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  • 1.
    Ahlander, Britt-Marie
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Magnetic Resonance Imaging of the Heart: Image quality, measurement accuracy and patient experience2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Non-invasive diagnostic imaging of atherosclerotic coronary artery disease (CAD) is frequently carried out with cardiovascular magnetic resonance imaging (CMR) or myocardial perfusion single photon emission computed tomography (MPS). CMR is the gold standard for the evaluation of scar after myocardial infarction and MPS the clinical gold standard for ischemia. Magnetic Resonance Imaging (MRI) is at times difficult for patients and may induce anxiety while patient experience of MPS is largely unknown.

    Aims: To evaluate image quality in CMR with respect to the sequences employed, the influence of atrial fibrillation, myocardial perfusion and the impact of patient information. Further, to study patient experience in relation to MRI with the goal of improving the care of these patients.

    Method: Four study designs have been used. In paper I, experimental cross-over, paper (II) experimental controlled clinical trial, paper (III) psychometric crosssectional study and paper (IV) prospective intervention study. A total of 475 patients ≥ 18 years with primarily cardiac problems (I-IV) except for those referred for MRI of the spine (III) were included in the four studies.

    Result: In patients (n=20) with atrial fibrillation, a single shot steady state free precession (SS-SSFP) sequence showed significantly better image quality than the standard segmented inversion recovery fast gradient echo (IR-FGRE) sequence (I). In first-pass perfusion imaging the gradient echo-echo planar imaging sequence (GREEPI) (n=30) had lower signal-to-noise and contrast–to-noise ratios than the steady state free precession sequence (SSFP) (n=30) but displayed a higher correlation with the MPS results, evaluated both qualitatively and quantitatively (II). The MRIAnxiety Questionnaire (MRI-AQ) was validated on patients, referred for MRI of either the spine (n=193) or the heart (n=54). The final instrument had 15 items divided in two factors regarding Anxiety and Relaxation. The instrument was found to have satisfactory psychometric properties (III). Patients who prior CMR viewed an information video scored significantly (lower) better in the factor Relaxation, than those who received standard information. Patients who underwent MPS scored lower on both factors, Anxiety and Relaxation. The extra video information had no effect on CMR image quality (IV).

    Conclusion: Single shot imaging in atrial fibrillation produced images with less artefact than a segmented sequence. In first-pass perfusion imaging, the sequence GRE-EPI was superior to SSFP. A questionnaire depicting anxiety during MRI showed that video information prior to imaging helped patients relax but did not result in an improvement in image quality.

    List of papers
    1. Image quality and myocardial scar size determined with magnetic resonance imaging in patients with permanent atrial fibrillation: a comparison of two imaging protocols
    Open this publication in new window or tab >>Image quality and myocardial scar size determined with magnetic resonance imaging in patients with permanent atrial fibrillation: a comparison of two imaging protocols
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    2010 (English)In: CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, ISSN 1475-0961, Vol. 30, no 2, p. 122-129Article in journal (Refereed) Published
    Abstract [en]

    Pandgt;Background: Magnetic resonance imaging (MRI) of the heart generally requires breath holding and a regular rhythm. Single shot 2D steady-state free precession (SS_SSFP) is a fast sequence insensitive to arrhythmia as well as breath holding. Our purpose was to determine image quality, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios and infarct size with a fast single shot and a standard segmented MRI sequence in patients with permanent atrial fibrillation and chronic myocardial infarction. Methods: Twenty patients with chronic myocardial infarction and ongoing atrial fibrillation were examined with inversion recovery SS_SSFP and segmented inversion recovery 2D fast gradient echo (IR_FGRE). Image quality was assessed in four categories: delineation of infarcted and non-infarcted myocardium, occurrence of artefacts and overall image quality. SNR and CNR were calculated. Myocardial volume (ml) and infarct size, expressed as volume (ml) and extent (%), were calculated, and the methodological error was assessed. Results: SS_SSFP had significantly better quality scores in all categories (P = 0 center dot 037, P = 0 center dot 014, P = 0 center dot 021, P = 0 center dot 03). SNRinfarct and SNRblood were significantly better for IR_FGRE than for SS_SSFP (P = 0 center dot 048, P = 0 center dot 018). No significant difference was found in SNRmyocardium and CNR. The myocardial volume was significantly larger with SS_SSFP (170 center dot 7 versus 159 center dot 2 ml, P andlt; 0 center dot 001), but no significant difference was found in infarct volume and infarct extent. Conclusion: SS_SSFP displayed significantly better image quality than IR_FGRE. The infarct size and the error in its determination were equal for both sequences, and the examination time was shorter with SS_SSFP.

    Keywords
    atrial fibrillation, magnetic resonance imaging, myocardial infarction, segmented inversion recovery 2D fast gradient echo, single shot inversion recovery 2D steady-state free precession
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-54159 (URN)10.1111/j.1475-097X.2009.00914.x (DOI)000274438800006 ()
    Available from: 2010-02-26 Created: 2010-02-26 Last updated: 2016-08-24
    2. An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion
    Open this publication in new window or tab >>An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion
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    2017 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 52-61Article in journal (Refereed) Published
    Abstract [en]

    Background To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference. Methods Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study. Results Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI). Conclusion GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2017
    Keywords
    cardiac imaging techniques, coronary heart disease, Magnetic Resonance Imaging, nuclear medicine, perfusion
    National Category
    Radiology, Nuclear Medicine and Medical Imaging Medical Laboratory and Measurements Technologies Medical Image Processing Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-130795 (URN)10.1111/cpf.12267 (DOI)000390688200008 ()26147785 (PubMedID)
    Note

    Funding agencies: Medical Research Council of Southeast Sweden [12437]; Futurum, the County council of Jonkoping [12440, 81851, 217261]; Linkoping University; County Council of Ostergotland [281281]; Swedish Heart-Lung Foundation [20120449]

    Available from: 2016-08-24 Created: 2016-08-24 Last updated: 2017-11-28Bibliographically approved
    3. Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging: the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ)
    Open this publication in new window or tab >>Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging: the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ)
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    2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 6, p. 1368-1380Article in journal (Refereed) Published
    Abstract [en]

    Aim. To develop and validate a new instrument measuring patient anxiety during Magnetic Resonance Imaging examinations, Magnetic Resonance Imaging-Anxiety Questionnaire. Background. Questionnaires measuring patients anxiety during Magnetic Resonance Imaging examinations have been the same as used in a wide range of conditions. To learn about patients experience during examination and to evaluate interventions, a specific questionnaire measuring patient anxiety during Magnetic Resonance Imaging is needed. Design. Psychometric cross-sectional study with test-retest design. Methods. A new questionnaire, Magnetic Resonance Imaging-Anxiety Questionnaire, was designed from patient expressions of anxiety in Magnetic Resonance Imaging-scanners. The sample was recruited between October 2012-October 2014. Factor structure was evaluated with exploratory factor analysis and internal consistency with Cronbachs alpha. Criterion-related validity, known-group validity and test-retest was calculated. Results. Patients referred for Magnetic Resonance Imaging of either the spine or the heart, were invited to participate. The development and validation of Magnetic Resonance Imaging-Anxiety Questionnaire resulted in 15 items consisting of two factors. Cronbachs alpha was found to be high. Magnetic Resonance Imaging-Anxiety Questionnaire correlated higher with instruments measuring anxiety than with depression scales. Known-group validity demonstrated a higher level of anxiety for patients undergoing Magnetic Resonance Imaging scan of the heart than for those examining the spine. Test-retest reliability demonstrated acceptable level for the scale. Conclusion. Magnetic Resonance Imaging-Anxiety Questionnaire bridges a gap among existing questionnaires, making it a simple and useful tool for measuring patient anxiety during Magnetic Resonance Imaging examinations.

    Place, publisher, year, edition, pages
    WILEY-BLACKWELL, 2016
    Keywords
    anxiety; instrument development; magnetic resonance imaging; nurse; nursing; reliability; validity
    National Category
    Other Medical Sciences not elsewhere specified
    Identifiers
    urn:nbn:se:liu:diva-129145 (URN)10.1111/jan.12917 (DOI)000376007400014 ()26893007 (PubMedID)
    Note

    Funding Agencies|Swedish Heart and Lung Foundation; Futurum County Council of Jonkoping

    Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2017-11-28
  • 2.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, Jönköping.
    Maret, Eva
    Department of Radiology, Ryhov County Hospital, Jönköping / Department of Clinical Physiology, Karolinska University Hospital, Stockholm.
    Brudin, Lars
    Department of Clinical Physiology, Kalmar County Hospital, Kalmar.
    Starck, Sven-Åke
    Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University / Department of Oncology, Hospital Physics, Ryhov County Hospital, Jönköping.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion2017In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 52-61Article in journal (Refereed)
    Abstract [en]

    Background To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference. Methods Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study. Results Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI). Conclusion GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

  • 3.
    Ahlström, Christer
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Health Sciences.
    Nonlinear phonocardiographic Signal Processing2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis work has been to develop signal analysis methods for a computerized cardiac auscultation system, the intelligent stethoscope. In particular, the work focuses on classification and interpretation of features derived from the phonocardiographic (PCG) signal by using advanced signal processing techniques.

    The PCG signal is traditionally analyzed and characterized by morphological properties in the time domain, by spectral properties in the frequency domain or by nonstationary properties in a joint time-frequency domain. The main contribution of this thesis has been to introduce nonlinear analysis techniques based on dynamical systems theory to extract more information from the PCG signal. Especially, Takens' delay embedding theorem has been used to reconstruct the underlying system's state space based on the measured PCG signal. This processing step provides a geometrical interpretation of the dynamics of the signal, whose structure can be utilized for both system characterization and classification as well as for signal processing tasks such as detection and prediction. In this thesis, the PCG signal's structure in state space has been exploited in several applications. Change detection based on recurrence time statistics was used in combination with nonlinear prediction to remove obscuring heart sounds from lung sound recordings in healthy test subjects. Sample entropy and mutual information were used to assess the severity of aortic stenosis (AS) as well as mitral insufficiency (MI) in dogs. A large number of, partly nonlinear, features was extracted and used for distinguishing innocent murmurs from murmurs caused by AS or MI in patients with probable valve disease. Finally, novel work related to very accurate localization of the first heart sound by means of ECG-gated ensemble averaging was conducted. In general, the presented nonlinear processing techniques have shown considerably improved results in comparison with other PCG based techniques.

    In modern health care, auscultation has found its main role in primary or in home health care, when deciding if special care and more extensive examinations are required. Making a decision based on auscultation is however difficult, why a simple tool able to screen and assess murmurs would be both time- and cost-saving while relieving many patients from needless anxiety. In the emerging field of telemedicine and home care, an intelligent stethoscope with decision support abilities would be of great value.

    List of papers
    1. A method for accurate localization of the first heart sound and possible applications
    Open this publication in new window or tab >>A method for accurate localization of the first heart sound and possible applications
    2008 (English)In: Physiological Measurement, ISSN 0967-3334, E-ISSN 1361-6579, Vol. 29, no 3, p. 417-428Article in journal (Refereed) Published
    Abstract [en]

    We have previously developed a method for localization of the first heart sound (S1) using wavelet denoising and ECG-gated peak-picking. In this study, an additional enhancement step based on cross-correlation and ECG-gated ensemble averaging (EA) is presented. The main objective of the improved method was to localize S1 with very high temporal accuracy in (pseudo-) real time. The performance of S1 detection and localization, with and without EA enhancement, was evaluated on simulated as well as experimental data. The simulation study showed that EA enhancement reduced the localization error considerably and that S1 could be accurately localized at much lower signal-to-noise ratios. The experimental data were taken from ten healthy subjects at rest and during invoked hyper- and hypotension. For this material, the number of correct S1 detections increased from 91% to 98% when using EA enhancement. Improved performance was also demonstrated when EA enhancement was used for continuous tracking of blood pressure changes and for respiration monitoring via the electromechanical activation time. These are two typical applications where accurate localization of S1 is essential for the results.

    Place, publisher, year, edition, pages
    Institutionen för medicinsk teknik, 2008
    Keywords
    ensemble averaging, detection, localization, heart sound, bioacoustics
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-11856 (URN)10.1088/0967-3334/29/3/011 (DOI)
    Note
    Original publication: C Ahlstrom, T Länne, P Ask and A Johansson, A method for accurate localization of the first heart sound and possible applications, 2008, Physiological Measurement, (29), 3, 417-428. http://dx.doi.org/10.1088/0967-3334/29/3/011. Copyright: Institute of Physics and IOP Publishing Limited, http://www.iop.org/EJ/journal/PMAvailable from: 2008-05-20 Created: 2008-05-20 Last updated: 2017-12-13
    2. Assessing Aortic Stenosis using Sample Entropy of the Phonocardiographic Signal in Dogs
    Open this publication in new window or tab >>Assessing Aortic Stenosis using Sample Entropy of the Phonocardiographic Signal in Dogs
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    2008 (English)In: IEEE Transactions on Biomedical Engineering, ISSN 0018-9294, E-ISSN 1558-2531, Vol. 55, no 8, p. 2107-2109Article in journal (Refereed) Published
    Abstract [en]

    In aortic valve stenosis (AS), heart murmurs arise as an effect of turbulent blood flow distal to the obstructed valves. With increasing AS severity, the flow becomes more unstable, and the ensuing murmur becomes more complex. We hypothesize that these hemodynamic flow changes can be quantified based on the complexity of the phonocardiographic (PCG) signal. In this study, sample entropy (SampEn) was investigated as a measure of complexity using a dog model. Twenty-seven boxer dogs with various degrees of AS were examined with Doppler echocardiography, and the peak aortic flow velocity (Vmax) was used as a reference of AS severity. SampEn correlated to Vmax with R = 0.70 using logarithmic regression. In a separate analysis, significant differences were found between physiologic murmurs and murmurs caused by AS (p < 0.05), and the area under a receiver operating characteristic curve was calculated to 0.96. Comparison with previously presented PCG measures for AS assessment showed improved performance when using SampEn, especially for differentiation between physiological murmurs and murmurs caused by mild AS. Studies in patients will be needed to properly assess the technique in humans.

    Keywords
    Aortic stenosis (AS), bioacoustics, heart sound, murmur, sample entropy (SampEn)
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13042 (URN)10.1109/TBME.2008.923767 (DOI)
    Available from: 2008-03-20 Created: 2008-03-20 Last updated: 2017-12-13
    3. Assessing mitral regurgitation attributable to myxomatous mitral valve disease in dogs using signal analysis of heart sounds and murmurs
    Open this publication in new window or tab >>Assessing mitral regurgitation attributable to myxomatous mitral valve disease in dogs using signal analysis of heart sounds and murmurs
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    2008 (English)Article in journal (Refereed) Submitted
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13043 (URN)
    Available from: 2008-03-20 Created: 2008-03-20 Last updated: 2009-03-26
    4. Feature Extraction for Systolic Heart Murmur Classification
    Open this publication in new window or tab >>Feature Extraction for Systolic Heart Murmur Classification
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    2006 (English)In: Annals of Biomedical Engineering, ISSN 0090-6964, E-ISSN 1573-9686, Vol. 34, no 11, p. 1666-1677Article in journal (Refereed) Published
    Abstract [en]

    Heart murmurs are often the first signs of pathological changes of the heart valves, and they are usually found during auscultation in the primary health care. Distinguishing a pathological murmur from a physiological murmur is however difficult, why an “intelligent stethoscope” with decision support abilities would be of great value. Phonocardiographic signals were acquired from 36 patients with aortic valve stenosis, mitral insufficiency or physiological murmurs, and the data were analyzed with the aim to find a suitable feature subset for automatic classification of heart murmurs. Techniques such as Shannon energy, wavelets, fractal dimensions and recurrence quantification analysis were used to extract 207 features. 157 of these features have not previously been used in heart murmur classification. A multi-domain subset consisting of 14, both old and new, features was derived using Pudil’s sequential floating forward selection (SFFS) method. This subset was compared with several single domain feature sets. Using neural network classification, the selected multi-domain subset gave the best results; 86% correct classifications compared to 68% for the first runner-up. In conclusion, the derived feature set was superior to the comparative sets, and seems rather robust to noisy data.

    Keywords
    Auscultation, Bioacoustics, Feature selection, Heart sounds, Valvular disease
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-13044 (URN)10.1007/s10439-006-9187-4 (DOI)
    Available from: 2008-03-20 Created: 2008-03-20 Last updated: 2017-12-13
    5. Heart sound cancellation from lung sound recordings using recurrence time statistics and nonlinear prediction
    Open this publication in new window or tab >>Heart sound cancellation from lung sound recordings using recurrence time statistics and nonlinear prediction
    2005 (English)In: IEEE Signal Processing Letters, ISSN 1070-9908, E-ISSN 1558-2361, Vol. 12, no 12, p. 812-815Article in journal (Refereed) Published
    Abstract [en]

    Heart sounds (HS) obscure the interpretation of lung sounds (LS). This letter presents a new method to detect and remove this undesired disturbance. The HS detection algorithm is based on a recurrence time statistic that is sensitive to changes in a reconstructed state space. Signal segments that are found to contain HS are removed, and the arising missing parts are replaced with predicted LS using a nonlinear prediction scheme. The prediction operates in the reconstructed state space and uses an iterated integrated nearest trajectory algorithm. The HS detection algorithm detects HS with an error rate of 4% false positives and 8% false negatives. The spectral difference between the reconstructed LS signal and an LS signal with removed HS was 0.34/spl plusmn/0.25, 0.50/spl plusmn/0.33, 0.46/spl plusmn/0.35, and 0.94/spl plusmn/0.64 dB/Hz in the frequency bands 20-40, 40-70, 70-150, and 150-300 Hz, respectively. The cross-correlation index was found to be 99.7%, indicating excellent similarity between actual LS and predicted LS. Listening tests performed by a skilled physician showed high-quality auditory results.

    Place, publisher, year, edition, pages
    Institutionen för medicinsk teknik, 2005
    Keywords
    Bioacoustics, heart sound (HS), lung sound (LS), nonlinear prediction, recurrence time statistics
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-11857 (URN)10.1109/LSP.2005.859528 (DOI)
    Note
    Original publication: Ahlstrom, C., Liljefeldt, O., Hult, P. and Ask, P., Heart sound cancellation from lung sound recordings using recurrence time statistics and nonlinear prediction, 2005, IEEE Signal Processing Letters, (12), 12, 812-815. http://dx.doi.org/10.1109/LSP.2005.859528. Copyright: IEEE, http://ieeexplore.ieee.org/xpl/RecentIssue.jsp?punumber=97Available from: 2008-05-20 Created: 2008-05-20 Last updated: 2017-12-13
  • 4.
    Ahlström, Christer
    et al.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Hult, Peter
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Arts and Sciences.
    Ask, Per
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Detection of the 3(rd) heart sound using recurrence time statistics2006In: 2006 IEEE International Conference on Acoustics, Speech and Signal Processing, Vols 1-13, 2006, Vol. 1-13, p. 2288-2291Conference paper (Refereed)
    Abstract [en]

    The 3(rd) heart sound (S3) is normally heard during auscultation of younger individuals, but it is also common in many patients with heart failure. Compared to the 1(st) and 2(nd) heart sounds, S3 has low amplitude and low frequency content, making it hard to detect (both manually for the physician and automatically by a detection algorithm). We present an algorithm based on a recurrence time statistic which is sensitive to changes in a reconstructed state space, particularly for detection of transitions with very low energy. Heart sound signals from ten children were used in this study. Most S3 occurrences were detected (98%), but the amount of false extra detections was rather high (7% of the heart cycles). In conclusion, the method seems capable of detecting S3 with high accuracy and robustness.

  • 5.
    Almeida, Nuno
    et al.
    Katholieke University of Leuven, Belgium; GE Vingmed Ultrasound AS, Norway.
    Papachristidis, Alexandros
    Kings Coll Hospital London, England.
    Pearson, Peter
    Kings Coll Hospital London, England.
    Imre Sarvari, Sebastian
    University of Oslo, Norway.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Edvardsen, Thor
    University of Oslo, Norway.
    Monaghan, Mark
    Kings Coll Hospital London, England.
    Gerard, Olivier
    GE Vingmed Ultrasound AS, Norway.
    Samset, Eigil
    GE Vingmed Ultrasound AS, Norway; University of Oslo, Norway.
    Dhooge, Jan
    Katholieke University of Leuven, Belgium.
    Left atrial volumetric assessment using a novel automated framework for 3D echocardiography: a multi-centre analysis2017In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 9, p. 1008-1015Article in journal (Refereed)
    Abstract [en]

    Aims This study aims at validating a software tool for automated segmentation and quantification of the left atrium (LA) from 3D echocardiography. Methods and results The LA segmentation tool uses a dual-chamber model of the left side of the heart to automatically detect and track the atrio-ventricular plane and the LA endocardium in transthoracic 3D echocardiography. The tool was tested in a dataset of 121 ultrasound images from patients with several cardiovascular pathologies (in a multi-centre setting), and the resulting volumes were compared with those assessed manually by experts in a blinded analysis using conventional contouring. Bland-Altman analysis showed good agreement between the automated method and the manual references, with differences (mean +/- 1.96 SD) of 0.5 +/- 5.7 mL for LA minimum volume and -1.6 +/- 9.7 mL for LA maximum volume (comparable to the inter-observer variability of manual tracings). The automated tool required no user interaction in 93% of the recordings, while 4% required a single click and only 2% required contour adjustments, reducing considerably the amount of time and effort required for LA volumetric analysis. Conclusion The automated tool was validated in a multi-centre setting, providing quantification of the LA volume over the cardiac cycle with minimal user interaction. The results of the automated analysis were in agreement with those estimated manually by experts. This study shows that such approach has clinical utility for the assessment of the LA morphology and function, automating and facilitating the time-consuming task of analysing 3D echocardiographic recordings.

  • 6.
    Almqvist, Ulf
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Sjörs, Anna
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Validation of MobileMe: a psychophysiological recording system – from a motion sickness perspective2006Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    MobileMe is a recently developed system for monitoring and recording physiological variables. It is wireless, and can therefore be suitable for field research, for example when measuring motion sickness symptoms.

    The aim of this thesis was to conclude whether the MobileMe recording system was valid for research studies. A validation study, consisting of two parts and including 10 subjects, was performed. The first part was a laboratory study, where data from MobileMe and a reference equipment were compared. A field study was also performed, onboard a combat boat, to determine the equipment’s validity in uncontrolled environments. Furthermore, the field study included an investigation of motion sickness symptoms, and provided data for evaluation of motion sickness rating scales.

    Statistical results from the laboratory study, and results from evaluation of data from the field study, showed that MobileMe was valid in both controlled and uncontrolled environments.

  • 7.
    Altgärde, Noomi
    Linköping University, Department of Physics, Chemistry and Biology.
    Local release of lithium from sol-gel coated orthopaedic screws: an in vitro and in vivo study2009Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

     

    In orthopaedic practice, fractures are usually stabilised with metal screws or rods. This is done in order to keep the fracture parts in place during the rather slow healing process. The healing time can potentially be reduced by local- or systemic treatment with different bone promoting drugs. In later years, lithium, otherwise used to treat bipolar disease, has shown promise to be such a drug.

     

    The aim of this master thesis was to find a way to coat metal bone screws with lithium and to characterise the coating. The coating was to be designed in such a way that it could release lithium to the surrounding bone tissue.

     

    Lithium chloride was incorporated into a titanate sol-gel and attached to silicon wafers and stainless steel screws by dip coating. Wafers were used for initial in vitro studies of how lithium changed coating characteristics. This was studied using ellipsometry, AFM and SEM. Lithium is most probably physisorbed and not incorporated into the network building up the sol-gel. Coating structure is changed as more lithium is incorporated. For large amounts of lithium, the nanoparticles normally formed when curing the sol-gel are inhibited. One effect of this is reduced bioactivity, seen as a reduced ability for calcium phosphate crystals to nucleate on the coating when immersed in simulated body fluid.

    Lithium release was investigated using AAS. Lithium is released from the coating, showing a burst effect. By changing the number of coating layers used, the release profile can be partly altered. The coating was also applied to screws, showing good attachment, and the lithium release profile was similar to the one seen from wafers.

    Finally, a screw model was used in rats to assess the effect of local lithium treatment from screws and systemic lithium treatment on fracture healing. In the model, a screw was inserted in tibia, mimicking a fracture. When the bone around the screw was healed, a pullout test was performed, giving information about the strength of the bone surrounding the screw. No significant difference could be found for either local- or systemic lithium treatment compared to control. However, when evaluating the strength of intact bone in a similar way, a positive effect of systemic lithium treatment could be seen. Therefore, it is still likely that lithium has a positive effect on bone and further studies are needed to fully evaluate its role in fracture healing.

     

  • 8. Anderson, C.
    et al.
    Andersson, T.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Changes in skin circulation after microdialysis probe insertion visualized by laser Doppler perfusion imaging1994In: Journal of Investigative Dermatology, ISSN 0022-202X, E-ISSN 1523-1747, Vol. 102, no 5, p. 807-811Article in journal (Refereed)
    Abstract [en]

    Microdialysis makes possible in vivo estimation of endogenous and exogenous substances in the dermal extracellular space. Insertion of the microdialysis probe and its subsequent presence in the skin may affect both the reactivity of the skin test site and the measurement of target substances. Laser Doppler flowmetry is a non-invasive method for estimating cutaneous blood flow. A further development of this technique, laser Doppler perfusion imaging, has been used to study the time course of the circulatory changes caused in the area of microdialysis probe insertion. Laser Doppler perfusion imaging was performed prior to, during, and after microdialysis probe insertion in the skin of the ventral forearm in three subjects. Probe insertion caused an increase in skin blood perfusion in the whole test area. About 15 min after probe insertion, the flare, which is presumed to be of chiefly axon reflex origin, began to subside and the circulatory response could be seen to center around the site of insertion and the tip of the probe. Skin perfusion levels had returned to near normal levels within 60 min. Local anesthesia of the point of guide insertion inhibited the flare, but did not affect circulatory reactivity in the skin nearby. Both microdialysis and laser Doppler perfusion imaging seem to be promising new methods in dermatologic research.

  • 9. Anderson, C.
    et al.
    Svensson, .
    Sjögren, F.
    Andersson, T.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Human in vivo microdialysis technique can be used to measure cytokines in contact reactions.1995In: Current Problems in Dermatology, ISSN 1421-5721, E-ISSN 1662-2944, Vol. 23, p. 121-130Article in journal (Refereed)
  • 10.
    Andersson, Mats
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Knutsson, Hans
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Kronander, Torbjorn
    Velocity Adaptive Filtered Angiography1999Patent (Other (popular science, discussion, etc.))
    Abstract [en]

    A method of imaging a blood vessel in a body using X-rays and an injectable contrast medium is described. The contrast medium is injected into the body, and signals constituted by an X-ray image sequence depicting X-ray attenuation values is recorded. The X-ray attenuated values in each spaced-time neighborhood are combined in a way that is dependent on the processed image sequence and separately established for each neighborhood, and separating, from background and vessel signals, flow signals having energy contributions mainly in an area of frequency domain bounded by surfaces corresponding to threshold velocities separately established for each neighborhood, which surfaces are shifted a specified amount along a temporal frequency axis.

  • 11. Andersson, R
    et al.
    Loyd, Dan
    Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology.
    Ask, Per
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Pressure sensed non-invasively directly on the extra corporeal bloodline tube2001In: PROCEEDINGS OF THE 23RD ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, VOLS 1-4: BUILDING NEW BRIDGES AT THE FRONTIERS OF ENGINEERING AND MEDICINE, 2001, Vol. 23, p. 3179-3181Conference paper (Refereed)
    Abstract [en]

    To clinically measure blood pressure at extra corporeal bloodlines involves a hazard due to the infection risk and a risk for thrombosis formation. The aim was to design a non-invasive pressure sensor, measuring directly on a tube section. A modified tube cross-section was used to improve sensitivity. Using the developed sensing principle, a consistent relation (r=0.999) was obtained between pressure and output signal. The output was stable and an acceptable drift within the temperature-range. The method shows great promise for applications in monitoring of the dialysis process.

  • 12. Andersson, T.
    et al.
    Anderson, C.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Human in vivo cutaneous microdialysis: Estimation of histamine release in cold urticaria.1995In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, no 75, p. 343-347Article in journal (Refereed)
    Abstract [en]

    A novel bioanalytical in vivo sampling technique, cutaneous microdialysis, was used to follow the chronology of skin histamine release in 3 patients with cold urticaria and in 2 healthy volunteers. Laser Doppler perfusion imaging was used simultaneously to monitor the skin circulatory response. Microdialysis samples were collected at 10-min intervals and analysed by radioimmunoassay technique. Fifty minutes after probe insertion, the ventral forearm skin in the area of the dialysis membrane was provoked for 5-15 min with a 25 x 40 mm ice cube covered with plastic foil. In the cold urticaria patients, an up to 80-fold increase of histamine was observed, with peak levels 20-30 min after challenge. Histamine levels then fell to reach "baseline" levels within 50 min. In the healthy subjects, the histamine increase was earlier, less pronounced and of shorter duration. Cutaneous microdialysis and laser Doppler imaging offer new possibilities for the chronological multiparameter assessment of inflammatory skin disorders in vivo.

  • 13.
    Antonsson, Johan
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    On optical methods for intracerebral measurements during stereotactic and functional neurosurgery: Experimental studies2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Radio frequency (RF) lesioning and deep brain stimulation (DBS) are the two prevailing surgical treatments for movement disorders within the field of stereotactic and functional neurosurgery. For RF-lesioning, a small volume of brain tissue is coagulated and knowledge of the lesion size and growth is of great importance for the safety and outcome of the procedure. This thesis deals with adapting the laser Doppler perfusion monitoring (LDPM) technique for measurements in brain tissue during RF-lesioning. The relation between LDPM signal changes and developed lesion size was investigated. LDPM measurements were evaluated both in vitro (albumin protein solution) and in vivo in the porcine brain during RF-lesioning corresponding to a bilateral thalamotomy in man. The investigated signals from the LDPI measurements can be used for following the lesioning time course and to detect if a lesion was created, both in vitro and in the animal model. For the albumin model, both the total backscattered light intensity and the perfusion signal can be used as markers for estimating the final coagulation size, while in the animal model this conclusion was not statistical verified.

    Independent on surgical method, RF-lesioning or DBS, intracerebral guidance is an important aspect within stereotactic and functional neurosurgery. To increase the accuracy and precision of reaching the correct target, different methods for intracerebral guidance exist, such as microelectrode recording and impedance methods. In this thesis, the possibility of developing an optical intracerebral guidance method has been investigated. Diffuse reflectance spectroscopy served as technology and all measurements were performed stereotactically in both porcine and human brain. Measurements of white and gray matter showed large differences, with higher reflectivity for white brain matter, both in porcine and in human brain. For the human measurements during DBS-implants, large differences between white matter and functional targets were found. Additionally, differences between native and lesioned porcine brain matter were detected. Both studies support the idea of using diffuse reflectance spectroscopy for developing an intracerebral guidance method.

    List of papers
    1. Radio frequency electrode system for optical lesion size estimation in functional neurosurgery
    Open this publication in new window or tab >>Radio frequency electrode system for optical lesion size estimation in functional neurosurgery
    2005 (English)In: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 10, no 3, p. 1-6Article in journal (Refereed) Published
    Abstract [en]

    Radiofrequency(RF) lesioning in the human brain is one possible surgicaltherapy for severe pain as well as movement disorders. Oneobstacle for a safer lesioning procedure is the lack ofsize monitoring. The aim of this study was to investigateif changes in laser Doppler or intensity signals could beused as markers for size estimation during experimental RF lesioning.A 2 mm in diameter monopolar RF electrode was equippedwith optical fibers and connected to a digital laser Dopplersystem. The optical RF electrode's performance was equal to astandard RF electrode with the same dimensions. An albumin solutionwith scatterers was used to evaluate the intensity and laserDoppler signal changes during lesioning at 70, 80, and 90 °C.Significant signal changes were found for these three different clotsizes, represented by the temperatures (p<0.05,  n=10). The volume, width, andlength of the created coagulations were correlated to the intensitysignal changes (r=0.88, n=30, p<0.0001) and to the perfusion signalchanges (r=0.81, n=30, p<0.0001). Both static and Doppler-shifted light canbe used to follow the lesioning procedure as well asbeing used for lesion size estimation during experimental RF lesioning.

    Place, publisher, year, edition, pages
    SPIE - International Society for Optical Engineering, 2005
    National Category
    Atom and Molecular Physics and Optics
    Identifiers
    urn:nbn:se:liu:diva-14232 (URN)10.1117/1.1924615 (DOI)000235127400040 ()16229664 (PubMedID)2-s2.0-24144476322 (Scopus ID)
    Available from: 2007-01-26 Created: 2007-01-26 Last updated: 2017-12-13Bibliographically approved
    2. Optical measurements during experimental stereotactic radiofrequency lesioning
    Open this publication in new window or tab >>Optical measurements during experimental stereotactic radiofrequency lesioning
    2006 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 84, no 2-3, p. 118-124Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to evaluate in vivo a laser Doppler measurement system in porcine brain tissue during thermal lesioning. A 2-mm monopolar radiofrequency lesioning electrode was equipped with optical fibers in order to monitor the lesioning procedure. Laser Doppler and backscattered light intensity signals were measured along the electrode trajectory and during bilateral lesioning in the central gray (70, 80 and 90°C, n = 14). The time course of the coagulation process could be followed by optical recordings. Two separate groups of tissue were identified from the intensity signals. The changes in the perfusion levels in both groups displayed significant changes (p < 0.05, n = 48) at all temperature settings, while backscattered light intensity was significant for only one group at the different temperatures (p < 0.05, n = 39). These results indicate that optical measurements correlate with lesion development in vivo. The study also indicates that it is possible to follow the lesioning process intra-operatively.

    Place, publisher, year, edition, pages
    S. Karger, 2006
    Keywords
    Laser Doppler, Radiofrequency lesioning, Functional neurosurgery, Brain electrodes
    National Category
    Biomedical Laboratory Science/Technology
    Identifiers
    urn:nbn:se:liu:diva-14233 (URN)10.1159/000094463 (DOI)000239562300010 ()16840822 (PubMedID)2-s2.0-33746647435 (Scopus ID)
    Available from: 2007-01-26 Created: 2007-01-26 Last updated: 2017-12-13Bibliographically approved
    3. In-vivo reflection spectroscopy measurements in pig brain during stereotactic surgery
    Open this publication in new window or tab >>In-vivo reflection spectroscopy measurements in pig brain during stereotactic surgery
    2003 (English)In: Biophotonics West: Biomedical Optics, 2003, Vol. 4958, p. 242-250Conference paper, Published paper (Refereed)
    Abstract [en]

    Radiofrequency (RF) lesioning in the human brain is a commonsurgical therapy for relieving severe pain as well as formovement disorders such as Parkinsonia. During the procedure a smallelectrode is introduced by stereotactic means towards a target arealocalized by CT or MRI. An RF-current is applied throughthe electrode tip when positioned in the target area. Thetissue in the proximity of the tip is heated bythe current and finally coagulated.The overall aim of this studywas to improve the RF-technique and its ability to estimatelesion size by means of optical methods. Therefore, the opticaldifferences between white and gray matter, as well as lesionedand unlesioned tissue were investigated. Reflection spectroscopy measurements in therange of 450-800 nm were conducted on fully anesthetized pigsduring stereotactic RF-lesioning (n=6). Light from a tungsten lamp wasguided to the electrode tip through optical fibers, inserted alonga 2 mm in diameter monopolar RF-electrode. Measurements were performedin steps of 0-10 mm from the target in eachhemisphere towards the entry point of the skull. In thecentral gray of the porcine brain measurements were performed bothbefore and after the creation of a lesion. A totalof 55 spectra were collected during this study. Correlation totissue type was done using post-operative MR-images. The spectral signaturefor white and gray matter differs significantly for the entirespectral range of 450-800 nm. Pre- and post-lesioning reflection spectroscopyshowed the largest differences below 600 and above 620 nm,which implies that lasers within this wavelength range may beuseful for in-vivo measurements of tissue optical changes during RF-lesioning.

    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-14234 (URN)10.1117/12.476131 (DOI)
    Available from: 2007-01-26 Created: 2007-01-26 Last updated: 2017-02-22Bibliographically approved
    4. Diffuse reflectance spectroscopy measurements for tissue type discrimination during deep brain stimulation
    Open this publication in new window or tab >>Diffuse reflectance spectroscopy measurements for tissue type discrimination during deep brain stimulation
    Show others...
    2008 (English)In: Journal of neural engineering, ISSN 1741-2560, Vol. 5, no 2, p. 185-190Article in journal (Refereed) Published
    Abstract [en]

    Diffuse reflectance spectroscopy as a method for improving intracerebral guidance during functional neurosurgery has been investigated. An optical probe was developed for measurements during stereotactic and functional neurosurgery in man. The aim of the study was to investigate the spectral differences between white and grey matter and between white matter and functional targets. Diffuse reflectance spectroscopy measurements in ten patients were recorded at incremental steps towards and in three different functional targets (STN, GPi and Zi). The recorded spectra along the trajectory were sorted into white or grey matter, based on preoperative MRI images or the recorded spectral shape and intensity. The difference between tissue types was calculated as a quotient. Significant intensity differences between white and grey matter were found to be at least 14% (p < 0.05) and 20% (p < 0.0001) for MRI and spectral-sorted data respectively. The reflectance difference between white matter and the functional targets of GPi was higher than for STN and Zi. The results indicate that diffuse reflectance spectroscopy has a potential to be developed to a suitable complement to other intracerebral guidance methods.

    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-14235 (URN)10.1088/1741-2560/5/2/009 (DOI)000257253800009 ()18460743 (PubMedID)2-s2.0-48949118315 (Scopus ID)
    Available from: 2007-01-26 Created: 2007-01-26 Last updated: 2017-02-10Bibliographically approved
    5. In vitro measurements of optical properties of porcine brain using a novel compact device
    Open this publication in new window or tab >>In vitro measurements of optical properties of porcine brain using a novel compact device
    Show others...
    2005 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 43, no 5, p. 658-666Article in journal (Refereed) Published
    Abstract [en]

    Knowledge of the optical properties of tissues can be applied in numerous medical and scientific fields, including cancer diagnostics and therapy. There are many different ways of determining the optical properties of turbid media. The paper describes measurements of the optical properties of porcine brain tissue using novel instrumentation for simultaneous absorption and scattering characterisation of small turbid samples. Integrating sphere measurements are widely used as a reference method for determination of the optical properties of relatively thin turbid samples. However, this technique is associated with bulky equipment, complicated measuring techniques, interference compensation techniques and inconvenient sample handling. It is believed that the sphere for some applications can be replaced by a new, compact device, called the combined angular and spatially resolved head sensor, to measure the optical properties of thin turbid samples. The results compare very well with data obtained with an integrating sphere for well-defined samples. The instrument was shown to be accurate to within 12% for μa and 1% for μ s in measurements of intralipid-ink samples. The corresponding variations of data were 17% and 2%, respectively. The reduced scattering coefficient for porcine white matter was measured to be 100 cm−1 at 633 nm, and the value for coagulated brain tissue was 65 cm−1. The corresponding absorption coefficients were 2 and 3 cm−1, respectively.

    Place, publisher, year, edition, pages
    Springer, 2005
    Keywords
    Optical properties, Turbid media, Integrating sphere, CASH sensor, Porcine brain tissue, Scattering
    National Category
    Other Medical Engineering
    Identifiers
    urn:nbn:se:liu:diva-14236 (URN)10.1007/BF02351040 (DOI)000234262300016 ()2-s2.0-29244462497 (Scopus ID)
    Available from: 2007-01-26 Created: 2007-01-26 Last updated: 2017-12-13Bibliographically approved
  • 14.
    Ask, Per
    et al.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Edwall, G
    Johansson, K E
    Tibbling, Lita
    On the use of monocrystalline antimony pH electrodes in gastro-oesophageal functional disorders.1982In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 20, no 3, p. 383-389Article in journal (Refereed)
    Abstract [en]

    Monocrystalline antimony electrodes have been shown to be suitable for thein vivo determination of pH in blood, tissue and in the upper gastro-intestinal canal. Thanks to their small dimensions it has been possible to mount them into conventional manometry catheters for oesophageal investigation. The monocrystalline antimony pH electrode has several advantages over the conventional pH glass electrode; better accuracy, shorter rise time, smaller dimensions. The monocrystalline antimony electrode has been used for long-term registration of gastro-oesophageal reflux, for the oesophageal acid clearing test and for identification of the pH gradient zone between the gastric and oesophageal mucosa. Its use in combination with pressure sensors has added a new dimension to the diagnosis of functional disorders in the gastro-oesophageal region.

  • 15.
    Ask, Per
    et al.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Skogh, Marcus
    Öberg, Åke
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Undersökning av EKG-elektroners elektriska och mekaniska långtidsegenskaper1974Report (Other academic)
  • 16.
    Azzouzi, Sawsen
    et al.
    University of Sousse, Tunisia.
    Patra, Hirak Kumar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Ben Ali, Mounir
    University of Sousse, Tunisia.
    Nooredeen Abbas, Mohammed
    National Research Centre, Egypt.
    Dridi, Cherif
    Centre Research Microelect and Nanotechnol CRMN Sousse, Tunisia.
    Errachid, Abdelhamid
    University of Lyon 1, France.
    Turner, Anthony
    Linköping University, Department of Physics, Chemistry and Biology, Biosensors and Bioelectronics. Linköping University, Faculty of Science & Engineering.
    Citrate-selective electrochemical mu-sensor for early stage detection of prostate cancer2016In: Sensors and actuators. B, Chemical, ISSN 0925-4005, E-ISSN 1873-3077, Vol. 228, p. 335-346Article in journal (Refereed)
    Abstract [en]

    The extremely specialised anatomical function of citrate inside the prostate, make it one of the preferred biomarkers for early stage detection of prostate cancer. However, current detection methods are seriously limited due to the very low citrate concentrations that need to be measured in order to follow disease progression. In the present work, we report a novel citrate-selective-sensor based on iron (III) phthalocyanine chloride-C-monoamido-Poly-n-Butyl Acrylate (Fe(III)MAPcC1 P n BA) modified gold -electrodes for the electrochemical determination and estimation of the pathophysiological range of citrate. The newly synthesised ionophore has been structurally characterised using Fourier transform infrared (FTIR) and UV-vis spectroscopy. Contact angle measurements and atomic force microscopy (AFM) have been used to investigate the adhesion and morphological properties of the membrane. The developed citrate-selective-electrodes had a Nernstian sensitivity of-19.34 +/- 0.83 mV/decade with a detection limit of about 9 x 10-6M and a linear range from 4 x 10(-5)M to 10(-1) M, which covered the pathologically important clinical range. Electrochemical impedance spectroscopy (EIS) showed very high sensitivity with a lower Limit of detection 1.7 x 10(-9) M and linear detection range (10(-8)-10(-1) M), which is very important not only for the early-stage diagnosis and screening procedures, but also in mapping the stage of the cancer too. (C) 2016 Elsevier B.V. All rights reserved.

  • 17.
    Bastuck, Manuel
    et al.
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, Faculty of Science & Engineering. Saarland University, Germany.
    Baur, T.
    Lab Measurement Technology, Germany.
    Schutze, A.
    Lab Measurement Technology, Germany.
    Fusing Cyclic Sensor Data with Different Cycle Length2016In: 2016 IEEE INTERNATIONAL CONFERENCE ON MULTISENSOR FUSION AND INTEGRATION FOR INTELLIGENT SYSTEMS (MFI), IEEE , 2016, p. 72-77Conference paper (Refereed)
    Abstract [en]

    Cyclic modulation of sensor parameters can improve sensitivity and selectivity of gas sensors. If the modulated parameter influences the sens environment, several readings can be gained, eventually resulting in a multi-dimensional response which can be analyzed with, e.g., principal component analysis. In certain cases, e.g. temperature modulated gas sensors with different thermal time constants, the length of the used cycles, and, thus, the temporal resolution of the sensors can differ. As a consequence, different sensors can produce datasets with an unequal number of observations which, nevertheless, cover the same interval of time. In this work, we explore three different strategies which enable combination of those datasets in order to retain the maximum amount of information from two sensors when used in parallel. Simulated data show that simple combination of a short cycle with the last complete long cycle can improve correct classification rate by 15 percent points while maintaining the better temporal resolution. On the other hand, performance can be further increased at the expense of temporal resolution by adding either several of the short cycles, or their mean, to a long cycle, effectively reducing noise. The proposed combination strategies and their dependence on preprocessing are validated with a real dataset of two gas sensors. Overall, and taking into account differences in data performance for simulated and real data is observed.

  • 18.
    Björneld, Olle
    Linköping University, Department of Biomedical Engineering.
    Optisk instrument för Laparoskopisk Kärldetektion1996Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Rapporten behandlar utvecklingen och konstruktionen av ett laparoskopiskt blodkärlsidentifierande instrument. Identifiering sker med hjälp av fotopletysmografi. Fotopletysmografi betyder ungefär "detektion av volymförändrings med hjälp av ljus". Laparoskopi kan översättas med titthålskirurgi. Laparoskopioperationer sker med små runda instrument som förs in i kroppen. Rapporten diskuterar olika probmodeller, det vill säga hur sensorn skall konstrueras för att erhålla en bra mätsignal. Konkurrerande tekniker och framtida applikationer redovisas på flera ställen i rapporten. Vid mätningar på blodmodell studerades och analyserades signalkvaliten. Till slut skall tilläggas att proben fungerade tillfredsställande. Proben kunde detektera pulsationer i blodmodellen.

  • 19.
    Borga, Magnus
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Knutsson, Hans
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    An Adaptive Stereo Algorithm Based on Canonial Correlation Analysis1998Conference paper (Refereed)
    Abstract [en]

    This paper presents a novel algorithm that uses CCA and phase analysis to detect the disparity in stereo images. The algorithm adapts filters in each local neighbourhood of the image in a way which maximizes the correlation between the filtered images. The adapted filters are then analysed to find the disparity. This is done by a simple phase analysis of the scalar product of the filters. The algorithm can even handle cases where the images have different scales. The algorithm can also handle depth discontinuities and give multiple depth estimates for semitransparent images.

  • 20.
    Borga, Magnus
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, The Institute of Technology.
    Rydell, Joakim
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Signal and Anatomical Constraints in Adaptive Filtering of fMRI Data2007In: Biomedical Imaging: From Nano to Macro, 2007. ISBI 2007: From Nano to Macro, IEEE , 2007, p. 432-435Conference paper (Refereed)
    Abstract [en]

    An adaptive filtering method for fMRI data is presented. The method is related to bilateral filtering, but with a range filter that takes into account local similarities in signal as well as in anatomy. Performance is demonstrated on simulated and real data. It is shown that using both these similarity constraints give better performance than if only one of them is used, and clearly better than standard low-pass filtering.

  • 21.
    Brandberg, Joakim
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Janerot Sjöberg, Birgitta
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Ask, Per
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Increased accuracy of echocardiographic measurement of flow using automated spherical integration of multiple plane velocity vectors1999In: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 25, no 2, p. 249-257Article in journal (Refereed)
    Abstract [en]

    The calculation of blood flow in the heart by surface integration of velocity vectors (SIVV) using Doppler ultrasound is independent of the angle. Flow is normally calculated from velocity in a spherical thick shell with its center located at the ultrasound transducer. In a numerical simulation, we have shown that the ratio between minor and major axes of an elliptic flow area substantially influences the accuracy of the estimation of flow in a single scan plane. The accuracy of flow measurements by SIVV can be improved by calculating the mean of the values from more than one scan plane. We have produced an automated computer program that includes an antialiasing procedure. We confirmed an improvement of flow measurements in a pulsatile hydraulic flow model, the 95% confidence interval for single estimations being reduced from 20% to 10% (p < 0.05) using the newly developed software. We think that the SIVV method has important implications for clinical transthoracic echocardiography.

  • 22.
    Brun, Anders
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Manifolds in Image Science and Visualization2007Doctoral thesis, monograph (Other academic)
    Abstract [en]

    A Riemannian manifold is a mathematical concept that generalizes curved surfaces to higher dimensions, giving a precise meaning to concepts like angle, length, area, volume and curvature. A glimpse of the consequences of a non-flat geometry is given on the sphere, where the shortest path between two points – a geodesic – is along a great circle. Different from Euclidean space, the angle sum of geodesic triangles on the sphere is always larger than 180 degrees.

    Signals and data found in applied research are sometimes naturally described by such curved spaces. This dissertation presents basic research and tools for the analysis, processing and visualization of such manifold-valued data, with a particular emphasis on future applications in medical imaging and visualization.

    Two-dimensional manifolds, i.e. surfaces, enter naturally into the geometric modelling of anatomical entities, such as the human brain cortex and the colon. In advanced algorithms for processing of images obtained from computed tomography (CT) and ultrasound imaging (US), images themselves and derived local structure tensor fields may be interpreted as two- or three-dimensional manifolds. In diffusion tensor magnetic resonance imaging (DT-MRI), the natural description of diffusion in the human body is a second-order tensor field, which can be related to the metric of a manifold. A final example is the analysis of shape variations of anatomical entities, e.g. the lateral ventricles in the brain, within a population by describing the set of all possible shapes as a manifold.

    Work presented in this dissertation include: Probabilistic interpretation of intrinsic and extrinsic means in manifolds. A Bayesian approach to filtering of vector data, removing noise from sampled manifolds and signals. Principles for the storage of tensor field data and learning a natural metric for empirical data.

    The main contribution is a novel class of algorithms called LogMaps, for the numerical estimation of logp (x) from empirical data sampled from a low-dimensional manifold or geometric model embedded in Euclidean space. The logp (x) function has been used extensively in the literature for processing data in manifolds, including applications in medical imaging such as shape analysis. However, previous approaches have been limited to manifolds where closed form expressions of logp (x) have been known. The introduction of the LogMap framework allows for a generalization of the previous methods. The application of LogMaps to texture mapping, tensor field visualization, medial locus estimation and exploratory data analysis is also presented.

  • 23.
    Brynolfsson, Patrik
    Linköping University, Department of Medicine and Health Sciences, Radiation Physics. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Using radial k-space sampling and temporal filters in MRI to improve temporal resolution2010Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In this master thesis methods for increasing temporal resolution when reconstructing radially sampled MRI data have been developed and evaluated. This has been done in two steps; first the order in which data is sampled in k-space has been optimized, and second; temporal filters have been developed in order to utilize the high sampling density in central regions of k-space as a result of the polar sampling geometry to increase temporal resolution while maintaining image quality.By properly designing the temporal filters the temporal resolution is increased by a factor 3–20 depending on other variables such as imageresolution and the size of the time varying areas in the image. The results are obtained from simulated raw data and subsequent reconstruction. The next step should be to acquire and reconstruct raw data to confirm the results.

  • 24.
    Cederberg, Erik
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Adipose tissue segmentation in whole-body MRI2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Adipose tissue volume and distribution is related to metabolic diseases such as diabetes and atherosclerosis. This relationship is in focus for much research, much due to a worldwide increase in obesity. It is in many cases of interest to calculate the amount of adipose tissue in different compartments within the body. Commonly used methods are however prone to introduce errors due to partial volume effects.

    Previous studies have successfully segmented three adipose tissue compartments from abdominal two-point Dixon fat-water MRI volumes using Morphon registration and atlas segmentation. This thesis extends upon the previous work by enabling segmentation of whole-body MRI volumes and by improving the registration with the use of both fat and water data. Possible methods for bone marrow segmentation are also tested and evaluated.

    The methods presented seem to be sufficient for creating whole-body volumes from a set of smaller volumes. The adipose tissue segmentation was adequate for subjects with relatively small volumes of adipose tissue, whereas segmentation of subjects with large amounts of adipose tissue require further improvement. Of the evaluated methods for bone marrow segmentation one seemed to perform adequately on all the tested datasets. Due to the few datasets available for testing it was not possible to draw any general conclusions as to how well the presented methods perform.

  • 25.
    Chen, Peng
    et al.
    Nanyang Technol Univ, Singapore.
    Liu, Xiaohu
    Nanyang Technol Univ, Singapore; Tsinghua Univ, Peoples R China.
    Goyal, Garima
    Nanyang Technol Univ, Singapore.
    Tran, Nhung Thi
    Nanyang Technol Univ, Singapore; Ho Chi Minh City Univ Technol and Educ, Vietnam.
    Ho, James Chin Shing
    Nanyang Technol Univ, Singapore.
    Wang, Yi
    Nanyang Technol Univ, Singapore; Wenzhou Med Univ, Peoples R China.
    Aili, Daniel
    Linköping University, Department of Physics, Chemistry and Biology, Molecular Physics. Linköping University, Faculty of Science & Engineering.
    Liedbereg, Bo
    Nanyang Technol Univ, Singapore; Nanyang Technol Univ, Singapore.
    Nanoplasmonic Sensing from the Human Vision Perspective2018In: Analytical Chemistry, ISSN 0003-2700, E-ISSN 1520-6882, Vol. 90, no 7, p. 4916-4924Article in journal (Refereed)
    Abstract [en]

    Localized surface plasmon resonance (LSPR) constitutes a versatile technique for biodetection, exploiting the sensitivity of plasmonic nanostructures to small changes in refractive index. The optical shift in the LSPR band caused by molecular interactions in the vicinity of the nanostructures are typically amp;lt;5 nm and can readily be detected by a spectrophotometer. Widespread use of LSPR-based sensors require cost-effective devices and would benefit from sensing schemes that enables use of very simple spectrophotometers or even naked-eye detection. This paper describes a new strategy facilitating visualization of minute optical responses in nanoplasmonic bioassays by taking into account the physiology of human color vision. We demonstrate, using a set of nine different plasmonic nanoparticles, that the cyan to green transition zone at similar to 500 nm is optimal for naked-eye detection of color changes. In this wavelength range, it is possible to detect a color change corresponding to a wavelength shift of similar to 2-3 nm induced by refractive index changes in the medium or by molecular binding to the surface of the nanoparticles. This strategy also can be utilized to improve the performance of aggregation-based nanoplasmonic colorimetric assays, which enables semiquantitative naked-eye detection of matrix metalloproteinase 7 (MMP7) activity at concentrations that are at least 5 times lower than previously reported assays using spherical gold nanoparticles. We foresee significant potential of this strategy in medical diagnostic and environmental monitoring, especially in situations where basic laboratory infrastructure is sparse or even nonexistent. Finally, we demonstrate that the developed concept can be used in combination with cell phone technology and red-green-blue (RGB) analysis for sensitive and quantitative detection of MMP7.

  • 26.
    Chen, Rong
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Georgii-Hemming, Patrik
    Department of Oncology, Uppsala University, Sweden.
    Åhlfeldt, Hans
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Representing a chemotherapy guideline using openEHR and rules2009In: Medical Informatics in a United and Healthy Europe / [ed] Klaus-Peter Adlassnig, Bernd Blobel, John Mantas, Izet Masic, IOS Press, 2009, Vol. 150, p. 653-657Conference paper (Refereed)
    Abstract [en]

    Computerized guidelines can provide decision support and facilitate the use of clinical guidelines. Several computerized guideline representation models (GRMs) exist but the poor interoperability between the guideline systems and the Electronic Health Record (EHR) systems limits their clinical usefulness. In this study we analyzed the clinical use of a published lymphoma chemotherapy guideline. We found that existing GRMs have limitations that can make it difficult to meet the clinical requirements. We hypothesized that guidelines could be represented as data and logic using openEHR archetypes, templates and rules. The design was tested by implementing the lymphoma guideline. We conclude that using the openEHR models and rules to represent chemotherapy guidelines is feasible and confers several advantages both from a clinical and from an informatics perspective.

  • 27.
    Chew, Michelle
    et al.
    Departments of Anaesthesia and Intensive Care, Institute of Experimental Clinical Research, Skejby Sygehus, Aarhus University Hospital, Denmark.
    Brandberg, Joakim
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Bjarum, Steinar
    Department of Biomerical Engineering, Trondheim University, Norway.
    Baek-Jensen, Katrine
    Institute of Experimental Clinical Research, Skejby Sygehus, Aarhus University Hospital, Denmark.
    Sloth, Erik
    Departments of Anaesthesia and Intensive Care, Skejby Sygehus, Aarhus University Hospital, Denmark.
    Ask, Per
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Hasenkam, J. Michael
    Department of Cardiothoracic Surgery, Skejby Sygehus, Aarhus University Hospital, Denmark.
    Janerot Sjöberg, Birgitta
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Pediatric cardiac output measurement using surface integration of velocity vectors: an in vivo validation study2000In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 28, no 11, p. 3664-3671Article in journal (Refereed)
    Abstract [en]

    Objective: To test the accuracy and reproducibility of systemic cardiac output (CO) measurements using surface integration of velocity vectors (SIVV) in a pediatric animal model with hemodynamic instability and to compare SIVV with traditional pulsed-wave Doppler measurements.

    Design: Prospective, comparative study.

    Setting: Animal research laboratory at a university medical center.

    Subjects: Eight piglets weighing 10-15 kg.

    Interventions: Hemodynamic instability was induced by using inhalation of isoflurane and infusions of colloid and dobutamine.

    Measurements: SIVV CO was measured at the left ventricular outflow tract, the aortic valve, and ascending aorta. Transit time CO was used as the reference standard.

    Results: There was good agreement between SIVV and transit time CO. At high frame rates, the mean difference ± 2 sd between the two methods was 0.01 ± 0.27 L/min for measurements at the left ventricular outflow tract, 0.08 ± 0.26 L/min for the ascending aorta, and 0.06 ± 0.25 L/min for the aortic valve. At low frame rates, measurements were 0.06 ± 0.25, 0.19 ± 0.32, and 0.14 ± 0.30 L/min for the left ventricular outflow tract, ascending aorta, and aortic valve, respectively. There were no differences between the three sites at high frame rates. Agreement between pulsed-wave Doppler and transit time CO was poorer, with a mean difference ± 2 sd of 0.09 ± 0.93 L/min. Repeated SIVV measurements taken at a period of relative hemodynamic stability differed by a mean difference ±2 sd of 0.01 ± 0.22 L/min, with a coefficient of variation = 7.6%. Intraobserver coefficients of variation were 5.7%, 4.9%, and 4.1% at the left ventricular outflow tract, ascending aorta, and aortic valve, respectively. Interobserver variability was also small, with a coefficient of variation = 8.5%.

    Conclusions: SIVV is an accurate and reproducible flow measurement technique. It is a considerable improvement over currently used methods and is applicable to pediatric critical care.

  • 28.
    Colantonio, Sara
    et al.
    CNR, Italy.
    Germanese, Danila
    CNR, Italy.
    Moroni, Davide
    CNR, Italy.
    Giorgi, Daniela
    CNR, Italy.
    Pascali, Mariantonietta
    CNR, Italy.
    Righi, Marco
    CNR, Italy.
    Coppini, Giuseppe
    CNR, Italy.
    Aurora Morales, Maria
    CNR, Italy.
    Chiarugi, Franco
    FORTH, Greece.
    Pediaditis, Mattew
    FORTH, Greece.
    Larsson, Marcus
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, Faculty of Science & Engineering.
    Strömberg, Tomas
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, Faculty of Science & Engineering.
    Henriquez, Pedro
    University of Central Lancashire, England.
    Matuszewski, Bogdan
    University of Central Lancashire, England.
    Milanic, Matijia
    Norwegian University of Science and Technology, Norway.
    Randeberg, Lise
    Norwegian University of Science and Technology, Norway.
    SEMEOTICONS - READING THE FACE CODE OF CARDIO-METABOLIC RISK2015In: 2015 INTERNATIONAL WORKSHOP ON COMPUTATIONAL INTELLIGENCE FOR MULTIMEDIA UNDERSTANDING (IWCIM), IEEE , 2015Conference paper (Refereed)
    Abstract [en]

    What if you could discover your health status by looking at yourself in the mirror? Since November 2013, the EU FP7 Project SEMEOTICONS is working to make this possible. The Project is building a multi-sensory device, having the form of a conventional mirror, able to read the semeiotic code of the face and detect possible evidence of the onset of cardio-metabolic diseases. The device, called Wize Mirror, integrates unobtrusive imaging sensors used to capture videos, images and 3D scans of the face. These are processed to assess the risk of a cardio-metabolic disease and thereby suggest possible strategies to prevent its onset.

  • 29.
    Danbolt, Christina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics.
    Hult, Peter
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, Faculty of Arts and Sciences.
    Grahn, Lita Tibbling
    Ask, Per
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Validation and characterization of the computerized laryngeal analyzer (CLA) technique.1999In: Dysphagia (New York. Print), ISSN 0179-051X, E-ISSN 1432-0460, Vol. 14, no 4, p. 191-195Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the response characteristics of the Computerized Laryngeal Analyzer (CLA) and the validity of the noninvasive CLA method to detect swallowing-induced laryngeal elevation correctly. Two healthy adults and two experimental models were used in the study. The CLA technique identified all swallowing events but was unable to discriminate between swallowing and other movements of the tongue or the neck. The computer program produced a derivated response to a square wave signal. Stepwise bending increments of the sensor displayed a linear amplitude response. The degree of laryngeal elevation could not be estimated with the CLA technique, and it was not possible to draw any reliable conclusions from the recordings as to whether the larynx was moving upward or downward.

  • 30.
    Deniz, Daniel
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Causes of multimodality of efficiency gain distributions in accelerated Monte Carlo based dose calculations for brachytherapy planning using correlated sampling2009Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Fixed-collision correlated sampling for Monte Carlo (MC) simulations is a method which can be used in order to shorten the simulation time for brachytherapy treatment planning in a 3D patient geometry. The increased efficiency compared to conventional MC simulation is measured by efficiency gain. However, a previous study showed that, in some cases, PDFs (probability density functions) of estimates of the efficiency gain, simulated using resampling and other MC methods, were multimodal with values below 1. This means that the method was less effective than conventional sampling for these cases. The aims of this thesis were to trace the causes of the multimodal distributions and to propose techniques to mitigate the problem caused by photons with high statistical weights.Two simulation environments were used for the study case, a homogeneous and a heterogeneous environment. The homogenous environment consisted of a water sphere with the radius 100mm. For the heterogeneous environment a cylindrical block of tungsten alloy (diameter 15 mm, height 2.5 mm) was placed in the water sphere. The sphere was divided into an array of cubic voxels of size 2.5 mm x 2.5 mm x 2.5 mm for dose calculations. A photon source was positioned in the middle of the water sphere and emitted photons with the energy 400 keV.It was found that the low values and multimodal PDFs for the efficiency gain estimates originated from photons depositing high values of energy in some voxels in the heterogeneous environment. The high energy deposits were due to extremely high statistical weights of photons interacting repeatedly in the highly attenuating tungsten cylinder. When photon histories contributing to the rare events of high energy deposits (outliers) were removed, the PDFs became uni-modal and efficiency gain increased. However, removing outliers will cause results to be biased calling for other techniques to handle the problem with high statistical weights.One way to resolve the problem in the current implementation of the fixed-collision correlated sampling scheme in PTRAN (the MC code used) could be to split photons with high statistical weights into several photons with the same sum weight as the initial photon. The splitting of photons will result in more time consuming simulations in areas with high attenuation coefficients, which may not be the areas of interest. This could be resolved by using Russian roulette, eliminating some of the photons with high statistical weight in such areas.Fixed-collision correlated sampling for Monte Carlo (MC) simulations is a method which can be used in order to shorten the simulation time for brachytherapy treatment planning in a 3D patient geometry. The increased efficiency compared to conventional MC simulation is measured by efficiency gain. However, a previous study showed that, in some cases, PDFs (probability density functions) of estimates of the efficiency gain, simulated using resampling and other MC methods, were multimodal with values below 1. This means that the method was less effective than conventional sampling for these cases. The aims of this thesis were to trace the causes of the multimodal distributions and to propose techniques to mitigate the problem caused by photons with high statistical weights.Two simulation environments were used for the study case, a homogeneous and a heterogeneous environment. The homogenous environment consisted of a water sphere with the radius 100mm. For the heterogeneous environment a cylindrical block of tungsten alloy (diameter 15 mm, height 2.5 mm) was placed in the water sphere. The sphere was divided into an array of cubic voxels of size 2.5 mm x 2.5 mm x 2.5 mm for dose calculations. A photon source was positioned in the middle of the water sphere and emitted photons with the energy 400 keV.It was found that the low values and multimodal PDFs for the efficiency gain estimates originated from photons depositing high values of energy in some voxels in the heterogeneous environment. The high energy deposits were due to extremely high statistical weights of photons interacting repeatedly in the highly attenuating tungsten cylinder. When photon histories contributing to the rare events of high energy deposits (outliers) were removed, the PDFs became uni-modal and efficiency gain increased. However, removing outliers will cause results to be biased calling for other techniques to handle the problem with high statistical weights.One way to resolve the problem in the current implementation of the fixed-collision correlated sampling scheme in PTRAN (the MC code used) could be to split photons with high statistical weights into several photons with the same sum weight as the initial photon. The splitting of photons will result in more time consuming simulations in areas with high attenuation coefficients, which may not be the areas of interest. This could be resolved by using Russian roulette, eliminating some of the photons with high statistical weight in such areas.

  • 31.
    Deshpande, S.
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biosensors and Bioelectronics.
    Tiwari, A.
    Linköping University, Department of Physics, Chemistry and Biology, Biosensors and Bioelectronics.
    Turner, A.P.F.
    Linköping University, Department of Physics, Chemistry and Biology, Biosensors and Bioelectronics.
    Smart auto-switchable cardiac troponin immunosensor for diagnosis of cardiac injury2012Conference paper (Refereed)
  • 32.
    Dickens, Erik
    Linköping University, Department of Science and Technology.
    Towards automatic detection and visualization of tissues in medical volume rendering2006Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The technique of volume rendering can be a powerful tool when visualizing 3D medical data sets. Its characteristic of capturing 3D internal structures within a 2D rendered image makes it attractive in the analysis. However, the applications that implement this technique fail to reach out to most of the supposed end-users at the clinics and radiology departments of today. This is primarily due to problems centered on the design of the Transfer Function (TF), the tool that makes tissues visually appear in the rendered image. The interaction with the TF is too complex for a supposed end-user and its capability of separating tissues is often insufficient. This thesis presents methods for detecting the regions in the image volume where tissues are contained. The tissues that are of interest can furthermore be identified among these regions. This processing and classification is possible thanks to the use of a priori knowledge, i.e. what is known about the data set and its domain in advance. The identified regions can finally be visualized using tissue adapted TFs that can create cleaner renderings of tissues where a normal TF would fail to separate them. In addition an intuitive user control is presented that allows the user to easily interact with the detection and the visualization.

  • 33.
    Diczfalusy, Elin
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Didzar, Nil
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Kullman, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Åström, Mattias
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Zsigmond, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Neurosurgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Biochemical monitoring and simulation of the electric field during deep brain stimulation (oral)2010Conference paper (Other academic)
  • 34.
    Diczfalusy, Elin
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Åström, Mattias
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Didzar, Nil
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Kullman, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Zsigmond, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Neurosurgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    A finite element model for biochemical monitoring in the brain during deep brain stimulation (poster)2010Conference paper (Refereed)
  • 35.
    Diczfalusy, Elin
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Åström, Mattias
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Dizdar, Nil
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Kullman, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Zsigmond, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Neurosurgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    A Finite Model for Biochemical Monitoring in the Brain during Deep Brain Stimulation (oral)2010Conference paper (Refereed)
  • 36.
    Durke, Anna
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Lindfors, Lina
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    En jämförelse mellan svenska mammografer med film-skärm system och nivåer satta av europeiska kommissionen2005Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    För att ta reda på hur svenska mammografiavdelningar står sig mot det europeiska protokollet undersöks nio mammografiavdelningar. Till hjälp har ett CDMAM-fantom version 3.4 och fyra plexiglasskivor använts för att simulera ett normaltjockt bröst. Även ljusskåpen och filmens egenskaper har undersökts och jämförts med kraven i europeiska protokollet. Avgränsningar har gjorts då koncentreringen ligger på mammografer som använder sig av film-skärm system.

    Röntgenbilderna har studerats utan tekniska hjälpmedel. Efter bedömning och poängsättning av bilderna på CDMAM-fantomet har värdena förts in i ett Excel-program där värdena presenteras i grafer. Från graferna utvärderas om bildkvaliteten ligger inom

    gränserna som anges för bra bildkvalitet. Det är endast ett av sjukhusen som ligger inom gränsen för bra bildkvalitet.

    Jämförelser har gjorts för att undersöka hur filmens egenskaper påverkar bildkvaliteten och om stråldosen har betydelse för bildkvaliteten. Samma sjukhus som har den högsta stråldosen har också den bästa bildkvaliteten.

  • 37.
    Dyverfeldt, Petter
    et al.
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology.
    Sigfridsson, Andreas
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Escobar Kvitting, John-Peder
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Ebbers, Tino
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology.
    Quantification of intravoxel velocity standard deviation and turbulence intensity by generalizing phase-contrast MRI2006In: Magnetic Resonance in Medicine, ISSN 0740-3194, E-ISSN 1522-2594, Vol. 56, no 4, p. 850-858Article in journal (Refereed)
    Abstract [en]

    Turbulent flow, characterized by velocity fluctuations, is a contributing factor to the pathogenesis of several cardiovascular diseases. A clinical noninvasive tool for assessing turbulence is lacking, however. It is well known that the occurrence of multiple spin velocities within a voxel during the influence of a magnetic gradient moment causes signal loss in phase-contrast magnetic resonance imaging (PC-MRI). In this paper a mathematical derivation of an expression for computing the standard deviation (SD) of the blood flow velocity distribution within a voxel is presented. The SD is obtained from the magnitude of PC-MRI signals acquired with different first gradient moments. By exploiting the relation between the SD and turbulence intensity (TI), this method allows for quantitative studies of turbulence. For validation, the TI in an in vitro flow phantom was quantified, and the results compared favorably with previously published laser Doppler anemometry (LDA) results. This method has the potential to become an important tool for the noninvasive assessment of turbulence in the arterial tree.

  • 38.
    Ebbers, Tino
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Department of Management and Engineering, Applied Thermodynamics and Fluid Mechanics. Linköping University, The Institute of Technology. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Clinical Physiology UHL.
    Flow Imaging: Cardiac Applications of 3D Cine Phase-Contrast MRI2011In: Current Cardiovascular Imaging Reports, ISSN 1941-9074, Vol. 4, no 2, p. 127-133Article, review/survey (Refereed)
    Abstract [en]

    Global and regional blood flow dynamics are of pivotal importance to cardiac function. Fluid mechanical forces can affect hemolysis and platelet aggregation, as well as myocardial remodeling. In recent years, assessment of blood flow patterns based on time-resolved, three-dimensional, three-directional phase-contrast MRI (3D cine PC MRI) has become possible and rapidly gained popularity. Initially, this technique was mainly known for its intuitive and appealing visualizations of the cardiovascular blood flow. Most recently, the technique has begun to go beyond compelling images toward comprehensive and quantitative assessment of blood flow. In this article, cardiac applications of 3D cine PC MRI data are discussed, starting with a review of the acquisition and analysis techniques, and including descriptions of promising applications of cardiac 3D cine PC MRI for the clinical evaluation of myocardial, valvular, and vascular disorders.

  • 39. Eriksson, O.
    et al.
    Johansson, Johannes
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Finite element simulations of rf lesions in porcine brain2002Conference paper (Refereed)
  • 40.
    Ewerlöf, Maria
    et al.
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Larsson, Marcus
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Salerud, Göran
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Spatial and temporal skin blood volume and saturation estimation using a multispectral snapshot imaging camera2017In: IMAGING, MANIPULATION, AND ANALYSIS OF BIOMOLECULES, CELLS, AND TISSUES XV, SPIE-INT SOC OPTICAL ENGINEERING , 2017, Vol. 10068, article id UNSP 1006814Conference paper (Refereed)
    Abstract [en]

    Hyperspectral imaging (HSI) can estimate the spatial distribution of skin blood oxygenation, using visible to near-infrared light. HSI oximeters often use a liquid-crystal tunable filter, an acousto-optic tunable filter or mechanically adjustable filter wheels, which has too long response/switching times to monitor tissue hemodynamics. This work aims to evaluate a multispectral snapshot imaging system to estimate skin blood volume and oxygen saturation with high temporal and spatial resolution. We use a snapshot imager, the xiSpec camera (MQ022HG-IM-SM4X4-VIS, XIMEA (R)), having 16 wavelength-specific Fabry-Perot filters overlaid on the custom CMOS-chip. The spectral distribution of the bands is however substantially overlapping, which needs to be taken into account for an accurate analysis. An inverse Monte Carlo analysis is performed using a two-layered skin tissue model, defined by epidermal thickness, haemoglobin concentration and oxygen saturation, melanin concentration and spectrally dependent reduced-scattering coefficient, all parameters relevant for human skin. The analysis takes into account the spectral detector response of the xiSpec camera. At each spatial location in the field-of-view, we compare the simulated output to the detected diffusively backscattered spectra to find the best fit. The imager is evaluated for spatial and temporal variations during arterial and venous occlusion protocols applied to the forearm. Estimated blood volume changes and oxygenation maps at 512x272 pixels show values that are comparable to reference measurements performed in contact with the skin tissue. We conclude that the snapshot xiSpec camera, paired with an inverse Monte Carlo algorithm, permits us to use this sensor for spatial and temporal measurement of varying physiological parameters, such as skin tissue blood volume and oxygenation.

  • 41.
    Ewerlöf, Maria
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Salerud, E. Göran
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Strömberg, Tomas
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Larsson, Marcus
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Estimating skin blood saturation by selecting a subset of hyperspectral imaging data2015In: Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues XIII / [ed] Daniel L. Farkas; Dan V. Nicolau; Robert C. Leif, SPIE, 2015, Vol. 9328Conference paper (Refereed)
    Abstract [en]

    Skin blood haemoglobin saturation (𝑠b) can be estimated with hyperspectral imaging using the wavelength (λ) range of 450-700 nm where haemoglobin absorption displays distinct spectral characteristics. Depending on the image size and photon transport algorithm, computations may be demanding. Therefore, this work aims to evaluate subsets with a reduced number of wavelengths for 𝑠b estimation. White Monte Carlo simulations are performed using a two-layered tissue model with discrete values for epidermal thickness (𝑇epi) and the reduced scattering coefficient (μ's ), mimicking an imaging setup. A detected intensity look-up table is calculated for a range of model parameter values relevant to human skin, adding absorption effects in the post-processing. Skin model parameters, including absorbers, are; μ's (λ), 𝑇epi, haemoglobin saturation (𝑠b), tissue fraction blood (𝑐b) and tissue fraction melanin (𝑐mel). The skin model paired with the look-up table allow spectra to be calculated swiftly. Three inverse models with varying number of free parameters are evaluated: A(𝑠b, 𝑐b), B(𝑠b, 𝑐b, 𝑐mel) and C(all parameters free). Fourteen wavelength candidates are selected by analysing the maximal spectral sensitivity to 𝑠b and minimizing the sensitivity to 𝑐b. All possible combinations of these candidates with three, four and 14 wavelengths, as well as the full spectral range, are evaluated for estimating 𝑠b for 1000 randomly generated evaluation spectra. The results show that the simplified models A and B estimated 𝑠b accurately using four wavelengths (mean error 2.2% for model B). If the number of wavelengths increased, the model complexity needed to be increased to avoid poor estimations.

  • 42.
    Fors, Carina
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Evaluation of a Laser Doppler System for Myocardial Perfusion Monitoring2007Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Coronary artery bypass graft (CABG) surgery is a common treatment for patients with coronary artery disease. A potential complication of CABG is myocardial ischemia or infarction. In this thesis, a method - based on laser Doppler flowmetry (LDF) - for detection of intra- and postoperative ischemia by myocardial perfusion monitoring is evaluated.

    LDF is sensitive to motion artifacts. In previous studies, a method for reduction of motion artifacts when measuring on the beating heart has been developed. By using the ECG as a reference, the perfusion signal is measured in intervals during the cardiac cycle where the cardiac motion is at a minimum, thus minimizing the artifacts in the perfusion signal.

    The aim of this thesis was to investigate the possibilities to use the ECG-triggered laser Doppler system for continuous monitoring of myocardial perfusion in humans during and after CABG surgery. Two studies were performed. In the first study, changes in myocardial perfusion during CABG surgery were investigated (n = 13), while the second study focused on postoperative measurements (n = 13). In addition, an ECG-triggering method was implemented and evaluated.

    It was found that the large variations in myocardial perfusion during CABG surgery could be monitored with the ECG-triggered laser Doppler system. Furthermore, a perfusion signal of good quality could be registered postoperatively from the closed chest in ten out of thirteen patients. In eight out of ten patients, a proper signal was obtained also the following morning, i.e., about 20 hours after probe insertion. The results show that respiration and blood pressure can have an influence on the perfusion signal.

    In conclusion, the results indicate that the method is able to detect fluctuations in myocardial perfusion under favourable circumstances. However, high heart rate, abnormal cardiac motion, improper probe attachment and limitations in the ECG-triggering method may result in variations in the perfusion signal that are not related to tissue perfusion.

    List of papers
    1. Myocardial perfusion monitoring during coronary artery bypass using an electrocardiogram-triggered laser Doppler technique
    Open this publication in new window or tab >>Myocardial perfusion monitoring during coronary artery bypass using an electrocardiogram-triggered laser Doppler technique
    2005 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 43, no 5, p. 582-588Article in journal (Refereed) Published
    Abstract [en]

    Electrocardiogram (ECG)—triggered laser Doppler perfusion monitoring (LDPM) was used to assess myocardial perfusion, with minimum myocardial tissue motion influence, during coronary artery bypass grafting (CABG). Thirteen subjects were investigated at six phases: pre- and post-CABG; post aorta cross-clamping; pre and post left internal mammary artery (LIMA) graft declamping; and post aorta declamping. The perfusion signal was calculated in late systole and late diastole, with expected minimum tissue motion, and compared with arrested heart measurements. Patient conditions or artifacts caused by surgical activity made it impossible to perform and analyse data in all six phases for some patients. No significant (n=5) difference between perfusion signals pre- and post-CABG was found. Diastolic perfusion signal levels were significantly (p<0.02) lower compared with systolic levels. After aorta cross-clamping, the signal level was almost zero. A distinct perfusion signal increase after LIMA and aorta declamping, compared with pre-LIMA declamping, was found in ten cases out of 13. A significantly (p<0.04) lower perfusion signal in the arrested heart compared with in the beating heart was registered. Influence from mechanical ventilation was observed in 14 measurements out of 17. In conclusion, ECG-triggered LDPM can be used to assess myocardial perfusion during CABG. Perfusion signals were lower in the arrested heart compared with in the beating heart and in late diastole compared with late systole. No significant difference between pre- and post-CABG was found.

    Place, publisher, year, edition, pages
    Springer, 2005
    Keywords
    Laser Doppler perfusion monitoring, Coronary artery bypass grafting, Beating heart, Myocardial microcirculation, Movement artifacts, Electrocardiography
    National Category
    Medical Laboratory and Measurements Technologies
    Identifiers
    urn:nbn:se:liu:diva-14612 (URN)10.1007/BF02351031 (DOI)000234262300007 ()2-s2.0-29244438810 (Scopus ID)
    Available from: 2007-08-27 Created: 2007-08-27 Last updated: 2017-12-13Bibliographically approved
    2. Analysis of breathing-related variations in ECG-triggered laser Doppler perfusion signals measured on the beating heart during surgery
    Open this publication in new window or tab >>Analysis of breathing-related variations in ECG-triggered laser Doppler perfusion signals measured on the beating heart during surgery
    2006 (English)In: Computers in cardiology, ISSN 0276-6574, Vol. 33, p. 181-184Article in journal (Refereed) Published
    Abstract [en]

    Laser Doppler perfusion monitoring (LDPM) is a

    method to assess microvascular perfusion. A modified,

    ECG-triggered LDPM system has been developed to

    measure myocardial perfusion with minimum influence

    from heart motion. With this method, one systolic (PLS)

    and one diastolic (PLD) perfusion value is obtained.

    The aim of this study was to analyse breathing-related

    variations in PLS and PLD measured during open-heart

    surgery. The phase delays between PLS, PLD, mean

    arterial blood pressure (MAP), heart rate and, indirectly,

    the respiration were determined.

    MAP tended to be in phase with or precede the

    variations in PLD, i.e., PLD was at a maximum at the end

    of inspiration or at the beginning of expiration. No clear

    relation between PLS and any of the other signals could

    be found.

    National Category
    Medical Laboratory and Measurements Technologies
    Identifiers
    urn:nbn:se:liu:diva-14613 (URN)2-s2.0-50149103402 (Scopus ID)
    Available from: 2007-08-27 Created: 2007-08-27 Last updated: 2017-12-13Bibliographically approved
    3. Determination of appropriate times during the cardiac cycle for online laser Doppler measurements of myocardial perfusion
    Open this publication in new window or tab >>Determination of appropriate times during the cardiac cycle for online laser Doppler measurements of myocardial perfusion
    2007 (English)Article in journal (Refereed) Submitted
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-14614 (URN)
    Available from: 2007-08-27 Created: 2007-08-27 Last updated: 2017-02-16Bibliographically approved
  • 43.
    Fors, Carina
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Casimir Ahn, Henrik
    Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Analysis of breathing-related variations in ECG-triggered laser Doppler perfusion signals measured on the beating heart during surgery2006In: Computers in cardiology, ISSN 0276-6574, Vol. 33, p. 181-184Article in journal (Refereed)
    Abstract [en]

    Laser Doppler perfusion monitoring (LDPM) is a

    method to assess microvascular perfusion. A modified,

    ECG-triggered LDPM system has been developed to

    measure myocardial perfusion with minimum influence

    from heart motion. With this method, one systolic (PLS)

    and one diastolic (PLD) perfusion value is obtained.

    The aim of this study was to analyse breathing-related

    variations in PLS and PLD measured during open-heart

    surgery. The phase delays between PLS, PLD, mean

    arterial blood pressure (MAP), heart rate and, indirectly,

    the respiration were determined.

    MAP tended to be in phase with or precede the

    variations in PLD, i.e., PLD was at a maximum at the end

    of inspiration or at the beginning of expiration. No clear

    relation between PLS and any of the other signals could

    be found.

  • 44.
    Forsberg, Anni
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Enhancement of X-ray Fluoroscopy Image Sequences using Temporal Recursive Filtering and Motion Compensation2006Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This thesis consider enhancement of X-ray fluoroscopy image sequences. The purpose is to investigate the possibilities to improve the image enhancement in Biplanar 500, a fluoroscopy system developed by Swemac Medical Appliances, for use in orthopedic surgery.

    An algorithm based on recursive filtering, for temporal noise suppression, and motion compensation, for avoidance of motion artifacts, is developed and tested on image sequences from the system. The motion compensation is done both globally, by using the theory of the shift theorem, and locally, by subtracting consecutive frames. Also a new type of contrast adjustment is presented, received with an unlinear mapping function.

    The result is a noise reduced image sequence that shows no blurring effects upon motion. A brief study of the result shows, that both the image sequences with this algorithm applied and the contrast adjusted images are preferred by orthopedists compared to the present images in the system.

  • 45.
    Forsgren, Mikael
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    The Non-Invasive Liver Biopsy: Determining Hepatic Function in Diffuse and Focal LiverDisease2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The liver is one of the largest organs within the human body and it handles many vital tasks such as nutrient processing, toxin removal, and synthesis of important proteins. The number of people suffering from chronic liver disease is on the rise, likely due to the present ‘western’ lifestyle. As disease develops in the liver there are pathophysiological manifestations within the liver parenchyma that are both common and important to monitor. These manifestations include inflammation, fatty infiltration (steatosis), excessive scar tissue formation (fibrosis and cirrhosis), and iron loading. Importantly, as the disease progresses there is concurrent loss of liver function. Furthermore, postoperative liver function insufficiency is an important concern when planning surgical treatment of the liver, because it is associated with both morbidity and mortality. Liver function can also be hampered due to drug-induced injuries, an important aspect to consider in drug-development.

    Currently, an invasive liver needle biopsy is required to determine the aetiology and to stage or grade the pathophysiological manifestations. There are important limitations with the biopsy, which include, risk of serious complications, mortality, morbidity, inter- and intra-observer variability, sampling error, and sampling variability. Cleary, it would be beneficial to be able investigate the pathophysiological manifestations accurately, non-invasively, and on regional level.

    Current available laboratory liver function blood panels are typically insufficient and often only indicate damage at a late stage. Thus, it would be beneficial to have access to biomarkers that are both sensitive and responds to early changes in liver function in both clinical settings and for the pharmaceutical industry and regulatory agencies.

    The main aim of this thesis was to develop and evaluate methods that can be used for a ‘non-invasive liver biopsy’ using magnetic resonance (MR). We also aimed to develop sensitive methods for measure liver function based on gadoxetate-enhanced MR imaging (MRI).

    The presented work is primarily based on a prospective study on c. 100 patients suffering from chronic liver disease of varying aetiologies recruited due to elevated liver enzyme levels, without clear signs of decompensated cirrhosis. Our results show that the commonly used liver fat cut-off for diagnosing steatosis should be lowered from 5% to 3% when using MR proton-density fat fraction (PDFF). We also show that MR elastography (MRE) is superior in staging fibrosis.

    Finally we presented a framework for quantifying liver function based on gadoxetate-enhanced MRI. The method is based on clinical images and a clinical approved contrast agent (gadoxetate). The framework consists of; state-of the-art image reconstruction and correction methods, a mathematical model, and a precise model parametrization method. The model was developed and validated on healthy subjects. Thereafter the model was found applicable on the chronic liver disease cohort as well as validated using gadoxetate levels in biopsy samples and blood samples. The liver function parameters correlated with clinical markers for liver function and liver fibrosis (used as a surrogate marker for liver function).

    In summary, it should be possible to perform a non-invasive liver biopsy using: MRI-PDFF for liver fat and iron loading, MRE for liver fibrosis and possibly also inflammation, and measure liver function using the presented framework for analysing gadoxetate-enhanced MRI. With the exception of an MREtransducer no additional hardware is required on the MR scanner. The liver function method is likely to be useful both in a clinical setting and in pharmaceutical trials.

    List of papers
    1. Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA
    Open this publication in new window or tab >>Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA
    Show others...
    2013 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 23, no 1, p. 174-181Article in journal (Refereed) Published
    Abstract [en]

    Objectives

    To apply dynamic contrast-enhanced (DCE) MRI on patients presenting with elevated liver enzymes without clinical signs of hepatic decompensation in order to quantitatively compare the hepatocyte-specific uptake of Gd-EOB-DTPA with histopathological fibrosis stage.

    Methods

    A total of 38 patients were prospectively examined using 1.5-T MRI. Data were acquired from regions of interest in the liver and spleen by using time series of single-breath-hold symmetrically sampled two-point Dixon 3D images (non-enhanced, arterial and venous portal phase; 3, 10, 20 and 30 min) following a bolus injection of Gd-EOB-DTPA (0.025 mmol/kg). The signal intensity (SI) values were reconstructed using a phase-sensitive technique and normalised using multiscale adaptive normalising averaging (MANA). Liver-to-spleen contrast ratios (LSC_N) and the contrast uptake rate (KHep) were calculated. Liver biopsy was performed and classified according to the Batts and Ludwig system.

    Results

    Area under the receiver-operating characteristic curve (AUROC) values of 0.71, 0.80 and 0.78, respectively, were found for KHep, LSC_N10 and LSC_N20 with regard to severe versus mild fibrosis. Significant group differences were found for KHep (borderline), LSC_N10 and LSC_N20.

    Conclusions

    Liver fibrosis stage strongly influences the hepatocyte-specific uptake of Gd-EOB-DTPA. Potentially the normalisation technique and KHep will reduce patient and system bias, yielding a robust approach to non-invasive liver function determination.

    Place, publisher, year, edition, pages
    Springer, 2013
    Keywords
    Quantification, Gd-EOB-DTPA, Dynamic contrast-enhanced MRI, Pharmacokinetics, Liver
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-87242 (URN)10.1007/s00330-012-2583-2 (DOI)000312324500022 ()
    Projects
    NILB
    Note

    Funding Agencies|Swedish Research Council|VR/M 2007-2884|Medical Research Council of South-east Sweden|FORSS 12621|Linkoping University, Linkoping University Hospital Research Foundations||County Council of Ostergotland||

    Available from: 2013-01-14 Created: 2013-01-14 Last updated: 2017-12-06
    2. Physiologically Realistic and Validated Mathematical Liver Model Revels Hepatobiliary Transfer Rates for Gd-EOB-DTPA Using Human DCE-MRI Data
    Open this publication in new window or tab >>Physiologically Realistic and Validated Mathematical Liver Model Revels Hepatobiliary Transfer Rates for Gd-EOB-DTPA Using Human DCE-MRI Data
    Show others...
    2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 4, p. 0095700-Article in journal (Refereed) Published
    Abstract [en]

    Objectives: Diffuse liver disease (DLD), such as non-alcoholic fatty liver disease (NASH) and cirrhosis, is a rapidly growing problem throughout the Westernized world. Magnetic resonance imaging (MRI), based on uptake of the hepatocyte-specific contrast agent (CA) Gd-EOB-DTPA, is a promising non-invasive approach for diagnosing DLD. However, to fully utilize the potential of such dynamic measurements for clinical or research purposes, more advanced methods for data analysis are required. Methods: A mathematical model that can be used for such data-analysis was developed. Data was obtained from healthy human subjects using a clinical protocol with high spatial resolution. The model is based on ordinary differential equations and goes beyond local diffusion modeling, taking into account the complete system accessible to the CA. Results: The presented model can describe the data accurately, which was confirmed using chi-square statistics. Furthermore, the model is minimal and identifiable, meaning that all parameters were determined with small degree of uncertainty. The model was also validated using independent data. Conclusions: We have developed a novel approach for determining previously undescribed physiological hepatic parameters in humans, associated with CA transport across the liver. The method has a potential for assessing regional liver function in clinical examinations of patients that are suffering of DLD and compromised hepatic function.

    Place, publisher, year, edition, pages
    Public Library of Science, 2014
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-106962 (URN)10.1371/journal.pone.0095700 (DOI)000335226500139 ()
    Available from: 2014-06-04 Created: 2014-06-02 Last updated: 2017-12-05
    3. Using a 3% Proton Density Fat Fraction as a Cut-off Value Increases Sensitivity of Detection of Hepatic Steatosis, Based on Results from Histopathology Analysis
    Open this publication in new window or tab >>Using a 3% Proton Density Fat Fraction as a Cut-off Value Increases Sensitivity of Detection of Hepatic Steatosis, Based on Results from Histopathology Analysis
    Show others...
    2017 (English)In: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 153, no 1, p. 53-+Article in journal (Refereed) Published
    Abstract [en]

    It is possible to estimate hepatic triglyceride content by calculating the proton density fat fraction (PDFF), using proton magnetic resonance spectroscopy (less thansuperscriptgreater than1less than/superscriptgreater thanH-MRS), instead of collecting and analyzing liver biopsies to detect steatosis. However, the current PDFF cut-off value (5%) used to define steatosis by magnetic resonance was derived from studies that did not use histopathology as the reference standard. We performed a prospective study to determine the accuracy of less thansuperscriptgreater than1less than/superscriptgreater thanH-MRS PDFF in measurement of steatosis using histopathology analysis as the standard. We collected clinical, serologic, less thansuperscriptgreater than1less than/superscriptgreater thanH-MRS PDFF, and liver biopsy data from 94 adult patients with increased levels of liver enzymes (6 months or more) referred to the Department of Gastroenterology and Hepatology at Linköping University Hospital in Sweden from 2007 through 2014. Steatosis was graded using the conventional histopathology method and fat content was quantified in biopsy samples using stereological point counts (SPCs). We correlated less thansuperscriptgreater than1less than/superscriptgreater thanH-MRS PDFF findings with SPCs (r = 0.92; P less than.001). less thansuperscriptgreater than1less than/superscriptgreater thanH-MRS PDFF results correlated with histopathology results (ρ = 0.87; P less than.001), and SPCs correlated with histopathology results (ρ = 0.88; P less than.001). All 25 subjects with PDFF values of 5.0% or more had steatosis based on histopathology findings (100% specificity for PDFF). However, of 69 subjects with PDFF values below 5.0% (negative result), 22 were determined to have steatosis based on histopathology findings (53% sensitivity for PDFF). Reducing the PDFF cut-off value to 3.0% identified patients with steatosis with 100% specificity and 79% sensitivity; a PDFF cut-off value of 2.0% identified patients with steatosis with 94% specificity and 87% sensitivity. These findings might be used to improve non-invasive detection of steatosis.

    Place, publisher, year, edition, pages
    Elsevier, 2017
    National Category
    Gastroenterology and Hepatology
    Identifiers
    urn:nbn:se:liu:diva-136544 (URN)10.1053/j.gastro.2017.03.005 (DOI)000403918300022 ()
    Note

    Funding agencies: Swedish Research Council/Medicine and Health [VR/M 2007-2884, VR/M 2012-3199]; Swedish Research Council/Natural and Engineering Sciences [VR/NT 2014-6157]; Swedish Innovation Agency VINNOVA [2013-01314]; Region Ostergotland (ALF)

    Available from: 2017-04-19 Created: 2017-04-19 Last updated: 2018-04-18Bibliographically approved
  • 46.
    Forslund, Pontus
    Linköping University, Department of Mechanical Engineering.
    A Neural Network Based Brain-Computer Interface for Classification of Movement Related EEG2003Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A brain-computer interface, BCI, is a technical system that allows a person to control the external world without relying on muscle activity. This thesis presents an EEG based BCI designed for automatic classification of two dimensional hand movements. The long-term goal of the project is to build an intuitive communication system for operation by people with severe motor impairments. If successful, such system could for example be used by a paralyzed patient to control a word processor or a wheelchair.

    The developed BCI was tested in an offine pilot study. In response to an external cue, a test subject moved a joystick in one of four directions. During the movement, EEG was recorded from seven electrodes mounted on the subject's scalp. An autoregressive model was fitted to the data, and the extracted coefficients were used as input features to a neural network based classifier. The classifier was trained to recognize the direction of the movements. During the first half of the experiment, real physical movements were performed. In the second half, subjects were instructed just to imagine the hand moving the joystick, but to avoid any muscle activity.

    The results of the experiment indicate that the EEG signals do in fact contain extractable and classifiable information about the performed movements, during both physical and imagined movements.

  • 47. Fraser, A.G.
    et al.
    Wilkenshoff, U.
    Janerot-Sjöberg, B.
    Linköping University, Department of Biomedical Engineering, Physiological Measurements. Linköping University, The Institute of Technology.
    Rosenhek, R.
    Payne, N.
    Brodin, L-A.
    Quantitative stress echocardiography using tissue Doppler for the diagnosis of coronary artery disease2000In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597Article in journal (Refereed)
  • 48.
    Fredly, Siv
    et al.
    Department of Neonatal Intensive Care Unit, Oslo University hospital, Ullevål, Oslo Norway.
    Häggblad, Erik
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Kvernebo, Knut
    Faculty of Medicine, University of Oslo, Oslo, Norway.
    Fugelseth, Drude
    Department of Neonatal Intensive Care Unit, Oslo University hospital, Ullevål, Oslo Norway.
    Skin microcirculation in healthy newborns- assessments of morphology, perfusion and oxygenation2010Conference paper (Refereed)
  • 49.
    Fredriksson, Alexandru Grigorescu
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Trzebiatowska-Krzynska, Aleksandra
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Dyverfeldt, Petter
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Engvall, Jan
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Ebbers, Tino
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Carlhäll, Carljohan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Turbulent kinetic energy in the right ventricle: Potential MR marker for risk stratification of adults with repaired Tetralogy of Fallot2018In: Journal of Magnetic Resonance Imaging, ISSN 1053-1807, E-ISSN 1522-2586, Vol. 47, no 4, p. 1043-1053Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess right ventricular (RV) turbulent kinetic energy (TKE) in patients with repaired Tetralogy of Fallot (rToF) and a spectrum of pulmonary regurgitation (PR), as well as to investigate the relationship between these 4D flow markers and RV remodeling.

    Materials and Methods: Seventeen patients with rToF and 10 healthy controls were included in the study. Patients were divided into two groups based on PR fraction: one lower PR fraction group (11%) and one higher PR fraction group (>11%). Field strength/sequences: 3D cine phase contrast (4D flow), 2D cine phase contrast (2D flow), and balanced steady-state free precession (bSSFP) at 1.5T. Assessment: The RV volume was segmented in the morphologic short-axis images and TKE parameters were computed inside the segmented RV volume throughout diastole. Statistical tests: One-way analysis of variance with Bonferroni post-hoc test; unpaired t-test; Pearson correlation coefficients; simple and stepwise multiple regression models; intraclass correlation coefficient (ICC).

    Results: The higher PR fraction group had more remodeled RVs (140 6 25 vs. 107 6 22 [lower PR fraction, P < 0.01] and 93 6 15 ml/m2[healthy, P < 0.001] for RV end-diastolic volume index [RVEDVI]) and higher TKE values (5.95 6 3.15 vs. 2.23 6 0.81 [lower PR fraction, P < 0.01] and 1.91 6 0.78 mJ [healthy, P < 0.001] for Peak Total RV TKE). Multiple regression analysis between RVEDVI and 4D/2D flow parameters showed that Peak Total RV TKE was the strongest predictor of RVEDVI (R25 0.47, P 5 0.002).

    Conclusion: The 4D flow-specific TKE markers showed a slightly stronger association with RV remodeling than conventional 2D flow PR parameters. These results suggest novel hemodynamic aspects of PR in the development of late complications after ToF repair.

  • 50.
    Fredriksson, Ingemar
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Quantitative Laser Doppler Flowmetry2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Laser Doppler flowmetry (LDF) is virtually the only non-invasive technique, except for other laser speckle based techniques, that enables estimation of the microcirculatory blood flow. The technique was introduced into the field of biomedical engineering in the 1970s, and a rapid evolvement followed during the 1980s with fiber based systems and improved signal analysis. The first imaging systems were presented in the beginning of the 1990s.

    Conventional LDF, although unique in many aspects and elegant as a method, is accompanied by a number of limitations that may have reduced the clinical impact of the technique. The analysis model published by Bonner and Nossal in 1981, which is the basis for conventional LDF, is limited to measurements given in arbitrary and relative units, unknown and non-constant measurement volume, non-linearities at increased blood tissue fractions, and a relative average velocity estimate.

    In this thesis a new LDF analysis method, quantitative LDF, is presented. The method is based on recent models for light-tissue interaction, comprising the current knowledge of tissue structure and optical properties, making it fundamentally different from the Bonner and Nossal model. Furthermore and most importantly, the method eliminates or highly reduces the limitations mentioned above.

    Central to quantitative LDF is Monte Carlo (MC) simulations of light transport in tissue models, including multiple Doppler shifts by red blood cells (RBC). MC was used in the first proof-of-concept study where the principles of the quantitative LDF were tested using plastic flow phantoms. An optically and physiologically relevant skin model suitable for MC was then developed. MC simulations of that model as well as of homogeneous tissue relevant models were used to evaluate the measurement depth and volume of conventional LDF systems. Moreover, a variance reduction technique enabling the reduction of simulation times in orders of magnitudes for imaging based MC setups was presented.

    The principle of the quantitative LDF method is to solve the reverse engineering problem of matching measured and calculated Doppler power spectra at two different source-detector separations. The forward problem of calculating the Doppler power spectra from a model is solved by mixing optical Doppler spectra, based on the scattering phase functions and the velocity distribution of the RBC, from various layers in the model and for various amounts of Doppler shifts. The Doppler shift distribution is calculated based on the scattering coefficient of the RBC:s and the path length distribution of the photons in the model, where the latter is given from a few basal MC simulations.

    When a proper spectral matching is found, via iterative model parameters updates, the absolute measurement data are given directly from the model. The concentration is given in g RBC/100 g tissue, velocities in mm/s, and perfusion in g RBC/100 g tissue × mm/s. The RBC perfusion is separated into three velocity regions, below 1 mm/s, between 1 and 10 mm/s, and above 10 mm/s. Furthermore, the measures are given for a constant output volume of a 3 mm3 half sphere, i.e. within 1.13 mm from the light emitting fiber of the measurement probe.

    The quantitative LDF method was used in a study on microcirculatory changes in type 2 diabetes. It was concluded that the perfusion response to a local increase in skin temperature, a response that is reduced in diabetes, is a process involving only intermediate and high flow velocities and thus relatively large vessels in the microcirculation. The increased flow in higher velocities was expected, but could not previously be demonstrated with conventional LDF. The lack of increase in low velocity flow indicates a normal metabolic demand during heating. Furthermore, a correlation between the perfusion at low and intermediate flow velocities and diabetes duration was found. Interestingly, these correlations were opposites (negative for the low velocity region and positive for the mediate velocity region). This finding is well in line with the increased shunt flow and reduced nutritive capillary flow that has previously been observed in diabetes.

    List of papers
    1. Absolute flow velocity components in laser Doppler flowmetry
    Open this publication in new window or tab >>Absolute flow velocity components in laser Doppler flowmetry
    2006 (English)In: Proceedings of SPIE, the International Society for Optical Engineering, ISSN 0277-786X, E-ISSN 1996-756X, Vol. 6094, p. 60940A-Article in journal (Refereed) Published
    Abstract [en]

    A method to separate a Doppler power spectrum into a number of flow velocity components, measured in absolute units (mm/s), is presented. A Monte Carlo software was developed to track each individual Doppler shift, to determine the probability, p(n), for a photon to undergo n Doppler shifts. Given this shift distribution, a mathematical relationship was developed and used to calculate a Doppler power spectrum originating from a certain combination of velocity components. The non linear Levenberg-Marquardt optimization method could thus be used to fit the calculated and measured Doppler power spectra, giving the true set of velocity components in the measured sample. The method was evaluated using a multi tube flow phantom perfused with either polystyrene microspheres or undiluted/diluted human blood (hct = 0.45). It estimated the velocity components in the flow phantom well, during both low and high concentrations of moving scatterers (microspheres or blood). Thus, further development of the method could prove to be a valuable clinical tool to differentiate capillary blood flow.

    Place, publisher, year, edition, pages
    IEEE, 2006
    Keywords
    Laser Doppler flowmetry, LDF, Monte Carlo simulations, flow phantom, blood perfusion, scattering phase
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-11703 (URN)10.1117/12.659206 (DOI)
    Note
    Ingemar Fredriksson, Marcus Larsson and Tomas Strömberg, Absolute flow velocity components in laser Doppler flowmetry, 2006, Proceedings of SPIE -- Volume 6094 Optical Diagnostics and Sensing VI. http://dx.doi.org/10.1117/12.659206. Copyright 2006 Society of Photo-Optical Instrumentation Engineers. This paper was published in Proceedings of SPIE -- Volume 6094 Optical Diagnostics and Sensing VI and is made available as an electronic reprint with permission of SPIE. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited.Available from: 2008-04-29 Created: 2008-04-29 Last updated: 2017-12-13Bibliographically approved
    2. Optical microcirculatory skin model: Assessed by Monte Carlo simulations paired with in vivo laser Doppler flowmetry
    Open this publication in new window or tab >>Optical microcirculatory skin model: Assessed by Monte Carlo simulations paired with in vivo laser Doppler flowmetry
    2008 (English)In: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 13, no 1, p. 14015-Article in journal (Refereed) Published
    Abstract [en]

    An optical microvascular skin model, valid at 780 nm, was developed. The model consisted of six layers with individual optical properties, and variable thicknesses and blood concentrations at three different blood flow velocities. Monte Carlo simulations were used to evaluate the impact of various model parameters on the traditional Laser Doppler flowmetry (LDF) measures. A set of reference Doppler power spectra was generated by simulating 7,000 configurations, varying the thickness and blood concentrations. Simulated spectra, at two different source detector separations, were compared with in vivo recorded spectra, using a non-linear search algorithm for minimizing the deviation between simulated and measured spectra. The model was validated by inspecting the thickness and blood concentrations which generated the best fit. These four parameters followed a priori expectations for the measurement situations, and the simulated spectra agreed well with the measured spectra for both detector separations. Average estimated dermal blood concentration was 0.08% at rest and 0.63% during heat provocation (44°C) on the volar side of the forearm, and 1.2% at rest on the finger pulp. The model is crucial for developing a technique for velocity-resolved absolute LDF measurements with known sampling volume, and can also be useful for other bio-optical modalities.

    Keywords
    laser Doppler velocimetry, simulations, biomedical optics, Doppler
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-11700 (URN)10.1117/1.2854691 (DOI)
    Note
    Ingemar Fredriksson, Marcus Larsson and Tomas Strömberg, Optical microcirculatory skin model: Assessed by Monte Carlo simulations paired with in vivo laser Doppler flowmetry, 2008, Journal of Biomedical Optics, (13), 1, 14015. http://dx.doi.org/10.1117/1.2854691. Copyright 2008 Society of Photo-Optical Instrumentation Engineers. This paper was published in Journal of Biomedical Optics and is made available as an electronic reprint with permission of SPIE. One print or electronic copy may be made for personal use only. Systematic or multiple reproduction, distribution to multiple locations via electronic or other means, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited.Available from: 2008-04-29 Created: 2008-04-29 Last updated: 2017-12-13
    3. Forced detection Monte Carlo algorithms for accelerated blood vessel image simulations
    Open this publication in new window or tab >>Forced detection Monte Carlo algorithms for accelerated blood vessel image simulations
    2009 (English)In: JOURNAL OF BIOPHOTONICS, ISSN 1864-063X, Vol. 2, no 3, p. 178-184Article in journal (Refereed) Published
    Abstract [en]

    Two forced detection (FD) variance reduction Monte Carlo algorithms for image simulations of tissue-embedded objects with matched refractive index are presented. The principle of the algorithms is to force a fraction of the photon weight to the detector at each and every scattering event. The fractional weight is given by the probability for the photon to reach the detector without further interactions. Two imaging setups are applied to a tissue model including blood vessels, where the ID algorithms produce identical results as traditional brute force simulations, while being accelerated with two orders of magnitude. Extending the methods to include refraction mismatches is discussed.

    The principle of forced detection; a part of the photon weight. based on the probability of reaching the detector without further interactions, is forced to the detector at each and every scattering event.

    Keywords
    Monte Carlo simulations, diffuse scattering, variance reduction, Image simulation
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-17749 (URN)10.1002/jbio.200810048 (DOI)
    Note
    This is the pre-peer reviewed version of the following article: Ingemar Fredriksson, Marcus Larsson and Tomas Strömberg, Forced detection Monte Carlo algorithms for accelerated blood vessel image simulations, 2009, JOURNAL OF BIOPHOTONICS, (2), 3, 178-184. which has been published in final form at: http://dx.doi.org/10.1002/jbio.200810048 Copyright: Wiley-Blackwell Available from: 2009-04-18 Created: 2009-04-17 Last updated: 2016-08-31Bibliographically approved
    4. Measurement depth and volume in laser Doppler flowmetry
    Open this publication in new window or tab >>Measurement depth and volume in laser Doppler flowmetry
    2009 (English)In: Microvascular Research, ISSN 0026-2862, E-ISSN 1095-9319, Vol. 78, no 1, p. 4-13Article in journal (Refereed) Published
    Abstract [en]

    A new method for estimating the measurement depth and volume in laser Doppler flowmetry (LDF) is presented. The method is based on Monte Carlo simulations of light propagation in tissue. The contribution from each individual Doppler shift is calculated and thereby multiple Doppler shifts are handled correctly. Different LDF setups for both probe based (0.0, 0.25, 0.5, and 1.2 mm source-detector separation) and imaging systems (0.5 and 2.0 mm beam diameter) are considered, at the wavelengths 543 nm, 633 nm, and 780 nm. Non-linear speckle pattern effects are accounted for in the imaging system setups. The effects of tissue optical properties, blood concentration, and blood oxygen saturation are evaluated using both homogeneous tissue models and a layered skin model. The results show that the effect on the measurement depth of changing tissue properties is comparable to the effect of changing the system setup, e.g. source-detector separation and wavelength. Skin pigmentation was found to have a negligible effect on the measurement depth. Examples of measurement depths are (values are given for a probe based system with 0.25 mm source-detector separation and an imaging system with a 0.5 mm beam diameter, respectively, both operating at 780 nm): muscle - 0.55/0.79 mm; liver - 0.40/0.53 mm; gray matter - 0.48/0.68 mm; white matter - 0.20/0.20 mm; index finger pulp - 0.41/0.53 mm; forearm skin - 0.53/0.56 mm; heat provoked forearm skin - 0.66/0.67 mm.

    Keywords
    Laser Doppler flowmetry, Laser Doppler perfusion monitoring, Laser Doppler perfusion imaging, Source-detector separation, Measurement volume, Sampling depth, Monte Carlo simulations, Tissue model, Multiple Doppler shifts
    National Category
    Engineering and Technology
    Identifiers
    urn:nbn:se:liu:diva-19656 (URN)10.1016/j.mvr.2009.02.008 (DOI)
    Note
    Original Publication: Ingemar Fredriksson, Marcus Larsson and Tomas Strömberg, Measurement depth and volume in laser Doppler flowmetry, 2009, Microvascular Research, (78), 1, 4-13. http://dx.doi.org/10.1016/j.mvr.2009.02.008 Copyright: Elsevier Science B.V., Amsterdam http://www.elsevier.com/ Available from: 2009-07-10 Created: 2009-07-10 Last updated: 2017-12-13Bibliographically approved
    5. Model-based quantitative laser Doppler flowmetry in skin
    Open this publication in new window or tab >>Model-based quantitative laser Doppler flowmetry in skin
    2010 (English)In: Journal of Biomedical Optics, ISSN 1083-3668, E-ISSN 1560-2281, Vol. 15, no 5Article in journal (Refereed) Published
    Abstract [en]

    Laser Doppler Flowmetry (LDF) can be used for assessing the microcirculatory perfusion. However, conventional LDF (cLDF) gives only a relative perfusion estimate in an unknown measurement volume. To overcome these limitations a model-based analysis method for quantitative LDF (qLDF) is proposed. The method uses an inverse Monte Carlo technique with an adaptive three layer skin model. By analyzing the optimal model where measured and simulated LDF spectra using two different source-detector separations match, the absolute microcirculatory perfusion for a specified velocity region in a predefined volume is determined. The robustness of the qLDF method and how much it is affected by physiologically relevant variations in optical properties were evaluated using additional Monte Carlo simulations. When comparing qLDF to cLDF, a much smaller deviation from the true perfusion was attained. For physiologically relevant variations in the optical properties of static tissue and blood absorption, qLDF displayed errors <12%. Variations in the scattering properties of blood displayed larger errors (<58%). Evaluations on inhomogeneous models containing small blood vessels, hair and sweat glands displayed errors <5%. For extremely inhomogeneous models containing larger blood vessels, the error increased substantially, but this was detected by analyzing the qLDF model residual. The qLDF algorithm was applied to an in vivo local heat provocation. The perfusion increase was higher with qLDF than cLDF, due to non-linear effects in the latter. The qLDF showed that the perfusion increase was due to an increased amount of blood cells with a velocity > 1 mm/s.

    Place, publisher, year, edition, pages
    Society of Photo-optical Instrumentation Engineers, 2010
    Keywords
    laser Doppler flowmetry, microcirculation, tissue modeling, inverse Monte Carlo, quantitative measures, flow speed differentiation
    National Category
    Medical Laboratory and Measurements Technologies
    Identifiers
    urn:nbn:se:liu:diva-20445 (URN)10.1117/1.3484746 (DOI)000284837400046 ()
    Available from: 2009-09-08 Created: 2009-09-08 Last updated: 2017-12-13Bibliographically approved
    6. Microcirculatory changes in type 2 diabetes assessed with velocity resolved quantitative laser Doppler flowmetry
    Open this publication in new window or tab >>Microcirculatory changes in type 2 diabetes assessed with velocity resolved quantitative laser Doppler flowmetry
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    The response to local heating (44oC for 20 min) was evaluated in 28 type 2 diabetes patients (DM) and 29 non-diabetes controls (ND). Microcirculatory perfusion was assessed using conventional and quantitative Laser Doppler flowmetry (cLDF and qLDF), respectively. The qLDF estimates perfusion in a physiological relevant unit (g RBC / 100 g tissue × mm/s) in a fixed output volume, separated into three velocity regions, v < 1 mm/s, 1 - 10 mm/s, and v > 10 mm/s. Perfusion in cLDF is given in arbitrary units with unknown velocity distribution and measurement volume.

    A significantly lower response in DM than in ND was found after heat provocation both for the initial peak and the plateau response, while no significant differences were found at baseline. The qLDF showed increased perfusion for the velocity regions 1-10 mm/s and above 10 mm/s, while no significant increase was found for v < 1 mm/s. In conclusion, we found a lowered LDF response to local heating in DM. The new qLDF method showed that the increased blood flow occurs in vessels with a velocity above 1 mm/s. Baseline qLDF-data indicated that a redistribution of flow to higher velocity regions was associated with longer DM duration and for DM a negative correlation between perfusion and BMI.

    National Category
    Medical Laboratory and Measurements Technologies Biomedical Laboratory Science/Technology Endocrinology and Diabetes
    Identifiers
    urn:nbn:se:liu:diva-20447 (URN)
    Available from: 2009-09-08 Created: 2009-09-08 Last updated: 2010-01-14Bibliographically approved
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