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Busoni S, Bruzzi M, Giomi S, Poggiali C, Quattrocchi M, Betti M, D'Urso D, Fedeli L, Mazzoni LN, Paolucci M, Rossi F, Taddeucci A, Bettarini S, Tortoli P, Belli G, Bernardi L, Gasperi C, Campanella F. Surgeon eye lens dose monitoring in interventional neuroradiology, cardiovascular and radiology procedures. Phys Med 2022; 104:123-128. [PMID: 36401940 DOI: 10.1016/j.ejmp.2022.11.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This study investigated the radiation dose to surgeon eye lens for single procedure and normalised to exposure parameters for eight selected neuroradiology, cardiovascular and radiology interventional procedures. METHODS The procedures investigated were diagnostic study, Arteriovenous Malformations treatment (AVM) and aneurysm embolization for neuroradiology procedures, Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (CA-PTCA), Pacemaker and Implantable Cardioverter-Defibrillator implantation (PM-ICD), Endovascular Aortic Repair (EVAR) and Fenestrated Endovascular Aortic Repair (FEVAR) for cardiovascular and electrophysiology procedures. CT-guided lung biopsy was also monitored. All procedures were performed with table-mounted and ceiling-suspended shields (0.5 mm lead equivalent thickness), except for FEVAR and PM-ICD where only a table mounted shield was present, and CT-guided lung biopsy where no shield was used. Dose assessment was performed using a dosemeter positioned close to the most exposed eye of the surgeon, outside the protective eyewear. RESULTS The surgeon most exposed eye lens median Hp(3) equivalent dose for a single procedure, without protective eyewear contribution, was 18 μSv for neuroradiology diagnostic study, 62 μSv for AVM, 38 μSv for aneurysm embolization, 33 μSv for CA-PTCA, 39 μSv for PM-ICD, 49 μSv for EVAR, 2500 μSv for FEVAR, 153 μSv for CT-guided lung biopsy. CONCLUSIONS In interventional procedures, the 20 mSv/year dose limit for surgeon eye lens exposure might be exceeded if shields or protective eyewear are not used. Surgeon eye lens doses, normalised to single procedures and to exposure parameters, are a valuable tool for determining appropriate radiation protection measures and dedicated eye lens dosemeter assignment.
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Affiliation(s)
- S Busoni
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy.
| | - M Bruzzi
- Physics and Astronomy Department, University of Florence, Italy
| | - S Giomi
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy; Physics and Astronomy Department, University of Florence, Italy
| | - C Poggiali
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy; Physics and Astronomy Department, University of Florence, Italy
| | | | - M Betti
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - D D'Urso
- Health Physics Unit, AULSS 2 Marca Trevigiana, Italy
| | - L Fedeli
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - L N Mazzoni
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - M Paolucci
- Health Physics Unit, AUSL Umbria 2, Italy
| | - F Rossi
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - A Taddeucci
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - S Bettarini
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - P Tortoli
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - G Belli
- Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy
| | - L Bernardi
- Health Physics Unit, AUSL Toscana Centro, Italy
| | - C Gasperi
- Health Physics Unit, AUSL Toscana Sud-Est, Italy
| | - F Campanella
- Department of Medicine, Epidemiology, Workplace and Environmental Hygiene, INAIL, Italy
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Busoni S, Bock M, Chmelik M, Colgan N, De Bondt T, Hanson LG, Israel M, Kugel H, Maieron M, Mazzoni LN, Seimenis I, Vestergaard P. ADDENDUM to EFOMP Policy statement No.14 "The role of the Medical Physicist in the management of safety within the magnetic resonance imaging environment: EFOMP recommendations". Phys Med 2021; 89:303-305. [PMID: 34492497 DOI: 10.1016/j.ejmp.2021.07.017] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- S Busoni
- Medical Physics Department, Firenze University Hospital - AOU Careggi, Firenze, Italy.
| | - M Bock
- Radiology - Medical Physics Dpt., University Medical Center Freiburg, Freiburg, Germany
| | - M Chmelik
- Department of Technical Disciplines in Health Care, Faculty of Health Care, University of Prešov, Prešov, Slovakia
| | - N Colgan
- Galway University Hospital, National University of Ireland Galway, Galway, Ireland
| | - T De Bondt
- Vinçotte - Controlatom, Vilvoorde, Belgium; De Bondt Consulting BV, Antwerp, Belgium
| | - L G Hanson
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark; Section for Magnetic Resonance, DTU Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - M Israel
- Department of Hygiene, Medical Ecology and Professional Diseases, Medical University - Pleven, Bulgaria; Department of Physical Factors, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - H Kugel
- University Clinic for Radiology, University Hospital Muenster, Muenster, Germany
| | - M Maieron
- Health Physics Department, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - L N Mazzoni
- Health Physics Unit, AUSL Toscana Centro, Pistoia, Italy
| | - I Seimenis
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - P Vestergaard
- Indkøb & Medicoteknik, Region Midtjylland, Aarhus, Denmark
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Nardone V, Tini P, Carbone SF, Grassi A, Biondi M, Sebaste L, Carfagno T, Vanzi E, De Otto G, Battaglia G, Rubino G, Pastina P, Belmonte G, Mazzoni LN, Banci Buonamici F, Mazzei MA, Pirtoli L. Bone texture analysis using CT-simulation scans to individuate risk parameters for radiation-induced insufficiency fractures. Osteoporos Int 2017; 28:1915-1923. [PMID: 28243706 DOI: 10.1007/s00198-017-3968-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 02/13/2017] [Indexed: 12/29/2022]
Abstract
UNLABELLED This study deals with the role of texture analysis as a predictive factor of radiation-induced insufficiency fractures in patients undergoing pelvic radiation. INTRODUCTION This study aims to assess the texture analysis (TA) of computed tomography (CT) simulation scans as a predictive factor of insufficiency fractures (IFs) in patients with pelvic malignancies undergoing radiation therapy (RT). METHODS We performed an analysis of patients undergoing pelvic RT from January 2010 to December 2014, 24 of whom had developed pelvic bone IFs. We analyzed CT-simulation images using ImageJ macro software and selected two regions of interest (ROIs), which are L5 body and the femoral head. TA parameters included mean (m), standard deviation (SD), skewness (sk), kurtosis (k), entropy (e), and uniformity (u). The IFs patients were compared (1:2 ratio) with controlled patients who had not developed IFs and matched for sex, age, menopausal status, type of tumor, use of chemotherapy, and RT dose. A reliability test of intra- and inter-reader ROI TA reproducibility with the intra-class correlation coefficient (ICC) was performed. Univariate and multivariate analyses (logistic regression) were applied for TA parameters observed both in the IFs and the controlled groups. RESULTS Inter- and intra-reader ROI TA was highly reproducible (ICC > 0.90). Significant TA parameters on paired t test included L5 m (p = 0.001), SD (p = 0.002), k (p = 0.006), e (p = 0.004), and u (p = 0.015) and femoral head m (p < 0.001) and SD (p = 0.001), whereas on logistic regression analysis, L5 e (p = 0.003) and u (p = 0.010) and femoral head m (p = 0.027), SD (p = 0.015), and sex (p = 0.044). CONCLUSIONS In our experience, bone CT TA could be correlated to the risk of radiation-induced IFs. Studies on a large patient series and methodological refinements are warranted.
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Affiliation(s)
- V Nardone
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy.
| | - P Tini
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
| | - S F Carbone
- Unit of Diagnostic Imaging, University Hospital of Siena, Siena, Italy
| | - A Grassi
- Unit of Diagnostic Imaging, University Hospital of Siena, Siena, Italy
| | - M Biondi
- Unit of Medical Physics, University Hospital of Siena, Siena, Italy
| | - L Sebaste
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
| | - T Carfagno
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
| | - E Vanzi
- Unit of Medical Physics, University Hospital of Siena, Siena, Italy
| | - G De Otto
- Unit of Medical Physics, University Hospital of Siena, Siena, Italy
| | - G Battaglia
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
| | - G Rubino
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
| | - P Pastina
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
| | - G Belmonte
- Unit of Medical Physics, University Hospital of Siena, Siena, Italy
| | - L N Mazzoni
- Unit of Medical Physics, University Hospital of Siena, Siena, Italy
| | | | - M A Mazzei
- Unit of Diagnostic Imaging, University Hospital of Siena, Siena, Italy
| | - L Pirtoli
- Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy
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Biondi M, Vanzi E, De Otto G, Banci Buonamici F, Belmonte GM, Mazzoni LN, Guasti A, Carbone SF, Mazzei MA, La Penna A, Foderà E, Guerreri D, Maiolino A, Volterrani L. Water/cortical bone decomposition: A new approach in dual energy CT imaging for bone marrow oedema detection. A feasibility study. Phys Med 2016; 32:1712-1716. [PMID: 27524684 DOI: 10.1016/j.ejmp.2016.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 07/29/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Many studies aimed at validating the application of Dual Energy Computed Tomography (DECT) in clinical practice where conventional CT is not exhaustive. An example is given by bone marrow oedema detection, in which DECT based on water/calcium (W/Ca) decomposition was applied. In this paper a new DECT approach, based on water/cortical bone (W/CB) decomposition, was investigated. MATERIALS AND METHODS Eight patients suffering from marrow oedema were scanned with MRI and DECT. Two-materials density decomposition was performed in ROIs corresponding to normal bone marrow and oedema. These regions were drawn on DECT images using MRI informations. Both W/Ca and W/CB were considered as material basis. Scatter plots of W/Ca and W/CB concentrations were made for each ROI in order to evaluate if oedema could be distinguished from normal bone marrow. Thresholds were defined on the scatter plots in order to produce DECT images where oedema regions were highlighted through color maps. The agreement between these images and MR was scored by two expert radiologists. RESULTS For all the patients, the best scores were obtained using W/CB density decomposition. CONCLUSIONS In all cases, DECT color map images based on W/CB decomposition showed better agreement with MR in bone marrow oedema identification with respect to W/Ca decomposition. This result encourages further studies in order to evaluate if DECT based on W/CB decomposition could be an alternative technique to MR, which would be important when short scanning duration is relevant, as in the case of aged or traumatic patients.
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Affiliation(s)
- M Biondi
- Department of Medical Physics, University Hospital of Siena, Italy.
| | - E Vanzi
- Department of Medical Physics, University Hospital of Siena, Italy
| | - G De Otto
- Department of Medical Physics, University Hospital of Siena, Italy
| | | | - G M Belmonte
- Department of Medical Physics, University Hospital of Siena, Italy
| | - L N Mazzoni
- Department of Medical Physics, University Hospital of Siena, Italy
| | - A Guasti
- Department of Medical Physics, Azienda USL Toscana sud est, Italy
| | - S F Carbone
- Department of Diagnostic Imaging, University Hospital of Siena, Italy
| | - M A Mazzei
- Department of Medical, Surgical and Neurosciences, University of Siena, Italy
| | - A La Penna
- Department of Medical, Surgical and Neurosciences, University of Siena, Italy
| | - E Foderà
- Department of Medical, Surgical and Neurosciences, University of Siena, Italy
| | - D Guerreri
- Department of Diagnostic Imaging, University Hospital of Siena, Italy
| | - A Maiolino
- Department of Medical, Surgical and Neurosciences, University of Siena, Italy
| | - L Volterrani
- Department of Medical, Surgical and Neurosciences, University of Siena, Italy
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Mascalchi M, Mazzoni LN, Falchini M, Belli G, Picozzi G, Merlini V, Vella A, Diciotti S, Falaschi F, Lopes Pegna A, Paci E. Dose exposure in the ITALUNG trial of lung cancer screening with low-dose CT. Br J Radiol 2012; 85:1134-9. [PMID: 21976631 PMCID: PMC3587091 DOI: 10.1259/bjr/20711289] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 01/31/2011] [Revised: 06/02/2011] [Accepted: 06/13/2011] [Indexed: 12/19/2022] Open
Abstract
Few data are available on the effective dose received by participants in lung cancer screening programmes with low-dose CT (LDCT). We report the collective effective dose delivered to 1406 current or former smokers enrolled in the ITALUNG trial who completed 4 annual LDCT examinations and related further investigations including follow-up LDCT, 2-[(18)F]flu-2-deoxy-d-glucose positron emission tomography (FDG-PET) or CT-guided fine needle aspiration biopsy (FNAB). Using the air CT dose index and Monte Carlo simulations on an anthropomorphic phantom, the whole-body effective dose associated with LDCT was determined for the eight CT scanners used in the trial. A value of 7 mSv was assigned to FDG-PET while the measured mean effective dose of CT-guided FNAB was 1.5 mSv. The mean collective effective dose in the 1406 subjects ranged between 8.75 and 9.36 Sv and the mean effective dose to the single subject over 4 years was between 6.2 and 6.8 mSv (range 1.7-21.5 mSv) according to the cranial-caudal length of the LDCT volume. 77.4% of the dose was owing to annual LDCT and 22.6% to further investigations. Considering the nominal risk coefficients for stochastic effects after exposure to low-dose radiation according to the National Radiological Protection Board, International Commission on Radiological Protection (ICRP) 60, ICRP103 and Biological Effects of Ionizing Radiation VII, the mean number of radiation-induced cancers ranged between 0.12 and 0.33 per 1000 subjects. The individual effective dose to participants in a 4-year lung cancer screening programme with annual LDCT is very low and about one-third of the effective dose that is associated with natural background radiation and diagnostic radiology in the same time period.
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Affiliation(s)
- M Mascalchi
- Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
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Pasquinelli F, Belli G, Mazzoni LN, Regini F, Nardi C, Grazioli L, Zignego AL, Colagrande S. Erratum to: MR-diffusion imaging in assessing chronic liver diseases: does a clinical role exist? Radiol Med 2011. [DOI: 10.1007/s11547-011-0759-5] [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] [Indexed: 11/29/2022]
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Pasquinelli F, Belli G, Mazzoni LN, Regini F, Nardi C, Grazioli L, Zignego AL, Zignego AL, Colagrande S. MR-diffusion imaging in assessing chronic liver diseases: does a clinical role exist? Radiol Med 2011; 117:242-53. [PMID: 22020423 DOI: 10.1007/s11547-011-0730-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 03/23/2011] [Indexed: 12/13/2022]
Abstract
PURPOSE This study was done to evaluate whether and which of the magnetic resonance diffusion-weighted imaging (MR-DWI) parameters - apparent diffusion coefficient (ADC), diffusion (D) or perfusion fraction (f) - correlates with the degree of chronic liver disease progression. MATERIALS AND METHODS Twenty-eight patients were evaluated with abdominal MR-DWI from March to November 2010: seven healthy volunteers, seven patients with chronic liver disease F0-F2 (METAVIR score), seven F3-F4 Child-Pugh A, and seven F4 Child-Pugh BC, classified as groups 1-4, respectively. DWI acquisitions were performed during breath-holding (b = 0-150 s/mm(2) and 1,000) and free breathing (multi-b = 0-200-400-600-800-1,000 s/mm(2)). Using a double-blind control procedure, two observers estimated ADC, D, and f by applying a region of interest (ROI) in 4/12 sections in the middle-lower portion of the right hepatic lobe. Statistical analysis was done with analysis of variance (ANOVA). RESULTS A reduction in the mean value of f, ADC(150) and, to a lesser extent, ADC(1,000) is shown to progress from healthy volunteers (group 1) to cirrhosis patients (group 4), with wide overlap among groups. There were no statistically significant changes of D. CONCLUSIONS Our results indicate that stratifying patients with chronic liver disease for clinical purposes cannot be done with DWI. However, there is a tendency among groups for reduced perfusion-related parameters as chronic liver disease progresses.
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Affiliation(s)
- F Pasquinelli
- Department of Clinical Physiopathology, Section of Radiodiagnostics, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni 85, 50134, Florence, Italy
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Ginestroni A, Battaglini M, Diciotti S, Della Nave R, Mazzoni LN, Tessa C, Giannelli M, Piacentini S, De Stefano N, Mascalchi M. Magnetization transfer MR imaging demonstrates degeneration of the subcortical and cortical gray matter in Huntington disease. AJNR Am J Neuroradiol 2010; 31:1807-12. [PMID: 20813872 DOI: 10.3174/ajnr.a2225] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE GM is typically affected in HD since the presymptomatic stage. Our aim was to investigate with MT MR imaging the microstructural changes of the residual brain subcortical and cortical GM in carriers of the HD gene and to preliminarily assess their correlation with the clinical features. MATERIALS AND METHODS Fifteen HD gene carriers with a range of clinical severity and 15 age- and sex-matched healthy controls underwent MT MR imaging on a 1.5T scanner. The MT ratio was measured automatically in several subcortical and cortical GM regions (striatal nuclei; thalami; and the neocortex of the frontal, temporal, parietal, and occipital lobes) by using FLS tools. RESULTS The MT ratio was significantly (P < .05 with Bonferroni correction for multiple comparison) decreased in all subcortical structures except the putamen and decreased diffusely in the cerebral cortex of HD carriers compared with controls. Close correlation was observed between the subcortical and cortical regional MT ratios and several clinical variables, including disease duration, motor disability, and scores in timed neuropsychological tests. CONCLUSIONS MT imaging demonstrates degeneration of the subcortical and cortical GM in HD carriers and might serve, along with volumetric assessment, as a surrogate marker in future clinical trials of HD.
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Affiliation(s)
- A Ginestroni
- Department of Clinical Physiopathology, University of Florence, Italy
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Mazzoni LN, Belli G, Ginestroni A, Pratesi A, Agnoloni S, Diciotti S, Mascalchi M. Computation of brain metabolite ratios in single-voxel proton MR spectroscopy: comparison between semiautomatic and automatic software. Radiol Med 2009; 115:125-32. [PMID: 19562268 DOI: 10.1007/s11547-009-0408-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 11/03/2008] [Indexed: 12/26/2022]
Abstract
PURPOSE Metabolite ratios are the measurements most commonly utilised for clinical applications of brain proton magnetic resonance spectroscopy ((1)H-MRS) [1]. We evaluated the agreement between the metabolite ratios calculated with semiautomatic and automatic software. MATERIALS AND METHODS Two single-voxel spectra (3.375 ml) localised in the frontal grey matter (GM) and peritrigonal white matter (WM) were obtained in 20 healthy subjects by using a point-resolved proton spectroscopy sequence (PRESS, TE=144 ms). The spectra were processed using the semiautomatic software J-Magnetic Resonance User Interface (JMRUI) and the automatic software SpectroView. Agreement of the N-acetyl-aspartate (NAA)/creatine (Cr), NAA/choline (Cho) and Cho/Cr ratios calculated with the two methods was assessed by estimating the 95% limits of agreement (LAs) of the differences of the values obtained with the two software packages. RESULTS Mean values and standard deviations of NAA/Cr, Cho/Cr and NAA/Cho (semiautomatic//automatic software) were 1.99+/-0.53//1.73+/-0.36, 1.13+/-0.40//1.04+/-0.33, 1.85+/-0.62//1.89+/-0.69 for the GM and 2.24+/-0.41//2.37+/-0.27, 0.96+/-0.17//1.13+/-0.15, 2.37+/-0.43//2.11+/-0.23 for the WM. The 95% LAs were wider for GM spectra and ranged between -0.51, 0.17 for Cho/Cr in the WM and -1.54, 1.47 for NAA/Cho in the GM. CONCLUSIONS The difference between brain metabolite ratios calculated with the two software packages is not negligible and reflects spectral quality.
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Affiliation(s)
- L N Mazzoni
- CIRM. University of Florence, Florence, Italy
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