Category Archives: Eur Radiol

Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models.

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Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models.

Eur Radiol. 2017 Sep 08;:

Authors: Xie T, Poletti PA, Platon A, Becker CD, Zaidi H

Abstract
PURPOSE: This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks.
MATERIALS AND METHODS: To produce realistic biological and physical representations of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients referred to the emergency unit of Geneva University Hospital for abdominal CT scans.
RESULTS: The effective dose to the mother varied from 1.1 mSv to 2.0 mSv with an average of 1.6 mSv, while commercial dose-tracking software reported an average effective dose of 1.9 mSv (range 1.7-2.3 mSv). The foetal dose normalised to CTDIvol varies between 0.85 and 1.63 with an average of 1.17.
CONCLUSION: The methodology for construction of personalised computational models can be exploited to estimate the patient-specific radiation dose from CT imaging procedures. Likewise, the dosimetric data can be used for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process.
KEY POINTS: • In CT examinations, the absorbed dose is non-uniformly distributed within foetal organs. • This work reports, for the first time, estimates of foetal organ-level dose. • The foetal brain and skeleton doses present significant correlation with gestational age. • The conceptus dose normalised to CTDI vol varies between 0.85 and 1.63. • The developed methodology is adequate for patient-specific CT radiation dosimetry.

PMID: 28887589 [PubMed – as supplied by publisher]

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Free DICOM de-identification tools in clinical research: functioning and safety of patient privacy.

Free DICOM de-identification tools in clinical research: functioning and safety of patient privacy.

Eur Radiol. 2015 Jun 3;

Authors: Aryanto KY, Oudkerk M, van Ooijen PM

Abstract
PURPOSE: To compare non-commercial DICOM toolkits for their de-identification ability in removing a patient’s personal health information (PHI) from a DICOM header.
MATERIALS AND METHODS: Ten DICOM toolkits were selected for de-identification tests. Tests were performed by using the system’s default de-identification profile and, subsequently, the tools’ best adjusted settings. We aimed to eliminate fifty elements considered to contain identifying patient information. The tools were also examined for their respective methods of customization.
RESULTS: Only one tool was able to de-identify all required elements with the default setting. Not all of the toolkits provide a customizable de-identification profile. Six tools allowed changes by selecting the provided profiles, giving input through a graphical user interface (GUI) or configuration text file, or providing the appropriate command-line arguments. Using adjusted settings, four of those six toolkits were able to perform full de-identification.
CONCLUSION: Only five tools could properly de-identify the defined DICOM elements, and in four cases, only after careful customization. Therefore, free DICOM toolkits should be used with extreme care to prevent the risk of disclosing PHI, especially when using the default configuration. In case optimal security is required, one of the five toolkits is proposed.
KEY POINTS: • Free DICOM toolkits should be carefully used to prevent patient identity disclosure. • Each DICOM tool produces its own specific outcomes from the de-identification process. • In case optimal security is required, using one DICOM toolkit is proposed.

PMID: 26037716 [PubMed – as supplied by publisher]

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The impact of radiologists’ expertise on screen results decisions in a CT lung cancer screening trial.

The impact of radiologists’ expertise on screen results decisions in a CT lung cancer screening trial.

Eur Radiol. 2014 Nov 4;

Authors: Heuvelmans MA, Oudkerk M, de Jong PA, Mali WP, Groen HJ, Vliegenthart R

Abstract
OBJECTIVE: To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial.
METHODS: In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule’s volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations.
RESULTS: A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant.
CONCLUSION: In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results.
KEY POINTS: • The NELSON study allowed radiologists to manually adjust the screen result • At baseline, radiologists adjusted the result in about one in 20 cases (95.4 % downwards) • Radiologists’ adjustments led to a 22 % reduction of false-positive screen results • Radiologists’ expertise can improve nodule classification in addition to a nodule protocol.

PMID: 25366707 [PubMed – as supplied by publisher]

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Effect of b value and pre-admission of contrast on diagnostic accuracy of 1.5-T breast DWI: a systematic review and meta-analysis.

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Effect of b value and pre-admission of contrast on diagnostic accuracy of 1.5-T breast DWI: a systematic review and meta-analysis.

Eur Radiol. 2014 Aug…

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The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas: the Toronto experience.

The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas: the Toronto experience.

Eur Radiol. 2014 Jul 12;

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Optimisation of volume-doubling time cutoff for fast-growing lung nodules in CT lung cancer screening reduces false-positive referrals.

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Optimisation of volume-doubling time cutoff for fast-growing lung nodules in CT lung cancer screening reduces false-positive referrals.

Eur Radiol. 2013…

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Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT: an anthropomorphic phantom study.

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Sensitivity and accuracy of volumetry of pulmonary nodules on low-dose 16- and 64-row multi-detector CT: an anthropomorphic phantom study.

Eur Radiol. 2013 Jan;23(1):139-47

Authors: Xie X, Zhao Y, Snijder RA, van Ooijen PM, de Jong PA, Oudkerk M, de Bock GH, Vliegenthart R, Greuter MJ

Abstract
OBJECTIVE: To assess the sensitivity of detection and accuracy of volumetry by manual and semi-automated quantification of artificial pulmonary nodules in an anthropomorphic thoracic phantom on low-dose CT.
METHODS: Fifteen artificial spherical nodules (diameter 3, 5, 8, 10 and 12 mm; CT densities -800, -630 and +100 HU) were randomly placed inside an anthropomorphic thoracic phantom. The phantom was examined on 16- and 64-row multidetector CT with a low-dose protocol. Two independent blinded observers screened for pulmonary nodules. Nodule diameter was measured manually, and volume calculated. For solid nodules (+100 HU), diameter and volume were also evaluated by semi-automated software. Differences in observed volumes between the manual and semi-automated method were evaluated by a t-test.
RESULTS: Sensitivity was 100 % for all nodules of >5 mm and larger, 60-80 % for solid and 0-20 % for non-solid 3-mm nodules. No false-positive nodules but high inter-observer reliability and inter-technique correlation were found. Volume was underestimated manually by 24.1 ± 14.0 % for nodules of any density, and 26.4 ± 15.5 % for solid nodules, compared with 7.6 ± 8.5 % (P < 0.01) semi-automatically.
CONCLUSION: In an anthropomorphic phantom study, the sensitivity of detection is 100 % for nodules of >5 mm in diameter. Semi-automated volumetry yielded more accurate nodule volumes than manual measurements.

PMID: 22797957 [PubMed – indexed for MEDLINE]

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Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score: systematic review and meta-analysis.

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Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score: systematic review and meta-analysis.
Eur Radiol. 2012 Dec;22(12):2688-98
Authors: den Dekker MA, de Smet K, … Continue reading

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Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis.

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Morphological measurements in computed tomography correlate with airflow obstruction in chronic obstructive pulmonary disease: systematic review and meta-analysis.

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Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume.

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Performance of computer-aided detection of pulmonary nodules in low-dose CT: comparison with double reading by nodule volume.

Eur Radiol. 2012 Oct;22(10):2076-84

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The prognostic value of multivoxel magnetic resonance spectroscopy determined metabolite levels in white and grey matter brain tissue for adverse outcome in term newborns following perinatal asphyxia.

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The prognostic value of multivoxel magnetic resonance spectroscopy determined metabolite levels in white and grey matter brain tissue for adverse outcome in term newborns following perinatal asphyxia.
Eur Radiol. 2012… Continue reading

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The added value of quantitative multi-voxel MR spectroscopy in breast magnetic resonance imaging.

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The added value of quantitative multi-voxel MR spectroscopy in breast magnetic resonance imaging.
Eur Radiol. 2012 Apr;22(4):915-22
Authors: Dorrius MD, Pijnappel RM, van der Weide Jansen MC, Jansen L, Kapper… Continue reading

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Effects of microperfusion in hepatic diffusion weighted imaging.

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Effects of microperfusion in hepatic diffusion weighted imaging.
Eur Radiol. 2012 Apr;22(4):891-9
Authors: Dijkstra H, Baron P, Kappert P, Oudkerk M, Sijens PE
Abstract
OBJECTIVE: Clinical hep… Continue reading

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Implementation of an anonymisation tool for clinical trials using a clinical trial processor integrated with an existing trial patient data information system.

Implementation of an anonymisation tool for clinical trials using a clinical trial processor integrated with an existing trial patient data information system.

Eur Radiol. 2012…

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Computer-aided detection in breast MRI: a systematic review and meta-analysis.

Computer-aided detection in breast MRI: a systematic review and meta-analysis.

Eur Radiol. 2011 Aug;21(8):1600-8

Authors: Dorrius MD, der Weide MC, van Ooijen PM, Pijnappel RM,…

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Feasibility of computed tomography based thermometry during interstitial laser heating in bovine liver.

Feasibility of computed tomography based thermometry during interstitial laser heating in bovine liver.

Eur Radiol. 2011 Aug;21(8):1733-8

Authors: Pandeya GD, Klaessens JH, Greuter…

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