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Slotman DJ, Bartels LW, Nijholt IM, Froeling M, Huirne JAF, Moonen CTW, Boomsma MF. Intravoxel incoherent motion (IVIM)-derived perfusion fraction mapping for the visual evaluation of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. Int J Hyperthermia 2024; 41:2321980. [PMID: 38616245 DOI: 10.1080/02656736.2024.2321980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/19/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND A method for periprocedural contrast agent-free visualization of uterine fibroid perfusion could potentially shorten magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) treatment times and improve outcomes. Our goal was to test feasibility of perfusion fraction mapping by intravoxel incoherent motion (IVIM) modeling using diffusion-weighted MRI as method for visual evaluation of MR-HIFU treatment progression. METHODS Conventional and T2-corrected IVIM-derived perfusion fraction maps were retrospectively calculated by applying two fitting methods to diffusion-weighted MRI data (b = 0, 50, 100, 200, 400, 600 and 800 s/mm2 at 1.5 T) from forty-four premenopausal women who underwent MR-HIFU ablation treatment of uterine fibroids. Contrast in perfusion fraction maps between areas with low perfusion fraction and surrounding tissue in the target uterine fibroid immediately following MR-HIFU treatment was evaluated. Additionally, the Dice similarity coefficient (DSC) was calculated between delineated areas with low IVIM-derived perfusion fraction and hypoperfusion based on CE-T1w. RESULTS Average perfusion fraction ranged between 0.068 and 0.083 in areas with low perfusion fraction based on visual assessment, and between 0.256 and 0.335 in surrounding tissues (all p < 0.001). DSCs ranged from 0.714 to 0.734 between areas with low perfusion fraction and the CE-T1w derived non-perfused areas, with excellent intraobserver reliability of the delineated areas (ICC 0.97). CONCLUSION The MR-HIFU treatment effect in uterine fibroids can be visualized using IVIM perfusion fraction mapping, in moderate concordance with contrast enhanced MRI. IVIM perfusion fraction mapping has therefore the potential to serve as a contrast agent-free imaging method to visualize the MR-HIFU treatment progression in uterine fibroids.
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Affiliation(s)
- Derk J Slotman
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn Froeling
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam UMC, Amsterdam, The Netherlands
| | - Chrit T W Moonen
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
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Langius-Wiffen E, Slotman DJ, Groeneveld J, Ac van Osch J, Nijholt IM, de Boer E, Nijboer-Oosterveld J, Veldhuis WB, de Jong PA, Boomsma MF. External validation of the RSNA 2020 pulmonary embolism detection challenge winning deep learning algorithm. Eur J Radiol 2024; 173:111361. [PMID: 38401407 DOI: 10.1016/j.ejrad.2024.111361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/17/2024] [Accepted: 02/08/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE To evaluate the diagnostic performance and generalizability of the winning DL algorithm of the RSNA 2020 PE detection challenge to a local population using CTPA data from two hospitals. MATERIALS AND METHODS Consecutive CTPA images from patients referred for suspected PE were retrospectively analysed. The winning RSNA 2020 DL algorithm was retrained on the RSNA-STR Pulmonary Embolism CT (RSPECT) dataset. The algorithm was tested in hospital A on multidetector CT (MDCT) images of 238 patients and in hospital B on spectral detector CT (SDCT) and virtual monochromatic images (VMI) of 114 patients. The output of the DL algorithm was compared with a reference standard, which included a consensus reading by at least two experienced cardiothoracic radiologists for both hospitals. Areas under the receiver operating characteristic curve (AUCs) were calculated. Sensitivity and specificity were determined using the maximum Youden index. RESULTS According to the reference standard, PE was present in 73 patients (30.7%) in hospital A and 33 patients (29.0%) in hospital B. For the DL algorithm the AUC was 0.96 (95% CI 0.92-0.98) in hospital A, 0.89 (95% CI 0.81-0.94) for conventional reconstruction in hospital B and 0.87 (95% CI 0.80-0.93) for VMI. CONCLUSION The RSNA 2020 pulmonary embolism detection on CTPA challenge winning DL algorithm, retrained on the RSPECT dataset, showed high diagnostic accuracy on MDCT images. A somewhat lower performance was observed on SDCT images, which suggest additional training on novel CT technology may improve generalizability of this DL algorithm.
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Affiliation(s)
| | - Derk J Slotman
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands; Department of Radiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jorik Groeneveld
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands
| | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands; Department of Radiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Erwin de Boer
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands
| | | | - Wouter B Veldhuis
- Department of Radiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands; Department of Radiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
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Knorren ER, de Ridder LA, Nijholt IM, Dijkstra JR, Braat MNGJA, Huirne JAF, Boomsma MF, Schutte JM. Effectiveness and complication rates of high intensity focused ultrasound treatment for abdominal wall endometriosis: A systematic review. Eur J Obstet Gynecol Reprod Biol 2024; 297:15-23. [PMID: 38555851 DOI: 10.1016/j.ejogrb.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
In this review, a systematic literature search on the effectiveness and complication rates of ultrasound-guided and magnetic resonance-guided high-intensity focused ultrasound (USg-/MRgHIFU) for abdominal wall endometriosis (AWE) was conducted in six databases in May/June 2023. Original articles of (non)randomized trials, cohort studies, case-control studies and case series published in peer-reviewed journals were included. Of the included studies the level of evidence (LoE) and methodological quality using the ROBINS-I and IHE-QAT was assessed. Primary outcomes were non-perfused volume ratio (NPV%), lesion size, pain scores, side effects and complication rates according to Society of Interventional Radiology (SIR) guidelines. Secondary outcomes were recurrence and re-intervention rates. Seven cohort studies (one of good methodological quality) (LoE 3) on USgHIFU were included (n = 212, AWE lesions = 240-245). Six months after USgHIFU treatment, pain scores were reduced with 3.3-5.2 points (baseline: 5.1-6.8, n = 135). Self-limiting side effects were pain (85.7 % (114/133)) and swelling (34.6 % (46/133)) in the treatment area. Complications occurred in 17.7 % (32/181), all of which were minor. Recurrence occurred in 12.8 % (11/86). Three of these seven cohort studies compared USgHIFU (n = 61) with surgical excision (n = 74). Pooled results showed no significant differences in pain scores, complications (resp. 26.3 % (10/38) vs. 32.6 % (15/46) (p = 0.53)) and recurrences (resp. 4.9 % (3/61) vs. 5.4 % (4/74) (p = 0.90)). This systematic review suggests that HIFU is an effective and safe treatment option for AWE. USgHIFU treatment led to reduced pain scores and lesion size, was free of major complications and had a pooled recurrence rate of 12.8 %. Compared to surgical excision pooled results showed no significant differences in pain scores, complications and recurrences after USgHIFU. However, many of the included studies had limitations in their methodological quality and therefore the results should be interpreted with caution. Well-structured high-quality randomized controlled trials comparing HIFU to standard care should be conducted to provide more conclusive evidence.
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Affiliation(s)
- Elisabeth R Knorren
- Department of Obstetrics and Gynecology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands; Department of Radiology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands.
| | - Larissa A de Ridder
- Department of Obstetrics and Gynecology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands
| | - Jeroen R Dijkstra
- Department of Obstetrics and Gynecology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands
| | - Manon N G J A Braat
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584XC Utrecht, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centre, location VUmc, Amsterdam Research Institute, Reproduction and Development, De Boelelaan 1117, 1081HV Amsterdam, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands; Imaging & Oncology Division, Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584XC Utrecht, The Netherlands
| | - Joke M Schutte
- Department of Obstetrics and Gynecology, Isala Hospital, Dokter van Deenweg 2, 8025AB Zwolle, The Netherlands
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Anneveldt KJ, Nijholt IM, Schutte JM, Hehenkamp WJK, Veersema S, Huirne JAF, Boomsma MF. Waste analysis and energy use estimation during MR-HIFU treatment: first steps towards calculating total environmental impact. Insights Imaging 2024; 15:83. [PMID: 38517607 PMCID: PMC10959896 DOI: 10.1186/s13244-024-01655-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/15/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVES To assess the environmental impact of the non-invasive Magnetic Resonance image-guided High-Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids, we aimed to perform a full Life Cycle Assessment (LCA). However, as a full LCA was not feasible at this time, we evaluated the CO2 (carbon dioxide) emission from the MRI scanner, MR-HIFU device, and the medication used, and analyzed solid waste produced during treatment. METHODS Our functional unit was one uterine fibroid MR-HIFU treatment. The moment the patient entered the day care-unit until she left, defined our boundaries of investigation. We retrospectively collected data from 25 treatments to assess the CO2 emission based on the energy used by the MRI scanner and MR-HIFU device and the amount and type of medication administered. Solid waste was prospectively collected from five treatments. RESULTS During an MR-HIFU treatment, the MRI scanner and MR-HIFU device produced 33.2 ± 8.7 kg of CO2 emission and medication administered 0.13 ± 0.04 kg. A uterine fibroid MR-HIFU treatment produced 1.2 kg (range 1.1-1.4) of solid waste. CONCLUSIONS Environmental impact should ideally be analyzed for all (new) medical treatments. By assessing part of the CO2 emission and solid waste produced, we have taken the first steps towards analyzing the total environmental impact of the MR-HIFU treatment of uterine fibroids. These data can contribute to future studies comparing the results of MR-HIFU LCAs with LCAs of other uterine fibroid therapies. CRITICAL RELEVANCE STATEMENT In addition to (cost-) effectiveness, the environmental impact of new treatments should be assessed. We took the first steps towards analyzing the total environmental impact of uterine fibroid MR-HIFU. KEY POINTS • Life Cycle Assessments (LCAs) should be performed for all (new) medical treatments. • We took the first steps towards analyzing the environmental impact of uterine fibroid MR-HIFU. • Energy used by the MRI scanner and MR-HIFU device corresponded to 33.2 ± 8.7 kg of CO2 emission.
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Affiliation(s)
- Kimberley J Anneveldt
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands.
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands
- Image Sciences Institute, Division of Imaging & Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Joke M Schutte
- Department of Gynecology, Isala Hospital, Dokter Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Wouter J K Hehenkamp
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Sebastiaan Veersema
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynecology and Amsterdam Research Institute Reproduction and Development, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands
- Image Sciences Institute, Division of Imaging & Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
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Selles M, Wellenberg RHH, Slotman DJ, Nijholt IM, van Osch JAC, van Dijke KF, Maas M, Boomsma MF. Image quality and metal artifact reduction in total hip arthroplasty CT: deep learning-based algorithm versus virtual monoenergetic imaging and orthopedic metal artifact reduction. Eur Radiol Exp 2024; 8:31. [PMID: 38480603 PMCID: PMC10937891 DOI: 10.1186/s41747-024-00427-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/02/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND To compare image quality, metal artifacts, and diagnostic confidence of conventional computed tomography (CT) images of unilateral total hip arthroplasty patients (THA) with deep learning-based metal artifact reduction (DL-MAR) to conventional CT and 130-keV monoenergetic images with and without orthopedic metal artifact reduction (O-MAR). METHODS Conventional CT and 130-keV monoenergetic images with and without O-MAR and DL-MAR images of 28 unilateral THA patients were reconstructed. Image quality, metal artifacts, and diagnostic confidence in bone, pelvic organs, and soft tissue adjacent to the prosthesis were jointly scored by two experienced musculoskeletal radiologists. Contrast-to-noise ratios (CNR) between bladder and fat and muscle and fat were measured. Wilcoxon signed-rank tests with Holm-Bonferroni correction were used. RESULTS Significantly higher image quality, higher diagnostic confidence, and less severe metal artifacts were observed on DL-MAR and images with O-MAR compared to images without O-MAR (p < 0.001 for all comparisons). Higher image quality, higher diagnostic confidence for bone and soft tissue adjacent to the prosthesis, and less severe metal artifacts were observed on DL-MAR when compared to conventional images and 130-keV monoenergetic images with O-MAR (p ≤ 0.014). CNRs were higher for DL-MAR and images with O-MAR compared to images without O-MAR (p < 0.001). Higher CNRs were observed on DL-MAR images compared to conventional images and 130-keV monoenergetic images with O-MAR (p ≤ 0.010). CONCLUSIONS DL-MAR showed higher image quality, diagnostic confidence, and superior metal artifact reduction compared to conventional CT images and 130-keV monoenergetic images with and without O-MAR in unilateral THA patients. RELEVANCE STATEMENT DL-MAR resulted into improved image quality, stronger reduction of metal artifacts, and improved diagnostic confidence compared to conventional and virtual monoenergetic images with and without metal artifact reduction, bringing DL-based metal artifact reduction closer to clinical application. KEY POINTS • Metal artifacts introduced by total hip arthroplasty hamper radiologic assessment on CT. • A deep-learning algorithm (DL-MAR) was compared to dual-layer CT images with O-MAR. • DL-MAR showed best image quality and diagnostic confidence. • Highest contrast-to-noise ratios were observed on the DL-MAR images.
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Affiliation(s)
- Mark Selles
- Department of Radiology, Isala, 8025 AB, Zwolle, the Netherlands.
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centre, 1105 AZ, Amsterdam, the Netherlands.
- Amsterdam Movement Sciences, 1081 BT, Amsterdam, the Netherlands.
| | - Ruud H H Wellenberg
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centre, 1105 AZ, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, 1081 BT, Amsterdam, the Netherlands
| | - Derk J Slotman
- Department of Radiology, Isala, 8025 AB, Zwolle, the Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala, 8025 AB, Zwolle, the Netherlands
| | | | - Kees F van Dijke
- Department of Radiology & Nuclear Medicine, Noordwest Ziekenhuisgroep, 1815 JD, Alkmaar, the Netherlands
| | - Mario Maas
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centre, 1105 AZ, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, 1081 BT, Amsterdam, the Netherlands
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Dam-Vervloet AJ, Morsink CF, Krommendijk ME, Nijholt IM, van Straaten HLM, Poot L, Bosschaart N. Skin color influences transcutaneous bilirubin measurements: a systematic in vitro evaluation. Pediatr Res 2024:10.1038/s41390-024-03081-y. [PMID: 38368497 DOI: 10.1038/s41390-024-03081-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Concerns have been raised about the effect of skin color on the accuracy of transcutaneous bilirubin (TcB) measurements, a widely used method for hyperbilirubinemia diagnosis in newborns. Literature is inconclusive, with both reported under- and overestimations of the TcB with increasing skin pigmentation. Therefore, the influence of skin color on TcB measurements was systematically evaluated in a controlled, in vitro setting. METHODS A bilirubin meter (JM-105) was evaluated on layered phantoms that mimic neonatal skin with varying dermal bilirubin concentrations (0-250 µmol/L) and varying epidermal melanosome volume fractions (0-40%; light-dark skin color). RESULTS TcB measurements were influenced by skin pigmentation. Larger mimicked melanosome volume fractions and higher bilirubin levels led to larger underestimations of the measured TcB, compared to an unpigmented epidermis. In the in vitro setting of this study, these underestimations amounted to 26-132 µmol/L at a TcB level of 250 µmol/L. CONCLUSION This in vitro study provides insight into the effect of skin color on TcB measurements: the TcB is underestimated as skin pigmentation increases and this effect becomes more pronounced at higher bilirubin levels. Our results highlight the need for improved TcB meter design and cautious interpretation of TcB readings on newborns with dark skin. IMPACT Key message: Skin color influences transcutaneous bilirubin measurements: the darker the skin, the larger the underestimation. What this study adds to existing literature: Existing literature is inconclusive regarding the influence of skin color on transcutaneous bilirubin measurements. This study systematically evaluates and clarifies the influence of skin color on transcutaneous bilirubin measurements in a controlled, in vitro setting. IMPACT This study aids to better interpret the measured TcB level in patients with varying skin colors, and is particularly important when using TcB meters on patients with dark skin colors.
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Affiliation(s)
- Alida J Dam-Vervloet
- Biomedical Photonic Imaging group, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
- Medical Physics Department, Isala hospital, Zwolle, The Netherlands.
| | - Claudia F Morsink
- Biomedical Photonic Imaging group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Marleen E Krommendijk
- Biomedical Photonic Imaging group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Ingrid M Nijholt
- Innovation & Science Department, Isala hospital, Zwolle, The Netherlands
- Radiology Department, Isala hospital, Zwolle, The Netherlands
| | | | - Lieke Poot
- Medical Physics Department, Isala hospital, Zwolle, The Netherlands
| | - Nienke Bosschaart
- Biomedical Photonic Imaging group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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Bergsma S, van Gent M, Dam-Vervloet AJ, Lagerweij MCM, van der Wouden EJ, Nijholt IM, Boomsma MF, Poot L. Image-guided point-shear-wave elastography: a valid and reliable technique for liver fibrotic staging. J Ultrasound 2024:10.1007/s40477-023-00854-9. [PMID: 38281292 DOI: 10.1007/s40477-023-00854-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 01/30/2024] Open
Abstract
PURPOSE Despite progressive implementation of image-guided point-shear wave elastography (pSWE) in guidelines as an alternative to transient elastography for the staging of fibrotic liver disease, pSWE is not widely adopted in clinical workflow. More information on reliability and validity of pSWE systems is needed. Therefore, we performed a phantom study to evaluate the validity and reliability of pSWE with ultrasound systems. METHODS Validity and reliability of pSWE measurements from three ultrasound systems were evaluated. Measurements were performed on an elasticity phantom with reference elasticities of 7 ± 1 (low) (median ± interquartile range (IQR)), 14 ± 2 (medium) and 26 ± 3 (high) kPa. Measurements were repeated in tenfold for each reference at 2, 3 and 4 cm depth. Results were considered valid when median elasticity ± IQR was between the uncertainty limits (IQR) for each reference elasticity value and reliable when IQR/median < 0.30. RESULTS pSWE with the systems provided valid results for all reference elasticities and focal depths, except for overestimation of high reference elasticity at 2 and 4 cm depth for one system (41.5 ± 4.3 and 39.0 ± 1.2 kPa, respectively). Measurements were reliable with a maximum IQR/median of 0.13, well below the guideline of IQR/median < 0.30. DISCUSSION The results support the use of pSWE as an alternative to invasive or non-image guided noninvasive techniques for liver fibrotic staging. CONCLUSIONS pSWE with ultrasound systems from different vendors is valid and reliable and can therefore be implemented to optimize clinical workflow by performing imaging and elastography simultaneously.
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Affiliation(s)
- Sietske Bergsma
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands.
| | - Margo van Gent
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Medical Center Leeuwarden, Department of Medical Physics, Leeuwarden, The Netherlands
| | | | | | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Department of Innovation & Science, Isala Hospital, Zwolle, The Netherlands
| | | | - Lieke Poot
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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8
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van den Wittenboer GJ, van der Kolk BYM, Nijholt IM, Langius-Wiffen E, van Dijk RA, van Hasselt BAAM, Podlogar M, van den Brink WA, Bouma GJ, Schep NWL, Maas M, Boomsma MF. Diagnostic accuracy of an artificial intelligence algorithm versus radiologists for fracture detection on cervical spine CT. Eur Radiol 2024:10.1007/s00330-023-10559-6. [PMID: 38206401 DOI: 10.1007/s00330-023-10559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/07/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES To compare diagnostic accuracy of a deep learning artificial intelligence (AI) for cervical spine (C-spine) fracture detection on CT to attending radiologists and assess which undetected fractures were injuries in need of stabilising therapy (IST). METHODS This single-centre, retrospective diagnostic accuracy study included consecutive patients (age ≥18 years; 2007-2014) screened for C-spine fractures with CT. To validate ground truth, one radiologist and three neurosurgeons independently examined scans positive for fracture. Negative scans were followed up until 2022 through patient files and two radiologists reviewed negative scans that were flagged positive by AI. The neurosurgeons determined which fractures were ISTs. Diagnostic accuracy of AI and attending radiologists (index tests) were compared using McNemar. RESULTS Of the 2368 scans (median age, 48, interquartile range 30-65; 1441 men) analysed, 221 (9.3%) scans contained C-spine fractures with 133 IST. AI detected 158/221 scans with fractures (sensitivity 71.5%, 95% CI 65.5-77.4%) and 2118/2147 scans without fractures (specificity 98.6%, 95% CI 98.2-99.1). In comparison, attending radiologists detected 195/221 scans with fractures (sensitivity 88.2%, 95% CI 84.0-92.5%, p < 0.001) and 2130/2147 scans without fracture (specificity 99.2%, 95% CI 98.8-99.6, p = 0.07). Of the fractures undetected by AI 30/63 were ISTs versus 4/26 for radiologists. AI detected 22/26 fractures undetected by the radiologists, including 3/4 undetected ISTs. CONCLUSION Compared to attending radiologists, the artificial intelligence has a lower sensitivity and a higher miss rate of fractures in need of stabilising therapy; however, it detected most fractures undetected by the radiologists, including fractures in need of stabilising therapy. Clinical relevance statement The artificial intelligence algorithm missed more cervical spine fractures on CT than attending radiologists, but detected 84.6% of fractures undetected by radiologists, including fractures in need of stabilising therapy. KEY POINTS The impact of artificial intelligence for cervical spine fracture detection on CT on fracture management is unknown. The algorithm detected less fractures than attending radiologists, but detected most fractures undetected by the radiologists including almost all in need of stabilising therapy. The artificial intelligence algorithm shows potential as a concurrent reader.
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Affiliation(s)
- Gaby J van den Wittenboer
- Department of Radiology and Nuclear Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands.
- Department of Emergency Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands.
| | - Brigitta Y M van der Kolk
- Department of Radiology and Nuclear Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
- Department of Emergency Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology and Nuclear Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
| | - Eline Langius-Wiffen
- Department of Radiology and Nuclear Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
| | - Rogier A van Dijk
- Department of Radiology and Nuclear Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
| | | | - Martin Podlogar
- Department of Neurosurgery, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
| | | | - Gert Joan Bouma
- Department of Neurosurgery, Amsterdam University Medical Centers, Location Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
| | - Niels W L Schep
- Department of Trauma surgery, Maasstad Hospital, Maasstadweg 21, Rotterdam, The Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology and Nuclear Medicine, Isala, Dr. van Heesweg 2, Zwolle, The Netherlands
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9
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Langius-Wiffen E, Nijholt IM, van Dijk RA, de Boer E, Nijboer-Oosterveld J, Veldhuis WB, de Jong PA, Boomsma MF. An artificial intelligence algorithm for pulmonary embolism detection on polychromatic computed tomography: performance on virtual monochromatic images. Eur Radiol 2024; 34:384-390. [PMID: 37542651 DOI: 10.1007/s00330-023-10048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES Virtual monochromatic images (VMI) are increasingly used in clinical practice as they improve contrast-to-noise ratio. However, due to their different appearances, the performance of artificial intelligence (AI) trained on conventional CT images may worsen. The goal of this study was to assess the performance of an established AI algorithm trained on conventional polychromatic computed tomography (CT) images (CPI) to detect pulmonary embolism (PE) on VMI. METHODS Paired 60 kiloelectron volt (keV) VMI and CPI of 114 consecutive patients suspected of PE, obtained with a detector-based spectral CT scanner, were retrospectively analyzed by an established AI algorithm. The CT pulmonary angiography (CTPA) were classified as positive or negative for PE on a per-patient level. The reference standard was established using a comprehensive method that combined the evaluation of the attending radiologist and three experienced cardiothoracic radiologists aided by two different detection tools. Sensitivity, specificity, positive and negative predictive values and likelihood ratios of the algorithm on VMI and CPI were compared. RESULTS The prevalence of PE according to the reference standard was 35.1% (40 patients). None of the diagnostic accuracy measures of the algorithm showed a significant difference between CPI and VMI. Sensitivity was 77.5% (95% confidence interval (CI) 64.6-90.4%) and 85.0% (73.9-96.1%) (p = 0.08) on CPI and VMI respectively and specificity 96.0% (91.4-100.0%) and 94.6% (89.4-99.7%) (p = 0.32). CONCLUSIONS Diagnostic performance of the AI algorithm that was trained on CPI did not drop on VMI, which is reassuring for its use in clinical practice. CLINICAL RELEVANCE STATEMENT A commercially available AI algorithm, trained on conventional polychromatic CTPA, could be safely used on virtual monochromatic images. This supports the sustainability of AI-aided detection of PE on CT despite ongoing technological advances in medical imaging, although monitoring in daily practice will remain important. KEY POINTS • Diagnostic accuracy of an AI algorithm trained on conventional polychromatic images to detect PE did not drop on virtual monochromatic images. • Our results are reassuring as innovations in hardware and reconstruction in CT are continuing, whilst commercial AI algorithms that are trained on older generation data enter healthcare.
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Affiliation(s)
- Eline Langius-Wiffen
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Rogier A van Dijk
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Erwin de Boer
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | | | - Wouter B Veldhuis
- Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
- Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
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10
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Langius-Wiffen E, de Jong PA, Mohamed Hoesein FA, Dekker L, van den Hoven AF, Nijholt IM, Boomsma MF, Veldhuis WB. Added value of an artificial intelligence algorithm in reducing the number of missed incidental acute pulmonary embolism in routine portal venous phase chest CT. Eur Radiol 2024; 34:367-373. [PMID: 37532902 DOI: 10.1007/s00330-023-10029-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the incremental value of artificial intelligence (AI) compared to the diagnostic accuracy of radiologists alone in detecting incidental acute pulmonary embolism (PE) on routine portal venous contrast-enhanced chest computed tomography (CT). METHODS CTs of 3089 consecutive patients referred to the radiology department for a routine contrast-enhanced chest CT between 27-5-2020 and 31-12-2020, were retrospectively analysed by a CE-certified and FDA-approved AI algorithm. The diagnostic performance of the AI was compared to the initial report. To determine the reference standard, discordant findings were independently evaluated by two readers. In case of disagreement, another experienced cardiothoracic radiologist with knowledge of the initial report and the AI output adjudicated. RESULTS The prevalence of acute incidental PE in the reference standard was 2.2% (67 of 3089 patients). In 25 cases, AI detected initially unreported PE. This included three cases concerning central/lobar PE. Sensitivity of the AI algorithm was significantly higher than the outcome of the initial report (respectively 95.5% vs. 62.7%, p < 0.001), whereas specificity was very high for both (respectively 99.6% vs 99.9%, p = 0.012). The AI algorithm only showed a slightly higher amount of false-positive findings (11 vs. 2), resulting in a significantly lower PPV (85.3% vs. 95.5%, p = 0.047). CONCLUSION The AI algorithm showed high diagnostic accuracy in diagnosing incidental PE, detecting an additional 25 cases of initially unreported PE, accounting for 37.3% of all positive cases. CLINICAL RELEVANCE STATEMENT Radiologist support from AI algorithms in daily practice can prevent missed incidental acute PE on routine chest CT, without a high burden of false-positive cases. KEY POINTS • Incidental pulmonary embolism is often missed by radiologists in non-diagnostic scans with suboptimal contrast opacification within the pulmonary trunk. • An artificial intelligence algorithm showed higher sensitivity detecting incidental pulmonary embolism on routine portal venous chest CT compared to the initial report. • Implementation of artificial intelligence support in routine daily practice will reduce the number of missed incidental pulmonary embolism.
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Affiliation(s)
- Eline Langius-Wiffen
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
| | - Pim A de Jong
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Lisette Dekker
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Andor F van den Hoven
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Nuclear Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
- Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Wouter B Veldhuis
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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11
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Slotman DJ, Nijholt IM, Schutte JM, Boomsma MF. No incision required for long-lasting symptom relief in a selection of women suffering from uterine fibroids. Eur Radiol 2023; 33:7357-7359. [PMID: 37740081 DOI: 10.1007/s00330-023-10197-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/09/2023] [Accepted: 08/15/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Derk J Slotman
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands.
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joke M Schutte
- Department of Gynecology, Isala Hospital, Zwolle, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
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12
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van Merode NAM, Nijholt IM, Heesakkers JP, van Koeveringe GA, Steffens MG, Witte LPW. Effect of bladder outlet procedures on urodynamic assessments in men with an acontractile or underactive detrusor: A systematic review and meta-analysis. Neurourol Urodyn 2023; 42:1822-1838. [PMID: 37498009 DOI: 10.1002/nau.25253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To review the effect of bladder outlet procedures on urodynamic outcomes and symptom scores in males with detrusor underactivity (DU) or acontractile detrusors (AD). MATERIALS AND METHODS We performed a systematic review and meta-analysis of research publications derived from PubMed, Embase, Web of Science, and Ovid Medline to identify clinical studies of adult men with non-neurogenic DU or AD who underwent any bladder outlet procedure. Outcomes comprised the detrusor pressure at maximum flow (Pdet Qmax ), maximum flow rate (Qmax ), international prostate symptom score (IPSS), and quality of life (QoL). This study is registered under PROSPERO CRD42020215832. RESULTS We included 13 studies of bladder outlet procedures, of which 6 reported decreased and 7 reported improved Pdet Qmax after the procedure. Meta-analysis revealed an increase in the pooled mean Pdet Qmax of 5.99 cmH2 0 after surgery (95% CI: 0.59-11.40; p = 0.03; I2 95%). Notably, the Pdet Qmax improved in all subgroups with a preoperative bladder contractility index (BCI) <50 and decreased in all subgroups with a BCI ≥50. All studies reported an improved Qmax after surgery, with a pooled mean difference of 5.87 mL/s (95% CI: 4.25-7.49; I2 93%). Only three studies reported QoL, but pooling suggested significant improvements after surgery (mean, -2.41 points; 95% CI: -2.81 to -2.01; p = 0.007). All seven studies reporting IPSS demonstrated improvement (mean, -12.82; 95% CI: -14.76 to -10.88; p < 0.001). CONCLUSIONS This review shows that Pdet Qmax and Qmax increases after surgical bladder outlet procedures in men with DU and AD. Bladder outlet procedures should be discussed as part of the shared decision-making process for this group. The evidence was of low to very low certainty.
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Affiliation(s)
- Nadine A M van Merode
- Department of Urology, Isala Hospital, Zwolle, The Netherlands
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Department of Innovation and Science, Isala Hospital, Zwolle, The Netherlands
| | - John P Heesakkers
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
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13
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Langius-Wiffen E, de Jong PA, Hoesein FAM, Dekker L, van den Hoven AF, Nijholt IM, Boomsma MF, Veldhuis WB. Retrospective batch analysis to evaluate the diagnostic accuracy of a clinically deployed AI algorithm for the detection of acute pulmonary embolism on CTPA. Insights Imaging 2023; 14:102. [PMID: 37278961 PMCID: PMC10244304 DOI: 10.1186/s13244-023-01454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023] Open
Abstract
PURPOSE To generate and extend the evidence on the clinical validity of an artificial intelligence (AI) algorithm to detect acute pulmonary embolism (PE) on CT pulmonary angiography (CTPA) of patients suspected of PE and to evaluate the possibility of reducing the risk of missed findings in clinical practice with AI-assisted reporting. METHODS Consecutive CTPA scan data of 3316 patients referred because of suspected PE between 24-2-2018 and 31-12-2020 were retrospectively analysed by a CE-certified and FDA-approved AI algorithm. The output of the AI was compared with the attending radiologists' report. To define the reference standard, discordant findings were independently evaluated by two readers. In case of disagreement, an experienced cardiothoracic radiologist adjudicated. RESULTS According to the reference standard, PE was present in 717 patients (21.6%). PE was missed by the AI in 23 patients, while the attending radiologist missed 60 PE. The AI detected 2 false positives and the attending radiologist 9. The sensitivity for the detection of PE by the AI algorithm was significantly higher compared to the radiology report (96.8% vs. 91.6%, p < 0.001). Specificity of the AI was also significantly higher (99.9% vs. 99.7%, p = 0.035). NPV and PPV of the AI were also significantly higher than the radiology report. CONCLUSION The AI algorithm showed a significantly higher diagnostic accuracy for the detection of PE on CTPA compared to the report of the attending radiologist. This finding indicates that missed positive findings could be prevented with the implementation of AI-assisted reporting in daily clinical practice. CRITICAL RELEVANCE STATEMENT Missed positive findings on CTPA of patients suspected of pulmonary embolism can be prevented with the implementation of AI-assisted care. KEY POINTS The AI algorithm showed excellent diagnostic accuracy detecting PE on CTPA. Accuracy of the AI was significantly higher compared to the attending radiologist. Highest diagnostic accuracy can likely be achieved by radiologists supported by AI. Our results indicate that implementation of AI-assisted reporting could reduce the number of missed positive findings.
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Affiliation(s)
- Eline Langius-Wiffen
- Department of Radiology, Isala Hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
| | - Pim A de Jong
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Lisette Dekker
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Andor F van den Hoven
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Nuclear Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
- Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Wouter B Veldhuis
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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14
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Selles M, Slotman DJ, van Osch JAC, Nijholt IM, Wellenberg RHH, Maas M, Boomsma MF. Is AI the way forward for reducing metal artifacts in CT? development of a generic deep learning-based method and initial evaluation in patients with sacroiliac joint implants. Eur J Radiol 2023; 163:110844. [PMID: 37119708 DOI: 10.1016/j.ejrad.2023.110844] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE To develop a deep learning-based metal artifact reduction technique (dl-MAR) and quantitatively compare metal artifacts on dl-MAR-corrected CT-images, orthopedic metal artifact reduction (O-MAR)-corrected CT-images and uncorrected CT-images after sacroiliac (SI) joint fusion. METHODS dl-MAR was trained on CT-images with simulated metal artifacts. Pre-surgery CT-images and uncorrected, O-MAR-corrected and dl-MAR-corrected post-surgery CT-images of twenty-five patients undergoing SI joint fusion were retrospectively obtained. Image registration was applied to align pre-surgery with post-surgery CT-images within each patient, allowing placement of regions of interest (ROIs) on the same anatomical locations. Six ROIs were placed on the metal implant and the contralateral side in bone lateral of the SI joint, the gluteus medius muscle and the iliacus muscle. Metal artifacts were quantified as the difference in Hounsfield units (HU) between pre- and post-surgery CT-values within the ROIs on the uncorrected, O-MAR-corrected and dl-MAR-corrected images. Noise was quantified as standard deviation in HU within the ROIs. Metal artifacts and noise in the post-surgery CT-images were compared using linear multilevel regression models. RESULTS Metal artifacts were significantly reduced by O-MAR and dl-MAR in bone (p < 0.001), contralateral bone (O-MAR: p = 0.009; dl-MAR: p < 0.001), gluteus medius (p < 0.001), contralateral gluteus medius (p < 0.001), iliacus (p < 0.001) and contralateral iliacus (O-MAR: p = 0.024; dl-MAR: p < 0.001) compared to uncorrected images. Images corrected with dl-MAR resulted in stronger artifact reduction than images corrected with O-MAR in contralateral bone (p < 0.001), gluteus medius (p = 0.006), contralateral gluteus medius (p < 0.001), iliacus (p = 0.017), and contralateral iliacus (p < 0.001). Noise was reduced by O-MAR in bone (p = 0.009) and gluteus medius (p < 0.001) while noise was reduced by dl-MAR in all ROIs (p < 0.001) in comparison to uncorrected images. CONCLUSION dl-MAR showed superior metal artifact reduction compared to O-MAR in CT-images with SI joint fusion implants.
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Affiliation(s)
- Mark Selles
- Department of Radiology, Isala, 8025 AB Zwolle, the Netherlands; Department of Radiology & Nuclear medicine, Amsterdam University Medical Centre, 1105 AZ Amsterdam, the Netherlands; Amsterdam Movement Sciences, 1081 BT Amsterdam, the Netherlands.
| | - Derk J Slotman
- Department of Radiology, Isala, 8025 AB Zwolle, the Netherlands
| | | | | | - Ruud H H Wellenberg
- Department of Radiology & Nuclear medicine, Amsterdam University Medical Centre, 1105 AZ Amsterdam, the Netherlands; Amsterdam Movement Sciences, 1081 BT Amsterdam, the Netherlands
| | - Mario Maas
- Department of Radiology & Nuclear medicine, Amsterdam University Medical Centre, 1105 AZ Amsterdam, the Netherlands; Amsterdam Movement Sciences, 1081 BT Amsterdam, the Netherlands
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Simões Corrêa Galendi J, Siefen AC, Moretti DM, Yeo SY, Grüll H, Bratke G, Morganti AG, Bazzocchi A, Gasperini C, De Felice F, Blanco Sequeiros R, Huhtala M, Nijholt IM, Boomsma MF, Bos C, Verkooijen HM, Müller D, Stock S. Factors Influencing the Adoption of Magnetic Resonance-Guided High-Intensity Focused Ultrasound for Painful Bone Metastases in Europe, A Group Concept Mapping Study. Int J Environ Res Public Health 2023; 20:1084. [PMID: 36673840 PMCID: PMC9858703 DOI: 10.3390/ijerph20021084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) is an innovative treatment for patients with painful bone metastases. The adoption of MR-HIFU will be influenced by several factors beyond its effectiveness. To identify contextual factors affecting the adoption of MR-HIFU, we conducted a group concept mapping (GCM) study in four European countries. The GCM was conducted in two phases. First, the participants brainstormed statements guided by the focus prompt "One factor that may influence the uptake of MR-HIFU in clinical practice is...". Second, the participants sorted statements into categories and rated the statements according to their importance and changeability. To generate a concept map, multidimensional scaling and cluster analysis were conducted, and average ratings for each (cluster of) factors were calculated. Forty-five participants contributed to phase I and/or II (56% overall participation rate). The resulting concept map comprises 49 factors, organized in 12 clusters: "competitive treatments", "physicians' attitudes", "alignment of resources", "logistics and workflow", "technical disadvantages", "radiotherapy as first-line therapy", "aggregating knowledge and improving awareness", "clinical effectiveness", "patients' preferences", "reimbursement", "cost-effectiveness" and "hospital costs". The factors identified echo those from the literature, but their relevance and interrelationship are case-specific. Besides evidence on clinical effectiveness, contextual factors from 10 other clusters should be addressed to support adoption of MR-HIFU.
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Affiliation(s)
- Julia Simões Corrêa Galendi
- Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Ann-Cathrine Siefen
- Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Debora M. Moretti
- Institute for Food and Resource Economics, Chair for Technology, Innovation Management and Entrepreneurship, University of Bonn, 53115 Bonn, Germany
| | - Sin Yuin Yeo
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
| | - Holger Grüll
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, University of Cologne, 50939 Cologne, Germany
| | - Grischa Bratke
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
| | - Alessio Giuseppe Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero, Universitaria of Bologna, 40138 Bologna, Italy
- Radiation Oncology, DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Chiara Gasperini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Mira Huhtala
- Department of Oncology, Turku University Hospital, University of Turku, 20521 Turku, Finland
| | - Ingrid M. Nijholt
- Department of Radiology, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Martijn F. Boomsma
- Department of Radiology, Isala Hospital, 8025 AB Zwolle, The Netherlands
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Clemens Bos
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Helena M. Verkooijen
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands
| | - Dirk Müller
- Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
| | - Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
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16
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Oerlemans LNT, Peeters CMM, Munnik-Hagewoud R, Nijholt IM, Witlox A, Verheyen CCPM. Foot orthoses for flexible flatfeet in children and adults: a systematic review and meta-analysis of patient-reported outcomes. BMC Musculoskelet Disord 2023; 24:16. [PMID: 36611153 PMCID: PMC9825043 DOI: 10.1186/s12891-022-06044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/30/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis examined the effectiveness of orthoses for flexible flatfeet in terms of patient-reported outcomes in children and adults. METHODS EMBASE, Medline (OvidSP), Web-of-Science, Scopus, CINAHL, Cochrane Central Register of Controlled Clinical Trials, i.e., Cochrane Central and Pubmed were searched to identify relevant studies since their inception up to February 2021. We included randomized controlled trials (RCT) and prospective studies in which patient reported outcomes at baseline and follow-up in an orthoses group were compared with a no orthoses or sham sole group. Methodological quality of the studies was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I). A meta-analysis was performed where there were multiple studies with the same outcome measures, which was the case for the Visual Analogue Scale (VAS) for pain in adults. RESULTS In total nine studies were included: four RCT in children (N = 353) and four RCT and one prospective study in adults (N = 268) were included. There was considerable heterogeneity between studies. A meta-analysis demonstrated that pain reduction between baseline and follow-up was significantly larger in the orthoses (N = 167) than in the control groups in adults (N = 157; - 4.76, 95% CI [- 9.46, - 0.06], p0.05). CONCLUSION Due to heterogeneity in study designs, we cannot conclude that foot orthoses are useful for flexible flatfoot in children and adults. However, based on the meta-analysis orthoses might be useful in decreasing pain in adults. The authors did not receive support from any organization for the submitted work.
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Affiliation(s)
- Leonoor N. T. Oerlemans
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Charles M. M. Peeters
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands ,grid.4494.d0000 0000 9558 4598Department of Orthopaedics, University Medical Center of Groningen, Groningen, The Netherlands
| | - Roelina Munnik-Hagewoud
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Innovation and Science, Isala Hospital, Zwolle, The Netherlands
| | - Ingrid M. Nijholt
- grid.452600.50000 0001 0547 5927Department of Innovation and Science, Isala Hospital, Zwolle, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology and Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
| | - Adhiambo Witlox
- grid.412966.e0000 0004 0480 1382Department of Orthopaedics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Cees C. P. M. Verheyen
- grid.452600.50000 0001 0547 5927Department of Orthopaedics, Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands ,grid.4494.d0000 0000 9558 4598Department of Orthopaedics, University Medical Center of Groningen, Groningen, The Netherlands
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Slotman DJ, Bartels MMTJ, Ferrer CJ, Bos C, Bartels LW, Boomsma MF, Phernambucq ECJ, Nijholt IM, Morganti AG, Siepe G, Buwenge M, Grüll H, Bratke G, Yeo SY, Blanco Sequeiros R, Minn H, Huhtala M, Napoli A, De Felice F, Catalano C, Bazzocchi A, Gasperini C, Campanacci L, Simões Corrêa Galendi J, Müller D, Braat MNGJA, Moonen C, Verkooijen HM. Focused Ultrasound and RadioTHERapy for non-invasive palliative pain treatment in patients with bone metastasis: a study protocol for the three armed randomized controlled FURTHER trial. Trials 2022; 23:1061. [PMID: 36582001 PMCID: PMC9798627 DOI: 10.1186/s13063-022-06942-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cancer-induced bone pain (CIBP), caused by bone metastases, is a common complication of cancer and strongly impairs quality of life (QoL). External beam radiotherapy (EBRT) is the current standard of care for treatment of CIBP. However, approximately 45% of patients have no adequate pain response after EBRT. Magnetic resonance image-guided high-intensity focused ultrasound (MR-HIFU) may improve pain palliation in this patient population. The main objective of this trial was to compare MR-HIFU, EBRT, and MR-HIFU + EBRT for the palliative treatment of bone metastases. METHODS/DESIGN The FURTHER trial is an international multicenter, three-armed randomized controlled trial. A total of 216 patients with painful bone metastases will be randomized in a 1:1:1 ratio to receive EBRT only, MR-HIFU only, or combined treatment with EBRT followed by MR-HIFU. During a follow-up period of 6 months, patients will be contacted at eight time points to retrieve information about their level of pain, QoL, and the occurrence of (serious) adverse events. The primary outcome of the trial is pain response at 14 days after start of treatment. Secondary outcomes include pain response at 14 days after trial enrolment, pain scores (daily until the 21st day and at 4, 6, 12 and 24 weeks), toxicity, adverse events, QoL, and survival. Cost-effectiveness and cost-utility analysis will be conducted. DISCUSSION The FURTHER trial aims to evaluate the effectiveness and cost-effectiveness of MR-HIFU-alone or in combination with EBRT-compared to EBRT to relieve CIBP. The trial will be performed in six hospitals in four European countries, all of which are partners in the FURTHER consortium. TRIAL REGISTRATION The FURTHER trial is registered under the Netherlands Trials Register number NL71303.041.19 and ClinicalTrials.gov registration number NCT04307914. Date of trial registration is 13-01-2020.
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Affiliation(s)
- Derk J. Slotman
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Marcia M. T. J. Bartels
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cyril J. Ferrer
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Clemens Bos
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lambertus W. Bartels
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Martijn F. Boomsma
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Erik C. J. Phernambucq
- grid.452600.50000 0001 0547 5927Department of Radiation Oncology, Isala Hospital, Zwolle, The Netherlands
| | - Ingrid M. Nijholt
- grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Alessio G. Morganti
- grid.6292.f0000 0004 1757 1758DIMES, Alma Mater Studiorum - Bologna University, Bologna, Italy ,grid.6292.f0000 0004 1757 1758Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giambattista Siepe
- grid.6292.f0000 0004 1757 1758Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Milly Buwenge
- grid.6292.f0000 0004 1757 1758DIMES, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Holger Grüll
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Grischa Bratke
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sin Yuin Yeo
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roberto Blanco Sequeiros
- grid.410552.70000 0004 0628 215XDepartment of Radiology, Turku University Hospital, Turku, Finland
| | - Heikki Minn
- grid.1374.10000 0001 2097 1371Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Mira Huhtala
- grid.1374.10000 0001 2097 1371Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Alessandro Napoli
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca De Felice
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alberto Bazzocchi
- grid.419038.70000 0001 2154 6641Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- grid.419038.70000 0001 2154 6641Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Laura Campanacci
- grid.419038.70000 0001 2154 66413Rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Julia Simões Corrêa Galendi
- grid.6190.e0000 0000 8580 3777Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Dirk Müller
- grid.6190.e0000 0000 8580 3777Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Manon N. G. J. A. Braat
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Chrit Moonen
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Helena M. Verkooijen
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
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18
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Slotman DJ, Bartels LW, Zijlstra A, Verpalen IM, van Osch JAC, Nijholt IM, Heijman E, van 't Veer-Ten Kate M, de Boer E, van den Hoed RD, Froeling M, Boomsma MF. Diffusion-weighted MRI with deep learning for visualizing treatment results of MR-guided HIFU ablation of uterine fibroids. Eur Radiol 2022; 33:4178-4188. [PMID: 36472702 DOI: 10.1007/s00330-022-09294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES No method is available to determine the non-perfused volume (NPV) repeatedly during magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablations of uterine fibroids, as repeated acquisition of contrast-enhanced T1-weighted (CE-T1w) scans is inhibited by safety concerns. The objective of this study was to develop and test a deep learning-based method for translation of diffusion-weighted imaging (DWI) into synthetic CE-T1w scans, for monitoring MR-HIFU treatment progression. METHODS The algorithm was retrospectively trained and validated on data from 33 and 20 patients respectively who underwent an MR-HIFU treatment of uterine fibroids between June 2017 and January 2019. Postablation synthetic CE-T1w images were generated by a deep learning network trained on paired DWI and reference CE-T1w scans acquired during the treatment procedure. Quantitative analysis included calculation of the Dice coefficient of NPVs delineated on synthetic and reference CE-T1w scans. Four MR-HIFU radiologists assessed the outcome of MR-HIFU treatments and NPV ratio based on the synthetic and reference CE-T1w scans. RESULTS Dice coefficient of NPVs was 71% (± 22%). The mean difference in NPV ratio was 1.4% (± 22%) and not statistically significant (p = 0.79). Absolute agreement of the radiologists on technical treatment success on synthetic and reference CE-T1w scans was 83%. NPV ratio estimations on synthetic and reference CE-T1w scans were not significantly different (p = 0.27). CONCLUSIONS Deep learning-based synthetic CE-T1w scans derived from intraprocedural DWI allow gadolinium-free visualization of the predicted NPV, and can potentially be used for repeated gadolinium-free monitoring of treatment progression during MR-HIFU therapy for uterine fibroids. KEY POINTS • Synthetic CE-T1w scans can be derived from diffusion-weighted imaging using deep learning. • Synthetic CE-T1w scans may be used for visualization of the NPV without using a contrast agent directly after MR-HIFU ablations of uterine fibroids.
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Affiliation(s)
- Derk J Slotman
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands.
- Imaging & Oncology Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Lambertus W Bartels
- Imaging & Oncology Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Aylene Zijlstra
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Inez M Verpalen
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Department of Radiology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Edwin Heijman
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
- Philips Research Eindhoven, High Tech Campus, Eindhoven, The Netherlands
| | | | - Erwin de Boer
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | | | - Martijn Froeling
- Imaging & Oncology Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
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19
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Dam-Vervloet AJ, de Boer FA, Nijholt IM, Poot L, Bosschaart N, van Straaten HLM. Quantification of cephalocaudal progression of jaundice in preterm infants. Pediatr Res 2022:10.1038/s41390-022-02396-y. [PMID: 36443401 DOI: 10.1038/s41390-022-02396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The cephalocaudal progression (CCP) of neonatal jaundice is a well-known phenomenon, but quantitative information on CCP in preterm infants is absent. In this study, CCP was quantified in preterm infants as a function of postnatal age and body location. METHODS 5.693 transcutaneous bilirubin (TcB) measurements were performed in 101 preterm infants from birth until postnatal day seven at five body locations (forehead, sternum, hipbone, tibia, ankle). Multi-level linear regression analysis was performed to evaluate the CCP as a function of body location and postnatal age. TcB measurements at all body locations and postnatal days were compared to total serum bilirubin (TSB) levels (N = 1.113). RESULTS The overall average change in ratio of TcB compared to forehead was for sternum +0.04 [95% CI -0.02;0.09]; hipbone +0.05 [0.00;0.01]; tibia -0.33 [-0.38;-0.27] and ankle -0.62 [-0.68;-0.57]. No effect modification of CCP by sex, gestational age, birthweight, phototherapy, and TSB was found. The TcB maximally underestimated the TSB at the ankle -79.5 µmol [-0.1;159.2]. CONCLUSIONS CCP is present in preterm infants and is relatively stable over time. Since TcB measurements on the tibia and ankle underestimate TSB significantly, we advise to use only measurement locations cephalic from the tibia; i.e., hipbone, sternum, and forehead. IMPACT Cephalocaudal progression (CCP) of jaundice in preterm infants, assessed by transcutaneous bilirubin (TcB) measurements, is substantial and rather stable over postnatal day 0 to 7. To the best of our knowledge, this study is the first to investigate CCP of jaundice in preterm infants as a function of postnatal age in preterm infants. Our results demonstrate that TcB measurements at the tibia and ankle differ from the TSB beyond the clinically used TcB safety margins. We advise to perform TcB measurements only at locations cephalic from the tibia; i.e., hipbone, forehead, and sternum.
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Affiliation(s)
- Alida J Dam-Vervloet
- Medical Physics Department, Isala Hospital, Zwolle, The Netherlands. .,Biomedical Photonic Imaging group, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | | | - Ingrid M Nijholt
- Innovation & Science Department, Isala Hospital, Zwolle, The Netherlands.,Radiology Department, Isala Hospital, Zwolle, The Netherlands
| | - Lieke Poot
- Medical Physics Department, Isala Hospital, Zwolle, The Netherlands
| | - Nienke Bosschaart
- Biomedical Photonic Imaging group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
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20
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Ridha H, de Vries RPH, Nijholt IM, Abbes S, Boomsma MF, Nijveldt RJ. Positive predictive value of ultrasound in correctly identifying an inguinal hernia: a single-centered retrospective pilot study. Insights Imaging 2022; 13:133. [PMID: 35962881 PMCID: PMC9375801 DOI: 10.1186/s13244-022-01272-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 07/20/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives To determine the clinical utility of preoperative ultrasound imaging for predicting an inguinal hernia in need of surgery. In addition, we aimed to identify factors associated with false positive (FP) ultrasound examinations. Methods In this retrospective pilot study, we included all 175 patients who underwent inguinal hernia surgery in our hospital in 2019 and of whom a positive preoperative ultrasound examination of the groin area was available. The positive predictive value (PPV) of the ultrasound examination was determined using inguinal hernia detected during surgery (yes/no) as golden standard. To identify possible predictive factors, we compared the characteristics of patients with a FP ultrasound with patients with a true positive (TP) ultrasound.
Results PPV of ultrasound examinations to identify an inguinal hernia in need of surgery correctly was 90.9% (159/175). The patients with a FP ultrasound examination had a significantly higher body mass index (BMI) than the patients with a TP ultrasound examination (27.6 ± 4.2 vs 25.8 ± 2.3, p = 0.043).
Conclusions With a false positive percentage of 9.1%, there is still room for improvement of preoperative diagnostic imaging. Studies with larger cohorts are necessary to establish prediction models that have the potential to reduce FP ultrasound results.
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Affiliation(s)
- Heroo Ridha
- Department of Radiology, Isala, Zwolle, The Netherlands. .,Department of Surgery, Isala, Zwolle, The Netherlands.
| | - Roelof P H de Vries
- Department of Radiology, Isala, Zwolle, The Netherlands.,Department of Surgery, Isala, Zwolle, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala, Zwolle, The Netherlands.,Department of Innovation and Science, Isala, Zwolle, The Netherlands
| | - Saskia Abbes
- Department of Innovation and Science, Isala, Zwolle, The Netherlands
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21
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Krüse-Ruijter MF, Boswinkel V, Consoli A, Nijholt IM, Boomsma MF, de Vries LS, van Wezel-Meijler G, Leijser LM. Neurological Surveillance in Moderate-Late Preterm Infants—Results from a Dutch–Canadian Survey. Children 2022; 9:children9060846. [PMID: 35740783 PMCID: PMC9221620 DOI: 10.3390/children9060846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
Preterm birth remains an important cause of abnormal neurodevelopment. While the majority of preterm infants are born moderate-late preterm (MLPT; 32–36 weeks), international and national recommendations on neurological surveillance in this population are lacking. We conducted an observational quantitative survey among Dutch and Canadian neonatal level I–III centres (June 2020–August 2021) to gain insight into local clinical practices on neurological surveillance in MLPT infants. All centres caring for MLPT infants designated one paediatrician/neonatologist to complete the survey. A total of 85 out of 174 (49%) qualifying neonatal centres completed the survey (60 level I–II and 25 level III centres). Admission of MLPT infants was based on infant-related criteria in 78/85 (92%) centres. Cranial ultrasonography to screen the infant’s brain for abnormalities was routinely performed in 16/85 (19%) centres, while only on indication in 39/85 (46%). In 57/85 (67%) centres, neurological examination was performed at least once during admission. Of 85 centres, 51 (60%) followed the infants’ development post-discharge, with follow-up duration ranging from 1–52 months of age. The survey showed a wide variety in neurological surveillance in MLPT infants among Dutch and Canadian neonatal centres. Given the risk for short-term morbidity and long-term neurodevelopmental disabilities, future studies are required to investigate best practices for in-hospital care and follow-up of MLPT infants.
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Affiliation(s)
- Martine F. Krüse-Ruijter
- Department of Neonatology, Isala Women and Children’s Hospital, 8025 AB Zwolle, The Netherlands; (M.F.K.-R.); (V.B.); (G.v.W.-M.)
| | - Vivian Boswinkel
- Department of Neonatology, Isala Women and Children’s Hospital, 8025 AB Zwolle, The Netherlands; (M.F.K.-R.); (V.B.); (G.v.W.-M.)
| | - Anna Consoli
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Ingrid M. Nijholt
- Department of Innovation & Science, Isala Hospital, 8025 AB Zwolle, The Netherlands;
- Department of Radiology, Isala Hospital, 8025 AB Zwolle, The Netherlands;
| | - Martijn F. Boomsma
- Department of Radiology, Isala Hospital, 8025 AB Zwolle, The Netherlands;
| | - Linda S. de Vries
- Department of Neonatology, University Medical Center, 3584 EA Utrecht, The Netherlands;
| | - Gerda van Wezel-Meijler
- Department of Neonatology, Isala Women and Children’s Hospital, 8025 AB Zwolle, The Netherlands; (M.F.K.-R.); (V.B.); (G.v.W.-M.)
| | - Lara M. Leijser
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
- Correspondence:
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22
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van der Kolk BBY, Slotman DJ, Nijholt IM, van Osch JA, Snoeijink TJ, Podlogar M, A.A.M. van Hasselt B, Boelhouwers HJ, van Stralen M, Seevinck PR, Schep NW, Maas M, Boomsma MF. Bone visualization of the cervical spine with deep learning-based synthetic CT compared to conventional CT: a single-center noninferiority study on image quality. Eur J Radiol 2022; 154:110414. [DOI: 10.1016/j.ejrad.2022.110414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/13/2022] [Indexed: 11/03/2022]
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23
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Verschuur AS, Boswinkel V, Tax CM, Osch JA, Nijholt IM, Slump CH, Vries LS, Wezel‐Meijler G, Leemans A, Boomsma MF. Improved neonatal brain MRI segmentation by interpolation of motion corrupted slices. J Neuroimaging 2022; 32:480-492. [PMID: 35253956 PMCID: PMC9314603 DOI: 10.1111/jon.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Anouk S. Verschuur
- Department of Radiology Isala Zwolle The Netherlands
- Image Sciences Institute University Medical Center Utrecht Utrecht The Netherlands
| | - Vivian Boswinkel
- Women and Children's Hospital Isala Zwolle The Netherlands
- UMC Utrecht Brain Center Utrecht University Utrecht The Netherlands
| | - Chantal M.W. Tax
- Image Sciences Institute University Medical Center Utrecht Utrecht The Netherlands
- Cardiff University Brain Research Imaging Centre Cardiff UK
| | | | | | - Cornelis H. Slump
- Department of Robotics and Mechatronics University of Twente Enschede The Netherlands
| | - Linda S. Vries
- Department of Neonatology Wilhelmina Children's Hospital Utrecht The Netherlands
| | | | - Alexander Leemans
- Image Sciences Institute University Medical Center Utrecht Utrecht The Netherlands
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24
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van der Kolk B(BY, van den Wittenboer G(GJ, Warringa N, Nijholt IM, van Hasselt BA, Buijteweg LN, Schep NW, Maas M, Boomsma MF. Assessment of cervical spine CT scans by emergency physicians: A comparative diagnostic accuracy study in a non-clinical setting. J Am Coll Emerg Physicians Open 2022; 3:e12609. [PMID: 35079729 PMCID: PMC8776040 DOI: 10.1002/emp2.12609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/04/2021] [Accepted: 10/28/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To determine and compare the diagnostic accuracy of assessing injuries on cervical spine computed tomography (CT) scans by trained emergency physicians and radiologists, both in a non-clinical setting. METHODS In this comparative diagnostic accuracy study, 411 cervical spine CT scans, of which 120 contained injuries (fractures and/or dislocations), were divided into 8 subsets. Eight emergency physicians received focused training and assessed 1 subset each before and after training. Four radiologists assessed 2 subsets each. Diagnostic accuracy between both groups was compared. The reference standard used was a multiverified data set, assessed by radiologists, neurosurgeons, and emergency physicians. The neurosurgeons also classified whether an "injury in need of stabilizing therapy" (IST) was present. RESULTS Posttraining, the emergency physicians demonstrated increased sensitivity and specificity for identifying cervical spine injuries compared to pretraining: sensitivity 88% (95% confidence interval [CI] 80% to 93%) versus 80% (95% CI 72% to 87%) and specificity 89% (95% CI 85% to 93%) versus 86% (95% CI 81% to 89%). When comparing the trained emergency physicians to the group of radiologists, no difference in sensitivity was found, 88% (95% CI 80% to 83%); however, the radiologists showed a significantly higher specificity (P < 0.01): 99% (95% CI 96% to 100%). In the 12% (15 scans) with missed injuries, emergency physicians missed more ISTs than radiologists, 6 versus 4 scans; however, this difference was not significant (P = 0.45). CONCLUSION After focused training and in a non-clinical setting, no significant difference was found between emergency physicians and radiologists in ruling out cervical spine injuries; however, the radiologists achieved a significantly higher specificity.
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Affiliation(s)
- Brigitta (Britt) Y.M. van der Kolk
- Department of Emergency MedicineIsalaZwolleThe Netherlands
- Department of Radiology and Nuclear MedicineIsalaZwolleThe Netherlands
- Department of Radiology and Nuclear MedicineAmsterdam University Medical Centers, location Academic Medical CenterAmsterdamThe Netherlands
| | | | - Niek Warringa
- Department of Radiology and Nuclear MedicineIsalaZwolleThe Netherlands
| | - Ingrid M. Nijholt
- Department of Radiology and Nuclear MedicineIsalaZwolleThe Netherlands
| | | | | | - Niels W.L. Schep
- Department of Trauma SurgeryMaasstad HospitalRotterdamThe Netherlands
| | - Mario Maas
- Department of Radiology and Nuclear MedicineAmsterdam University Medical Centers, location Academic Medical CenterAmsterdamThe Netherlands
- Amsterdam Movement SciencesAmsterdamThe Netherlands
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25
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Anneveldt KJ, van ’t Oever HJ, Verpalen IM, Nijholt IM, Bartels W, Dijkstra JR, van den Hoed RD, van ’t Veer - ten Kate M, de Boer E, Veersema S, Huirne JA, Schutte JM, Boomsma MF. Increased MR-guided high intensity focused ultrasound (MR-HIFU) sonication efficiency of uterine fibroids after carbetocin administration. Eur J Radiol Open 2022; 9:100413. [PMID: 35340827 PMCID: PMC8942847 DOI: 10.1016/j.ejro.2022.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/01/2022] Open
Abstract
Purpose Method Results Conclusion Carbetocin administration resulted in more efficient MR-HIFU fibroid sonications. 16.7% of the women experienced mild side effects of carbetocin administration. Carbetocin may lead to a broader patient eligibility and reduced treatment times.
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26
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Anneveldt KJ, Verpalen IM, Nijholt IM, Dijkstra JR, van den Hoed RD, Van't Veer-Ten Kate M, de Boer E, van Osch JAC, Heijman E, Naber HR, Ista E, Franx A, Veersema S, Huirne JAF, Schutte JM, Boomsma MF. Lessons learned during implementation of MR-guided High-Intensity Focused Ultrasound treatment of uterine fibroids. Insights Imaging 2021; 12:188. [PMID: 34921657 PMCID: PMC8684568 DOI: 10.1186/s13244-021-01128-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although promising results have been reported for Magnetic Resonance image-guided High-Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids, this treatment is not yet widely implemented in clinical practice. During the implementation of a new technology, lessons are learned and an institutional learning-curve often has to be completed. The primary aim of our prospective cohort study was to characterize our learning-curve based on our clinical outcomes. Secondary aims included identifying our lessons learned during implementation of MR-HIFU on a technical, patient selection, patient counseling, medical specialists and organizational level. RESULTS Our first seventy patients showed significant symptom reduction and improvement of quality of life at 3, 6 and 12 months after MR-HIFU treatment compared to baseline. After the first 25 cases, a clear plateau phase was reached in terms of failed treatments. The median non-perfused volume percentage of these first 25 treatments was 44.6% (range: 0-99.7), compared to a median of 74.7% (range: 0-120.6) for the subsequent treatments. CONCLUSIONS Our findings describe the learning-curve during the implementation of MR-HIFU and include straightforward suggestions to shorten learning-curves for future users. Moreover, the lessons we learned on technique, patient selection, patient counseling, medical specialists and organization, together with the provided supplements, may be of benefit to other institutions aiming to implement MR-HIFU treatment of uterine fibroids. Trial registration ISRCTN14634593. Registered January 12, 2021-Retrospectively registered, https://www.isrctn.com/ISRCTN14634593 .
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Affiliation(s)
- K J Anneveldt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands. .,Department of Gynecology, Isala Hospital, Zwolle, The Netherlands.
| | - I M Verpalen
- Department of Radiology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - I M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - J R Dijkstra
- Department of Gynecology, Isala Hospital, Zwolle, The Netherlands
| | - R D van den Hoed
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | | | - E de Boer
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - J A C van Osch
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
| | - E Heijman
- Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany.,Department of Oncology, Philips Research Eindhoven, Eindhoven, The Netherlands
| | - H R Naber
- Department of Anesthesiology, Isala Hospital, Zwolle, The Netherlands
| | - E Ista
- Department of Internal Medicine, Section of Nursing Science, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A Franx
- Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - S Veersema
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J A F Huirne
- Department of Gynecology, Amsterdam University Medical Center, location AMC, Amsterdam, The Netherlands
| | - J M Schutte
- Department of Gynecology, Isala Hospital, Zwolle, The Netherlands
| | - M F Boomsma
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
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Anneveldt KJ, Nijholt IM, Schutte JM, Dijkstra JR, Frederix GWJ, Ista E, Verpalen IM, Veersema S, Huirne JAF, Hehenkamp WJK, Boomsma MF. Comparison of (Cost-)Effectiveness of Magnetic Resonance Image-Guided High-Intensity-Focused Ultrasound With Standard (Minimally) Invasive Fibroid Treatments: Protocol for a Multicenter Randomized Controlled Trial (MYCHOICE). JMIR Res Protoc 2021; 10:e29467. [PMID: 34821569 PMCID: PMC8663707 DOI: 10.2196/29467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Magnetic resonance image-guided high-intensity-focused ultrasound (MR-HIFU) is a rather new, noninvasive option for the treatment of uterine fibroids. It is safe, effective, and has a very short recovery time. However, a lack of prospectively collected data on long-term (cost-)effectiveness of the MR-HIFU treatment compared with standard uterine fibroid care prevents the MR-HIFU treatment from being reimbursed for this indication. Therefore, at this point, when conservative treatment for uterine fibroid symptoms has failed or is not accepted by patients, standard care includes the more invasive treatments hysterectomy, myomectomy, and uterine artery embolization (UAE). Primary outcomes of currently available data on MR-HIFU treatment often consist of technical outcomes, instead of patient-centered outcomes such as quality of life (QoL), and do not include the use of the latest equipment or most up-to-date treatment strategies. Moreover, data on cost-effectiveness are rare and seldom include data on a societal level such as productivity loss or use of painkillers. Because of the lack of reimbursement, broad clinical implementation has not taken place, nor is the proper role of MR-HIFU in uterine fibroid care sufficiently clear. OBJECTIVE The objective of our study is to determine the long-term (cost-)effectiveness of MR-HIFU compared with standard (minimally) invasive fibroid treatments. METHODS The MYCHOICE study is a national, multicenter, open randomized controlled trial with randomization in a 2:1 ratio to MR-HIFU or standard care including hysterectomy, myomectomy, and UAE. The sample size is 240 patients in total. Women are included when they are 18 years or older, in premenopausal stage, diagnosed with symptomatic uterine fibroids, conservative treatment has failed or is not accepted, and eligible for MR-HIFU. Primary outcomes of the study are QoL 24 months after treatment and costs of treatment including direct health care costs, loss of productivity, and patient costs. RESULTS Inclusion for the MYCHOICE study started in November 2020 and enrollment will continue until 2024. Data collection is expected to be completed in 2026. CONCLUSIONS By collecting data on the long-term (cost-)effectiveness of the MR-HIFU treatment in comparison to current standard fibroid care, we provide currently unavailable evidence about the proper place of MR-HIFU in the fibroid treatment spectrum. This will also facilitate reimbursement and inclusion of MR-HIFU in (inter)national uterine fibroid care guidelines. TRIAL REGISTRATION Netherlands Trial Register NL8863; https://www.trialregister.nl/trial/8863. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/29467.
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Affiliation(s)
- Kimberley J Anneveldt
- Department of Radiology, Isala Hospital, Zwolle, Netherlands.,Department of Gynecology, Isala Hospital, Zwolle, Netherlands
| | | | - Joke M Schutte
- Department of Gynecology, Isala Hospital, Zwolle, Netherlands
| | | | - Geert W J Frederix
- Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Erwin Ista
- Department of Internal Medicine, Section of Nursing Science, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Inez M Verpalen
- Department of Radiology, Amsterdam University Medical Center, Academic Medical Center, Amsterdam, Netherlands
| | - Sebastiaan Veersema
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Judith A F Huirne
- Department of Gynecology, Amsterdam University Medical Center, Academic Medical Center, Amsterdam, Netherlands.,Department of Gynecology, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, Netherlands
| | - Wouter J K Hehenkamp
- Department of Gynecology, Amsterdam University Medical Center, Academic Medical Center, Amsterdam, Netherlands
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Selles M, Stuivenberg VH, Wellenberg RHH, van de Riet L, Nijholt IM, van Osch JAC, van Hamersvelt RW, Leiner T, Boomsma MF. Quantitative analysis of metal artifact reduction in total hip arthroplasty using virtual monochromatic imaging and orthopedic metal artifact reduction, a phantom study. Insights Imaging 2021; 12:171. [PMID: 34817722 PMCID: PMC8613319 DOI: 10.1186/s13244-021-01111-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To quantify metal artifact reduction using 130 keV virtual monochromatic imaging (VMI) with and without orthopedic metal artifact reduction (O-MAR) in total hip arthroplasty. Methods Conventional polychromatic images and 130 keV VMI of a phantom with pellets representing bone with unilateral or bilateral prostheses were reconstructed with and without O-MAR on a dual-layer CT. Pellets were categorized as unaffected, mildly affected and severely affected. Results When 130 keV VMI with O-MAR was compared to conventional imaging with O-MAR, a relative metal artifact reduction in CT values, contrast-to-noise (CNR), signal-to-noise (SNR) and noise in mildly affected pellets (67%, 74%, 48%, 68%, respectively; p < 0.05) was observed but no significant relative metal artifact reduction in severely affected pellets. Comparison between 130 keV VMI without O-MAR and conventional imaging with O-MAR showed relative metal artifact reduction in CT values, CNR, SNR and noise in mildly affected pellets (92%, 72%, 38%, 51%, respectively; p < 0.05) but negative relative metal artifact reduction in CT values and noise in severely affected pellets (− 331% and -223%, respectively; p < 0.05), indicating aggravation of metal artifacts. Conclusion Overall, VMI of 130 keV with O-MAR provided the strongest metal artifact reduction. Supplementary Information The online version contains supplementary material available at 10.1186/s13244-021-01111-5.
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Affiliation(s)
- Mark Selles
- Department of Radiology, Isala, 8025 AB, Zwolle, The Netherlands.
| | | | - Ruud H H Wellenberg
- Department of Radiology, Amsterdam University Medical Centre, 1105 AZ, Amsterdam, The Netherlands
| | - Loes van de Riet
- Department of Radiology, Isala, 8025 AB, Zwolle, The Netherlands.,Department of Radiology, University Medical Centre Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala, 8025 AB, Zwolle, The Netherlands
| | | | | | - Tim Leiner
- Department of Radiology, University Medical Centre Utrecht, 3584 CX, Utrecht, The Netherlands
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Langius-Wiffen E, Nijholt IM, de Boer E, Nijboer-Oosterveld J, Huurman L, Rozema I, Walen S, van den Berg JWK, de Jong PA, Boomsma MF. Computer-aided Pulmonary Embolism Detection on Virtual Monochromatic Images Compared to Conventional CT Angiography. Radiology 2021; 301:420-422. [PMID: 34491128 DOI: 10.1148/radiol.2021204620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eline Langius-Wiffen
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Ingrid M Nijholt
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Erwin de Boer
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Jacqueline Nijboer-Oosterveld
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Lisa Huurman
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Ilse Rozema
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Stefan Walen
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Jan W K van den Berg
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Pim A de Jong
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
| | - Martijn F Boomsma
- From the Departments of Radiology (E.L.W., I.M.N., E.d.B., J.N.O., L.H., I.R., M.F.B.) and Pulmonology (S.W., J.W.K.v.d.B.), Isala Hospital, Dokter van Heesweg 2, 8025 AB Zwolle, the Netherlands; and Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands (P.A.d.J.)
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Anneveldt KJ, van 't Oever HJ, Nijholt IM, Dijkstra JR, Hehenkamp WJ, Veersema S, Huirne JAF, Schutte JM, Boomsma MF. Systematic review of reproductive outcomes after High Intensity Focused Ultrasound treatment of uterine fibroids. Eur J Radiol 2021; 141:109801. [PMID: 34116454 DOI: 10.1016/j.ejrad.2021.109801] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/10/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Myomectomy is currently the gold standard for the treatment of uterine fibroids in women who desire pregnancy. However, this surgical fibroid removal has a long convalescence. Promising alternatives may be non-invasive High Intensity Focused Ultrasound (HIFU) under either MRI (MR-HIFU) or ultrasound guidance (USgHIFU). In this systematic review, an overview is provided of reproductive outcomes after these two relatively new ablation techniques. METHOD A systematic literature search was performed to identify studies reporting reproductive outcomes after HIFU treatment of fibroids. Only peer reviewed, full papers were included. Outcomes included pregnancy-, live-birth- miscarriage and caesarian section rate, time to conceive, reported complications, and possible prognostic factors. RESULTS In total 21 studies were included. Fourteen studies reported 124 pregnancies after MR-HIFU. Two placenta previas and no uterus ruptures were reported. Pregnancy rates were only retrospectively collected and ranged between 7% and 36%. Miscarriage rate in the oldest and largest prospective registry was 39%. After USgHIFU 366 pregnancies were reported with one fetal intrauterine death, six placenta previas and no uterus ruptures. The only prospective study reported a pregnancy rate of 47% and a miscarriage rate of 11%. Possible prognostic factors like age were not available in most studies. CONCLUSIONS Based on the heterogeneous data currently available, reproductive outcomes after HIFU appear non-inferior to outcomes after the current standard of care. However, a (randomized) controlled trial comparing reproductive outcomes after HIFU and standard care is necessary to provide sufficient evidence on the preferred fibroid treatment for women with a pregnancy wish.
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Affiliation(s)
- Kimberley J Anneveldt
- Department of Radiology, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands; Department of Gynecology, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands.
| | - Heleen J van 't Oever
- Department of Emergency Medicine, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
| | - Jeroen R Dijkstra
- Department of Gynecology, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
| | - Wouter J Hehenkamp
- Department of Gynecology, Amsterdam University Medical Centre, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Sebastiaan Veersema
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - Judith A F Huirne
- Department of Gynecology, Amsterdam University Medical Centre, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Joke M Schutte
- Department of Gynecology, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala hospital, Dokter van Heesweg 2, 8025 AB, Zwolle, the Netherlands
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Boswinkel V, Nijboer-Oosterveld J, Nijholt IM, Edens MA, Mulder-de Tollenaer SM, Boomsma MF, de Vries LS, van Wezel-Meijler G. Corrigendum to "A systematic review on brain injury and altered brain development in moderate-late preterm infants" [Early Hum. Dev., 148 (2020) 105094]. Early Hum Dev 2021; 155:105226. [PMID: 33082067 DOI: 10.1016/j.earlhumdev.2020.105226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vivian Boswinkel
- Department of Neonatology, Isala Women and Children's Hospital, Zwolle, the Netherlands.
| | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands
| | - Mireille A Edens
- Department of Innovation and Science, Isala Hospital, Zwolle, the Netherlands
| | | | | | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
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Bartels MMTJ, Verpalen IM, Ferrer CJ, Slotman DJ, Phernambucq ECJ, Verhoeff JJC, Eppinga WSC, Braat MNGJA, van den Hoed RD, van 't Veer-Ten Kate M, de Boer E, Naber HR, Nijholt IM, Bartels LW, Bos C, Moonen CTW, Boomsma MF, Verkooijen HM. Combining radiotherapy and focused ultrasound for pain palliation of cancer induced bone pain; a stage I/IIa study according to the IDEAL framework. Clin Transl Radiat Oncol 2021; 27:57-63. [PMID: 33532631 PMCID: PMC7822778 DOI: 10.1016/j.ctro.2021.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
Combined treatment of EBRT and MR-HIFU is feasible and well tolerated by patients. Clinical outcomes of combined treatment of EBRT and MR-HIFU are promising. Superiority of combined treatment over standard EBRT needs to be evaluated in a comparative study.
Background Cancer induced bone pain (CIBP) strongly interferes with patient’s quality of life. Currently, the standard of care includes external beam radiotherapy (EBRT), resulting in pain relief in approximately 60% of patients. Magnetic Resonance guided High Intensity Focused Ultrasound (MR-HIFU) is a promising treatment modality for CIBP. Methods A single arm, R-IDEAL stage I/IIa study was conducted. Patients presenting at the department of radiation oncology with symptomatic bone metastases in the appendicular skeleton, as well as in the sacrum and sternum were eligible for inclusion. All participants underwent EBRT, followed by MR-HIFU within 4 days. Safety and feasibility were assessed, and pain scores were monitored for 4 weeks after completing the combined treatment. Results Six patients were enrolled. Median age was 67 years, median lesion diameter was 56,5 mm. In all patients it was logistically possible to plan and perform the MR-HIFU treatment within 4 days after EBRT. All patients tolerated the combined procedure well. Pain response was reported by 5 out of 6 patients at 7 days after completion of the combined treatment, and stabilized on 60% at 4 weeks follow up. No treatment related serious adverse events occurred. Conclusion This is the first study to combine EBRT with MR-HIFU. Our results show that combined EBRT and MR-HIFU in first-line treatment of CIBP is safe and feasible, and is well tolerated by patients. Superiority over standard EBRT, in terms of (time to) pain relief and quality of life need to be evaluated in comparative (randomized) study.
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Affiliation(s)
- Marcia M T J Bartels
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.,University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Inez M Verpalen
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Cyril J Ferrer
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Derk J Slotman
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Erik C J Phernambucq
- Isala Hospital, Department of Radiation Oncology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Joost J C Verhoeff
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Wietse S C Eppinga
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Manon N G J A Braat
- University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Rolf D van den Hoed
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | | | - Erwin de Boer
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Harry R Naber
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Ingrid M Nijholt
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Lambertus W Bartels
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Clemens Bos
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Chrit T W Moonen
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Martijn F Boomsma
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Helena M Verkooijen
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.,University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Boswinkel V, Krüse-Ruijter MF, Nijboer-Oosterveld J, Nijholt IM, Edens MA, Mulder-de Tollenaer SM, Smit-Wu MN, Boomsma MF, de Vries LS, van Wezel-Meijler G. Incidence of brain lesions in moderate-late preterm infants assessed by cranial ultrasound and MRI: The BIMP-study. Eur J Radiol 2020; 136:109500. [PMID: 33429207 DOI: 10.1016/j.ejrad.2020.109500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the incidence and characteristics of brain lesions in moderate-late preterm (MLPT) infants, born at 32-36 weeks' gestation using cranial ultrasound (cUS) and magnetic resonance imaging (MRI). METHODS Prospective cohort study carried out at Isala Women and Children's Hospital between August 2017 and November 2019. cUS was performed at postnatal day 3-4 (early-cUS), before discharge and repeated at term equivalent age (TEA) in MLPT infants born between 32+0 and 35+6 weeks' gestation. At TEA, MRI was also performed. Several brain lesions were assessed e.g. hemorrhages, white matter and deep gray matter injury. Brain maturation was visually evaluated. Lesions were classified as mild or moderate-severe. Incidences and confidence intervals were calculated. RESULTS 166 MLPT infants were included of whom 127 underwent MRI. One or more mild lesions were present in 119/166 (71.7 %) and moderate-severe lesions in 6/166 (3.6 %) infants on cUS and/or MRI. The most frequent lesions were signs suggestive of white matter injury: inhomogeneous echogenicity in 50/164 infants (30.5 %) at early-cUS, in 12/148 infants (8.1 %) at TEA-cUS and diffuse white matter signal changes (MRI) in 27/127 (23.5 %) infants. Cerebellar hemorrhage (MRI) was observed in 16/127 infants (12.6 %). Delayed maturation (MRI) was seen in 17/117 (13.4 %) infants. Small hemorrhages and punctate white matter lesions were more frequently detected on MRI than on cUS. CONCLUSIONS In MLPT infants mild brain lesions were frequently encountered, especially signs suggestive of white matter injury and small hemorrhages. Moderate-severe lesions were less frequently seen.
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Affiliation(s)
- Vivian Boswinkel
- Department of Neonatology, Isala Women and Children's Hospital, Zwolle, the Netherlands; University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
| | | | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, the Netherlands
| | - Mireille A Edens
- Department of Innovation and Science, Isala Hospital, Zwolle, the Netherlands
| | | | - Mei-Nga Smit-Wu
- Department of Pediatrics, Isala Women and Children's Hospital, Zwolle, the Netherlands
| | | | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
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Boswinkel V, Nijboer-Oosterveld J, Nijholt IM, Edens MA, Mulder-de Tollenaer SM, Boomsma MF, de Vries LS, van Wezel-Meijler G. A systematic review on brain injury and altered brain development in moderate-late preterm infants. Early Hum Dev 2020; 148:105094. [PMID: 32711341 DOI: 10.1016/j.earlhumdev.2020.105094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To provide a systematic review of brain injury and altered brain development in moderate-late preterm (MLPT) infants as compared to very preterm and term infants. STUDY DESIGN A systematic search in five databases was performed in January 2020. Original research papers on incidence of brain injury and papers using quantitative data on brain development in MLPT infants were selected. The Johanna Briggs Institute 'Critical Appraisal Checklist for Studies Reporting Prevalence Data' was used for quality appraisal. Data extraction included: imaging modality, incidences of brain injury, brain volumes, 2D-measurements and diffusivity values. RESULTS In total, 24 studies were eligible. Most studies had a moderate quality. Twenty studies reported on the incidence of brain injury in MLPT infants. The incidence of intraventricular hemorrhage (IVH) ranged from 0.0% to 23.5% and of white matter injury (WMI) from 0.5% to 10.8%. One study reported the incidence of arterial infarction (0.3%) and none of cerebellar hemorrhage. Eleven studies compared incidences of brain injury between MLPT infants and very preterm or term infants. Five studies reported signs of altered brain development in MLPT infants. CONCLUSIONS The incidences of IVH and WMI in MLPT infants varied widely between studies. Other abnormalities were sparsely reported. Evidence regarding a higher or lower incidence of brain injury in MLPT infants compared to very preterm or term infants is weak due to moderate methodological quality of reported studies. There is limited evidence suggesting a difference in brain development between MLPT and term infants.
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Affiliation(s)
- Vivian Boswinkel
- Department of Neonatology, Isala Women and Children's hospital, Zwolle, the Netherlands; University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
| | | | - Ingrid M Nijholt
- Department of Radiology, Isala hospital, Zwolle, the Netherlands
| | - Mireille A Edens
- Department of Innovation and Science, Isala hospital, Zwolle, the Netherlands
| | | | | | - Linda S de Vries
- Department of Neonatology, University Medical Center Utrecht, Utrecht, the Netherlands
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Verpalen IM, Anneveldt KJ, Vos PC, Edens MA, Heijman E, Nijholt IM, Dijkstra JR, Schutte JM, Franx A, Bartels LW, Moonen CTW, Boomsma MF. Use of multiparametric MRI to characterize uterine fibroid tissue types. MAGMA 2020; 33:689-700. [PMID: 32219676 DOI: 10.1007/s10334-020-00841-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/02/2020] [Accepted: 03/10/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although the biological characteristics of uterine fibroids (UF) have implications for therapy choice and effectiveness, there is limited MRI data about these characteristics. Currently, the Funaki classification and Scaled Signal Intensity (SSI) are used to predict treatment outcome but both screening-tools appear to be suboptimal. Therefore, multiparametric and quantitative MRI was studied to evaluate various biological characteristics of UF. METHODS 87 patients with UF underwent an MRI-examination. Differences between UF tissues and myometrium were investigated using T2-mapping, Apparent Diffusion Coefficient (ADC) maps with different b-value combinations, contrast-enhanced T1-weighted and T2-weighted imaging. Additionally, the Funaki classification and SSI were calculated. RESULTS Significant differences between myometrium and UF tissue in T2-mapping (p = 0.001), long-TE ADC low b-values (p = 0.002), ADC all b-values (p < 0.001) and high b-values (p < 0.001) were found. Significant differences between Funaki type 3 versus type 1 and 2 were observed in SSI (p < 0.001) and T2-values (p < 0.001). Significant correlations were found between SSI and T2-mapping (p < 0.001; ρs = 0.82), ADC all b-values (p = 0.004; ρs = 0.31), ADC high b-values (p < 0.001; ρs = 0.44) and long-TE ADC low b-values (p = 0.004; ρs = 0.31). CONCLUSIONS Quantitative MR-data allowed us to distinguish UF tissue from myometrium and to discriminate different UF tissue types and may, therefore, be a useful tool to predict treatment outcome/determine optimal treatment modality.
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Affiliation(s)
- Inez M Verpalen
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands.
| | - Kimberley J Anneveldt
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands
- Department of Gynecology, Isala, Zwolle, The Netherlands
| | - Pieter C Vos
- Oncology Solutions, Philips Research, Eindhoven, The Netherlands
| | - Mireille A Edens
- Department of Innovation and Science, Isala, Zwolle, The Netherlands
| | - Edwin Heijman
- Oncology Solutions, Philips Research, Eindhoven, The Netherlands
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands
| | | | - Joke M Schutte
- Department of Gynecology, Isala, Zwolle, The Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Lambertus W Bartels
- Imaging Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands
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Brand PLP, Rosingh HJ, Meijssen MAC, Nijholt IM, Dünnwald S, Prins J, Schönrock-Adema J. Reliability of residents' assessments of their postgraduate medical education learning environment: an observational study. BMC Med Educ 2019; 19:450. [PMID: 31796005 PMCID: PMC6892206 DOI: 10.1186/s12909-019-1874-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Even in anonymous evaluations of a postgraduate medical education (PGME) program, residents may be reluctant to provide an honest evaluation of their PGME program, because they fear embarrassment or repercussions from their supervisors if their anonymity as a respondent is endangered. This study was set up to test the hypothesis that current residents in a PGME program provide more positive evaluations of their PGME program than residents having completed it. We therefore compared PGME learning environment evaluations of current residents in the program to leaving residents having completed it. METHODS This observational study used data gathered routinely in the quality cycle of PGME programs at two Dutch teaching hospitals to test our hypothesis. At both hospitals, all current PGME residents are requested to complete the Scan of Postgraduate Education Environment Domains (SPEED) annually. Residents leaving the hospital after completion of the PGME program are also asked to complete the SPEED after an exit interview with the hospital's independent residency coordinator. All SPEED evaluations are collected and analysed anonymously. We compared the residents' grades (on a continuous scale ranging from 0 (poor) to 10 (excellent)) on the three SPEED domains (content, atmosphere, and organization of the program) and their mean (overall department grade) between current and leaving residents. RESULTS Mean (SD) overall SPEED department grades were 8.00 (0.52) for 287 current residents in 39 PGME programs and 8.07 (0.48) for 170 leaving residents in 39 programs. Neither the overall SPEED department grades (t test, p = 0.53, 95% CI for difference - 0.16 to 0.31) nor the department SPEED domain grades (MANOVA, F(3, 62) = 0.79, p = 0.51) were significantly different between current and leaving residents. CONCLUSIONS Residents leaving the program did not provide more critical evaluations of their PGME learning environment than current residents in the program. This suggests that current residents' evaluations of their postgraduate learning environment were not affected by social desirability bias or fear of repercussions from faculty.
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Affiliation(s)
- Paul L P Brand
- Isala Academy, Department of Medical Education and Faculty Development, Isala Hospital, Zwolle, the Netherlands.
- Center for Education Development and Research in Health Professions, University of Groningen and University Medical Centre, Groningen, the Netherlands.
| | - H Jeroen Rosingh
- Department of Ear, Nose and Throat Surgery, Isala Hospital, Zwolle, the Netherlands
| | | | - Ingrid M Nijholt
- Isala Academy, Department of Medical Education and Faculty Development, Isala Hospital, Zwolle, the Netherlands
| | - Saskia Dünnwald
- MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Jelle Prins
- Center for Education Development and Research in Health Professions, University of Groningen and University Medical Centre, Groningen, the Netherlands
- MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Johanna Schönrock-Adema
- Center for Education Development and Research in Health Professions, University of Groningen and University Medical Centre, Groningen, the Netherlands
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Verpalen IM, Anneveldt KJ, Nijholt IM, Schutte JM, Dijkstra JR, Franx A, Bartels LW, Moonen CT, Edens MA, Boomsma MF. Magnetic resonance-high intensity focused ultrasound (MR-HIFU) therapy of symptomatic uterine fibroids with unrestrictive treatment protocols: A systematic review and meta-analysis. Eur J Radiol 2019; 120:108700. [DOI: 10.1016/j.ejrad.2019.108700] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/02/2019] [Indexed: 12/29/2022]
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de Boer E, Nijholt IM, Jansen S, Edens MA, Walen S, van den Berg JWK, Boomsma MF. Optimization of pulmonary emphysema quantification on CT scans of COPD patients using hybrid iterative and post processing techniques: correlation with pulmonary function tests. Insights Imaging 2019; 10:102. [PMID: 31591646 PMCID: PMC6779684 DOI: 10.1186/s13244-019-0776-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 08/09/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives The aim of this study was to assess the effect of hybrid iterative reconstruction and post processing on emphysema quantification in low-dose CT scans of COPD patients using pulmonary function tests (PFT) as a reference. Methods CT scans of 23 COPD patients diagnosed with GOLD I or higher were reconstructed with iDose4 level 1 to 7 in IntelliSpace Portal (ISP) 6 and 7. ISP7 was used with and without specific denoising filter for COPD. The extent of emphysema was measured as percentage of lung voxels with attenuation < − 950 Hounsfield units (%LAA-950). The correlation between %LAA-950 and PFT, age, BMI, pack years, and the Clinical COPD Questionnaire (CCQ) and Medical Research Council dyspnea scale (MRC) was determined. Results Denoising significantly reduced %LAA-950 as was demonstrated by lower %LAA-950 in ISP7 with denoising filter and a significant reduction in %LAA-950 with higher iDose4 levels. All PFT except forced vital capacity (FVC) were significantly inversely correlated with %LAA-950. There was a trend toward a stronger correlation at higher iDose4 levels. %LAA-950 was also significantly correlated with BMI, GOLD class, and CCQ scores. Conclusions Our study showed that hybrid iterative reconstruction and use of post processing denoising can optimize the use of emphysema quantification in CT scans as a complimentary diagnostic tool to stage COPD in addition to PFT.
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Affiliation(s)
- E de Boer
- Department of Radiology, Isala hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - I M Nijholt
- Department of Radiology, Isala hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - S Jansen
- Department of Radiology, Isala hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - M A Edens
- Department of Innovation and Science, Isala hospital, Zwolle, The Netherlands
| | - S Walen
- Department of Pulmonology, Isala hospital, Zwolle, The Netherlands
| | | | - M F Boomsma
- Department of Radiology, Isala hospital, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
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Nijholt IM, Heldeweg MLA, Schönrock-Adema J, Brand PLP. [Need for a uniform clinical placement quality cycle]. Ned Tijdschr Geneeskd 2018; 162:D3069. [PMID: 30212026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate how quality control of clinical placements in the Netherlands is organised, which tools are available for this purpose, and what Dutch clinical placement students think about current clinical placement assessment. DESIGN Document analysis, literature search and questionnaire. METHOD In 2017, we asked all 8 medical schools to share their procedures and tools for assessing clinical placement quality with us. We searched various databases to find all published tools developed to measure clinical placement quality. In the same year, we also conducted a survey of 15 clinical placement students per school with questions about current and desired clinical placement assessment. RESULTS All 8 schools sent detailed information about clinical placement quality assessment contents and procedures. All schools indicated that they are cyclically measuring each clinical placement's quality using evaluations by the clinical placement students. Each school uses its own questionnaire, none of these questionnaires have been validated. Literature search only found two tools specifically developed for assessing clinical placement quality, none of which have been validated for the Dutch language and situation. Clinical placement students feel that not enough noticeable improvement actions are being taken as a result of their evaluations. They preferred a short, uniform questionnaire with questions about clinical placement content, atmosphere and organisation. CONCLUSION The quality cycle of clinical placements in the Netherlands could be improved with respect to uniformity and implementation of actions for improvement. There is a need for standardisation of the clinical placement quality cycle and for development of a validated Dutch measuring tool for this.
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Affiliation(s)
| | | | - Johanna Schönrock-Adema
- Onderwijsinstituut UMCG, Center for Education Development and Research in Health Professions, Groningen
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Dobos N, de Vries EF, Kema IP, Patas K, Prins M, Nijholt IM, Dierckx RA, Korf J, den Boer JA, Luiten PG, Eisel UL. The Role of Indoleamine 2,3-Dioxygenase in a Mouse Model of Neuroinflammation-Induced Depression. ACTA ACUST UNITED AC 2012; 28:905-15. [DOI: 10.3233/jad-2011-111097] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Nikoletta Dobos
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Erik F.J. de Vries
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Ido P. Kema
- Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Konstantinos Patas
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands
| | - Marloes Prins
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands
| | - Ingrid M. Nijholt
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands
| | - Rudi A. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Jakob Korf
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan A. den Boer
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | - Paul G.M. Luiten
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Ulrich L.M. Eisel
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands
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van Waarde A, Ramakrishnan NK, Rybczynska AA, Elsinga PH, Ishiwata K, Nijholt IM, Luiten PGM, Dierckx RA. The cholinergic system, sigma-1 receptors and cognition. Behav Brain Res 2011; 221:543-54. [PMID: 20060423 DOI: 10.1016/j.bbr.2009.12.043] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 12/26/2009] [Indexed: 12/31/2022]
Abstract
This article provides an overview of present knowledge regarding the relationship between the cholinergic system and sigma-1 receptors, and discusses potential applications of sigma-1 receptor agonists in the treatment of memory deficits and cognitive disorders. Sigma-1 receptors, initially considered as a subtype of the opioid family, are unique ligand-regulated molecular chaperones in the endoplasmatic reticulum playing a modulatory role in intracellular calcium signaling and in the activity of several neurotransmitter systems, particularly the cholinergic and glutamatergic pathways. Several central nervous system (CNS) drugs show high to moderate affinities for sigma-1 receptors, including acetylcholinesterase inhibitors (donepezil), antipsychotics (haloperidol, rimcazole), selective serotonin reuptake inhibitors (fluvoxamine, sertraline) and monoamine oxidase inhibitors (clorgyline). These compounds can influence cognitive functions both via their primary targets and by activating sigma-1 receptors in the CNS. Sigma-1 agonists show powerful anti-amnesic and neuroprotective effects in a large variety of animal models of cognitive dysfunction involving, among others (i) pharmacologic target blockade (with muscarinic or NMDA receptor antagonists or p-chloroamphetamine); (ii) selective lesioning of cholinergic neurons; (iii) CNS administration of β-amyloid peptides; (iv) aging-induced memory loss, both in normal and senescent-accelerated rodents; (v) neurodegeneration induced by toxic compounds (CO, trimethyltin, cocaine), and (vi) prenatal restraint stress.
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Affiliation(s)
- Aren van Waarde
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
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Ostroveanu A, van der Zee EA, Eisel ULM, Schmidt M, Nijholt IM. Exchange protein activated by cyclic AMP 2 (Epac2) plays a specific and time-limited role in memory retrieval. Hippocampus 2011; 20:1018-26. [PMID: 19739231 DOI: 10.1002/hipo.20700] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Knowledge on the molecular mechanisms involved in memory retrieval is limited due to the lack of tools to study this stage of the memory process. Here we report that exchange proteins activated by cAMP (Epac) play a surprisingly specific role in memory retrieval. Intrahippocampal injection of the Epac activator 8-pCPT-2'O-Me-cAMP was shown to improve fear memory retrieval in contextual fear conditioning whereas acquisition and consolidation were not affected. The retrieval enhancing effect of the Epac activator was even more prominent in the passive avoidance paradigm. Down-regulation of Epac2 expression in the hippocampal CA1 area impaired fear memory retrieval when the memory test was performed 72 h after training, but not when tested after 17 days. Our data thus identify an important time-limited role for hippocampal Epac2 signaling in cognition and opens new avenues to investigate the molecular mechanisms underlying memory retrieval.
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Affiliation(s)
- Anghelus Ostroveanu
- Department of Molecular Neurobiology, Graduate School of Behavioral and Cognitive Neurosciences, University of Groningen, The Netherlands
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Dolga AM, Terpolilli N, Kepura F, Nijholt IM, Knaus HG, D'Orsi B, Prehn JHM, Eisel ULM, Plant T, Plesnila N, Culmsee C. KCa2 channels activation prevents [Ca2+]i deregulation and reduces neuronal death following glutamate toxicity and cerebral ischemia. Cell Death Dis 2011; 2:e147. [PMID: 21509037 PMCID: PMC3122061 DOI: 10.1038/cddis.2011.30] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Exacerbated activation of glutamate receptor-coupled calcium channels and subsequent increase in intracellular calcium ([Ca2+]i) are established hallmarks of neuronal cell death in acute and chronic neurological diseases. Here we show that pathological [Ca2+]i deregulation occurring after glutamate receptor stimulation is effectively modulated by small conductance calcium-activated potassium (KCa2) channels. We found that neuronal excitotoxicity was associated with a rapid downregulation of KCa2.2 channels within 3 h after the onset of glutamate exposure. Activation of KCa2 channels preserved KCa2 expression and significantly reduced pathological increases in [Ca2+]i providing robust neuroprotection in vitro and in vivo. These data suggest a critical role for KCa2 channels in excitotoxic neuronal cell death and propose their activation as potential therapeutic strategy for the treatment of acute and chronic neurodegenerative disorders.
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Affiliation(s)
- A M Dolga
- Institut für Pharmakologie und Klinische Pharmazie, Fachbereich Pharmazie, Philipps-Universität Marburg, Marburg, Germany
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Affiliation(s)
- Ingrid M Nijholt
- Department of Molecular Neurobiology, University of Groningen, Groningen, The Netherlands.
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Granic I, Masman MF, (Kees) Mulder C, Nijholt IM, Naude PJ, de Haan A, Borbély E, Penke B, Luiten PG, Eisel UL. LPYFDa Neutralizes Amyloid-β-Induced Memory Impairment and Toxicity. ACTA ACUST UNITED AC 2010; 19:991-1005. [DOI: 10.3233/jad-2010-1297] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ivica Granic
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
| | - Marcelo F. Masman
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
| | | | - Ingrid M. Nijholt
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
- Department of Neuroscience, Section Anatomy, University Medical Center Groningen, The Netherlands
| | - Pieter J.W. Naude
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
- Department of Biological Psychiatry, University Medical Center Groningen, The Netherlands
| | - Ammerins de Haan
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
| | - Emöke Borbély
- Department of Medical Chemistry, University of Szeged, Szeged, Hungary
| | - Botond Penke
- Department of Medical Chemistry, University of Szeged, Szeged, Hungary
| | - Paul G.M. Luiten
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
- Department of Biological Psychiatry, University Medical Center Groningen, The Netherlands
| | - Ulrich L.M. Eisel
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
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Dolga AM, Granic I, Nijholt IM, Nyakas C, van der Zee EA, Luiten PGM, Eisel ULM. Pretreatment with lovastatin prevents N-methyl-D-aspartate-induced neurodegeneration in the magnocellular nucleus basalis and behavioral dysfunction. J Alzheimers Dis 2009; 17:327-36. [PMID: 19363269 DOI: 10.3233/jad-2009-1052] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Besides a beneficial cardiovascular effect, it was recently suggested that statins can also exert neuroprotective actions. In a previous study, we provided in vitro evidence that lovastatin treatment abates excitotoxic cell death in primary cortical neurons. Here, we investigated the neuroprotective effect of lovastatin in an in vivo mouse model. We found that administration of lovastatin (20 mg/kg) significantly protects cholinergic neurons and their cortical projections against N-methyl-D-aspartate (60 nmol)-induced cell death in the magnocellular nucleus basalis, a neuronal cell group that is characteristically affected in Alzheimer's disease. Furthermore, lovastatin-mediated neuroprotection was shown to be dependent on protein kinase B (PKB)/Akt signaling since treatment with the PKB/Akt inhibitor LY294002 blocked the lovastatin-induced neuroprotective effect. The loss of cholinergic neurons after the lesion in the magnocellular nucleus basalis resulted in memory impairment as tested in a passive avoidance paradigm. This was reverted by pre-lesion lovastatin treatment. From these studies we conclude that treatment with lovastatin may provide protection against neuronal injury in excitotoxic conditions associated with neurodegenerative diseases including Alzheimer's disease.
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Affiliation(s)
- Amalia M Dolga
- Department of Molecular Neurobiology, Graduate School of Behavioral and Cognitive Neurosciences, University of Groningen, Haren, The Netherlands
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Abstract
Inflammatory processes are a hallmark of many chronic diseases including Alzheimer's disease and diabetes mellitus. Fairly recent statistical evidence indicating that type 2 diabetes increases the risk of developing Alzheimer's disease has led to investigations of the potential common processes that could explain this relation. Here, we review the literature on how inflammation and the inducible nuclear factor NF-kappaB might be involved in both diabetes mellitus and Alzheimer's disease and whether these factors can link both diseases.
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Affiliation(s)
- Ivica Granic
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands
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Dolga AM, Granic I, Blank T, Knaus HG, Spiess J, Luiten PGM, Eisel ULM, Nijholt IM. TNF-alpha-mediates neuroprotection against glutamate-induced excitotoxicity via NF-kappaB-dependent up-regulation of K2.2 channels. J Neurochem 2008; 107:1158-67. [PMID: 18823372 DOI: 10.1111/j.1471-4159.2008.05701.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Previous studies have shown that tumor necrosis factor-alpha (TNF-alpha) induces neuroprotection against excitotoxic damage in primary cortical neurons via sustained nuclear factor-kappa B (NF-kappaB) activation. The transcription factor NF-kappaB can regulate the expression of small conductance calcium-activated potassium (K(Ca)) channels. These channels reduce neuronal excitability and as such may yield neuroprotection against neuronal overstimulation. In the present study we investigated whether TNF-alpha-mediated neuroprotective signaling is inducing changes in the expression of small conductance K(Ca) channels. Interestingly, the expression of K(Ca)2.2 channel was up-regulated by TNF-alpha treatment in a time-dependent manner whereas the expression of K(Ca)2.1 and K(Ca)2.3 channels was not altered. The increase in K(Ca)2.2 channel expression after TNF-alpha treatment was shown to be dependent on TNF-R2 and NF-kappaB activation. Furthermore, activation of small conductance K(Ca) channels by 6,7-dichloro-1H-indole-2,3-dione 3-oxime or cyclohexyl-[2-(3,5-dimethyl-pyrazol-1-yl)-6-methyl-pyrimidin-4-yl]-amine-induced neuroprotection against a glutamate challenge. Treatment with the small conductance K(Ca) channel blocker apamin or K(Ca)2.2 channel siRNA reverted the neuroprotective effect elicited by TNF-alpha. We conclude that treatment of primary cortical neurons with TNF-alpha leads to increased K(Ca)2.2 channel expression which renders neurons more resistant to excitotoxic cell death.
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Affiliation(s)
- Amalia M Dolga
- Department of Molecular Neurobiology, University of Groningen, Haren, The Netherlands.
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Murthy SRK, Teodorescu G, Nijholt IM, Dolga AM, Grissmer S, Spiess J, Blank T. Identification and characterization of a novel, shorter isoform of the small conductance Ca2+-activated K+channel SK2. J Neurochem 2008; 106:2312-21. [DOI: 10.1111/j.1471-4159.2008.05557.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nijholt IM, Ostroveanu A, Scheper WA, Penke B, Luiten PG, Van der Zee EA, Eisel UL. Inhibition of PKA anchoring to A-kinase anchoring proteins impairs consolidation and facilitates extinction of contextual fear memories. Neurobiol Learn Mem 2008; 90:223-9. [DOI: 10.1016/j.nlm.2008.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 03/13/2008] [Accepted: 03/17/2008] [Indexed: 10/22/2022]
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