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Biomedical subjects

E H Madsen

Publications and source records attributed to E H Madsen.

11 recordsLinked to original sources
PubMed1996

Quantitative assessment of radiation-induced lung changes by computerized optical densitometry of routine chest x-rays.

PURPOSE: To develop a quantitative assay of radiological lung changes after postmastectomy radiotherapy applicable for analysis of routine chest x-rays. METHODS AND MATERIALS: The assay relies on measurement of the optical density of chest x-rays by means of a standard personal computer-controlled film densitometer used for scanning dosimetry films. Density profiles were recorded at 1 mm steps along two reference lines in each lung. The crossing between the clavicula and the first rib in the x-ray projection was used as an easily identifiable anatomical landmark and was used to establish two parallel cranio-caudal reference lines separated by 20 mm. The starting point for recording optical densities was 5 mm below a line perpendicular to the reference lines and tangent to the top of the lung. Data were stored in a computer file for subsequent processing. The optical film densities in the apex of the lungs were converted into equivalent absorber thickness (EAT). To minimize the dependency on technical factors, the unirradiated lung was used as a control. Lung density changes were quantified by the relative change in EAT (REAT), which was evaluated as the difference between the summed EATs along the reference lines in the two lungs, corrected for any pretreatment difference in lung density, and taken as a percentage of the pretreatment EAT value of the lung. RESULTS: Four different test were carried out to investigate the reproducibility and validity of the proposed assay. (a) An anthropomorphic phantom was used to test the relationship between REAT and the layer of plastic absorber placed in front of one lung. A linear relationship was found with a correlation coefficient of 0.9993. (b) A series of 10 repeat measurements of the same arbitrarily chosen x-ray showed a mean REAT value of 9.8%, with a standard deviation of 0.21%. (c) Forty-three chest x-rays exposed on the same day were available from the clinical series. These were treated as double determinations of REAT values, and the standard deviation was estimated at 1.35%. (d) REAT values estimated with this assay were significantly correlated with the scores of two experienced specialists, an oncologist and a radiologist (Spearman's rank correlation coefficient being 0.605, p < 10(-8)). CONCLUSION: This assay quantifies radiation-induced lung injury from routine chest x-rays. Thus, it is possible to take advantage of the very large retrospective materials available in most oncological institutions. The assay has been validated in a phantom experiment and shown to be reproducible. Furthermore, it is technically easy to perform.

Female↗
PubMed1987

The value of the NSD formula in equation of acute and late radiation complications in normal tissue following 2 and 5 fractions per week in breast cancer patients treated with postmastectomy irradiation.

In 1978-1980, inclusive, all breast cancer patients referred for postmastectomy irradiation were treated by 2 fractions per week (73 patients) but due to a high incidence of late complications this fractionation schedule was changed from early 1981 to 5 fractions per week (66 patients) with dose adjustment according to the nominal standard dose (NSD) concept. The dose aim in both regimens was 1345 ret minimum target dose. This allowed a comparison of acute and late complications in the two patient groups treated to the same NSD value, but with different fractionation. The patients have been analysed with respect to acute and late reaction in the skin, subcutaneous tissue, lung and bone, as well as related complications, such as arm oedema and impairment of shoulder movement. Except for the acute skin reactions, all other endpoints could not be adequately predicted by the NSD formula. Thus, telangiectasia greater than or equal to grade 1 and skin fibrosis greater than or equal to grade 2 were found to be 75% and 67% in patients treated with the 2-fraction scheme versus 39% and 5% in patients treated with the 5-fraction scheme. In the 2-fraction regimen, a higher frequency of impairment of shoulder movement and arm oedema was found compared to the 5-fraction regimen, 38% versus 11% and 44% versus 33%, respectively. The acute lung reaction as well as late lung reaction were significantly more pronounced in the 2-fraction regimen than in the 5-fraction regimen (pneumonitis greater than or equal to grade 2, 43% versus 23%, and lung fibrosis greater than or equal to grade 2, 32% versus 17%, in the photon fields, respectively). Further, radiation-induced osteonecrosis in the ribs was significantly more frequent in patients treated with large dose per fraction (19% versus 2%). The data clearly demonstrates the danger by using the NSD formula in equation of two different fractionation schedules. This formula as well as other mathematical models can only be used with caution within the limitations defined by the underlying clinical and experimental data on which they have been derived.

Breast Neoplasms↗
PubMed1984

Specimen radiography of bone tumours.

Radiographs obtained with a transportable roentgen apparatus and a shielded cabinet on fine grain films of whole specimens and/or slabs of transsected bone in primary bone tumours and soft tissue tumours with skeletal invasion or ossification were compared with clinical roentgenograms and related to gross and microscopic pathology as demonstrated in selected cases. Specimen radiography is found to be a valuable adjunct to standard morphologic examination and forms a link to clinical radiology in the study of bone tumours and related diseases.

Adolescent↗
PubMed1983

Histopathological grading in soft-tissue tumours. Relation to survival in 261 surgically treated patients.

A system for histopathological grading of malignancy in soft-tissue sarcoma is described in detail, and the importance of the grade of tumour in predicting survival is demonstrated in a consecutive series of 261 surgically treated patients with sarcoma of the somatic soft tissue. Mitosis index is the main discriminating criterion. Delay in fixation, for instance in large specimens, may cause an artificially low mitosis index calling for the need of other criteria, too, reflecting grade of malignancy: cellularity, anaplasia, number of pycnotic and/or fragmented nuclei. There is a significant difference in survival between the three grades, 10 years survival with surgical treatment alone is 97%, 57% and 29% for grades 1, 2 and 3 respectively.

Adolescent↗
PubMed1979

Lymph node metastases from osteoblastic osteogenic sarcoma visible on plain films.

The radiologic features of lymph node metastases from osteogenic sarcoma visible on plain films in two patients are described. In one patient the lymph node ossification was visible on presentation and in the other patient it was demonstrated six months after the initial diagnosis. The radiologic pattern in both cases was similar. Deposition of metastatic osteoid tissue in lymph nodes, to such a degree that it can be recognized on plain films, appears to be a distinctly uncommon complication of this malignant neoplasm. It is considered probable that this complication occurs with the osteoblastic type of osteogenic sarcoma. It is suggested that lymphography might be of value in the detection of such metastases at an earlier stage, thus influencing the plan of treatment.

Adolescent↗
PubMed1977

X-ray examination of endoscopy? A blind prospective study including barium meal, double contrast examiniation, and endoscopy of esophagus, stomach, and duodenum.

One hundred and one consecutive patients with upper abdominal dyspepsia were examined by conventional barium meal, double contrast examination, and endoscopy of the stomach and the duodenum in a blind prospective investigation. All the examiners were specially trained. Only small differences between the sensitivity and the specificity of the methods were found, but the clinical importance of the false positive and the false negative errors of the three methods of examination was not the same. The sensitivity of the ordinary X-ray examination was found to be sufficiently high for still recommending this method for primary screening. In case of posivite findings in the stomach, supplementary gastroscopy ought to be performed in order to increase the diagnostic specificity.

Adult↗
PubMed1976

Complications by translumbar aortography.

The complications resulting from different methods of translumbar aortography were evaluated by checking 1192 examinations performed with 1) a cannula, 2) a straight catheter, and 3) a curved catheter. The latter method was found to be far more safe than the other two. According to the complication rates found in the literature the curved catheter translumbar method is also safer than the transaxillar and comparable to transfemoral aortography by the Seldinger method.

Aortography↗