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  • SAGE Publications  (5)
  • Medicine  (5)
  • 1
    Online Resource
    Online Resource
    Ultra-low dose dual-source high-pitch computed tomography of the paranasal sinus: diagnostic sensitivity and radiation dose
    SAGE Publications ; 2012
    In:  Acta Radiologica Vol. 53, No. 4 ( 2012-05), p. 435-440
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 53, No. 4 ( 2012-05), p. 435-440
    Abstract: Today's gold standard for diagnostic imaging of inflammatory diseases of the paranasal sinus is computed tomography (CT). Purpose To evaluate diagnostic sensitivity and radiation dose of an ultra-low dose dual-source CT technique. Material and Methods Paranasal sinuses of 14 cadaveric heads were independently evaluated by two readers using a modern dual-source CT with lowest reasonable dosage in high-pitch mode (100 kV, 10 mAs, collimation 0.6 mm, pitch value 3.0). Additionally the head part of an anthropomorphic Alderson-Rando phantom was equipped with thermoluminiscent detectors to measure radiation exposure to the eye lenses and thyroid gland. Results Diagnostic accuracy regarding sinusoidal fluid, nasal septum deviation, and mucosal swelling was 100%. Mastoid fluid was detected in 76% and 92%, respectively. In the phantom study, average measured eye lens dosage was 0.64 mGy; radiation exposure of the thyroid gland was 0.085 mGy. Conclusion Regarding evaluation of inflammatory diseases of the paranasal sinus this study indicates sufficient accuracy of the proposed CT protocol at a very low dosage level.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1258/ar.2012.110579
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2024579-8
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  • 2
    Online Resource
    Online Resource
    Comparison of the Nasal Release of IL-4, IL-10, IL-17, CCL13/MCP-4, and CCL26/eotaxin-3 in Allergic Rhinitis during Season and after Allergen Challenge
    SAGE Publications ; 2013
    In:  American Journal of Rhinology & Allergy Vol. 27, No. 4 ( 2013-07), p. 266-272
    Details
    In: American Journal of Rhinology & Allergy, SAGE Publications, Vol. 27, No. 4 ( 2013-07), p. 266-272
    Abstract: Allergic rhinitis is an inflammatory disease characterized by local overproduction of type 2 cytokines and tissue eosinophilia. Recent research suggests the involvement of additional cytokines such as IL-17, chemokine (C-C motif) ligand (CCL) 26/eotaxin-3, and CCL13/monocyte chemoattractant protein-4 (MCP-4) in its pathophysiology. Furthermore, bronchial epithelial cells treated with IL-17 and type 2 cytokines distinctively up-regulated eotaxin-3 gene expression. In this study we investigated the kinetics of IL-4, IL-10, IL-17, eotaxin-3, and MCP-4 in seasonal allergic rhinitis volunteers after nasal allergen challenge (NAC) and their release during natural pollen exposure. Methods The nasal lavages of 15 symptomatic allergic and 14 nonallergic subjects were collected during the pollination season. Additionally, six allergic subjects underwent a single unilateral nasal allergen and control challenge out of season, and nasal secretions were collected. Levels of IL-4, IL-10, IL-17, eotaxin-3, and MCP-4 in nasal lavages and secretions were measured using an electrochemiluminescent assay. Results After NAC, allergic subjects had a significant immediate response of nasal symptoms as well as a significant increase at 5 hours of IL-4, IL-10, and IL-17 and at 2, 5, and 24 hours significantly raising levels of eotaxin-3. IL-17 and eotaxin-3 concentrations at 5 hours were correlated (r = 0.94; p = 0.005). During natural pollen exposure, barely detectable levels of IL-17 in allergic subjects were also correlated with eotaxin-3 (r = 0.62; p = 0.01). Eotaxin-3 and MCP-4 levels were significantly elevated 9- or 3.7-fold, respectively, and IL-10 and, unexpectedly, IL-4 were significantly lower in allergic subjects compared with nonallergic subjects. Conclusion Nasal IL-17, MCP-4, and, possibly, eotaxin-3 may aggravate and IL-10 may alleviate nasal mucosal allergy.
    Type of Medium: Online Resource
    ISSN: 1945-8924 , 1945-8932
    URL: Article
    DOI: 10.2500/ajra.2013.27.3913
    RVK:
    XA 20278
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2554548-6
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  • 3
    Online Resource
    Online Resource
    70 kV computed tomography of the thorax: valence for computer-assisted nodule evaluation and radiation dose – first clinical results
    SAGE Publications ; 2014
    In:  Acta Radiologica Vol. 55, No. 9 ( 2014-11), p. 1056-1062
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 55, No. 9 ( 2014-11), p. 1056-1062
    Abstract: Computed tomography (CT) is the gold standard for evaluation of pulmonary nodules and is at the same time responsible for the majority of the collective effective dose. Purpose To evaluate radiation dose and efficacy of computer-assisted detection (CAD) for solid pulmonary nodules in low dose chest CT performed at 70 kV. Material and Methods CAD was performed upon chest CT with 70 kV and 100 kV (gold standard) at manufacture’s recommended tube current of 87 mAs (collimation, 64 × 0.6 mm). Detection rate for pulmonary nodules and size measurements of both techniques were compared to each other. Radiation dosage in terms of effective dose (E) was measured using an Alderson-Rando Phantom. Results Seventy-four patients with 301 solid nodules were included in the study. CAD detection rate was similar for 70 kV (94.7%) and 100 kV (92.4%). Mean transversal nodule diameter was 5.5 mm for 70 kV and 5.7 mm for 100 kV with an average volume of 0.12 mL (both techniques). Derived from the phantom measurements patient examinations resulted in an E of 0.51 mSv (70 kV) versus 2.02 mSv (100 kV). Conclusion 70 kV low-dose chest CT is suitable for CAD based lung nodule analysis at a fraction of the radiation burden of the standard technique. Since the measurements are highly accurate, 70 kV CT could be used for detection of pulmonal lesions as well as follow-up studies.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185113513258
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2024579-8
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  • 4
    Online Resource
    Online Resource
    Assessment of operability by means of CTPA and perfusion SPECT in patients with chronic thromboembolic pulmonary hypertension
    SAGE Publications ; 2016
    In:  Acta Radiologica Vol. 57, No. 1 ( 2016-01), p. 33-40
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 57, No. 1 ( 2016-01), p. 33-40
    Abstract: Chronic thromboembolic pulmonary hypertension (CTEPH) can potentially be cured by pulmonary thrombendarterectomy (PEA), the criteria for differentiation between operable and non-operable patients are not standardized. Purpose To retrospectively evaluate the value of rigidly registered computed tomography pulmonary angiography (CTPA) and single photon emission CT (SPECT) in differentiating for PEA. Material and Methods Forty-nine patients with CTEPH (21 men; age, 58 ± 13 years) were evaluated by an interdisciplinary expert board using all available diagnostic information and their consensus statement as gold standard. For SPECT a lobe based perfusion score was visually assessed using the score of 0 (lack of perfusion) to 1 (normal perfusion) calculating percentage of vascular obstruction (PVO). By CTPA, vascular obstruction index (OI) of central, peripheral, and global PA-bed were determined. The accuracy of the alignment between CTPA and SPECT was determined by fusion score (FS) ranging from 1 (no alignment) to 5 (exact alignment). Angiography provided PA pressure (PAP), pulmonary vascular resistance (PVR), and PA wedge pressure (PAWP). Receiver operating characteristics (ROC) analysis was performed. Results Twenty-nine patients were considered surgically amenable, and 20 patients were inoperable. Mean PAP, PVR, and PAWP were 48 ± 11 mmHg, 868 ± 461 dynes*sec*cm −5 , and 11 ± 5 mmHg, without differences between surgical and non-surgical patients ( P  〉  0.5). In all patients accurate registration was reached (FS = 4.1 ± 0.7; range, 2–5). PVO and central OI separated PEA-amenable patients ( P ≤ 0.001) resulting in the area under the curve of 0.828 (cutoff for PVO: 37.8% with a sensitivity of 82% and specificity of 79%) and 0.755 (cutoff for central OI: 29% with a sensitivity and specificity of 86.2% and 79%) for operability. Conclusion An accurate interpretation of rigidly registered CTPA and perfusion SPECT may contribute to stratification of operability in patients with CTEPH.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185114567561
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
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  • 5
    Online Resource
    Online Resource
    High-pitch dual-source paranasal sinus CT in agitated patients with maxillofacial trauma: analysis of image quality, motion artifacts, and dose aspects
    SAGE Publications ; 2018
    In:  Acta Radiologica Vol. 59, No. 8 ( 2018-08), p. 909-916
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 59, No. 8 ( 2018-08), p. 909-916
    Abstract: Image quality benefits from high-pitch scanning in agitated patients by reducing acquisition time. Purpose To compare image quality and exposure parameters in patients with maxillofacial trauma on second- and third-generation dual-source computed tomography (DSCT). Material and Methods Four groups were compared. Group 1 was examined on second-generation DSCT (120 kV/50 mAs, pitch 3.0). The other three groups were examined on third-generation DSCT. Group 2 was scanned with 120 kV/50 mAs, pitch 2.2. Automated exposure control (AEC) was used in group 3 and group 4 with pitch factors of 2.2 and 3.0, respectively. Images of third-generation DSCT were reconstructed with iterative reconstruction (IR), of second-generation DSCT with filtered back-projection. CTDIvol, acquisition time, and image quality were compared. Results Thirty patients were included in each group. Average CTDIvol (2.76 ± 0.00 mGy, 2.66 ± 0.00 mGy, 0.74 ± 0.23 mGy, and 0.75 ± 0.17 mGy) was significantly lower on third-generation DSCT with AEC ( P  〈  0.001). Subjective image quality was rated worst in group 4 due to strong high-pitch artifacts, while in the remaining three groups it was rated good or very good with good inter-observer agreement (k  〉  0.64). Average acquisition time was significantly shorter with third-generation DSCT (0.47 s, 0.36 s, 0.38 s, 0.30 s; P  〈  0.001). Conclusion Third-generation DSCT yields faster acquisition times and substantial dose reduction with AEC. A pitch of 2.2 should be preferred, as it results in fewer artifacts. If AEC is used, latest IR ensures that diagnostic image quality is guaranteed.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185117740931
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2024579-8
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