011In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 56, no 2, p. 299-314Article in journal (Refereed)
    Abstract [en]

    A method to correct for the general recombination losses for liquid ionization chambers in continuous beams has been developed. The proposed method has been derived from Greening's theory for continuous beams and is based on measuring the signal from a liquid ionization chamber and an air filled monitor ionization chamber at two different dose rates. The method has been tested with two plane parallel liquid ionization chambers in a continuous radiation x-ray beam with a tube voltage of 120 kV and with dose rates between 2 and 13 Gy min-1. The liquids used as sensitive media in the chambers were isooctane (C8H18) and tetramethylsilane (Si(CH3)4). The general recombination effect was studied using chamber polarizing voltages of 100, 300, 500, 700 and 900 V for both liquids. The relative standard deviation of the results for the collection efficiency with respect to general recombination was found to be a maximum of 0.7 % for isooctance and 2.4 % for tetramethylsilane. The results are in excellent agreement with Greening's theory for collection efficiencies over 90 %. The measured and corrected signals from the liquid ionization chambers used in this work are in very good agreement with the air filled monitor chambers with respect to signal to dose linearity.

  • 32.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Tölli, Heikki
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Modeling ion recombination in liquid ionization chambers: Improvement and analysis of the two-dose-rate method2017In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 44, no 11, p. 5977-5987Article in journal (Refereed)
    Abstract [en]

    Purpose: The use of liquid ionization chambers can provide useful information to endeavors with radiation dosimetry for highly modulated beams. Liquid ionization chambers may be particularly suitable for computed tomography applications where conventional ionization chambers do not present a high enough sensitivity for the spatial resolution required to characterize common X-ray beams. Due to the sensitivity, which leads to high charge densities, liquid ionization chambers can suffer from large recombination losses leading to degradation in signal to dose rate linearity. To solve this problem, a two-dose-rate method for general recombination correction has been proposed for liquid ionization chambers. However, the valid range of recombination losses that the method can accurately account for has been found to vary depending on radiation quality. The present work provides an in-depth analysis of the performance of the two-dose-rate method. Furthermore, the soundness of applying gas theory to liquids is investigated by using the two-dose-rate method.

    Methods: In the present work, the two-dose-rate method for general recombination correction of liquid ionization chambers used in continuous beams is studied by employing theory for gas-filled ionization chambers. An approximate relation for the general collection efficiency containing a material-specific parameter that is traceable to liquids has been derived for theoretical and experimental investigation alongside existing theory. Furthermore, the disassociation between initial and general recombination in the method is analyzed both theoretically and experimentally.

    Results: The results indicate that liquids and gases share general recombination characteristics, where the liquids investigated (isooctane and tetramethylsilane) to a large extent mimic the behavior theoretically expected in gases. Furthermore, it is shown that the disassociation between initial and general recombination in the two-dose-rate method is an approximation that depends on the relation between initial recombination and the collecting electric field strength at the dose rates used.

    Conclusions: Due to the approximation used to separate initial and general recombination the valid range of collection efficiencies for the two-dose-rate method will not only depend on the model used to describe general recombination but also on the type of liquid and radiation beam quality. As there is no robust theory for initial recombination in liquids to apply, the valid range of general collection efficiencies for the two-dose-rate method should be experimentally evaluated for each radiation dosimetry application.

  • 33.
    Andersson, Kennet
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Suhr, Ole B.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Faes, Luca
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Directed coherence analysis in patients with severe autonomic dysfunction2014In: 2014 8th conference of the European Study Group on Cardiovascular Oscillations (ESGCO), IEEE conference proceedings, 2014, p. 167-168Conference paper (Refereed)
    Abstract [en]

    Many different approaches have been applied to analyse the coupling between cardiovascular signals. This study evaluated the use of directed coherence, based on multivariate autoregressive modelling, for analysis of cardiovascular signals in patients with transthyretin amyloidosis, a rare disease where severe autonomic dysfunction is common.

  • 34.
    Andersson, Kristina
    Umeå University, Faculty of Science and Technology, Department of Physics.
    Evaluation of uncertainties in sub-volume based image registration: master of science thesis in medical radiation physics2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Physicians often utilize different imaging techniques to provide clear, visual information about internal parts of the patient. Since the different imaging modalities give different types of information, the combination of them serves as a powerful tool while determining the diagnosis, planning of treatment or during therapy follow-up. To simplify the interpretation of the image information, image registration is often used. The goal of the registration is to put different images in a common coordinate system. It is essential that the registration between the images is accurate.

    Normalized Mutual Information (NMI) is a metric that quantifies the conformity between images. Even though NMI is a robust method it is often dominated by large structures as the external contour of the patient as well as by the structures of the bones. The prostate is an organ that does not have a fixed position relative to the other organs and host small amounts of image information. The accuracy of the registration is therefore limited with respect to the prostate when using the whole image volume. This master thesis investigates the possibility to restrict the part of the image used for registration to a small volume around the prostate with goal to receive a better registration of the prostate than if full sized images are used.

    A registration program, utilizing NMI, was written and optimized in MatLab. Four Magnetic Resonance (MR) series and one Computed Tomographic (CT) series where taken over the pelvic area of five patients with the diagnosis prostate cancer. The prostate were delineated by a physician. By adding margin to the delineations five different sized Regions of Interest (ROI) where created.  The smallest ROI precisely covered the prostate while the largest covered the whole image. The deviation in Center of Mass (CoM) between the images and the Percentage Volume Overlap (PVO) were calculated and used as a measure of alignment.

    The registrations performed with sub-volumes showed an improvement compared to those that used full-volume while registering a MR image to another MR image. In one third of the cases a 2 cm margin to the prostate is preferable. A 3 cm margin is the most favorable option in another third of the cases. The use of sub-volumes to register MR images to CT series turned out to be unpredictable with poor accuracy.

    Full sized image registration between two MR image pairs has a high precision but, due to the motion of the prostate, poor accuracy. As a result of the high information content in the MR images both high precision as well as high accuracy can be achieved by the use of sub-volume registration. CT images do not contain the same amount of image information around the prostate and the sub-volume based registrations between MR and CT images are hence inconsistent with a low precision.  

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  • 35. Andersson, M.
    et al.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Minarik, D.
    Mattsson, S.
    Leide-Svegborn, S.
    Absorbed dose to the urinary bladder wall for different radiopharmaceuticals using dynamic S-values2013In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 40, no Supplement 2, p. S161-S161Article in journal (Other academic)
  • 36. Andersson, M.
    et al.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Minarik, D.
    Mattsson, S.
    Leide-Svegborn, S.
    An internal radiation dosimetry computer program, IDAC 2.0, for estimation of patient doses from radiopharmaceuticals2014In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 162, no 3, p. 299-305Article in journal (Refereed)
    Abstract [en]

    The internal dosimetry computer program internal dose assessment by computer (IDAC) for calculations of absorbed doses to organs and tissues as well as effective doses to patients from examinations with radiopharmaceuticals has been developed. The new version, IDAC2.0, incorporates the International Commission on Radiation Protection (ICRP)/ICRU computational adult male and female voxel phantoms and decay data from the ICRP publication 107. Instead of only 25 source and target regions, calculation can now be made with 63 source regions to 73 target regions. The major advantage of having the new phantom is that the calculations of the effective doses can be made with the latest tissue weighting factors of ICRP publication 103. IDAC2.0 uses the ICRP human alimentary tract (HAT) model for orally administrated activity and for excretion through the gastrointestinal tract and effective doses have been recalculated for radiopharmaceuticals that are orally administered. The results of the program are consistent with published data using the same specific absorption fractions and also compared with published data from the same computational phantoms but with segmentation of organs leading to another set of specific absorption fractions. The effective dose is recalculated for all the 34 radiopharmaceuticals that are administered orally and has been published by the ICRP. Using the new HAT model, new tissue weighting factors and the new adult computational voxel phantoms lead to an average effective dose of half of its earlier estimated value. The reduction mainly depends on electron transport simulations to walled organs and the transition from the stylised phantom with unrealistic interorgan distances to more realistic voxel phantoms.

  • 37. Andersson, M.
    et al.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Minarik, D.
    Mattsson, S.
    Leide-Svegborn, S.
    IDAC2.0 a new generation of internal dosimetric calculations for diagnostic examinations in nuclear medicine using the adult ICRP/ICRU reference computational voxel phantoms2013In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 40, no Supplement 2, p. S175-S176Article in journal (Other academic)
  • 38. Andersson, M.
    et al.
    Mattsson, S.
    Johansson, L.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Dynamic absorbed dose calculations to the urinary bladder wall for the ICRP compartmental models of iodide and technetium2019In: European Journal of Nuclear Medicine and Molecular Imaging, ISSN 1619-7070, E-ISSN 1619-7089, Vol. 46, no SUPPL 1, p. S281-S282Article in journal (Other academic)
    Abstract [en]

    Aim/Introduction: The urinary bladder wall is a radiosensitive organ that can receive a high absorbed dose from radiopharmaceuticals used even in diagnostic nuclear medicine. The commonly used method to calculate the absorbed dose to the urinary bladder wall is to apply absorbed fractions or S-values derived for a static volume of the content e.g. 200 mL for adult males. However, there are some dynamic models to estimate the photon and electron absorbed dose contributions to the inner surface or the mean absorbed dose to the bladder wall. These models have only been applied on adults and use descriptive biokinetic models for the transfer of radionuclides. The aim of this work is to estimate the absorbed dose, based on Monte Carlo-simulated dynamic urinary bladders and the ICRP compartmental biokinetic models of iodide and pertechnetate. The calculations include sex specific absorbeddose and estimations for preadults of 15- 10- 5- 1-year and newborn.

    Materials and Methods: S-values were calculated for different volumes of the content with a fix mass of the wall. As an approximation a spherical shape was assumed. Calculations were based on anatomical and physiological data of the reference sets of values given in ICRP Publication 89. The reference values were given for both male and female subjects of six different ages: newborn, 1-, 5-, 10-, 15-years, and adult. The elemental compositions of the urinary bladder wall and content were taken from the ICRP Publication 110.

    Results: For adult male assuming a urinary flow rate of 1600 ml/day, an initial urine volume of 100 ml, a voiding volume at 300 ml and a residual volume of 30 ml, the cumulated activity will for intravenously administered activity of Tc-99m pertechnetate be 30 % lower than assuming a 3.5 hour voiding interwall. The absorbed dose to the urinary bladder wall will be 64% lower also applying the dynamic S-values on the dynamic case. Using the same biological parameters for intravenous intake of I-131 iodide, the cumulated activity will be 60 % higher for the dynamic case and the mean absorbed dose to the urinary bladder wall 30 % lower.

    Conclusion: This project aims to perform more realistic calculation of absorbed dose to the urinary bladder calculations. This is done by tracking the activity in the urinary content at each time on compartment models and applying the time dependent activity to urinary flow and Monte Carlo simulated S-values.

  • 39. Andersson, Martin
    et al.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Eckerman, Keith
    Mattsson, Sören
    IDAC-Dose 2.1, an internal dosimetry program for diagnostic nuclear medicine based on the ICRP adult reference voxel phantoms2017In: EJNMMI Research, E-ISSN 2191-219X, Vol. 7, article id 88Article in journal (Refereed)
    Abstract [en]

    Background: To date, the estimated radiation-absorbed dose to organs and tissues in patients undergoing diagnostic examinations in nuclear medicine is derived via calculations based on models of the human body and the biokinetic behaviour of the radiopharmaceutical. An internal dosimetry computer program, IDAC-Dose2.1, was developed based on the International Commission on Radiological Protection (ICRP)-specific absorbed fractions and computational framework of internal dose assessment given for reference adults in ICRP Publication 133. The program uses the radionuclide decay database of ICRP Publication 107 and considers 83 different source regions irradiating 47 target tissues, defining the effective dose as presented in ICRP Publications 60 and 103. The computer program was validated against another ICRP dosimetry program, Dose and Risk Calculation (DCAL), that employs the same computational framework in evaluation of occupational and environmental intakes of radionuclides. IDAC-Dose2.1 has a sub-module for absorbed dose calculations in spherical structures of different volumes and composition; this sub-module is intended for absorbed dose estimates in radiopharmaceutical therapy. For nine specific alpha emitters, the absorbed dose contribution from their decay products is also included in the committed absorbed dose calculations. Results: The absorbed doses and effective dose of I-131-iodide determined by IDAC-Dose2.1 were validated against the dosimetry program DCAL, showing identical results. IDAC-Dose2.1 was used to calculate absorbed doses for intravenously administered F-18-FDG and orally administered Tc-99m-pertechnetate and I-131-iodide, three frequently used radiopharmaceuticals. Using the tissue weighting factors from ICRP Publication 103, the effective dose per administered activity was estimated to be 0.016 mSv/MBq for F-18-FDG, 0.014 mSv/MBq for Tc-99m-pertechnetate, and 16 mSv/MBq for I-131-iodide. Conclusions: The internal dosimetry program IDAC-Dose2.1 was developed and applied to three radiopharmaceuticals for validation against DCAL and to generate improved absorbed dose estimations for diagnostic nuclear medicine using specific absorbed fraction values of the ICRP computational voxel phantoms. The sub-module for absorbed dose calculations in spherical structures 1 mm to 9 cm in diameter and different tissue composition was included to broaden the clinical usefulness of the program. The IDAC-Dose2.1 program is free software for research and available for download at http://www.idac-dose.org.

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  • 40. Andersson, Martin
    et al.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Mattsson, Sören
    Minarik, David
    Leide-Svegborn, Sigrid
    Organ doses and effective dose for five pet radiopharmaceuticals2016In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 169, no 1-4, p. 253-258Article in journal (Refereed)
    Abstract [en]

    Diagnostic investigations with positron-emitting radiopharmaceuticals are dominated by 18F-fluorodeoxyglucose (18F-FDG), but other radiopharmaceuticals are also commercially available or under development. Five of them, which are all clinically important, are 18F-fluoride, 18F-fluoroethyltyrosine (18F-FET), 18F-deoxyfluorothymidine (18F-FLT), 18F-fluorocholine (18F-choline) and 11C-raclopride. To estimate the potential risk of stochastic effects (mainly lethal cancer) to a population, organ doses and effective dose values were updated for all five radiopharmaceuticals. Dose calculations were performed using the computer program IDAC2.0, which bases its calculations on the ICRP/ICRU adult reference voxel phantoms and the tissue weighting factors from ICRP publication 103. The biokinetic models were taken from ICRP publication 128. For organ doses, there are substantial changes. The only significant change in effective dose compared with previous estimations was a 46 % reduction for 18F-fluoride. The estimated effective dose in mSv MBq−1 was 1.5E−02 for 18F-FET, 1.5E−02 for 18F-FLT, 2.0E−02 for 18F-choline, 9.0E−03 for 18F-fluoride and 4.4E−03 for 11C-raclopride.

  • 41.
    Andersson, Martin
    et al.
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Minarik, David
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
    Leide-Svegborn, Sigrid
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
    Mattsson, Sören
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
    Effective dose to adult patients from 338 radiopharmaceuticals estimated using ICRP biokinetic data, ICRP/ICRU computational reference phantoms and ICRP 2007 tissue weighting factors2014In: EJNMMI Physics, E-ISSN 2197-7364, Vol. 1, no 1, article id 9Article in journal (Refereed)
    Abstract [en]

    Background: Effective dose represents the potential risk to a population of stochastic effects of ionizing radiation (mainly lethal cancer). In recent years, there have been a number of revisions and updates influencing the way to estimate the effective dose. The aim of this work was to recalculate the effective dose values for the 338 different radiopharmaceuticals previously published by the International Commission on Radiological Protection (ICRP).

    Method: The new estimations are based on information on the cumulated activities per unit administered activity in various organs and tissues and for the various radiopharmaceuticals obtained from the ICRP publications 53, 80 and 106. The effective dose for adults was calculated using the new ICRP/International Commission on Radiation Units (ICRU) reference voxel phantoms and decay data from the ICRP publication 107. The ICRP human alimentary tract model has also been applied at the recalculations. The effective dose was calculated using the new tissue weighting factors from ICRP publications 103 and the prior factors from ICRP publication 60. The results of the new calculations were compared with the effective dose values published by the ICRP, which were generated with the Medical Internal Radiation Dose (MIRD) adult phantom and the tissue weighting factors from ICRP publication 60.

    Results: For 79% of the radiopharmaceuticals, the new calculations gave a lower effective dose per unit administered activity than earlier estimated. As a mean for all radiopharmaceuticals, the effective dose was 25% lower. The use of the new adult computational voxel phantoms has a larger impact on the change of effective doses than the change to new tissue weighting factors.

    Conclusion: The use of the new computational voxel phantoms and the new weighting factors has generated new effective dose estimations. These are supposed to result in more realistic estimations of the radiation risk to a population undergoing nuclear medicine investigations than hitherto available values.

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  • 42. Andersson, Martin
    et al.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Minarik, David
    Mattsson, Soren
    Svegborn, Sigrid Leide
    An upgrade of the internal dosimetry computer program IDAC2012In: Medical Physics in the Baltic States / [ed] Adliene, D., Kaunas University of Technology , 2012, p. 120-123Conference paper (Refereed)
    Abstract [en]

    A full update of the internal dosimetry computer program IDAC has been conducted. The new update is based on new and more accurate computational phantoms to calculate effective dose and absorbed dose to organs and tissues. The new ICRP Adult Reference Computational Phantoms has been adopted as well as the latest of the ICRP standardized biokinetic models. The updated computer program includes a user-friendly graphical user interface.

  • 43.
    Andersson, Martin
    et al.
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden .
    Minarik, David
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden .
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Mattsson, Soren
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden .
    Leide-Svegborn, Sigrid
    Medical Radiation Physics, Department of Clinical Sciences Malmö, Lund University, Skåne University Hospital, Malmö, Sweden .
    Improved estimates of the radiation absorbed dose to the urinary bladder wall2014In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 59, no 9, p. 2173-2182Article in journal (Refereed)
    Abstract [en]

    Specific absorbed fractions (SAFs) have been calculated as a function of the content in the urinary bladder in order to allow more realistic calculations of the absorbed dose to the bladder wall. The SAFs were calculated using the urinary bladder anatomy from the ICRP male and female adult reference computational phantoms. The urinary bladder and its content were approximated by a sphere with a wall of constant mass, where the thickness of the wall depended on the amount of urine in the bladder. SAFs were calculated for males and females with 17 different urinary bladder volumes from 10 to 800 mL, using the Monte Carlo computer program MCNP5, at 25 energies of mono-energetic photons and electrons ranging from 10 KeV to 10 MeV. The decay was assumed to be homogeneously distributed in the urinary bladder content and the urinary bladder wall, and the mean absorbed dose to the urinary bladder wall was calculated. The Monte Carlo simulations were validated against measurements made with thermoluminescent dosimeters. The SAFs obtained for a urine volume of 200 mL were compared to the values calculated for the urinary bladder wall using the adult reference computational phantoms. The mean absorbed dose to the urinary wall from F-18-FDG was found to be 77 mu Gy/MBq formales and 86 mu Gy/MBq for females, while for (99)mTc-DTPA the mean absorbed doses were 80 mu Gy/MBq for males and 86 mu Gy/MBq for females. Compared to calculations using a constant value of the SAF from the adult reference computational phantoms, the mean absorbed doses to the bladder wall were 60% higher for F-18-FDG and 30% higher for (99)mTc-DTPA using the new SAFs.

  • 44.
    Andersson, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Eklund, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Adaptive method for assessment of cerebrospinal fluid outflow conductance.2007In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 45, no 4, p. 337-343Article in journal (Refereed)
    Abstract [en]

    Outflow conductance (C out) is important for predicting shunt responsiveness in patients with suspected idiopathic adult hydrocephalus syndrome (IAHS). C out is determined by performing an infusion test into the cerebrospinal fluid system, and the reliability of the test is dependent on the measurement time. The objective of this study was to develop an adaptive signal analysis method to reduce the investigation time, by taking the individual intracranial pressure variations of the patient into consideration. The method was evaluated on 28 patients with suspected IAHS. The results from full time investigations (60 min) were compared to the results of the new algorithm. Applying the new adaptive method resulted in a reduction of mean investigation time by 14.3 ± 5.9 min (mean ± SD), p < 0.01. The reduction of reliability in the C out estimation was found clinically negligible. We thus recommend this adaptive method to be used when performing constant pressure infusion tests.

  • 45.
    Arteaga-Marrero, Natalia
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Department of Physics and Technology, University of Bergen, Bergen, Norway.
    Mainou-Gomez, Jose F.
    Rygh, Cecilie Brekke
    Lutay, Nataliya
    Roehrich, Dieter
    Reed, Rolf K.
    Olsen, Dag R.
    Radiation treatment monitoring with DCE-US in CWR22 prostate tumor xenografts2019In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 60, no 6, p. 788-797Article in journal (Refereed)
    Abstract [en]

    Background: Longitudinal monitoring of potential radiotherapy treatment effects can be determined by dynamic contrast-enhanced ultrasound (DCE-US).

    Purpose: To assess functional parameters by means of DCE-US in a murine subcutaneous model of human prostate cancer, and their relationship to dose deposition and time-frame after treatment. A special focus has been placed to evaluate the vascular heterogeneity of the tumor and on the most suitable data analysis approach that reflects this heterogeneity.

    Material and Methods: In vivo DCE-US was acquired 24 h and 48 h after radiation treatment with a single dose of 7.5 Gy and 10 Gy, respectively. Tumor vasculature was characterized pixelwise using the Brix pharmacokinetic analysis of the time-intensity curves.

    Results: Longitudinal changes were detected (P < 0.001) at 24 h and 48 h after treatment. At 48 h, the eliminating rate constant of the contrast agent from the plasma, kel, was correlated (P ≤ 0.05) positively with microvessel density (MVD; rτ = 0.7) and negatively with necrosis (rτ = –0.6) for the treated group. Furthermore, Akep, a parameter related to transcapillary transport properties, was also correlated to MVD (rτ = 0.6, P ≤ 0.05).

    Conclusion: DCE-US has been shown to detect vascular changes at a very early stage after radiotherapy, which is a great advantage since DCE-US is non-invasive, available at most hospitals, and is low in cost compared to other techniques used in clinical practice.

  • 46.
    Arvidsson, Peder
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Science and Technology, Department of Physics.
    Implementation and Evaluation of Volumetric Modulated Arc Therapy at the Radiation Therapy Department at The University Hospital of Umeå.2011Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
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    2011 VMAT Peder Arvidsson
  • 47.
    Axelsson, Jan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    PET/MR ur fysikerns perspektiv2015Conference paper (Other academic)
  • 48. Bailey, D. L.
    et al.
    Pichler, B. J.
    Gueckel, B.
    Antoch, G.
    Barthel, H.
    Bhujwalla, Z. M.
    Biskup, S.
    Biswal, S.
    Bitzer, M.
    Boellaard, R.
    Braren, R. F.
    Brendle, C.
    Brindle, K.
    Chiti, A.
    la Fougere, C.
    Gillies, R.
    Goh, V.
    Goyen, M.
    Hacker, M.
    Heukamp, L.
    Knudsen, G. M.
    Krackhardt, A. M.
    Law, I.
    Morris, J. C.
    Nikolaou, K.
    Nuyts, J.
    Ordonez, A. A.
    Pantel, K.
    Quick, H. H.
    Riklund, Katrine
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Sabri, O.
    Sattler, B.
    Troost, E. G. C.
    Zaiss, M.
    Zender, L.
    Beyer, Thomas
    Combined PET/MRI: Global Warming-Summary Report of the 6th International Workshop on PET/MRI, March 27-29, 2017, Tubingen, Germany2018In: Molecular Imaging and Biology, ISSN 1536-1632, E-ISSN 1860-2002, Vol. 20, no 1, p. 4-20Article, review/survey (Refereed)
    Abstract [en]

    The 6th annual meeting to address key issues in positron emission tomography (PET)/magnetic resonance imaging (MRI) was held again in Tubingen, Germany, from March 27 to 29, 2017. Over three days of invited plenary lectures, round table discussions and dialogue board deliberations, participants critically assessed the current state of PET/MRI, both clinically and as a research tool, and attempted to chart future directions. The meeting addressed the use of PET/MRI and workflows in oncology, neurosciences, infection, inflammation and chronic pain syndromes, as well as deeper discussions about how best to characterise the tumour microenvironment, optimise the complementary information available from PET and MRI, and how advanced data mining and bioinformatics, as well as information from liquid biomarkers (circulating tumour cells and nucleic acids) and pathology, can be integrated to give a more complete characterisation of disease phenotype. Some issues that have dominated previous meetings, such as the accuracy of MR-based attenuation correction (AC) of the PET scan, were finally put to rest as having been adequately addressed for the majority of clinical situations. Likewise, the ability to standardise PET systems for use in multicentre trials was confirmed, thus removing a perceived barrier to larger clinical imaging trials. The meeting openly questioned whether PET/MRI should, in all cases, be used as a whole-body imaging modality or whether in many circumstances it would best be employed to give an in-depth study of previously identified disease in a single organ or region. The meeting concluded that there is still much work to be done in the integration of data from different fields and in developing a common language for all stakeholders involved. In addition, the participants advocated joint training and education for individuals who engage in routine PET/MRI. It was agreed that PET/MRI can enhance our understanding of normal and disrupted biology, and we are in a position to describe the in vivo nature of disease processes, metabolism, evolution of cancer and the monitoring of response to pharmacological interventions and therapies. As such, PET/MRI is a key to advancing medicine and patient care.

  • 49. Bailey, D. L.
    et al.
    Pichler, B. J.
    Gueckel, B.
    Barthel, H.
    Beer, A. J.
    Botnar, R.
    Gillies, R.
    Goh, V.
    Gotthardt, M.
    Hicks, R. J.
    Lanzenberger, R.
    la Fougere, C.
    Lentschig, M.
    Nekolla, S. G.
    Niederdraenk, T.
    Nikolaou, K.
    Nuyts, J.
    Olego, D.
    Åhlstrom Riklund, Katrine
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Signore, A.
    Schaefers, M.
    Sossi, V.
    Suminski, M.
    Veit-Haibach, P.
    Umutlu, L.
    Wissmeyer, M.
    Beyer, T.
    Combined PET/MRI: from Status Quo to Status Go. Summary Report of the Fifth International Workshop on PET/MR Imaging; February 15-19, 2016; Tubingen, Germany2016In: Molecular Imaging and Biology, ISSN 1536-1632, E-ISSN 1860-2002, Vol. 18, no 5, p. 637-650Article in journal (Refereed)
    Abstract [en]

    This article provides a collaborative perspective of the discussions and conclusions from the fifth international workshop of combined positron emission tomorgraphy (PET)/magnetic resonance imaging (MRI) that was held in Tubingen, Germany, from February 15 to 19, 2016. Specifically, we summarise the second part of the workshop made up of invited presentations from active researchers in the field of PET/MRI and associated fields augmented by round table discussions and dialogue boards with specific topics. This year, this included practical advice as to possible approaches to moving PET/MRI into clinical routine, the use of PET/MRI in brain receptor imaging, in assessing cardiovascular diseases, cancer, infection, and inflammatory diseases. To address perceived challenges still remaining to innovatively integrate PET and MRI system technologies, a dedicated round table session brought together key representatives from industry and academia who were engaged with either the conceptualisation or early adoption of hybrid PET/MRI systems. Discussions during the workshop highlighted that emerging unique applications of PET/MRI such as the ability to provide multi-parametric quantitative and visual information which will enable not only overall disease detection but also disease characterisation would eventually be regarded as compelling arguments for the adoption of PET/MR. However, as indicated by previous workshops, evidence in favour of this observation is only growing slowly, mainly due to the ongoing inability to pool data cohorts from independent trials as well as different systems and sites. The participants emphasised that moving from status quo to status go entails the need to adopt standardised imaging procedures and the readiness to act together prospectively across multiple PET/MRI sites and vendors.

  • 50.
    Barut, Oya
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ahlqvist, Jan
    Umeå University, Faculty of Medicine, Department of Odontology.
    Garoff, Maria
    Umeå University, Faculty of Medicine, Department of Odontology.
    Johansson, Elias
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Johansson, Magnus
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Department of Clinical Sciences, Karolinska Institutet, Danderyds Hospital, Stockholm, Sweden.
    Levring Jäghagen, Eva
    Umeå University, Faculty of Medicine, Department of Odontology.
    Calcifications in the neck region of patients with carotid artery stenosis: a computed tomography angiography study of topographic anatomy2020In: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 129, no 5, p. 523-530Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to map the vertical locations of calcified carotid plaques (CCPs), osseous anatomic structures, and calcified soft tissues in the area of the carotid artery, determine to what extent CCPs are superimposed on the cervical spine in coronal images, and analyze the differences between men and women.

    Study Design: Computed tomography angiography (CTA) scans of 79 patients were studied. CCPs were discovered in 152 of the total 158 neck sides. Evaluations were performed by using sagittal and coronal reformatted CTA images with maximum intensity projection.

    Results: Most of the calcified anatomic structures studied, including the carotid bifurcation, were found in close relationship to the level of the third and fourth cervical vertebrae. In the coronal view, all or most of the areas of the CCPs were superimposed on the cervical spine in 22 of 44 (50%) neck sides with CCP in women and in 37 of 108 (34.2%) in men (P = .070).

    Conclusions: The carotid bifurcation is in close proximity to various calcified anatomic structures. This should be taken into account when diagnosing CCPs in panoramic radiographs. In the coronal view, CCPs and the cervical spine are often superimposed; thus, coronal images are not recommended for confirmation of putative carotid calcifications diagnosed on the basis of panoramic radiographs.

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