Nick Edsborg

Karolinska Institutet, Solna, Stockholm, Sweden

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Publications (7)14.52 Total impact

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    ABSTRACT: To compare respiratory-triggered, free-breathing, and breath-hold DWI techniques regarding (1) image quality, and (2) signal intensity (SI) and ADC measurements in pancreatic ductal adenocarcinoma (PDAC). Fifteen patients with histopathologically proven PDAC underwent DWI prospectively at 1.5 T (b = 0, 50, 300, 600 and 1,000 s/mm(2)) with the three techniques. Two radiologists, independently and blindly, assigned total image quality scores [sum of rating diffusion images (lesion detection, anatomy, presence of artefacts) and ADC maps (lesion characterisation, overall image quality)] per technique and ranked them. The lesion SI, signal-to-noise ratio, mean ADC and coefficient of variation (CV) were compared. Total image quality scores for respiratory-triggered, free-breathing and breath-hold techniques were 17.9, 16.5 and 17.1 respectively (respiratory-triggered was significantly higher than free-breathing but not breath-hold). The respiratory-triggered technique had a significantly higher ranking. Lesion SI on all b-values and signal-to-noise ratio on b300 and b600 were significantly higher for the respiratory-triggered technique. For respiratory-triggered, free-breathing and breath-hold techniques the mean ADCs were 1.201, 1.132 and 1.253 × 10(-3) mm(2)/s, and mean CVs were 8.9, 10.8 and 14.1 % respectively (respiratory-triggered and free-breathing techniques had a significantly lower mean CV than the breath-hold technique). In both analyses, respiratory-triggered DWI showed superiority and seems the optimal DWI technique for demonstrating PDAC. KEY POINTS : • Diffusion-weighted magnetic resonance imaging is increasingly used to detect pancreatic cancer • Images are acquired using various breathing techniques and multiple b-values • Breathing techniques used: respiratory-triggering, free-breathing and breath-hold • Respiratory-triggering seems the optimal breathing technique for demonstrating pancreatic cancer.
    European Radiology 05/2012; 22(10):2186-92. · 4.34 Impact Factor
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    ABSTRACT: A thorough understanding of magnetic resonance (MR) contrast media dynamics makes it possible to choose the optimal contrast media for each investigation. Differences in visualizing hepatobiliary function between Gd-BOPTA and Gd-EOB-DTPA have previously been demonstrated, but less has been published regarding differences in liver vessel visualization. To compare the liver vessel and liver parenchymal enhancement dynamics of Gd-BOPTA (MultiHance) and Gd-EOB-DTPA (Primovist). The signal intensity of the liver parenchyma, the common hepatic artery, the middle hepatic vein, and a segmental branch of the right portal vein was obtained in 10 healthy volunteers before contrast media administration, during arterial and portal venous phases, and 10, 20, 30, 40, and 130 min after intravenous contrast medium injection, but, due to scanner limitations, not during the hepatic venous phase. The doses of contrast media were 0.1 mmol/kg for Gd-BOPTA and 0.025 mmol/kg for Gd-EOB-DTPA. Maximum enhancement of liver parenchyma was observed from the portal venous phase until 130 min after Gd-BOPTA administration and from 10 min to 40 min after Gd-EOB-DTPA. There was no difference in maximum enhancement of liver parenchyma between the two contrast media. When using Gd-BOPTA, the vascular contrast enhancement was still apparent 40 min after injection, but had vanished 10 min after Gd-EOB-DTPA injection. The maximum difference in signal intensity between the vessels and the liver parenchyma was significantly greater with Gd-BOPTA than with Gd-EOB-DTPA (P<0.0001). At the dosage used in this study, Gd-BOPTA yields higher maximum enhancement of the hepatic artery, portal vein, and middle hepatic vein during the arterial and the portal venous phase and during the delayed phases than Gd-EOB-DTPA does, whereas there is no difference in liver parenchymal enhancement between the two contrast agents.
    Acta Radiologica 09/2009; 50(7):709-15. · 1.33 Impact Factor
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    ABSTRACT: To assess gallbladder emptying and its association with cholecystitis and abdominal pain in patients with primary sclerosing cholangitis (PSC). Twenty patients with PSC and ten healthy subjects were investigated. Gallbladder fasting volume, ejection fraction and residual volume after ingestion of a test meal were compared in patients with PSC and healthy controls using magnetic resonance imaging. Symptoms, thickness and contrast enhancement of the gallbladder wall and the presence of cystic duct strictures were also assessed. Median fasting gallbladder volume in patients with PSC [67 (19-348) mL] was twice that in healthy controls [32 (16-55) mL] (P < 0.05). The median postprandial gallbladder volume in patients with PSC was significantly larger than that in healthy controls (P < 0.05). There was no difference in ejection fraction, gallbladder emptying volume or mean thickness of the gallbladder wall between PSC patients and controls. Contrast enhancement of the gallbladder wall in PSC patients was higher than that in controls; (69% +/- 32%) and (42% +/- 21%) (P < 0.05). No significant association was found between the gallbladder volumes and occurrence of abdominal pain in patients and controls. Patients with PSC have increased fasting gallbladder volume. Gallbladder Mucosal dysfunction secondary to chronic cholecystitis, may be a possible mechanism for increased gallbladder.
    World Journal of Gastroenterology 07/2009; 15(28):3498-503. · 2.55 Impact Factor
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    ABSTRACT: This study aimed to relate the results of physiological measurements of the pharyngoesophageal (PE) segment in subjects using tracheoesophageal (TE) or esophageal (E) speech with perceptual assessment of the speakers' voice quality and acoustic measurements of the voice function. It further aimed to investigate possible differences in appearance and placement of the voice source between TE and E speakers. Nine subjects who had undergone a laryngectomy (five TE speakers and four E speakers) participated in the study. They were videoradiographically examined during phonation and silence. Measurements were made of size and placement of the PE segment, the distance between the PE segment and the anterior wall, and the distance between the posterior and anterior esophageal walls beneath the segment. Five trained listeners perceptually assessed the subjects' voice quality, and acoustical analyses of fundamental frequency and sound pressure level were made. The physiological measurements of the nine subjects' individual PE segments varied in terms of appearance and placement during both phonation and silence, but all of the subjects showed a good closure at the PE segment level during phonation. Statistically significant results were found between all of the physiological measurements of the PE segment. Significant results were also found between the acoustical and perceptual assessments of the subjects' voices. No relations were found between the physiological measurements and the acoustic and perceptual results. The conclusion of this study was that there were no specified differences in the PE segment between TE speakers and E speakers, but that there were large individual differences within each speaker group.
    Logopedics Phoniatrics Vocology 02/2008; 33(3):115-25. · 0.57 Impact Factor
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    ABSTRACT: PURPOSE The purpose was to evaluate if an orally administered manganese containing contrast agent can be used for screening of liver metastases. METHOD AND MATERIALS 10 patients under evaluation for curative liver resection due to liver metastasis from colon carcinoma were recruited. Three hours after oral intake of 100 ml of the manganese contrast agent a single phase MRI of the liver at 1.5 T was performed. As gold standard a clinical 5-phase (native, arterio-porta, porto-venous, 5 min and 2 hour) Gd-BOPTA protocol was used. RESULTS Metastases appear dark against a bright liver when using CMC 001 and Gd-BOPTA protocols. In total 24 metastases (average diameter 21 mm ± 18 mm) were observed when using Gd-BOPTA. 23 of these were detected using CMC (96% sensitivity). At CMC 001 a total of four false positive metastases were found in two patients (85% specificity). The false positive metastases were due to artefacts produced by clips (n=1) and hemangioma (n=3). Among the true positive 23 metastases the difference in SI between liver parenchyma and lesion was 165 (± 86) after CMC 001 and 66 (± 34) after Gd-BOPTA. CONCLUSION CMC 001 has a high sensitivity and specificity to identify liver metastases of colon cancer. CLINICAL RELEVANCE/APPLICATION The orally administered manganese containing contrast agent CMC 001 has a good potential for screening of liver metastases.
    Radiological Society of North America 2007 Scientific Assembly and Annual Meeting; 11/2007
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    ABSTRACT: With a worldwide incidence of more than 200,000 cases and almost as many deaths, pancreatic carcinoma (PC) remains one of the leading causes of cancer deaths, especially in the Western world. Due to the late onset of symptoms, almost all patients suffer from disseminated disease at the time of diagnosis and only a minority will ever be candidates for radical surgery. Only about one tenth of the operated patients remain disease free. For these reasons, development of effective palliative systemic therapy is important. Almost a decade ago, gemcitabine replaced 5-Fu as the gold standard in systemic treatment of advanced PC. Since then, a number of trials have investigated the potential additional effect of several cytotoxic or targeted agents in combination with gemcitabine. As shown in this review, nearly all these trials have proved disappointing. This review provides an overview of the results of current phase III trials of gemcitabine based systemic therapy. Furthermore, we discuss the role of systemic therapy compared to BSC only and the potential future role of targeted therapies.
    Acta Oncologica 02/2006; 45(2):136-43. · 2.87 Impact Factor
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    Acta Oncologica 02/2006; 45(2):210-2. · 2.87 Impact Factor