Oystein E Olsen

Great Ormond Street Hospital for Children NHS Foundation Trust, Londinium, England, United Kingdom

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Publications (52)205.65 Total impact

  • Peter J. Strouse · Oystein E. Olsen

    No preview · Article · Jan 2016 · Pediatric Radiology
  • Øystein E. Olsen

    No preview · Article · Dec 2015 · Pediatric Radiology
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    ABSTRACT: Objectives: To compare the diagnostic yield of whole-body post-mortem computed tomography (PMCT) imaging to post-mortem magnetic resonance (PMMR) imaging in a prospective study of fetuses and children. Methods: We compared PMCT and PMMR to conventional autopsy as the gold standard for the detection of (a) major pathological abnormalities related to the cause of death and (b) all diagnostic findings in five different body organ systems. Results: Eighty two cases (53 fetuses and 29 children) underwent PMCT and PMMR prior to autopsy, at which 55 major abnormalities were identified. Significantly more PMCT than PMMR examinations were non-diagnostic (18/82 vs. 4/82; 21.9 % vs. 4.9 %, diff 17.1 % (95 % CI 6.7, 27.6; p < 0.05)). PMMR gave an accurate diagnosis in 24/55 (43.64 %; 95 % CI 31.37, 56.73 %) compared to 18/55 PMCT (32.73 %; 95 % CI 21.81, 45.90). PMCT was particularly poor in fetuses <24 weeks, with 28.6 % (8.1, 46.4 %) more non-diagnostic scans. Where both PMCT and PMMR were diagnostic, PMMR gave slightly higher diagnostic accuracy than PMCT (62.8 % vs. 59.4 %). Conclusion: Unenhanced PMCT has limited value in detection of major pathology primarily because of poor-quality, non-diagnostic fetal images. On this basis, PMMR should be the modality of choice for non-invasive PM imaging in fetuses and children. Key points: • Overall 17.1 % more PMCT examinations than PMMR were non-diagnostic • 28.6 % more PMCT were non-diagnostic than PMMR in fetuses <24 weeks • PMMR detected almost a third more pathological abnormalities than PMCT • PMMR gave slightly higher diagnostic accuracy when both were diagnostic.
    Full-text · Article · Oct 2015 · European Radiology
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    ABSTRACT: Wilms' tumours (WTs) are large heterogeneous tumours, which typically consist of a mixture of histological cell types, together with regions of chemotherapy-induced regressive change and necrosis. The predominant cell type in a WT is assessed histologically following nephrectomy, and used to assess the tumour subtype and potential risk. The purpose of this study was to develop a mathematical model to identify subregions within WTs with distinct cellular environments in vivo, determined using apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI). We recorded the WT subtype from the histopathology of 32 tumours resected in patients who received DWI prior to surgery after pre-operative chemotherapy had been administered. In 23 of these tumours, DWI data were also available prior to chemotherapy. Histograms of ADC values were analysed using a multi-Gaussian model fitting procedure, which identified 'subpopulations' with distinct cellular environments within the tumour volume. The mean and lower quartile ADC values of the predominant viable tissue subpopulation (ADC1MEAN , ADC1LQ ), together with the same parameters from the entire tumour volume (ADC0MEAN , ADC0LQ ), were tested as predictors of WT subtype. ADC1LQ from the multi-Gaussian model was the most effective parameter for the stratification of WT subtype, with significantly lower values observed in high-risk blastemal-type WTs compared with intermediate-risk stromal, regressive and mixed-type WTs (p < 0.05). No significant difference in ADC1LQ was found between blastemal-type and intermediate-risk epithelial-type WTs. The predominant viable tissue subpopulation in every stromal-type WT underwent a positive shift in ADC1MEAN after chemotherapy. Our results suggest that our multi-Gaussian model is a useful tool for differentiating distinct cellular regions within WTs, which helps to identify the predominant histological cell type in the tumour in vivo. This shows potential for improving the risk-based stratification of patients at an early stage, and for guiding biopsies to target the most malignant part of the tumour. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    No preview · Article · Jun 2015 · NMR in Biomedicine
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    Annemieke S Littooij · Paul D Humphries · Øystein E Olsen
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    ABSTRACT: The apparent diffusion coefficient (ADC) is potentially useful for assessing treatment response in nephroblastoma (Wilms tumour). However the precision of ADC measurements in these heterogeneous lesions is unknown. To assess intra- and interobserver variability of whole-tumour ADC measurements in viable parts of nephroblastomas at diagnosis and after preoperative chemotherapy. We included children with histopathologically proven nephroblastoma who had undergone MRI with diffusion-weighted imaging before and after preoperative chemotherapy. Three independent observers performed whole-tumour ADC measurements of all lesions, excluding non-enhancing areas. One observer evaluated all lesions on two occasions. We performed analyses using Bland-Altman plots and concordance correlation coefficient (CCC) calculations with 95% limits of agreement for median ADC, difference between pre- and post-chemotherapy median ADC (ADC shift) and percentage of pixels with ADC values <1.0 × 10(-3) mm(2)/s. In 22 lesions (13 pretreatment and 9 post-treatment) in 10 children the interobserver variability in median ADC and ADC shift were within the interval of approximately ±0.1 × 10(-3) mm(2)/s (limits of agreement for median ADC ranged -0.08-0.11 × 10(-3) mm(2)/s and for ADC-shift -0.11-0.09 × 10(-3) mm(2)/s). The interobserver variability for percentage of low-ADC pixels was larger and also biased. The calculated CCC confirmed good intra- and interobserver agreement (ρ-c ranging from 0.968 to 0.996). Measurements of whole-tumour ADC values excluding necrotic areas seem to be sufficiently precise for detection of chemotherapy-related change.
    Preview · Article · May 2015 · Pediatric Radiology
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    Full-text · Dataset · Jan 2015
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    Øystein E Olsen
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    ABSTRACT: This article questions the scientific justification of ingrained radiologic practices exemplified by size measurements of childhood solid tumours. This is approached by a critical review of staging systems from a selection of paediatric oncological treatment protocols. Local staging remains size-dependent for some tumour types. The consequent stage assignment can significantly influence treatment intensity. Still, the protocols tend not to give precise guidance on how to perform scans and standardise measurements. Also, they do not estimate or account for the inevitable variability in measurements. Counts and measurements of lung nodules are, within some tumour groups, used for diagnosis of metastatic disease. There is, however, no evidence that nodule size is a useful discriminator of benign and malignant lung nodules. The efficacy of imaging depends chiefly on observations being precise, accurate and valid for the desired diagnostic purpose. Because measurements without estimates of their errors are meaningless, studies of variability dependent on tumour shape and location, imaging device and observer need to be encouraged. Reproducible observations make good candidates for staging parameters if they have prognostic validity and at the same time show little covariation with (thereby adding new information to) the existing staging system. The lack of scientific rigour has made the validity of size measurement very difficult to assess. Action is needed, the most important being radiologists' active contribution in development of oncological staging systems, attention to standardisation, knowledge about errors in measurement and protection against undue influence of such errors in the staging of the individual child.
    Preview · Article · Jan 2015 · Pediatric Radiology
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    ABSTRACT: To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for abdominal pathology in foetuses and children, compared to conventional autopsy. Institutional ethics approval and parental consent was obtained. 400 unselected foetuses and children underwent PMMR using a 1.5T Siemens Avanto MR scanner before conventional autopsy. PMMR images and autopsy findings were reported blinded to the other data respectively. Abdominal abnormalities were found in 70/400 (12%) autopsies. Overall sensitivity and specificity (95% confidence interval) of PMMR for abdominal pathology was 72.5% (61.0, 81.6) and 90.8% (87.0, 93.6), with positive (PPV) and negative predictive values (NPV) of 64.1% (53.0, 73.9) and 93.6% (90.2, 95.8) respectively. PMMR was good at detecting renal abnormalities (sensitivity 80%), particularly in foetuses, and relatively poor at detecting intestinal abnormalities (sensitivity 50%). Overall accuracy was 87.4% (83.6, 90.4). PMMR has high overall accuracy for abdominal pathology in foetuses, newborns and children. PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
    Full-text · Article · Dec 2014 · European Journal of Radiology
  • Tom A Watson · Oystein E Olsen
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    ABSTRACT: Interpreting complex paediatric body MRI studies requires the integration of information from multiple sequences. Image processing software, some freely available, allows the radiologist to use simple and rapid post-processing techniques that may aid diagnosis. We demonstrate the use of fusion and subtraction post-processing techniques with examples from four areas of application: enterography, oncological imaging, musculoskeletal imaging and MR fistulography.
    No preview · Article · Sep 2014 · Pediatric Radiology
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    Oystein E Olsen

    Preview · Article · Jul 2014 · Pediatric Radiology
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    Alex Weller · Joy L Barber · Oystein E Olsen
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    ABSTRACT: Nephrogenic systemic fibrosis (NSF) is a multisystem disease seen exclusively in patients with renal impairment. It can be severely debilitating and sometimes fatal. There is a strong association with gadolinium-based contrast agents used in magnetic resonance imaging (MRI). Risk factors include renal impairment and proinflammatory conditions, e.g. major surgery and vascular events. Although there is no single effective treatment for NSF, the most successful outcomes are seen following restoration of renal function, either following recovery from acute kidney injury or following renal transplantation. There have been ten biopsy-proved pediatric cases of NSF, with no convincing evidence that children have a significantly altered risk compared with the adult population. After implementation of guidelines restricting the use of gadolinium-based contrast agents in at-risk patients, there has been a sharp reduction in new cases and no new reports in children. Continued vigilance is recommended: screening for renal impairment, use of more stable gadolinium chelates, consideration of non-contrast-enhanced MRI or alternative imaging modalities where appropriate.
    Full-text · Article · Oct 2013 · Pediatric Nephrology
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    ABSTRACT: Magnetic resonance imaging (MRI), frequently with contrast enhancement, is the preferred imaging modality for many indications in children. Practice varies widely between centers, reflecting the rapid pace of change and the need for further research. Guide-line changes, for example on contrast-medium choice, require continued practice reappraisal. This article reviews recent developments in pediatric contrast-enhanced MRI and offers recommendations on current best practice. Nine leading pediatric radiologists from internationally recognized radiology centers convened at a consensus meeting in Bordeaux, France, to discuss applications of contrast-enhanced MRI across a range of indications in children. Review of the literature indicated that few published data provide guidance on best practice in pediatric MRI. Discussion among the experts concluded that MRI is preferred over ionizing-radiation modalities for many indications, with advantages in safety and efficacy. Awareness of age-specific adaptations in MRI technique can optimize image quality. Gadolinium-based contrast media are recommended for enhancing imaging quality. The choice of most appropriate contrast medium should be based on criteria of safety, tolerability, and efficacy, characterized in age-specific clinical trials and personal experience.
    Full-text · Article · Oct 2013 · Magnetic Resonance Insights
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    ABSTRACT: BACKGROUND: Post-mortem MRI is a potential diagnostic alternative to conventional autopsy, but few large prospective studies have compared its accuracy with that of conventional autopsy. We assessed the accuracy of whole-body, post-mortem MRI for detection of major pathological lesions associated with death in a prospective cohort of fetuses and children. METHODS: In this prospective validation study, we did pre-autopsy, post-mortem, whole-body MRI at 1·5 T in an unselected population of fetuses (≤24 weeks' or >24 weeks' gestation) and children (aged <16 years) at two UK centres in London between March 1, 2007 and Sept 30, 2011. With conventional autopsy as the diagnostic gold standard, we assessed MRI findings alone, or in conjunction with other minimally invasive post-mortem investigations (minimally invasive autopsy), for accuracy in detection of cause of death or major pathological abnormalities. A radiologist and pathologist who were masked to the autopsy findings indicated whether the minimally invasive autopsy would have been adequate. The primary outcome was concordance rate between minimally invasive and conventional autopsy. FINDINGS: We analysed 400 cases, of which 277 (69%) were fetuses and 123 (31%) were children. Cause of death or major pathological lesion detected by minimally invasive autopsy was concordant with conventional autopsy in 357 (89·3%, 95% CI 85·8-91·9) cases: 175 (94·6%, 90·3-97·0) of 185 fetuses at 24 weeks' gestation or less, 88 (95·7%, 89·3-98·3) of 92 fetuses at more than 24 weeks' gestation, 34 (81·0%, 67·7-90·0) of 42 newborns aged 1 month or younger, 45 (84·9%, 72·9-92·1) of 53 infants aged older than 1 month to 1 year or younger, and 15 (53·6%, 35·8-70·5) of 28 children aged older than 1 year to 16 years or younger. The dedicated radiologist or pathologist review of the minimally invasive autopsy showed that in 165 (41%) cases a full autopsy might not have been needed; in these cases, concordance between autopsy and minimally invasive autopsy was 99·4% (96·6-99·9). INTERPRETATION: Minimally invasive autopsy has accuracy similar to that of conventional autopsy for detection of cause of death or major pathological abnormality after death in fetuses, newborns, and infants, but was less accurate in older children. If undertaken jointly by pathologists and radiologists, minimally invasive autopsy could be an acceptable alternative to conventional autopsy in selected cases. FUNDING: Policy research Programme, Department of Health, UK.
    Full-text · Article · Jul 2013 · The Lancet
  • Oystein Erlend Olsen
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    ABSTRACT: Magnetic resonance imaging (MRI) is rich in diagnostic information but requires optimization for use in children. The main problems are motion artifacts and poor signal-to-noise ratio (SNR). SNR is proportional to voxel volume, which must therefore not be too small, however, usually needs to be reduced compared to adult imaging to account for the finer anatomy of the child. The use of multi-channel coils with element sizes appropriate for the anatomy of interest ensures optimal baseline SNR. Longer acquisition time increases SNR (with a square-root factor), but the flip-side is that this allows more motion artifacts. Attention to patient preparation and to techniques for motion artifact reduction is therefore crucial, and the most important principles are discussed. Low SNR may in part be compensated by optimizing the image contrast by weighting (tissue and lesions T1 and T2 may differ from adults) and by using contrast agents. It is also powerful to combine different image contrasts during postprocessing. The basic principles are discussed, followed by an example scan protocol.
    No preview · Article · Feb 2013 · Acta Radiologica
  • Carolyn Young · Øystein E. Olsen · Catherine M. Owens

    No preview · Article · Dec 2012
  • Sílvia Costa Dias · Oystein E Olsen
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    ABSTRACT: MRI has a fundamental role in paediatric imaging. The T2-weighted fast/turbo spin-echo sequence is important because it has high signal-to-noise ratio compared to gradient-echo sequences. It is usually acquired as 2-D sections in one or more planes. Volumetric spin-echo has until recently only been possible with very long echo times due to blurring of the soft-tissue contrast with long echo trains. A new 3-D spin-echo sequence uses variable flip angles to overcome this problem. It may reproduce useful soft-tissue contrast, with improved spatial resolution. Its isotropic capability allows subsequent reconstruction in standard, curved or arbitrary planes. It may be particularly useful for visualisation of small lesions, or if large lesions distort the usual anatomical relations. We present clinical examples, describe the technical parameters and discuss some potential artefacts and optimisation of image quality.
    No preview · Article · Aug 2012 · Pediatric Radiology

  • No preview · Article · May 2012 · Archives of Disease in Childhood
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    ABSTRACT: Minimally invasive autopsy by post mortem magnetic resonance (MR) imaging has been suggested as an alternative for conventional autopsy in view of the declining consented autopsy rates. However, large prospective studies rigorously evaluating the accuracy of such an approach are lacking. We intend to compare the accuracy of a minimally invasive autopsy approach using post mortem MR imaging with that of conventional autopsy in fetuses, newborns and children for detection of the major pathological abnormalities and/or determination of the cause of death. We recruited 400 consecutive fetuses, newborns and children referred for conventional autopsy to one of the two participating hospitals over a three-year period. We acquired whole body post mortem MR imaging using a 1.5 T MR scanner (Avanto, Siemens Medical Solutions, Enlargen, Germany) prior to autopsy. The total scan time varied between 90 to 120 minutes. Each MR image was reported by a team of four specialist radiologists (paediatric neuroradiology, paediatric cardiology, paediatric chest & abdominal imaging and musculoskeletal imaging), blinded to the autopsy data. Conventional autopsy was performed according to the guidelines set down by the Royal College of Pathologists (UK) by experienced paediatric or perinatal pathologists, blinded to the MR data. The MR and autopsy data were recorded using predefined categorical variables by an independent person. Using conventional post mortem as the gold standard comparator, the MR images will be assessed for accuracy of the anatomical morphology, associated lesions, clinical usefulness of information and determination of the cause of death. The sensitivities, specificities and predictive values of post mortem MR alone and MR imaging along with other minimally invasive post mortem investigations will be presented for the final diagnosis, broad diagnostic categories and for specific diagnosis of each system. NCT01417962 NIHR PORTFOLIO NUMBER: 6794.
    Full-text · Article · Dec 2011 · BMC Pediatrics
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    Oystein E Olsen · Catherine M Owens

    Full-text · Article · Sep 2011 · Pediatric Radiology
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    Øystein E Olsen · Catherine M Owens

    Full-text · Article · Jun 2011 · Pediatric Radiology

Publication Stats

828 Citations
205.65 Total Impact Points

Institutions

  • 2004-2016
    • Great Ormond Street Hospital for Children NHS Foundation Trust
      • Department of Radiology
      Londinium, England, United Kingdom
  • 2001-2010
    • Haukeland University Hospital
      • Department of Radiology
      Bergen, Hordaland, Norway
  • 2007
    • Washington University in St. Louis
      San Luis, Missouri, United States
  • 2006
    • Institute of Cancer Research
      Londinium, England, United Kingdom
  • 2002
    • University of Bergen
      Bergen, Hordaland, Norway