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PubMed2006

Differences in renal registries between the Balkans and Western Europe.

The epidemiology data of renal replacement therapy are collected by national renal registries and extended to international registries as the European Renal Association Renal Registry. The extent and accuracy of data vary widely among countries. The aim of this study was to compare combined data from the national renal registries of Balkan countries contributing the ERA-EDTA Registry or from other sources, with combined data from renal registries of the Western and Northern European Countries and regions contributing the ERA-EDTA Registry. Data regarding incident and prevalent patients in 2003, mean age of incident and prevalent patients, incidence and prevalence by cause of renal failure and prevalence by established therapy were compared between the countries of the Balkan region and the countries of Western and Northern Europe contributing to the ERA-EDTA Registry. Data were obtained by the Annual Report 2003 of the ERA-EDTA Registry, and for Romania by the study of G. Mirescu published in NDT 2004. Some data were obtained by the questionarries sent to people responsible for the national registries. The results showed the following: the incident number of patients per million population (pmp) at day 1 of RRT, as well as at day 91, adjusted for age and gender, did not statistically differ between the Balkans and Western Europe: 119.2 +/-25.1 vs. 123.3 +/- 25.9 and 110.9 +/- 34.7 vs. 106.5 +/- 18.3, respectively. The mean age of incident patients at day 91 of RRT significantly differed between the Balkans and Western Europe, 57.7 +/- 4.49 vs. 63.3 +/- 2.2, p < 0.005. The percentage of incident patients by cause of renal failure at day 91 of RRT did not significantly differ between the Balkans and Europe. The mean incidence of the percentage of DM as a cause of renal failure between the Balkans and Western Europe did not differ, 23.05+/- 4.5 vs. 20.3 +/- 7.2. When adjusted for age and gender, the significant difference in prevalent number of ESRD patients between the Balkans and Western Europe disappeared. The mean age of prevalent patients between the Balkans and Europe did not significantly differ, 54.3 +/- 4.2 vs. 58.2 +/- 2.8. The percentage of primary renal disease in prevalent patients did not significantly differ, except for policystic kidney disease which is significantly more frequent in Western Europe compared to the Balkans, 9.2 +/- 1.9 vs. 6.8 +/- 1.8, p < 0.01. Diabetes mellitus and hypertensive nephropathy are much more frequent in incident patients compared to prevalent ones. Transplantation is significantly more frequent in Western Europe, predominantly cadaveric, whereas dialysis is more frequent in the Balkans. It can be concluded that no difference exists between the incidence and prevalence of diabetes mellitus as a primary renal disease in ESRD patients between the Balkan and European countries, indicating that the epidemic of diabetes is already present in the Balkans and imposing, perhaps, efforts to be undertaken for planning prevention strategies; kidney transplantation is significantly less represented as RRT in Balkan countries compared to Western and Northern Europe, and efforts should be made for its increase, particularly the cadaveric one, and moreover, because the population on RRT is significantly younger in the Balkans.

Europe↗
PubMed2006

Accuracy and completeness of mortality data in the Department of Veterans Affairs.

BACKGROUND: One of the national mortality databases in the U.S. is the Beneficiary Identification and Record Locator Subsystem (BIRLS) Death File that contains death dates of those who have received any benefits from the Department of Veterans Affairs (VA). The completeness of this database was shown to vary widely from cohort to cohort in previous studies. Three other sources of death dates are available in the VA that can complement the BIRLS Death File. The objective of this study is to evaluate the completeness and accuracy of death dates in the four sources available in the VA and to examine whether these four sources can be combined into a database with improved completeness and accuracy. METHODS: A random sample of 3,000 was drawn from 8.3 million veterans who received benefits from the VA between 1997 and 1999 and were alive on January 1, 1999 according to at least one source. Death dates found in BIRLS Death File, Medical SAS Inpatient Datasets, Medicare Vital Status, and Social Security Administration (SSA) Death Master File were compared with dates obtained from the National Death Index. A combined dataset from these sources was also compared with National Death Index dates. RESULTS: Compared with the National Death Index, sensitivity (or the percentage of death dates correctly recorded in a source) was 77.4% for BIRLS Death File, 12.0% for Medical SAS Inpatient Datasets, 83.2% for Medicare Vital Status, and 92.1% for SSA Death Master File. Over 95% of death dates in these sources agreed exactly with dates from the National Death Index. Death dates in the combined dataset demonstrated 98.3% sensitivity and 97.6% exact agreement with dates from the National Death Index. CONCLUSION: The BIRLS Death File is not an adequate source of mortality data for the VA population due to incompleteness. When the four sources of mortality data are carefully combined, the resulting dataset can provide more timely data for death ascertainment than the National Death Index and has comparable accuracy and completeness.

Journal Article↗
PubMed1994

Proliferative cell indices measured by DNA flow cytometry in node-negative adenocarcinomas of breast: accuracy and significance in cytokeratin-stained archival specimens.

Proliferative rates of 73 node-negative adenocarcinomas of breast with 5-year or greater follow-up were studied using cytokeratin staining in two-parameter DNA flow cytometry of archival specimens. Quality control data of accuracy of the measurements were determined and all analyses were compared with single-parameter results of the same specimens, using demarcated tumor areas, quadruple analyses, and computerized nonspecific staining subtraction. Mitotic rates of the same samples correlated highly significantly with the S-phase fractions and proliferative index (S + G2 + M phases), especially for the cytokeratin data. The predictive value of mitotic rates was found significant, but that of the DNA flow-cytometry-obtained indices was not, probably because of low numbers of deaths in this study. The cytokeratin method identified heteroploid tumors containing a diploid cell population not identifiable by single-parameter analysis. In conclusion, cytokeratin staining can be reliably applied to DNA flow cytometry of archival specimens giving accurate ploidy, S-phase fractions, and proliferative index data limited almost exclusively to neoplastic cell populations. This will permit large-scale retrospective studies aimed at establishing the usefulness of DNA flow cytometry for clinical decisions on therapy of surgically removed node-negative adenocarcinomas of breast.

Adenocarcinoma↗
PubMed2006

Screening for autism in pre-school children in primary care: systematic review of English Language tools.

OBJECTIVES: To review the accuracy of brief screening tools for autism in pre-school children. DESIGN: Systematic review of diagnostic accuracy studies. DATA SOURCES: Medline, Embase, Cinahl and Psychlit plus references of identified papers and contact with authors. SUBJECTS: Children and infants aged 5 years or less without a prior diagnosis of autism or pervasive development delay. INTERVENTIONS: Tools/checklists appropriate for use in screening for autism in primary care settings. OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive value of screening tools and likelihood ratios relative to a diagnostic assessment made using either DSM-III/IV or ICD 10 diagnosis. RESULTS: Three studies considering two tools were identified. The CHecklist for Autism in Toddlers (CHAT) was tested on an appropriate population sample with moderate long-term follow-up but demonstrated poor sensitivity and positive predictive value. Weaker evidence suggested that the Modified CHecklist for Autism in Toddlers (M-CHAT) had high sensitivity but follow-up was of shorter term and less comprehensive. CONCLUSIONS: The CHAT demonstrated a level of sensitivity unlikely to be useful for population screening purposes, however, its high specificity suggests it has utility in secondary screening. The M-CHAT is a parent only report and might be more sensitive, and therefore appropriate for population screening. However, full conclusions regarding its accuracy cannot be drawn until follow-up data has been collected.

Age Factors↗
PubMed2005

Are we on track - can we monitor bed targets in the NHS plan for England?

The NHS plan announced sustained increases in funding accompanied by wide ranging reform, the success of which would be measured by targets set across the board, including increases in numbers of beds, staff, hospitals and equipment. In this article we assess progress towards the target of 7,000 extra beds in hospitals and intermediate care to be achieved by 2004. Summary points are as follows. (1) Although the 2003/2004 target for availability of general and acute NHS beds in England was achieved, the increase did not offset the overall decrease in all categories of beds. Bed availability fell by 2083, from 1,86,290 in 1999/2000 to 1,84,207 in 2003/2004, following a fall of 12,558 from 1996/1997 to 1999/2000. (2) Lack of standardized definitions and data collection systems both within the NHS and for the independent sector, compounded by ambiguity over the funding of extra capacity for the NHS, call into question the accuracy of data collected about intermediate care beds. (3) Systems for collecting data about intermediate care should be made subject to the same code of practice as official NHS statistics in order to monitor future targets and plan for provision of care. (4) Changes in definitions, lack of detail about criteria used in setting targets and lack of data about private sector care, make it impossible to monitor the overall capacity available to the NHS and assess whether bed availability targets have been met.

Data Collection↗
PubMed2004

MR angiography with sensitivity encoding (SENSE) for suspected pulmonary embolism: comparison with MDCT and ventilation-perfusion scintigraphy.

OBJECTIVE: The aim of our study was to determine the utility of time-resolved contrast-enhanced MR angiography combined with sensitivity encoding (SENSE) for patients with pulmonary embolism. SUBJECTS AND METHODS. Forty-eight consecutive patients (26 men and 22 women; age range, 27-73 years; mean age, 55 years) with suspected pulmonary embolism underwent chest radiography, contrast-enhanced MDCT, MR angiography with SENSE, ventilation-perfusion scintigraphy, and pulmonary angiography. MR angiography with SENSE was performed using IV administration of gadolinium contrast medium with a 3D turbo field-echo pulse sequence (TR/TE, 4.0/1.2; flip angle, 30 degrees ) on a 1.5-T scanner. Capabilities of diagnosing pulmonary embolism using MR angiography (data set A), contrast-enhanced MDCT (data set B), contrast-enhanced MDCT with MR angiography (data set C), ventilation-perfusion scintigraphy (data set D), and contrast-enhanced MDCT with ventilation-perfusion scintigraphy (data set E) were determined by receiver operating characteristic analysis, using the results of pulmonary angiography as the reference standard. The diagnostic capability of each data set was analyzed on a per-vascular zone and a per-patient basis with the McNemar test. RESULTS: Sensitivity and specificity of data set A were 83% and 97%, respectively, on a per-vascular zone basis and 92% and 94%, respectively, on a per-patient basis. Specificity and accuracy of data set A were significantly higher than those of data set D on a per-patient basis (p < 0.05). CONCLUSION: Time-resolved MR angiography with SENSE is effective for the diagnosis of pulmonary embolism.

Contrast Media↗
PubMed1992

Positional changes of the mandibular condyle assessed by three-dimensional computed tomography.

This investigation was designed to test the validity and reliability of three-dimensional computed tomography (3-D CT) for quantification of positional changes of the condyle in a laboratory model. The model consisted of a mounted dried human skull and a mandibular condyle attached to a micromanipulator. Controlled changes in condylar position were made and the condyle/fossa was imaged. Positional changes were measured by triangulation methods based on specific 3-D CT landmarks. The data were analyzed using descriptive statistics, analyses of variance to evaluate the sources of variability, and linear contrasts to evaluate the differences between observed and expected values. The results indicated that selection of appropriate anatomic landmarks for assessment of movement influences technique accuracy. The data also indicate that 3-D CT is most accurate in detecting inferior condylar movements. Lateral and posterior movements were assessed with less accuracy than the inferior positional changes. The clinical significance of these differences has yet to be determined.

Analysis of Variance↗
PubMed1990

Intercultural communication in assessing dietary habits: Liberia as an example.

Nutritionists in both clinical and field settings often work with populations whose cultures and languages differ from their own. Therefore, intercultural communication skills are often needed. This article presents a method used to collect dietary data for 125 children under 26 months old living in Liberia. The method was designed to reduce intercultural communication errors during collection of dietary data by avoiding terms directly related to the English language words "food" or "to eat," and by replacing such terms with words or phrases with a more general meaning, for example, "thing" for food or "had" for eat. By using this method the following results were obtained: mean age for introducing non-breast-milk foods to infants, 1.9 months (no. = 113, standard deviation [SD] = 2.1 months); mean age for introducing milk-based foods, 1.5 months (no. = 74, SD = 1.6 months); and mean age for introducing non-milk foods, 2.9 months (no. = 110, SD = 2.5 months). These ages are 2 to 4 months earlier than those determined in two previous studies conducted in Liberia. The difference is probably attributable to incongruity between the interviewer's and interviewee's definitions of words. The resultant impact on feeding recommendations because of differences in data and, therefore, in conclusions, demonstrates that accuracy of dietary data at the individual level may be critical for epidemiological studies. The method of using more general terms and avoiding restricting terms such as "food" and "eat" may help nutritionists improve the accuracy and completeness of dietary data during intercultural interviews. Additional research in wording dietary recall questions will help determine whether this method is generally applicable.

Child, Preschool↗
PubMed1980

[4 years of electronic data processing of serial school health data. Current situation and prospects].

The school health service of the city of Basle is storing the routinly collected data not only in the personal records of each child but also on a data banc for several years now. The data concern developmental and health status of each child and the anamnestic informations given by his parents. The children are examined at the age of 5, 10 and 14 years. On the average nearly 6,000 children are screened each year. Annual evaluations of the data provide an overview of the present health situation of the youth and trends in morbidity, immunisation etc. E.g. gives a comparison of 10 years old Italian and Swiss children evidence that their average weight is significantly different while their size is nearly equal. Four years ago the ADP-system was reorganized in order to link each child's data of the three screening examinations at the three ages. Thus not only cross sectional but also longitudinal studies can be performed in future. It will enable to monitor growth and development of the children and to evaluate the outcome of the referals to therapeutic and preventive measures. At present the data of more than 22,000 children are stored, i.e. of 5,500 children of the Kindergarten, of 7,500 of the 4.th class (primary school) and 9,000 of the 8.th class (intermediate school). An attempt will be made to replace the present data input system (typing) by the application of a mark sense reader. This will avoid the present delay in data input and improve the accuracy of the data. A special effort has to be made in order to fulfill the new legislations concerning confidentiality.

Body Height↗
PubMed2006

The 1918 influenza A epidemic in the city of São Paulo, Brazil.

The 1918 pandemic H1N1 outbreak in the city of São Paulo is revisited. The outbreak lasted for 10 weeks and reached 116,771 officially recorded cases amongst 523,194 inhabitants. The total number of deaths summed up to 5331, with a lethality rate of 4.5% and an overall mortality rate of around 1%. We propose a mathematical model that tallies available data with good accuracy and allows the estimation of the basic reproductive number, R(0). The model showed a remarkably good accuracy in retrieving the real data from São Paulo city outbreak considering the total number of recorded cases and deaths and the timing of the outbreak. The basic reproduction number calculated of 2.68 can be compared to estimates carried out for other flu strains, like the estimates for H3N2, whose values ranged from 1.5 to 2.5. We hypothesize that the Southern parts of the world in which there was relatively little impact of the Great War, like South America, suffered a much lower H1N1 influenza mortality as compared with that reported for the Northern hemisphere heavily affected by the I World War.

Brazil↗
PubMed1998

Response preparation begins before mental rotation is finished: evidence from event-related brain potentials.

Behavioral data (response time (RT) and accuracy) and psychophysiological data (event-related brain potentials of ERPs, and lateralized readiness potential or LRP) were studied in an experiment in which rotated alphanumeric characters were presented normally or mirror-reversed. In half of the trials, character classification (letter versus digit) determined whether or not the response was to be executed (go versus nogo) and parity determined the responding hand. In the other half, classification determined the responding hand and parity determined go versus nogo. LRP data indicated that response preparation occurred before mental rotation was finished. These data contradict strictly sequential discrete models of information processing and suggest continuous flow of information.

Adult↗
PubMed2002

[Descriptive study of mental disorders in ethnic minorities residing in an urban area of Barcelona].

AIM: To observe the differences between ethnic groups and the autochthonous population in the frequency of mental disorders. To study epidemiological data and the accuracy of recording of such data. DESIGN: Descriptive study. Setting. Raval Sud Basic Health Care Area. Drassanes Primary Health Care Center, Barcelona, Spain. PATIENTS: A random sample of 112 immigrant patients belonging to ethnic minorities, seen between January 1995 and December 1997, matched for age and sex with autochthonous patients. Interventions. We studied variables related with mental disorders in immigrants. Variables included age, country of origin, reason for immigrating, employment status, marital status, other persons in household, educational level, knowledge of Spanish and toxic habits. We recorded the following impressions of diagnosis: anxiety, depression, somatization, psychosis, personality disorder, number of visits for each diagnosis, treatment, and overall number of visits between January 1995 and December 1997. Statistical studies consisted of descriptive analysis and chi-squared tests. MEASURES AND RESULTS: Mean age was 39 14 years, 52.7% of the immigrant patients were men, 36.6% (95% CI, 27.6-45.5%) were from the Maghreb region, and 23.2% (95% CI, 15.4-31.0%) were Hindustani. 43% (95% CI, 33.6-52.0%) understood Spanish. Smoking was more frequent among autochthonous patients (59.8%; 95% CI, 50.7-68.9%) than in immigrant patients (26.8%; 95% CI, 18.5-34.9%; p < 0.001), as was alcohol abuse (24.1%; 95% CI, 16.1-32.0%, versus 5.4%; 95% CI, 1.1-9.5%; p < 0.001). Depression tended to be more frequent in patients belonging to ethnic groups (15.2%; 95% CI, 8.5-21.8%) than in autochthonous patients (13.4%; 95% CI, 7.0-19.7%; p = ns), as did somatization disorder (10.7%; 95% CI, 4.9-167.4%, versus 6.3%; 95% CI, 1.7-10.7%, p = ns), but was undertreated (19.8%; 95% CI, 2.4-27.2%, versus 32.1%; 95% CI, 23.4-40.7%; p = ns). The total number of visits during the study period was higher in autochthonous patients (1138 versus 1017), as was the number of visits for mental disorders (17.9%; 95% CI, 15.7-20.1%, versus 13%; 95% CI, 1.9-15.0%; p = ns). CONCLUSIONS: There were no differences in the percentages of mental disorder

Adult↗
PubMed1991

Detection of periodontal disease activity with a scintillation camera.

The goal of this study was to assess the ability of a scintillation camera method to detect areas of active bone loss due to periodontitis. Technetium 99m methylene diphosphonate was used as the bone-seeking radiopharmaceutical. Bone-seeking radiopharmaceutical uptake (BSRU) was imaged and quantified in alveolar bone regions of interest with a scintillation camera and a computer. Analysis of the sequential radiographs over six months constituted the basis for determination of sites of active disease. The study was composed of two parts. First, 18 subjects, nine with adult periodontitis and nine controls, were enrolled in a cross-sectional study to determine whether the quantitative scintillation amera methodology detected differences in BSRU in periodontitis vs. periodontally healthy patients. Second, the nine patients with periodontitis were studied longitudinally in order to determine whether the BSRU examination was indicative of bone loss subsequently measured radiographically. In the cross-sectional study, the mean uptake ratio for the periodontitis group was significantly higher than that for the control group (1.63 +/- 0.06 and 1.42 +/- 0.04, respectively, p less than 0.01, t test). From the longitudinal study, the mean patient scintillation image uptake ratios were highly correlated with the mean bone loss determined from serial radiographs (p less than 0.01). The accuracy, sensitivity, and specificity of the quantitative gamma camera method for detecting site(s) of active bone loss within the region of interest were assessed relative to the longitudinal radiographic data. The accuracy, sensitivity, and specificity were 85%, 90%, and 79%, respectively. Alveolar bone scintigraphy with a gamma camera and computer may provide a simple and valid technique for the immediate indication of areas of periodontal disease activity.

Adult↗
PubMed1992

MR imaging in the evaluation of SLAP injuries of the shoulder: findings in 10 patients.

OBJECTIVE: Injuries to the superior portion of the glenoid labrum, called SLAP (superior labrum, anterior and posterior) injuries, are recently recognized injuries consisting of tears of the long head of the biceps tendon anchor/superior labral complex. The purpose of this study was to determine if the MR imaging findings in patients with surgically proved SLAP injuries correspond to the abnormalities found at arthroscopy. MATERIALS AND METHODS: Four variants of SLAP lesions have been described; they are based on the degree of compromise of the superior portion of the glenoid labrum, biceps tendon, and labral-biceps anchor. A type I lesion has superior labral fraying in the region of the biceps anchor. A type II lesion has superior labral fraying and stripping of the superior part of the glenoid labrum and attached biceps off the underlying glenoid fossa. A type III lesion has a bucket-handle tear of the superior portion of the glenoid labrum in the region of the biceps anchor. A type IV lesion has a bucket-handle tear of the superior part of the glenoid labrum with extension of the tear into the proximal biceps tendon. Standard spin-echo MR imaging studies in 10 patients with surgically proved SLAP lesions were evaluated retrospectively. Correlations were made between MR imaging findings and the SLAP injury type determined from descriptions in the surgical report. MR imaging studies in a control group of seven symptomatic patients surgically proved not to have SLAP injuries also were evaluated. RESULTS: MR imaging examinations of two patients with type I lesions showed irregularity of the labral contour and a slight increase in signal intensity on all imaging sequences. MR imaging examinations of two patients with type II lesions showed globular high signal interposed between the superior part of the glenoid labrum and the superior portion of the glenoid fossa. One case showed high signal in the labral-biceps anchor. The other case showed paired cleavages in the superior and inferior aspects of the superior part of the glenoid labrum at the labral-biceps anchor. MR imaging examinations of two patients with type III lesions showed superior labral tears identified as high signal intensity within the superior part of the labrum separate from the normal superior part of the labral cavity. MR imaging examinations of the four patients with type IV lesions showed diffuse high signal intensity within the superior part of the glenoid labrum with marked abnormal high signal intensity extending into the proximal high signal intensity within the superior part of the labrum separate from the normal superior part of the labral cavity. MR imaging examinations of the four patients with type IV lesions showed diffuse high signal intensity within the superior part of the glenoid labrum with marked abnormal high signal intensity extending into the proximal biceps tendon. None of the MR imaging studies of patients in the control group showed findings seen on MR imaging studies of patients with surgically proved SLAP lesions. CONCLUSION: Although prospective data are required to document accuracy, these preliminary data suggest that an MR examination can be useful in detecting SLAP abnormalities and establishing the type of SLAP lesion before surgery, thereby permitting better operative planning.

Adult↗
PubMed1989

Methodologic approach for a large functional trauma registry.

The utility of a clinical trauma registry (TR) is directly related to the constituents of the data base and to the accuracy of the data, which is contingent on a carefully constructed data collection system. A TR was developed by traumatologists at a busy Level I trauma facility that predominantly receives patients having incurred blunt injury. Four dedicated data collectors gather the AP information within 24 to 48 hours after admission, with prompt Attending Surgical review for verification. Examples of data output prove this is a functional system. Using a careful methodologic approach for design and implementation, clinicians can create a large, functional trauma registry with many potential applications.

Data Collection↗
PubMed2002

DNA electrophoresis in agarose gels: effects of field and gel concentration on the exponential dependence of reciprocal mobility on DNA length.

Electrophoretic mobilities of DNA molecules ranging in length from 200 to 48 502 base pairs (bp) were measured in agarose gels with concentrations T = 0.5% to 1.3% at electric fields from E = 0.71 to 5.0 V/cm. This broad data set determines a range of conditions over which the new interpolation equation nu(L) = (beta+alpha(1+exp(-L/gamma))(-1) can be used to relate mobility to length with high accuracy. Mobility data were fit with chi(2) > 0.999 for all gel concentrations and fields ranging from 2.5 to 5 V/cm, and for lower fields at low gel concentrations. Analyses using so-called reptation plots (Rousseau, J., Drouin, G., Slater, G. W., Phys. Rev. Lett. 1997, 79, 1945-1948) indicate that this simple exponential relation is obeyed well when there is a smooth transition from the Ogston sieving regime to the reptation regime with increasing DNA length. Deviations from this equation occur when DNA migration is hindered, apparently by entropic-trapping, which is favored at low fields and high gel concentrations in the ranges examined.

DNA↗
PubMed1996

Do commercial serological kits for Helicobacter pylori infection differ in accuracy? A meta-analysis.

OBJECTIVES: To compare the accuracy of common commercial serological kits for Helicobacter pylori and to ascertain factors affecting accuracy. METHODS: A comprehensive MEDLINE and manual search strategy was used to identify all articles comparing two or more kits. Each article was critically appraised for sample characteristics, study design, and data handling. The data comparing accuracy of the kits was analyzed by standard statistical methods as well as summary receiver operator characteristic curves (sROCs). A sROC also was used to estimate overall test accuracy and to identify factors affecting the measurement of accuracy. RESULTS: The 21 studies identified were of varying quality, but our analyses suggested that different commercial kits did not have significantly different accuracy. Overall, at a sensitivity of 85%, specificity was estimated to be 79%. Test accuracy measured was significantly higher in studies with smaller proportions of infected patients. CONCLUSIONS: There is little evidence in the literature to suggest that any one of the common commercial serological kits is more accurate than any other. The overall accuracy of these kits may not be adequate for clinical decision-making in all patient groups.

Helicobacter Infections↗
PubMed2003

Evaluation of a multimodality image (CT, MRI and PET) coregistration procedure on phantom and head and neck cancer patients: accuracy, reproducibility and consistency.

BACKGROUND AND PURPOSE: In radiotherapy planning of head and neck tumors, coregistration of various anatomical (e.g. CT and MRI) and functional (e.g. PET) images is a promising way to improve the delineation of the target volumes. In this paper, we report data on accuracy, reproducibility and consistency of an interactive coregistration procedure in a specifically designed phantom and in a group of patients with primary head and neck tumors. PATIENTS AND METHODS: A phantom and a group of four patients with pharyngo-laryngeal tumors were imaged by CT scan (taken as the reference image), MRI (T1- and T2-weighed sequences) and PET (transmission and FDG emission). Sets of images were coregistered using an interactive rigid coregistration method based on interactive surface segmentation. Translational and rotational displacements relative to the reference CT scan were measured and expressed in terms of accuracy, reproducibility (inter- and intra-observer variation) and consistency (between T1- and T2-weighed MRI). RESULTS: Coregistration accuracy was in the range of 0.8-6.2 mm and 1.2-4.6 mm for the phantom and the patients, respectively. Accuracy was slightly worse in the z direction, and was significantly correlated with the spatial resolution of the imaging modalities, at least for the phantom. Inter- and intra-observer variations were very small and always far below the residual variance. Consistency was perfect except in the y direction. CONCLUSION: Providing adequate set-up is chosen, accurate coregistration of CT, MR and FDG-PET images can be obtained in the head and neck area. Coregistration was consistent and highly reproducible among observers.

Head and Neck Neoplasms↗