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PubMed1998

Absolute organ activity estimated by five different methods of background correction.

UNLABELLED: Accurate absorbed dose estimates in radionuclide therapy require patient-specific dosimetry. In patient-based dosimetry, estimation of absolute organ uptake is essential. The methods used should be reasonably accurate as well as easy to perform in routine clinical practice. One of the major sources of uncertainty in quantification of organ or tumor activity from planar images is the activity present in the tissue surrounding the source. METHODS: To estimate organ activity as a function of organ-to-background activity concentration ratio, a cylindrical phantom, filled with 5.6 liters of water was used to simulate the abdomen of a patient. Two other cylinders of 150 ml each, representing the kidneys, were each filled with 19 MBq 99mTC and were positioned in the abdomen phantom. The phantom was imaged with a dual-head gamma camera with the kidneys placed at posterior depths of 1-, 5- and 10-cm at kidney-to-background activity concentration ratios of infinity, 10:1, 5:1 and 2:1. The conjugate view geometric mean counting method was used to quantify activity. Five methods for background correction were applied: (1) no correction; (2) conventional background correction (simple subtraction of the background counting rate from the source region counting rate); (3) Kojima method (background corrected for organ thickness and depth); (4) Thomas method (analytical solution); and (5) Buijs method (background corrected for organ and total-body thickness). RESULTS: Since the results were identical for both kidneys, only the left kidney activity measurements are presented. The accuracy of the five background correction methods is given as the percentage difference between the actual and measured activity in the left kidney. For Method 1, the percentage difference ranged from 2% with an infinite kidney-to-background activity concentration ratio to +413% with a 2:1 ratio. For Method 2, these values ranged from -1% to -80%, for Method 3 from +11% to -18%, for Method 4 from -2% to +120% and for Method 5 from -4% to +39%. CONCLUSION: Even though quantitative SPECT is the most rigorous method for activity quantification in conditions of low organ-to-background activity concentration ratio, planar scintigraphy can be applied accurately if appropriate attention is paid to background correction. Using relatively simple background subtraction methods, the quantitative planar imaging technique can result in reasonably accurate activity estimates (Methods 3 and 5). The use of Kojima's method is preferable, especially at very low source-to-background activity concentration ratios.

Humans↗
PubMedDate not supplied

Human exposure assessment. II: Quantifying and reducing the uncertainties.

Alternative methods of human exposure assessment that reduce and/or allow quantification of the uncertainties associated with exposure estimates are surveyed and illustrated. These alternative approaches include (1) use of more appropriate exposure parameter default values rather than values that result in extreme exposure estimates; (2) incorporation of time-activity data to better define appropriate exposure duration values; (3) the use of reasonable exposure scenarios rather than the traditional Maximally Exposed Individual (MEI) approach; (4) the use of stochastic approaches such as Monte Carlo-based and information analysis-based methods; (5) use of bivariate analysis to identify the extent to which interdependencies between different exposure parameters affect the distribution of exposure estimates; (6) use of less-than-lifetime exposure and risk assessment; and (7) incorporation of physiological considerations relevant to absorbed dose estimation, including route-specific impacts, use of improved absorption factors, and application of pharmacokinetic models. Other ways to improve the exposure assessment process, including assuring statistical equivalency in comparing different exposure estimates and incorporation of sensitive subpopulation considerations are also discussed, as are key research needs.

Child↗
PubMed1989

Evaluation of uncertainty in input parameters to pharmacokinetic models and the resulting uncertainty in output.

Physiologically-based pharmacokinetic (PBPK) models may be used to predict the concentrations of parent chemical or metabolites in tissues, resulting from specified chemical exposures. An important application of PBPK modeling is in assessment of carcinogenic risks to humans, based on animal data. The parameters of a PBPK model may include metabolic parameters, blood/air and tissue/blood partition coefficients, and physiological parameters, such as organ weights and blood flow rates. Uncertainty in estimates of these parameters results in uncertainty regarding tissue concentrations and resulting risks. Data are reviewed relevant to the quantification of these uncertainties, for a PBPK model-based risk assessment for tetrachloroethylene. Probability distributions are developed to express uncertainty in model parameters, and uncertainties are propagated by a sequence of operations that simulates processes recognized as contributing to estimates of human risk. Distributions of PBPK model output and human risk estimates are used to characterize uncertainty resulting from uncertainty in model parameters.

Animals↗
PubMed1998

A probabilistic approach for deriving acceptable human intake limits and human health risks from toxicological studies: general framework.

The use of uncertainty factors in the standard method for deriving acceptable intake or exposure limits for humans, such as the Reference Dose (RfD), may be viewed as a conservative method of taking various uncertainties into account. As an obvious alternative, the use of uncertainty distributions instead of uncertainty factors is gaining attention. This paper presents a comprehensive discussion of a general framework that quantifies both the uncertainties in the no-adverse-effect level in the animal (using a benchmark-like approach) and the uncertainties in the various extrapolation steps involved (using uncertainty distributions). This approach results in an uncertainty distribution for the no-adverse-effect level in the sensitive human subpopulation, reflecting the overall scientific uncertainty associated with that level. A lower percentile of this distribution may be regarded as an acceptable exposure limit (e.g., RfD) that takes account of the various uncertainties in a nonconservative fashion. The same methodology may also be used as a tool to derive a distribution for possible human health effects at a given exposure level. We argue that in a probabilistic approach the uncertainty in the estimated no-adverse-effect-level in the animal should be explicitly taken into account. Not only in this source of uncertainty too large to be ignored, it also has repercussions for the quantification of the other uncertainty distributions.

Animals↗
PubMed1999

Geographic exposure modeling: a valuable extension of geographic information systems for use in environmental epidemiology.

Geographic modeling of individual exposures using air pollution modeling techniques can help in both the design of environmental epidemiologic studies and in the assignment of measures that delineate regions that receive the highest exposure in space and time. Geographic modeling can help in the interpretation of environmental sampling data associated with airborne concentration or deposition, and can act as a sophisticated interpolator for such data, allowing values to be assigned to locations between points where the data have actually been collected. Recent advances allow for quantification of the uncertainty in a geographic model and the resulting impact on estimates of association, variability, and study power. In this paper we present the terminology and methodology of geographic modeling, describe applications to date in the field of epidemiology, and evaluate the potential of this relatively new tool.

Calibration↗
PubMed1998

The LYMFASIM simulation program for modeling lymphatic filariasis and its control.

The LYMFASIM modeling framework for the transmission and control of the tropical parasitic disease lymphatic filariasis is described and its use in the context of an endemic community in north-eastern Brazil is illustrated. Lymphatic filariasis is a disease with a complex natural history with many unknowns. This complicates decision making with respect to control strategies. With LYMFASIM, a variety of hypotheses can be tested about the life history of the parasite Wuchereria bancrofti, its transmission from man to man through mosquitoes, the role of the immune system in regulating parasite numbers, the development of disease symptoms, and the effects of control measures (drug treatment or mosquito control). The implications of alternative assumptions and uncertainty about the quantification of parameters for the effectiveness of control strategies can be investigated. Thanks to the use of stochastic microsimulation, LYMFASIM is highly flexible and can be adapted and extended as new knowledge emerges.

Adolescent↗
PubMed1996

Reduced transit-time sensitivity in noninvasive magnetic resonance imaging of human cerebral blood flow.

Herein, we present a theoretical framework and experimental methods to more accurately account for transit effects in quantitative human perfusion imaging using endogenous magnetic resonance imaging (MRI) contrast. The theoretical transit time sensitivities of both continuous and pulsed inversion spin tagging experiments are demonstrated. We propose introducing a delay following continuous labeling, and demonstrate theoretically that introduction of a delay dramatically reduces the transit time sensitivity of perfusion imaging. The effects of magnetization transfer saturation on this modified continuous labeling experiment are also derived, and the assumption that the perfusion signal resides entirely within tissue rather than the arterial microvasculature is examined. We present results demonstrating the implementation of the continuous tagging experiment with delay on an echoplanar scanner for measuring cerebral blood flow (CBF) in normal volunteers. By varying the delay, we estimate transit times in the arterial system, values that are necessary for assessing the accuracy of our quantification. The effect of uncertainties in the transit time from the tagging plane to the arterial microvasculature and the transit time to the tissue itself on the accuracy of perfusion quantification is discussed and found to be small in gray matter but still potentially significant in white matter. A novel method for measuring T1, which is fast, insensitive to contamination by cerebrospinal fluid, and compatible with the application of magnetization transfer saturation, is also presented. The methods are combined to produce quantitative maps of resting and hypercarbic CBF.

Cerebrovascular Circulation↗
PubMed1987

Statistical issues in the estimation of assigned shares for carcinogenesis liability.

Congress is currently considering adopting a mathematical formula to assign shares in cancer causation to specific doses of radiation, for use in establishing liability and compensation awards. The proposed formula, if it were sound, would allow difficult problems in tort law and public policy to be resolved by reference to tabulated "probabilities of causation." This article examines the statistical and conceptual bases for the proposed methodology. We find that the proposed formula is incorrect as an expression for "probability and causation," that it implies hidden, debatable policy judgments in its treatment of factor interactions and uncertainties, and that it can not in general be quantified with sufficient precision to be useful. Three generic sources of statistical uncertainty are identified--sampling variability, population heterogeneity, and error propagation--that prevent accurate quantification of "assigned shares." These uncertainties arise whenever aggregate epidemiological or risk data are used to draw causal inferences about individual cases.

Disease Susceptibility↗
PubMed1984

Quantification of regional extravascular lung water in dogs with positron emission tomography, using constant infusion of 15O-labeled water.

Continuous infusion of 15O-labeled water allows a quantitative measurement of the total water pool in the chest region by positron emission tomography (PET). By subsequent inhalation of 11CO the intravascular space (blood pool) can be quantitated as well. After a suitable normalization of the intravascular activities the extravascular water can be determined by subtraction of the blood pool from the water pool. The regional extravascular lung water distribution can be visualized in tomographic slices. The method was validated in an animal experiment using five dogs. They were measured before and after induction of a lung edema by IV injection of oleic acid. The increase of extravascular lung water was monitored by the thermo-dye-dilution method (TDD). The correlation of extravascular lung water as measured by TDD with PET measurements is good (r = 0.94). The PET values agree also with gravimetric lung water determinations. An absolute quantitation of regional extravascular lung water is possible after absorption correction of the PET data via transmission measurements and calibration of the camera system. The uncertainty in the absolute quantification is +/- 20%. In the experiments described here the mean extravascular lung water was 0.13 g/cm3 before and 0.25 g/cm3 after induction of lung edema.

Animals↗
PubMed2025

An integrated multiscale air quality modelling framework for industrial park pollution: Linking local emissions to regional transport.

Capturing the spatiotemporal distribution of pollutants in industrial parks remains challenging for regional air quality models because of their coarse resolution (3 km), resulting in uncertainties in local emission quantification. To address this, we developed the Integrated Multiscale Air Quality Modelling System for Industry (IAQMS-Industry), coupling the regional Nested Air Quality Prediction Modelling System (NAQPMS) with a city-scale chemical transport model. This framework integrates point-source locations and Gaussian plume dispersion to simulate particulate matter with a diameter smaller than 2.5 micrometres (PM2.5) at 100 m resolution. Applied to the Beijing Yi Zhuang and Tangshan industrial parks and evaluated against observations. The coupled model achieved a normalized mean bias (NMB) ranging from 3.1 % to 6.2 %, improving upon NAQPMS (-16.9 % to -7.7 %). Spatial analysis revealed that coarse regional grids underestimated the PM2.5​ concentrations at industrial sites by smoothing gradients, whereas IAQMS-Industry successfully resolved spatial patterns. Industrial point emissions accounted for 22.9 %-26.4 % of PM2.5 in the coupled model, which was significantly greater than the regional model estimates of 1.6 %-13.7 %. These findings indicate that regional models overestimate pollutant dispersion processes in industrial parks while underestimating local industrial impacts. By explicitly resolving point-source dynamics and linking them to regional transport, IAQMS-Industry provides a robust tool for designing targeted emission controls in industrial cities and balancing local air quality improvements with minimized regional pollution outflow. This study underscores the necessity of multiscale modelling for accurate source apportionment and informed environmental governance in industrial zones.

Air Pollution↗
PubMed1994

In search of power and significance: issues in the design and analysis of stochastic cost-effectiveness studies in health care.

Application of techniques such as cost-effectiveness analysis (CEA) is growing rapidly in health care. There are two general approaches to analysis: deterministic models based upon assumptions and secondary analysis of retrospective data, and prospective stochastic analyses in which the design of a clinical experiment such as randomised controlled trial is adapted to collect patient-specific data on costs and effects. An important methodological difference between these two approaches is in the quantification and analysis of uncertainty. Whereas the traditional CEA model utilizes sensitivity analysis, the mean-variance data on costs and effects from a prospective trial presents the opportunity to analyze cost-effectiveness using conventional inferential statistical methods. In this study we explored some of the implications of moving economic appraisal away from deterministic models and toward the experimental paradigm. Our specific focus was on the feasibility and desirability of constructing statistical tests of economic hypotheses and estimation of cost-effectiveness ratios with associated 95% confidence intervals. We show how relevant variances can be estimated for this task and discuss the implications for the design and analysis of prospective economic studies.

Confidence Intervals↗
PubMed1995

Non-T1-weighted 31P chemical shift imaging of the human liver.

A 31P chemical shift imaging (CSI) protocol was developed for human liver studies. It is shown that at the commonly used repetition time (TR) of 1 s T1-weighting reduces the integrated intensities of liver phosphate metabolite signals by 18 +/- 15% (inorganic phosphate, Pi) to 46 +/- 10% (phosphodiester, PDE), that is for an RF pulse angle of 60 degrees (weighted average) in liver. The loss in signal-to-noise ratio (S/N) at TR = 20 s, sufficient to eliminate spectral distortions caused by saturation, compared with TR = 1 s (47-65%) can be overcome by using one-dimensional (1D)-phase encoding with a small number of phase-encode steps. The liver spectra obtained by 1D-CSI with 4-step phase-encoding (spatial resolution 10 cm) have the highest S/N and, after multiplication of the PDE signal by a factor of 1.4, closely reflect the liver metabolite levels. It is concluded that clinical 31P MR studies of liver function can be performed without T1-weighting and that the current practice to compromise the MRS quantification of lever metabolites with uncertainties caused by (differential changes in) T1-weighting is not warranted.

Humans↗
PubMed2000

Methods for ELNES-quantification: characterization of the degree of inversion of Mg-Al-spinels

The energy loss near-edge structures in electron energy-loss spectra contain information about bonding characteristics, the electronic structure and coordinations of the excited atoms. We have calculated sets of reference spectra for the normal and for the inverse Mg-Al-spinel using a full multiple scattering approach. By a quantitative comparison of these reference spectra with experimental data ELNES-quantification becomes possible. We characterized the degree of inversion lambda by the analysis of the relative peak-intensities and the relative peak-positions within 35 eV beyond the edge onset. The results demonstrate that by using the provided methods ELNES-quantification will become possible when uncertainties in the experiment are reduced and a better fit of the simulations to the experiment is achieved.

Journal Article↗
PubMed2000

Direct in situ measurements of labile inorganic and organically bound metal species in synthetic solutions and natural waters using diffusive gradients in thin films.

The emerging technique of DGT (diffusive gradients in thin films) is shown to be capable of performing new speciation measurements in situ in natural waters. In DGT, metals are bound to a resin layer after passing through a well-defined diffusion layer. Cd was measured in solutions containing glycine, EDTA, and fulvic (FA) and humic acids (HA) by atomic absorption spectroscopy (AAS), anodic stripping voltammetry (ASV), and DGT. DGT measured similar labile fractions to ASV, with detailed differences being consistent with a thicker diffusion layer allowing more dissociation of labile complexes and a slower diffusion of FA and HA complexes through the gel. When single measurements are made in complex solutions with DGT, precise quantification is impossible due to uncertainties concerning the distribution of species with different diffusion coefficients. A new procedure was proposed based on the advantage of DGT of being able to control the pore size of the diffusive gel layer. Small (inorganic) species diffuse freely through all gels but larger FA and HA (organic) complexes diffuse less freely in more constrained gels. When measurements were made on known solutions of Cu and FA or HA, it was possible to quantify the inorganic and organic species separately. They agreed well with predictions made using the WHAM speciation code. Multiple DGT units were also deployed in situ in a stream with high dissolved organic carbon (14.6 mg/L). The systematic differences between the devices with different gel compositions enabled determination, for the first time, of the in situ concentrations of both labile inorganic and organic species in natural water. A single DGT device with a constrained gel can be used to quantify inorganic species directly, providing absolute accuracy is not required. This ability of DGT to measure well-defined fractions of metals in situ using a simple device gives it considerable potential as a regulatory tool. A direct speciation measurement may be preferable to modeling approaches which require diverse input data that are difficult to determine.

Benzopyrans↗
PubMedDate not supplied

Processing biological images from very low light emissions.

As opposed to strong light signals (> 10(8) photons mm-2 s-1), the construction of images from object sources with low level signals (< 10(2) photons mm-2 s-1) involves a probabilistic transfer- or point-spread function. The resulting images carry considerable uncertainty or spread, restricting resolution and quantification. In this paper we propose various strategies how to reconstruct object characteristics from very low light emissions by unfolding the imaging equation. Further, calibration techniques which help to associate light emissions with the decomposition of luminogenic substrates in a spatially selective way will be discussed.

Animals↗
PubMed1993

The evaluation and interpretation of cervical cytology: application of the likelihood ratio concept.

The Papanicolaou smear (Pap test), used for the detection and prevention of neoplastic lesions of the cervix, is known to have both false negative and false positive results. Proper handling of the diagnostic uncertainty resulting from these errors demands quantification of flaws. Traditionally, sensitivity, specificity and predictive values are used for that aim. In this study another approach is advocated, namely the use of the likelihood ratio. For cervical cytology this ratio is the quotient of the probability of a Pap class within the diseased population to the probability of that same Pap class within the non-diseased group. This approach enables the characterization of each Pap class separately, and is therefore much better for clinical interpretation of the result. It is also a superior approach for quality assessment.

Female↗
PubMedDate not supplied

The representation of uncertainty in medical expert systems.

The development of the rule-based expert system has provided important new techniques for the representation of knowledge. However, continued use of this representational scheme has highlighted some of its deficiencies. In particular, many within scientific and non-scientific fields attempting to use the rule-base design to describe natural phenomena often find it difficult to represent the complexities of the world as 'absolute' rules. For this reason, many investigators acknowledge the need to add an uncertainty mechanism to the rule-base construct. Such a facility would allow the quantification of accuracy or strength of association within individual rules Although agreement exists on the need for an uncertainty representation facility, the debate concerning the most appropriate methodology is far from resolved. The purpose of this paper is to provide a review and commentary on the current state of debate over the five most popular candidate uncertainty models: symbolic representation, MYCIN certainty factors, Bayesian, Dempster-Shafer and fuzzy set logic. The advantages and disadvantages of each uncertainty calculi will be presented and assessed with respect to their applicability to the medical expert systems domain.

Bayes Theorem↗
PubMed1977

Improved method for the analysis of estrogenic steroids in pregnancy urine by high-performance liquid chromatography.

The use of microparticulate packing materials and large injection volumes gives significant improvements in the analysis of complex samples, such as urine extracts by high-performance liquid chromatography. Lower detection limits and improved accuracy can now be attained. In addition, the combined use of adsorption and reversed-phase chromatography leads to reduced uncertainty in peak identification and gives more reliable quantification.

Chromatography, High Pressure Liquid↗