The prevalence of interstitial lung disease (ILD) in RA is ∼5%. Previous work identified increasing age, active articular disease and articular damage as risk factors for RA-associated ILD (RA-ILD). ...The roles of high-resolution CT (HRCT) and lung function testing in defining the nature and extent of pulmonary involvement have recently been explored. This study is the first to examine predictive and prognostic factors for the development of RA-ILD and to report on the physiological and radiological characteristics of the condition from a large multicentre UK network.
We collected data from centres across the UK on patients with both RA and ILD (proved on HRCT) diagnosed over a 25-year period from 1987 to 2012 using a standard pro forma. Potential predictors of RA-ILD were analysed. Baseline lung function data were recorded and related to HRCT findings. We analysed HRCT for subtype and extent of lung involved and examined the relationship between these and both all-cause and pulmonary mortality. We compared our results with case controls matched for age and gender using computer-generated selection from the RA population from one contributing centre.
A total of 230 patients were identified from across the UK with proven RA-ILD diagnosed over 25 years. Median age at diagnosis was 64 years and the male:female ratio was 1:1.09. Univariate analysis showed anti-CCP antibody titres to be the single most strongly associated predictor of RA-ILD. Male gender, age at onset, smoking and RF were all independently associated with RA-ILD on multivariate analysis. Vital capacity (VC) was preserved in limited disease but reduced in extensive disease, while gas transfer was reduced in both. Usual interstitial pneumonia (UIP) was the most common subtype on HRCT and both this and extensive disease were associated with increased all-cause mortality.
This is the largest study of RA-ILD in the UK. Anti-CCP antibodies were strongly associated with RA-ILD in both sexes. Smoking was strongly associated with ILD in males, which may explain the higher frequency of RA-ILD in men. The predominant HRCT pattern was UIP and most patients had limited disease at presentation. The presence of UIP and extensive disease are associated with increased mortality. Baseline gas transfer is a useful screening tool for ILD, while the preservation of VC at baseline might predict limited disease on HRCT.
This study processed the recent in vivo survey results for over a thousand patients and optimized their neck and head CT angiography triggered timing (CTA-TT) via the inverse problem algorithm, which ...ensured the maximal ratio of both left and right arterial to upper sinuses (LRA/US). These results are instrumental in examining the ischemic stroke syndromes along the neck and head. These 1001 patients were randomly categorized into test surveyed (802 patients) and verification group (199 patients), then a six factors semi-empirical formula was constructed by the STATISTICA program. The six factors were assigned a patient’s biological data and preset of the CTA facility; namely Age, mean arterial pressure (MAP), heart rate (HR), contrast media dose (CMD), Pre (injected pressure of CMD), and body surface area (BSA). Each factor was normalized into dimensionless values and incorporated into the dataset matrix
V
8
0
2
×
2
2
to analyze the coefficient matrix
M
2
2
×
1
. The derived semi-empirical formula closely correlated with experimental data, according to the loss function
Φ
=
4
.
4
0
8
4
, correlation coefficient
r
2
=
0
.
9
4
6
8
, and variance of 0.8965. The formula verification for 199 more patients (verification group) yielded a correlation coefficient
r
2
=
0
.
8
9
6
5
. Thus, it can be used for the CTA-TT estimation of patients without their preliminary tests, avoiding unnecessary irradiation. The estimated LRA/US was
2
.
1
9
±
0
.
3
0
for the verification group in this study. A simplified three-factor formula, featuring only age, MAP, and BSA, was also proposed.
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The minimum detectable difference (MDD) at various beats/min (BPM) of CT angiography (CTA) was evaluated using an oblique V-shape line gauge and poly methyl methacrylate (PMMA) phantom in this study. ...The customized phantom with the size of
3
0
×
3
0
×
3
0
cm3 was made from a 1
cm-thick PMMA. The reciprocating mechanism in the phantom was run by a step motor with an eccentric gear connected to a crank rod to provide a stable harmonic motion, simulating the cardiac beats. The MDD has a unique feature in defining the quality characteristic of CT-scanned images and provides more information than simple line pair/cm in the previous studies. The derived MDD was quantified according to various BPM, and the CTA factor combination was preset following either the conventional recommendation or the optimal one. In doing so, the performance was substantiated by the Taguchi-based signal-to-noise ratio and integrated by another index, namely, figure of merit (FOM). The MDD and corresponding
η
(dB) changed from
1
.
7
0
±
0
.
0
1
mm to
2
.
6
6
±
0
.
0
1
mm and from 16.7
dB to 14.2
dB, respectively, for conventional settings; while those obtained for the optimal preset changed from
1
.
7
1
±
0
.
0
3
mm to
2
.
5
8
±
0
.
0
2
mm and from 12.2 dB to 16.4 dB, respectively of CTA at 0–90 BPM. The integrated FOM values for conventional or optimal cases were 1240 and 1337, respectively. The MDD proved to be a useful technique in justifying the CTA-scanned images. For compliance with previous studies, MDD results can be converted to the line pair/cm results, but it is more informative than the quantized number of line pairs.
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Background Several epidemiologic studies have reported associations between fruit and vegetable intake and reduced risk of prostate cancer, but the findings are inconsistent and data on clinically ...relevant advanced prostate cancer are limited. Methods We evaluated the association between prostate cancer risk and intake of fruits and vegetables in 1338 patients with prostate cancer among 29361 men (average follow-up = 4.2 years) in the screening arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Participants completed both a general risk factor and a 137-item food-frequency questionnaire at baseline. Cox proportional hazards models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. Results Vegetable and fruit consumption was not related to prostate cancer risk overall; however, risk of extraprostatic prostate cancer (stage III or IV tumors) decreased with increasing vegetable intake (RR = 0.41, 95% CI = 0.22 to 0.74, for high versus low intake; Ptrend = .01). This association was mainly explained by intake of cruciferous vegetables (RR = 0.60, 95% CI = 0.36 to 0.98, for high versus low intake; Ptrend = .02), in particular, broccoli (RR = 0.55, 95% CI = 0.34 to 0.89, for >1 serving per week versus <1 serving per month; Ptrend = .02) and cauliflower (RR = 0.48, 95% CI = 0.25 to 0.89 for >1 serving per week versus <1 serving per month; Ptrend = .03). We found some evidence that risk of aggressive prostate cancer decreased with increasing spinach consumption, but the findings were not consistently statistically significant when restricted to extraprostatic disease. Conclusion High intake of cruciferous vegetables, including broccoli and cauliflower, may be associated with reduced risk of aggressive prostate cancer, particularly extraprostatic disease.
Subject: This study assessed the absorbed dose for patients who underwent Tc-99m Methylene Diphosphonates (MDP) bone scan examination based on a series of personal dosimeter measurements and a ...derived semi-empirical formula. Material and methods: 210 volunteers among the patients, who were administrated 925 MBq Tc-99m MDP for the bone scan examination in the Department of Nuclear Medicine in the Dalin Tuzchi Hospital, Taiwan, underwent personal dosimeter measurements at 30, 120, and 180
min after the injection. A personal dosimeter was held at a 30
cm distance from the patient’s stomach. The acquired data were analyzed to derive the residence time of Tc-99m radionuclide in the patient’s body. Five biological parameters (gender, age, BMI, eGFR, and creatinine) of these 210 patients were collected and processed by the STATISTICA program, yielding a nonlinear 16-term first-order semi-empirical formula for the radionuclide residence time prediction. The respective four- and three-factor calculations, excluding creatinine and eGFR, provided poor correlation. Results and Conclusion: According to the phantom concept, treating a patient’s body as a homogenous spherical ball, a simplified formula was used to assess the absorbed dose rate and magnitude. Therefore, the derived residence time, dose rate, and absorbed dose were
1
4
6
.
1
±
3
6
.
3
min,
8
.
3
±
1
.
0
μ
Sv/min, and
1
2
1
1
.
7
±
3
5
4
.
2
μ
Sv, respectively. These results were lower than those obtained in previous studies, which can be attributed to accelerated radionuclide excretion of patients who drank 2000 cc of water after the procedure, yielding shorter residence times.
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Objective: The minimum detectable difference (MDD) of computed tomography (CT) scanned images was quantified and optimized according to an indigenous hepatic phantom, line group gauge and Taguchi
L
1
...8
optimization analysis in this work. Methods: Optimal combinations of CT scan factors in every group with the level organization were judged using the Taguchi analysis, in which every factor was organized into only 18 groups, creating evaluated outcomes with the same confidence as if every factor was analyzed independently. The five practical factors of the CT scan were (1) kVp, (2) mAs, (3) pitch increment, (4) field of view (FOV) and (5) rotation time for one loop of CT scan. Insofar as each factor had two or three levels, the total number of 162 (i.e.,
2
×
3
×
3
×
3
×
3
) combinations was considered. Results: The optimal setting was 120
kVp, 300
mAs, 0.641 pitch, 320
mm FOV and 1.0
s of rotation time of CT scan. The minimal MDD was 2.65
mm under 0.39
mm of the slit depth from the revised Student’s
t
-test with a 95% confidence level. In contrast, the MDD of conventional and the best one (no. 7) among all original 18 groups were 3.27
mm and 2.93
mm for 0.43
mm and 0.41
mm slit depths, respectively. Conclusion: The Taguchi analysis was found very lucrative for the design of imaging analysis in practical diagnosis. The indigenous line group gauge and hepatic phantom also proved to be suitable in simulating the human body in real hepatic carcinoma examination.
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The CT scan protocol optimization for peripheral arterial occlusive disease (PAOD) syndrome was performed by organizing seven CT factors kVp, mAs, pitch, field of view (FOV) (mm), time of rotation ...(s), slice thickness (mm), and matrix size into Taguchi unique
L
1
8
orthogonal array. The minimum detectable difference (MDD) in the optimizing process was quantified by adopting a customized line group gauge. Besides, three qualified experts in radiology examined by the double-blind criterion the gauge scanned images and ranked them, yielding the optimal setting of CT scan protocols. The latter setting for PAOD included the kVp of 100, mAs of 240, pitch of 0.513, FOV of 320
mm, rotation time of 0.75
s, slice thickness of 4.0, and matrix size of
7
6
8
×
7
6
8
. The ANOVA and revised Student’s
t
-test verified the smallest MDD as 1.43
mm at a 0.45-mm gauge depth. The ranking process, which makes it possible to magnify and emphasize the imaging correlation among groups, was found to be preferable to grading in the optimization process. The comparative analysis of various MDDs obtained from different medical facilities and literary sources was performed, which revealed that the cardiac X-ray provided the finest spatial resolution according to the quantified MDD. Meanwhile, the CT scan protocol for PAOD adopted in this study had finer MDD than that for the abdomen due to comparatively low kVp or/and mAs.
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In this study, the correlation between triggered timing for head and neck CT angiography (TT CTA) scanning and the average of CT values of both left and right arterial to upper sinuses (LRA/US) ...reaching a maximal ratio was surveyed and explored using the inverse problem algorithm according to a six-factor semi-quantitative analysis of 251 patients. Six risk factors, namely TT CTA, mean arterial pressure (MAP), heart rate (HR), contrast media solution (CMS), given pressure (Pre), and body surface area (BSA) were used to identify a nonlinear first-order regression correlation between projected and actual LRA/US values. The respective 22 terms were derived via the STATISTICA program. In doing so, a customized loss function (
Φ
) was defined according to the total fluctuation between theoretically projected and actual LRA/US values for all 216 patients. Thus,
2
1
6
×
2
2
=
4
7
5
2
individual data points were included in the algorithm to optimize the compromised solution array
2
2
×
1
=
2
2
of LRA/US values. The results exhibited a close correlation with loss function
Φ
=
2
.
0
1
4
4
, correlation coefficient
r
2
=
0
.
9
6
5
0
, and a 93.13% variance. Another group of 35 patients with similar symptoms was selected to verify the prediction accuracy and exhibited a high coincidence, although the reverse calculation-based correlation between CC CTA and LRA/US was still controversial from a clinical viewpoint. The proposed algorithm is considered quite instrumental in predicting the LRA/US with ischemic stroke symptoms in the CTA examination.
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Objective: To optimize the minimum detectable difference (MDD) of a cardiac X-ray imaging system using the Taguchi L8(27) analysis and a precise line pair (LP) gauge. Methods: The optimal combination ...of the four critical factors of the cardiac X-ray imaging system, namely X-ray focus, kilovoltage (kVp), milliamper-seconds (mAs) and source image distance (SID), providing the MDD was calculated via the Taguchi analysis and experimentally verified. Two (low and high) levels were assigned for each factor, and eight combinations of four factors were used to acquire instant X-ray images using an NDT commercial LP gauge (with a gauge length of 64
mm and a width of
3
.
5
mm). The latter had five lines and was split gradually from top to bottom for the inspection of X-ray images, whose quality was ranked by three well-trained radiologists according to the double-blind criterion. The ranking grade was given by sharp contrast, low noise and precision to distinguish the LP. Accordingly, the MDD was derived to represent the spatial resolution of instant X-ray images by the revised Student’s
t
-test analysis. The optimal combination of factors was experimentally identified and clinically verified in the follow-up inspections. Results: For the conventional setting, Group No. 7 (which obtained the highest grade among eight groups) and the optimal setting, the obtained MDD values were
0
.
1
8
3
,
0
.
1
6
7
and
0
.
1
5
7
mm, respectively, while the LP (line pair/mm) interpolated from the gauge scale amounted to
2
.
7
,
3
.
1
and
3
.
2
LP/mm, respectively. Conclusion: The Taguchi L8 analysis was proved to be instrumental in optimizing the cardiac X-ray imaging system MDD and is recommended to be used jointly with the revised Student’s
t
-test analysis for improving the spatial resolution of instant X-ray images.
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The TLD-100H readout system performance under various radioactive I-131 exposure doses was optimized by four key factors via the revised Taguchi dynamic quality loss function. Taguchi dynamic ...analysis and the orthogonal array reorganizing the essential factors are crucial for the optimization of the thermoluminescent dosimeter (TLD) readout system given strict criteria of multiple irradiated environments and long-term exposure for calibrated TLDs. Accordingly, 96 TLD-100H chips were selected and randomly categorized into three batches with eight groups (four TLD chips in each group). Four factors, namely (1) initial temperature, (2) heating rate, (3) maximal temperature, and (4) TLD preheat time before reading were organized into eight combinations according to Taguchi suggestion, whereas each factor was preset at two levels. All 96
(
3
×
8
×
4
=
9
6
)
chips were put in three concentric circles with 30, 60, and 90 cm radii for 48 h, surrounding the radioactive 150
mCi (
5
.
5
5
×
1
0
3
MBq) I-131 capsule and exposed to the cumulative doses of 88.2, 18.6, and 8.6
mSv for the respective radii, accordingly. The TLD readings obtained from each group were analyzed to derive the sensitivity, coincidence, and reproducibility, then those were reorganized to draw four fish-bone-plots for the optimization. The optimal option for the TLD readout system implied the combination of A1 (a
1
3
5
∘
C initial temperature), B1 (a
1
0
∘
C/s heating rate), C1 (a
2
4
0
∘
C maximal temperature), and D2 (a 15
s preheat time), which was further verified by the follow-up measurements. The dominant factors were A (initial temperature) and B (heating rate), whereas C (maximal temperature) and D (preheat time) were minor and provided negligible contributions to the system performance optimization.
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