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Smit MA, van Pelt GW, Dequeker EM, Al Dieri R, Tollenaar RA, van Krieken JHJ, Mesker WE. e-Learning for Instruction and to Improve Reproducibility of Scoring Tumor-Stroma Ratio in Colon Carcinoma: Performance and Reproducibility Assessment in the UNITED Study. JMIR Form Res 2021; 5:e19408. [PMID: 33739293 PMCID: PMC8122297 DOI: 10.2196/19408] [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: 04/17/2020] [Revised: 12/14/2020] [Accepted: 03/03/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The amount of stroma in the primary tumor is an important prognostic parameter. The tumor-stroma ratio (TSR) was previously validated by international research groups as a robust parameter with good interobserver agreement. OBJECTIVE The Uniform Noting for International Application of the Tumor-Stroma Ratio as an Easy Diagnostic Tool (UNITED) study was developed to bring the TSR to clinical implementation. As part of the study, an e-Learning module was constructed to confirm the reproducibility of scoring the TSR after proper instruction. METHODS The e-Learning module consists of an autoinstruction for TSR determination (instruction video or written protocol) and three sets of 40 cases (training, test, and repetition sets). Scoring the TSR is performed on hematoxylin and eosin-stained sections and takes only 1-2 minutes. Cases are considered stroma-low if the amount of stroma is ≤50%, whereas a stroma-high case is defined as >50% stroma. Inter- and intraobserver agreements were determined based on the Cohen κ score after each set to evaluate the reproducibility. RESULTS Pathologists and pathology residents (N=63) with special interest in colorectal cancer participated in the e-Learning. Forty-nine participants started the e-Learning and 31 (63%) finished the whole cycle (3 sets). A significant improvement was observed from the training set to the test set; the median κ score improved from 0.72 to 0.77 (P=.002). CONCLUSIONS e-Learning is an effective method to instruct pathologists and pathology residents for scoring the TSR. The reliability of scoring improved from the training to the test set and did not fall back with the repetition set, confirming the reproducibility of the TSR scoring method. TRIAL REGISTRATION The Netherlands Trial Registry NTR7270; https://www.trialregister.nl/trial/7072. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/13464.
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Affiliation(s)
- Marloes A Smit
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Gabi W van Pelt
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Elisabeth Mc Dequeker
- Department of Public Health and Primary Care, Biomedical Quality Assurance Research Unit, University of Leuven, Leuven, Belgium
| | | | - Rob Aem Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - J Han Jm van Krieken
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wilma E Mesker
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
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- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
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Wei BR, Halsey CH, Hoover SB, Puri M, Yang HH, Gallas BD, Lee MP, Chen W, Durham AC, Dwyer JE, Sánchez MD, Traslavina RP, Frank C, Bradley C, McGill LD, Esplin DG, Schaffer PA, Cramer SD, Lyle LT, Beck J, Buza E, Gong Q, Hewitt SM, Simpson RM. Agreement in Histological Assessment of Mitotic Activity Between Microscopy and Digital Whole Slide Images Informs Conversion for Clinical Diagnosis. Acad Pathol 2019; 6:2374289519859841. [PMID: 31321298 PMCID: PMC6628521 DOI: 10.1177/2374289519859841] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 03/08/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 01/27/2023] Open
Abstract
Validating digital pathology as substitute for conventional microscopy in diagnosis
remains a priority to assure effectiveness. Intermodality concordance studies typically
focus on achieving the same diagnosis by digital display of whole slide images and
conventional microscopy. Assessment of discrete histological features in whole slide
images, such as mitotic figures, has not been thoroughly evaluated in diagnostic practice.
To further gauge the interchangeability of conventional microscopy with digital display
for primary diagnosis, 12 pathologists examined 113 canine naturally occurring mucosal
melanomas exhibiting a wide range of mitotic activity. Design reflected diverse diagnostic
settings and investigated independent location, interpretation, and enumeration of mitotic
figures. Intermodality agreement was assessed employing conventional microscopy (CM40×),
and whole slide image specimens scanned at 20× (WSI20×) and at 40× (WSI40×) objective
magnifications. An aggregate 1647 mitotic figure count observations were available from
conventional microscopy and whole slide images for comparison. The intraobserver
concordance rate of paired observations was 0.785 to 0.801; interobserver rate was 0.784
to 0.794. Correlation coefficients between the 2 digital modes, and as compared to
conventional microscopy, were similar and suggest noninferiority among modalities,
including whole slide image acquired at lower 20× resolution. As mitotic figure counts
serve for prognostic grading of several tumor types, including melanoma, 6 of 8
pathologists retrospectively predicted survival prognosis using whole slide images,
compared to 9 of 10 by conventional microscopy, a first evaluation of whole slide image
for mitotic figure prognostic grading. This study demonstrated agreement of replicate
reads obtained across conventional microscopy and whole slide images. Hence, quantifying
mitotic figures served as surrogate histological feature with which to further credential
the interchangeability of whole slide images for primary diagnosis.
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Affiliation(s)
- Bih-Rong Wei
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, USA
| | - Charles H Halsey
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shelley B Hoover
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Munish Puri
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Howard H Yang
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Brandon D Gallas
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USA
| | - Maxwell P Lee
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Weijie Chen
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USA
| | - Amy C Durham
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer E Dwyer
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Melissa D Sánchez
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ryan P Traslavina
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Chad Frank
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Charles Bradley
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Paula A Schaffer
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Sarah D Cramer
- Cancer and Inflammation Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - L Tiffany Lyle
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jessica Beck
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth Buza
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Qi Gong
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USA
| | - Stephen M Hewitt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - R Mark Simpson
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Sasse J, Kant J, Cole BJ, Klein AP, Arsova B, Schlaepfer P, Gao J, Lewald K, Zhalnina K, Kosina S, Bowen BP, Treen D, Vogel J, Visel A, Watt M, Dangl JL, Northen TR. Multilab EcoFAB study shows highly reproducible physiology and depletion of soil metabolites by a model grass. New Phytol 2019. [PMID: 30585637 DOI: 10.1101/435818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
There is a dynamic reciprocity between plants and their environment: soil physiochemical properties influence plant morphology and metabolism, and root morphology and exudates shape the environment surrounding roots. Here, we investigate the reproducibility of plant trait changes in response to three growth environments. We utilized fabricated ecosystem (EcoFAB) devices to grow the model grass Brachypodium distachyon in three distinct media across four laboratories: phosphate-sufficient and -deficient mineral media allowed assessment of the effects of phosphate starvation, and a complex, sterile soil extract represented a more natural environment with yet uncharacterized effects on plant growth and metabolism. Tissue weight and phosphate content, total root length, and root tissue and exudate metabolic profiles were consistent across laboratories and distinct between experimental treatments. Plants grown in soil extract were morphologically and metabolically distinct, with root hairs four times longer than with other growth conditions. Further, plants depleted half of the metabolites investigated from the soil extract. To interact with their environment, plants not only adapt morphology and release complex metabolite mixtures, but also selectively deplete a range of soil-derived metabolites. The EcoFABs utilized here generated high interlaboratory reproducibility, demonstrating their value in standardized investigations of plant traits.
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Affiliation(s)
- Joelle Sasse
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Josefine Kant
- Institut für Bio- & Geowissenschaften, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52428, Jülich, Germany
| | - Benjamin J Cole
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Andrew P Klein
- Department of Biology, Howard Hughes Medical Institute, University of North Carolina Chapel Hill, 250 Bell Tower Drive, Chapel Hill, NC, 27599, USA
| | - Borjana Arsova
- Institut für Bio- & Geowissenschaften, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52428, Jülich, Germany
| | - Pascal Schlaepfer
- Institute of Molecular Plant Biology, ETH Zürich, Universitätsstrasse 2, 8092, Zürich, Switzerland
| | - Jian Gao
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Kyle Lewald
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Kateryna Zhalnina
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Suzanne Kosina
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Benjamin P Bowen
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Daniel Treen
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - John Vogel
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - Axel Visel
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
- School of Natural Sciences, University of California, Merced, CA, 95343, USA
| | - Michelle Watt
- Institut für Bio- & Geowissenschaften, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52428, Jülich, Germany
| | - Jeffery L Dangl
- Department of Biology, Howard Hughes Medical Institute, University of North Carolina Chapel Hill, 250 Bell Tower Drive, Chapel Hill, NC, 27599, USA
| | - Trent R Northen
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA, 94720, USA
- Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
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Sasse J, Kant J, Cole BJ, Klein AP, Arsova B, Schlaepfer P, Gao J, Lewald K, Zhalnina K, Kosina S, Bowen BP, Treen D, Vogel J, Visel A, Watt M, Dangl JL, Northen TR. Multilab EcoFAB study shows highly reproducible physiology and depletion of soil metabolites by a model grass. New Phytol 2019; 222:1149-1160. [PMID: 30585637 PMCID: PMC6519027 DOI: 10.1111/nph.15662] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/18/2018] [Indexed: 05/12/2023]
Abstract
There is a dynamic reciprocity between plants and their environment: soil physiochemical properties influence plant morphology and metabolism, and root morphology and exudates shape the environment surrounding roots. Here, we investigate the reproducibility of plant trait changes in response to three growth environments. We utilized fabricated ecosystem (EcoFAB) devices to grow the model grass Brachypodium distachyon in three distinct media across four laboratories: phosphate-sufficient and -deficient mineral media allowed assessment of the effects of phosphate starvation, and a complex, sterile soil extract represented a more natural environment with yet uncharacterized effects on plant growth and metabolism. Tissue weight and phosphate content, total root length, and root tissue and exudate metabolic profiles were consistent across laboratories and distinct between experimental treatments. Plants grown in soil extract were morphologically and metabolically distinct, with root hairs four times longer than with other growth conditions. Further, plants depleted half of the metabolites investigated from the soil extract. To interact with their environment, plants not only adapt morphology and release complex metabolite mixtures, but also selectively deplete a range of soil-derived metabolites. The EcoFABs utilized here generated high interlaboratory reproducibility, demonstrating their value in standardized investigations of plant traits.
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Affiliation(s)
- Joelle Sasse
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Josefine Kant
- Institut für Bio‐ & GeowissenschaftenForschungszentrum JülichWilhelm‐Johnen‐Straße52428JülichGermany
| | - Benjamin J. Cole
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Andrew P. Klein
- Department of BiologyHoward Hughes Medical InstituteUniversity of North Carolina Chapel Hill250 Bell Tower DriveChapel HillNC27599USA
| | - Borjana Arsova
- Institut für Bio‐ & GeowissenschaftenForschungszentrum JülichWilhelm‐Johnen‐Straße52428JülichGermany
| | - Pascal Schlaepfer
- Institute of Molecular Plant BiologyETH ZürichUniversitätsstrasse 28092ZürichSwitzerland
| | - Jian Gao
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Kyle Lewald
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Kateryna Zhalnina
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Suzanne Kosina
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Benjamin P. Bowen
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Daniel Treen
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - John Vogel
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
| | - Axel Visel
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
- School of Natural SciencesUniversity of CaliforniaMercedCA95343USA
| | - Michelle Watt
- Institut für Bio‐ & GeowissenschaftenForschungszentrum JülichWilhelm‐Johnen‐Straße52428JülichGermany
| | - Jeffery L. Dangl
- Department of BiologyHoward Hughes Medical InstituteUniversity of North Carolina Chapel Hill250 Bell Tower DriveChapel HillNC27599USA
| | - Trent R. Northen
- Lawrence Berkeley National Laboratory1 Cyclotron RoadBerkeleyCA94720USA
- Joint Genome Institute2800 Mitchell DriveWalnut CreekCA94598USA
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5
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Armbrecht G, Felsenberg D, Ganswindt M, Lunt M, Kaptoge SK, Abendroth K, Aroso Dias A, Bhalla AK, Cannata Andia J, Dequeker J, Eastell R, Hoszowski K, Lyritis G, Masaryk P, van Meurs J, Miazgowski T, Nuti R, Poór G, Redlund-Johnell I, Reid DM, Schatz H, Todd CJ, Woolf AD, Rivadeneira F, Javaid MK, Cooper C, Silman AJ, O'Neill TW, Reeve J. Degenerative inter-vertebral disc disease osteochondrosis intervertebralis in Europe: prevalence, geographic variation and radiological correlates in men and women aged 50 and over. Rheumatology (Oxford) 2017; 56:1189-1199. [PMID: 28398504 DOI: 10.1093/rheumatology/kex040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 01/26/2016] [Indexed: 11/14/2022] Open
Abstract
Objectives To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.
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Affiliation(s)
- Gabriele Armbrecht
- Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany
| | - Dieter Felsenberg
- Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany
| | - Melanie Ganswindt
- Department of Radiology and Nuclear Medicine, Free University, Berlin, Germany
| | - Mark Lunt
- NIHR Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, & Arthritis Research UK Centre for Epidemiology, Manchester, University of Manchester
| | - Stephen K Kaptoge
- Department of Public Health and Primary Care, Strangeways Research Laboratory, Cambridge, UK
| | | | | | - Ashok K Bhalla
- Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
| | | | - Jan Dequeker
- Rheumatology, University Hospital, Leuven, Belgium
| | - Richard Eastell
- Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | | | - George Lyritis
- Laboratory for the Research of Musculoskeletal System, University of Athens, Athens, Greece
| | - Pavol Masaryk
- Rheumatology, Institute of Rheumatic Diseases, Piestany, Slovakia
| | - Joyce van Meurs
- Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, Netherlands
| | - Tomasz Miazgowski
- Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Ranuccio Nuti
- Institute of Clinical Medicine, University of Siena, Siena, Italy
| | - Gyula Poór
- 1st Department of Rheumatology and Metabolic Osteology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | | | - David M Reid
- School of Medicine, Medical Science and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Helmut Schatz
- Rheumatology, Med Klinik & Polyklinik, Bochum, Germany
| | - Christopher J Todd
- School of Health Sciences, The University of Manchester, Oxford Road, Manchester
| | - Anthony D Woolf
- Institute of Health Care Research, Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, Royal Cornwall Hospital, Truro
| | - Fernando Rivadeneira
- Department of Epidemiology and Department of Internal Medicine, Erasmus University, Rotterdam, Netherlands
| | - Muhammad K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Cyrus Cooper
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Alan J Silman
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Terence W O'Neill
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
| | - Jonathan Reeve
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Musculo-skeletal Biomedical Research Unit, Botnar Research Centre, Oxford, UK
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Stankovic Z, Jung B, Collins J, Russe MF, Carr J, Euringer W, Stehlin L, Csatari Z, Strohm PC, Langer M, Markl M. Reproducibility study of four-dimensional flow MRI of arterial and portal venous liver hemodynamics: influence of spatio-temporal resolution. Magn Reson Med 2013; 72:477-84. [PMID: 24018798 DOI: 10.1002/mrm.24939] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 02/05/2013] [Revised: 08/01/2013] [Accepted: 08/08/2013] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate influence of variation in spatio-temporal resolution and scan-rescan reproducibility on three-dimensional (3D) visualization and quantification of arterial and portal venous (PV) liver hemodynamics at four-dimensional (4D) flow MRI. METHODS Scan-rescan reproducibility of 3D hemodynamic analysis of the liver was evaluated in 10 healthy volunteers using 4D flow MRI at 3T with three different spatio-temporal resolutions (2.4 × 2.0 × 2.4 mm(3), 61.2 ms; 2.5 × 2.0 × 2.4 mm(3), 81.6 ms; 2.6 × 2.5 × 2.6 mm(3), 80 ms) and thus different total scan times. Qualitative flow analysis used 3D streamlines and time-resolved particle traces. Quantitative evaluation was based on maximum and mean velocities, flow volume, and vessel lumen area in the hepatic arterial and PV systems. RESULTS 4D flow MRI showed good interobserver variability for assessment of arterial and PV liver hemodynamics. 3D flow visualization revealed limitations for the left intrahepatic PV branch. Lower spatio-temporal resolution resulted in underestimation of arterial velocities (mean 15%, P < 0.05). For the PV system, hemodynamic analyses showed significant differences in the velocities for intrahepatic portal vein vessels (P < 0.05). Scan-rescan reproducibility was good except for flow volumes in the arterial system. CONCLUSION 4D flow MRI for assessment of liver hemodynamics can be performed with low interobserver variability and good reproducibility. Higher spatio-temporal resolution is necessary for complete assessment of the hepatic blood flow required for clinical applications.
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Affiliation(s)
- Zoran Stankovic
- Department of Radiology, Northwestern University, Chicago, Illinois, USA; Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA; Department of Diagnostic Radiology and Medical Physics, University Medical Center Freiburg, Freiburg, Germany
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