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In memoriam: Dirk J Kwekkeboom (1958–2017)

Wouter W de Herder, Erik P Krenning, Gabriel P Krestin
2017 Endocrine-Related Cancer  
doi:10.1530/erc-17-0087 fatcat:snls37mdenfq7miozxcj7zakke

Evidence-based radiology: why and how?

Francesco Sardanelli, Myriam G. Hunink, Fiona J. Gilbert, Giovanni Di Leo, Gabriel P. Krestin
2009 European Radiology  
Introduction Over the past three decades, the medical community has increasingly supported the principle that clinical practice is based on the critical evaluation of the results obtained from medical scientific research. Today this evaluation is facilitated by the Internet which provides instantaneous online access to the most recent publications even before they appear in print form. More and more information is solely accessible through the Internet and through quality-and relevance-filtered
more » ... secondary publications (meta-analyses, systematic reviews, and guidelines). This principle -a clinical practice based on the results (the evidence) given by the research -has engendered a discipline, evidence-based medicine (EBM), which is increasingly expanding into healthcare and bringing a striking change in teaching, learning, clinical practice, and decision making by physicians, administrators, and policy makers. EBM has entered radiology with a relative delay but a substantial impact of this approach is expected in the near future. The aim of this article is to provide an overview of EBM in relation to radiology and to define a policy for this principle in the European radiological community. What is EBM? Evidence-based medicine, also referred to as evidence-based healthcare, or evidence-based practice [1] has been defined as "the systematic application of the best evidence to evaluate the available options and decision making in clinical management and policy settings", i.e., "integrating clinical expertise with the best available external clinical evidence from research"[2]. This concept is not new. The basis for this way of thinking was developed in the 19th century (Pierre C.A. Luis) and during the 20th century (Ronald A. Fisher, Austin Bradford Hill, Richard Doll, and Archie Cochrane). However, it was not until the second half of the last century that the Canadian School leaded by Gordon Guyatt and Dave L. Sackett at McMaster University (Hamilton, Hontario, Canada) promoted the tendency to guide clinical practice using the best results − the evidence − produced by scientific research [2, 3a]. This approach was subsequently refined also by the Center for Evidence-based Medicine (CEBM) at University of Oxford, England [1, 4]. Dave L. Sackett said that: Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decision about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external evidence from systematic research [5]. A highly attractive alternative but more technical definition, explicitly including diagnosis and investigation, has been proposed by Anna Donald and Trisha Greenhalgh: Evidence-based medicine is the use of mathematical estimates of the risk of benefit and harm, derived from high-quality research on population samples, to inform clinical decision making in the diagnosis, investigation or management of individual patients [3b].
doi:10.1007/s00330-009-1574-4 pmid:20069736 fatcat:jkjydg6k5jhyhenmcrop6pmpti

Nanoparticles and clinically applicable cell tracking

Monique R Bernsen, Jamal Guenoun, Sandra T van Tiel, Gabriel P Krestin
2015 British Journal of Radiology  
In vivo cell tracking has emerged as a much sought after tool for design and monitoring of cell-based treatment strategies. Various techniques are available for pre-clinical animal studies, from which much has been learned and still can be learned. However, there is also a need for clinically translatable techniques. Central to in vivo cell imaging is labelling of cells with agents that can give rise to signals in vivo, that can be detected and measured non-invasively. The current imaging
more » ... logy of choice for clinical translation is MRI in combination with labelling of cells with magnetic agents. The main challenge encountered during the cell labelling procedure is to efficiently incorporate the label into the cell, such that the labelled cells can be imaged at high sensitivity for prolonged periods of time, without the labelling process affecting the functionality of the cells. In this respect, nanoparticles offer attractive features since their structure and chemical properties can be modified to facilitate cellular incorporation and because they can carry a high payload of the relevant label into cells. While these technologies have already been applied in clinical trials and have increased the understanding of cell-based therapy mechanism, many challenges are still faced. 19 F, fluorine-19. a at intracellular concentrations of 9-50 pg/cell; voxel size 0.26-1 3 10 23 mm 3 . b at intracellular Gd concentrations of 0.05-70 pg/cell; voxel size 2.24-10.3 3 10 23 mm 3 . c at intracellular Mn concentrations of 0.35-0.7 pg/cell; voxel size 160 3 10 2-3 mm 3 (only specified by Letourneau et al. 35 ). d at intracellular CEST agent concentrations of 3-4 mM/cell; voxel size 24-73 3 10 23 mm 3 . e at intracellular 19 F concentrations of 0.35-0.7 pg/cell; voxel size 660-2000 3 10 23 mm 3 . f Detection sensitivity is highly dependent of various conditions, such as the cell type, intracellular loading, imaging parameters including voxel size, and magnetic field strength.
doi:10.1259/bjr.20150375 pmid:26248872 pmcid:PMC4730978 fatcat:l7rc73rf2fb57hdc25g37vwrfi

Molecular imaging in radiology: the latest fad or the new frontier?

Gabriel P. Krestin, Monique R. Bernsen
2006 European Radiology  
doi:10.1007/s00330-006-0454-4 pmid:17021647 pmcid:PMC1705500 fatcat:njvl2zkfdjbejghlqxnpat5rpq

Labelling of mammalian cells for visualisation by MRI

Monique R. Bernsen, Amber D. Moelker, Piotr A. Wielopolski, Sandra T. van Tiel, Gabriel P. Krestin
2009 European Radiology  
Farrell E, Wielopolski P, Pavljasevic P et al (2008) Effects of iron oxide incorporation for long term cell tracking on MSC differentiation in vitro and in vivo.  ...  Wang YX, Hussain SM, Krestin GP (2001) Superparamagnetic iron oxide contrast agents: physicochemical characteristics and applications in MR imaging. Eur Radiol 11:2319-2331 58.  ... 
doi:10.1007/s00330-009-1540-1 pmid:19672602 fatcat:quwylobbjncgnckgj6p7hujece

Development of molecular imaging in the European radiological community

Nicolas Grenier, Francesco Sardanelli, Christoph D. Becker, Jerzy Walecki, Guy Sebag, David John Lomas, Gabriel P. Krestin
2009 European Radiology  
Krestin (Netherlands, Chair of the ESR Research Committee).  ... 
doi:10.1007/s00330-008-1279-0 pmid:19153742 fatcat:q7p2up64brbe3mgz56zquktaju

Superparamagnetic iron oxide contrast agents: physicochemical characteristics and applications in MR imaging

Yi-Xiang J. Wang, Shahid M. Hussain, Gabriel P. Krestin
2001 European Radiology  
ECR 2000 abstract book, p 129 33. Tombach B, Reimer P, Bremer C, Allkemper T, Engehardt M, Mahler M, Heindel, WL (2000) MRA with a new blood pool contrast agent: Phase I clinical trial.  ...  Presented at the 1996, Los Angeles, American Society of Neuroradiology, Seattle, p 269 31.  ... 
doi:10.1007/s003300100908 pmid:11702180 fatcat:d27kiroqwne3tfe3455iikc7nq

Multidetector CT for Visualization of Coronary Stents

Francesca Pugliese, Filippo Cademartiri, Carlos van Mieghem, Willem B. Meijboom, Patrizia Malagutti, Nico R. A. Mollet, Carlo Martinoli, Pim J. de Feyter, Gabriel P. Krestin
2006 Radiographics  
Whereas the clinical diagnosis of in-stent thrombosis is straightforward, that of in-stent restenosis remains a problem, because although many patients experience chest pain after coronary stent placement, that symptom is secondary to ischemia in only a few. The use of a noninvasive technique to identify such patients for early invasive intervention versus more conservative management is thus highly desirable. Multidetector computed tomography (CT) performed with 16-section scanners recently
more » ... rged as such a technique and has overtaken modalities such as electron-beam CT and magnetic resonance imaging as an alternative to conventional angiography for the assessment of instent restenosis. The improved hardware design of the current 64-section CT scanners allows even better delineation of stent struts and lumen. The more reliable criterion of direct lumen visualization thus may be substituted for the presence of distal runoff, which lacks specificity for a determination of in-stent patency because of the possibility of collateral pathways. However, the capability to accurately visualize the in-stent lumen depends partly on knowledge of the causes of artifacts and how they can be compensated for with postprocessing and proper image display settings. In addition, an understanding of the major stent placement techniques used in the treatment of lesions at arterial bifurcations is helpful.
doi:10.1148/rg.263055182 pmid:16702461 fatcat:rbg4xdxogjhhbi5vjyvrp44ati


Stella-Lida Papadopoulou, Chrysafios Girasis, Anoeshka Dharampal, Vasim Farooq, Yoshinobu Onuma, Alexia Rossi, Marie-angèle Morel, Gabriel P. Krestin, Patrick W. Serruys, Pim J. de Feyter, Hector M. Garcia Garcia
2013 JACC Cardiovascular Imaging  
(p ϭ 0.025).  ...  On multivariable logistic regression analysis, infarct transmurality was the strongest independent predictor of early pericardial damage (p ϭ 0.004) followed by peak CRP (p ϭ 0.007) and anterior MI location  ...  Papadopoulou, MD, Chrysafios Girasis, MD, Anoeshka Dharampal, MD, Vasim Farooq, MBChB, Yoshinobu Onuma, MD, Alexia Rossi, MD, Marie-angèle Morel, BSc, Gabriel P. Krestin, MD, PhD, Patrick W.  ... 
doi:10.1016/j.jcmg.2012.09.013 pmid:23473118 fatcat:m6ahdw3n6rcpzmxt4bru4uegea

Cell tracking in cardiac repair: what to image and how to image

Alessandro Ruggiero, Daniel L. J. Thorek, Jamal Guenoun, Gabriel P. Krestin, Monique R. Bernsen
2011 European Radiology  
Farrell E, Wielopolski P, Pavljasevic P et al (2009) Cell labelling with superparamagnetic iron oxide has no effect on chondrocyte behaviour. Osteoarthr Cartil 17:961-967 38.  ...  Bernsen MR, Moelker AD, Wielopolski PA, van Tiel ST, Krestin GP Labelling of mammalian cells for visualisation by MRI. Eur Radiol 20:255-274. doi:10.1007/s00330-009-1540-1 34.  ... 
doi:10.1007/s00330-011-2190-7 pmid:21735069 pmcid:PMC3229694 fatcat:ohn7xsdkuvddzlova7ifvq32mi

Benign versus Malignant Hepatic Nodules: MR Imaging Findings with Pathologic Correlation

Shahid M. Hussain, Pieter E. Zondervan, Jan N. M. IJzermans, Solko W. Schalm, Rob A. de Man, Gabriel P. Krestin
2002 Radiographics  
According to the currently used nomenclature, there are only two types of hepatocellular nodular lesions: regenerative lesions and dysplastic or neoplastic lesions. Regenerative nodules include monoacinar regenerative nodules, multiacinar regenerative nodules, cirrhotic nodules, segmental or lobar hyperplasia, and focal nodular hyperplasia. Dysplastic or neoplastic nodules include hepatocellular adenoma, dysplastic foci, dysplastic nodules, and hepatocellular carcinoma (HCC). Many of these
more » ... of hepatic nodules play a role in the de novo and stepwise carcinogenesis of HCC, which comprises the following steps: regenerative nodule, low-grade dysplastic nodule, high-grade dysplastic nodule, small HCC, and large HCC. State-of-the-art magnetic resonance (MR) imaging facilitates detection and characterization in most cases of hepatic nodules. State-of-the-art MR imaging includes single-shot fast spin-echo imaging, in-phase and opposed-phase T1-weighted gradient-echo imaging, T2-weighted fast spin-echo imaging with fat saturation, and two-dimensional or three-dimensional dynamic multiphase contrast material-enhanced imaging. © RSNA, 2002 Abbreviations: FNH ϭ focal nodular hyperplasia, HCC ϭ hepatocellular carcinoma, H-E ϭ hematoxylin-eosin . Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly.
doi:10.1148/radiographics.22.5.g02se061023 pmid:12235331 fatcat:oqd3u3zhvvgbrklxtprpdxodbq

Chest computed tomography: a validated surrogate endpoint of cystic fibrosis lung disease?

Martine Loeve, Gabriel P. Krestin, Margaret Rosenfeld, Marleen de Bruijne, Stephen M. Stick, Harm A. Tiddens
2012 European Respiratory Journal  
Proc Am Thorac Soc 2007; vol 4: p. E1-E6. CYSTIC FIBROSIS | M. LOEVE ET AL. DOI: 10.1183/09031936.00051512 1  ... 
doi:10.1183/09031936.00051512 pmid:23258780 fatcat:hfghuty3grbx7pe6pdqxfdsw64

Women in radiology: gender diversity is not a metric—it is a tool for excellence

Rahel A. Kubik-Huch, Valérie Vilgrain, Gabriel P. Krestin, Maximilian F. Reiser, Ulrike I. Attenberger, Ada U. Muellner, Christopher P. Hess, Hedvig Hricak
2019 European Radiology  
Women in Focus: Be Inspired was a unique programme held at the 2019 European Congress of Radiology that was structured to address a range of topics related to gender and healthcare, including leadership, mentoring and the generational progression of women in medicine. In most countries, women constitute substantially fewer than half of radiologists in academia or private practice despite frequently accounting for at least half of medical school enrolees. Furthermore, the proportion of women
more » ... eases at higher academic ranks and levels of leadership, a phenomenon which has been referred to as a "leaky pipeline". Gender diversity in the radiologic workplace, including in academic and leadership positions, is important for the present and future success of the field. It is a tool for excellence that helps to optimize patient care and research; moreover, it is essential to overcome the current shortage of radiologists. This article reviews the current state of gender diversity in academic and leadership positions in radiology internationally and explores a wide range of potential reasons for gender disparities, including the lack of role models and mentorship, unconscious bias and generational changes in attitudes about the desirability of leadership positions. Strategies for both individuals and institutions to proactively increase the representation of women in academic and leadership positions are suggested. KEY POINTS: • Gender-diverse teams perform better. Thus, gender diversity throughout the radiologic workplace, including in leadership positions, is important for the current and future success of the field. • Though women now make up roughly half of medical students, they remain underrepresented among radiology trainees, faculty and leaders. • Factors leading to the gender gap in academia and leadership positions in Radiology include a lack of role models and mentors, unconscious biases, other societal barriers and generational changes.
doi:10.1007/s00330-019-06493-1 pmid:31802213 pmcid:PMC7033068 fatcat:pw76cwncvzgsxbqkpcpqbgs2iu

The Rotterdam Scan Study: design update 2016 and main findings

M. Arfan Ikram, Aad van der Lugt, Wiro J. Niessen, Peter J. Koudstaal, Gabriel P. Krestin, Albert Hofman, Daniel Bos, Meike W. Vernooij
2015 European Journal of Epidemiology  
Imaging plays an essential role in research on neurological diseases in the elderly. The Rotterdam Scan Study was initiated as part of the ongoing Rotterdam Study with the aim to elucidate the causes of neurological disease by performing imaging of the brain in a prospective population-based setting. Initially, in 1995 and 1999, random subsamples of participants from the Rotterdam Study underwent neuroimaging, whereas from 2005 onwards MRI has been implemented into the core protocol of the
more » ... rdam Study. In this paper, we discuss the background and rationale of the Rotterdam Scan Study. Moreover, we describe the imaging protocol, image post-processing techniques, and the main findings to date. Finally, we provide recommendations for future research, which will also be topics of investigation in the Rotterdam Scan Study.
doi:10.1007/s10654-015-0105-7 pmid:26650042 pmcid:PMC4690838 fatcat:ufywuzkeejdarhvdxcj4cgwpte

Improved diagnostic accuracy with 16-row multi-slice computed tomography coronary angiography

Nico R. Mollet, Filippo Cademartiri, Gabriel P. Krestin, Eugène P. McFadden, Chourmouzios A. Arampatzis, Patrick W. Serruys, Pim J. de Feyter
2005 Journal of the American College of Cardiology  
OBJECTIVES We sought to compare the diagnostic value of multi-slice computed tomography (MSCT) coronary angiography (CA) to detect significant stenoses (Ն50% lumen diameter reduction) with that of invasive CA. BACKGROUND The latest 16-row MSCT scanner has a faster rotation time (375 ms) and permits scanning with a higher X-ray tube current (500 to 600 mA) during MSCT CA when compared with previous scanners. METHODS We studied 51 patients (37 men, mean age 58.9 Ϯ 10.0 years) with stable angina
more » ... atypical chest pain. Patients with pre-scan heart rates Ն70 beats/min received oral beta-blockade. The heart was scanned after intravenous injection of 100 ml contrast (iodine content, 400 mg/ml). Mean scan time was 18.9 Ϯ 1.0 s. The MSCT scans were analyzed by two observers unaware of the results of invasive angiography, and all available coronary branches Ն2 mm were included. RESULTS Invasive CA demonstrated normal arteries in 16% (8 of 51), non-significant disease in 21% (11 of 51), single-vessel disease in 37% (19 of 51), and multi-vessel disease in 26% (13 of 51) of patients. There were 64 significant lesions. Sensitivity, specificity, and positive and negative predictive values for detection of significant lesions on a segment-based analysis were 95% (61 of 64, 95% confidence interval [CI] 86 to 99), 98% (537 of 546, 95% CI 96 to 99), 87% (61 of 70, 95% CI 76 to 98), and 99% (537 of 540, 95% CI 98 to 99), respectively. All patients with angiographically normal coronary arteries or significant lesions were correctly identified. Three of 11 patients with Ͻ50% lesions were incorrectly classified as having single-vessel disease. CONCLUSIONS The 16-row MSCT CA reliably detects significant coronary stenoses in patients with atypical chest pain or stable angina pectoris. (J Am Coll Cardiol 2005;45:128 -32)
doi:10.1016/j.jacc.2004.09.074 pmid:15629386 fatcat:5qc2hkuvjza6lhswq3mbhzbl5i
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