Kvalitetssäkring av den spatiella nogrannheten hos magnetresonanstomografi vid användning av ett stort Field of View

In todays Radiotherapy Treatment Planning, RTP, it is common to use Computed Tomography, CT, together with Magnetic Resonance Imaging, MRI, where CT provides electron density information and a geometrical reference, and where MRI provides superior soft tissue contrast. To sim- plify the workflow and improve treatment accuracy, research groups have demonstrated how to exclude CT and use a MRI-only approach. In this thesis, a method for spatial distortion analysis, ultimately enabling quality assurance, QA, of the spatial accuracy of MRI, was defined, tested and evaluated. A phantom was built to cover the entire clinical Field Of View, FOV, and 6mm-diameter fluid filled paintball markers were placed in a well-defined geometrical pattern within the phantom, and used as positive contrast. The phantom was imaged with a 3D Fast Gradient Echo sequence and a 3D Fast Spin Echo sequence. The markers were identified in the image data by a MATLAB-algorithm, and the location of the center of mass was calculated for each marker and compared to a theoretical reference. The location error was defined as the spatial distortion - a measurement of the spatial accuracy. Imaging parameters were altered and the effect on the spatial accuracy was analyzed. The spatial distortions were successfully measured within the entire (maximal) clinical FOV. It was shown that high readout bandwidth reduced distortions in the frequency encoding direction. These distortions could thus be attributed to B0-inhomogeneities. It was also determined that increasing the readout bandwidth to the maximum value reduced the maximum distortions in the frequency encoding direction to the same level as the maximum distortions in the other two phase-encoding directions of the 3D acquisitions. The voxel size had a very small effect on the spatial accuracy, enabling large voxelsize to be used when imaging the phantom, to decrease the scan time. The method was deemed capable of serving as a basis for QA of the spatial accuracy of large FOV MRI, which is needed in future MRI-only RTP approaches.

Promotion of positive behaviour using role play scenes for 5-6 years old children

Diplomdarbs „Pozitīvas uzvedības veicināšana 5-6 gadus veciem bērniem izmantojot sižeta – lomu rotaļas” ir izstrādāts, lai izpētītu, kādas uzvedības problēmas ir bērniem PII X un rastu veidu, kā tās risināt, izmantojot sižeta – lomu rotaļas. Diplomdarba autors ir Ieva Alberta, darba vadītāja Dr. paed. Linda Daniela. Izvirzīti četri uzdevumi: teorētiski analizēt pozitīvas uzvedības veidošanos 5-6 gadus veciem bērniem, izmantojot sižeta - lomu rotaļas, analizēt uzvedības izpausmes 5-6 gadus veciem bērniem, veikt pedagoģisko izmēģinājumdarbību, analizēt iegūtos rezultātus. Darbam izvirzīta hipotēze: mērķtiecīgi atlasot un organizējot sižeta – lomu rotaļas, var tikt sekmēta pozitīvas uzvedības veidošanās 5-6 gadus veciem bērniem. Darbam ir anotācija, ievads, teorētiskais un praktiskais izklāsts, nobeigums un izmantotās literatūras saraksts. Atslēgvārdi: •Pozitīva uzvedība; •Novērojums; •5-6 gadus veci bērni.The qualification work’s theme is „To stimulate the positive well – mannered for children 5-6 years old to use the role plays?” There is research about well – mannered problems to children in pre-school X and find to way how its developed using the role plays. The author is Ieva Alberta, the leader is Dr. Paed. Linda Daniela. There are 4 tasks: •Theoretical analyze for positive well – mannered to children 5-6 years old; •To analyze well – mannered to make know to children 5-6 years old; •To do pedagogical work with children; •To analyze the results. There is hypothesis: purposeful to select and organized the role plays, we can progressed the positive well – mannered for children 5-6 years old. There is annotation, introduction, theoretical and practical parts, conclusion and list of literature. The key-words: •The positive well- mannered; •Observation; •Children 5-6 years old

Interactive training workshop to improve prostate mpMRI knowledge: results from the ESOR Nicholas Gourtsoyiannis teaching fellowship

Purpose Prostate MRI is established for the investigation of patients presenting with suspected early prostate cancer. Outcomes are dependent on both image quality and interpretation. This study assessed the impact of an educational intervention on participants’ theoretical knowledge of the technique. Methods Eighty-one clinicians from two centres with varying experience in prostate MRI participated. Baseline knowledge was assessed with 10 written and image-based multiple-choice questions (MCQs) prior to a course including didactic lectures and hands-on interactive workshops on prostate MRI interpretation. Post-course, participants completed a second 10-question MCQ test, matched by format, themes, and difficulty, to assess for any improvement in knowledge and performance. Results were assessed using the Wilcoxon rank sum test, and the Wilcoxon signed-rank test for paired data. Results Thirty-nine participants, including 25/49 (51.0%) and 14/32 (43.8%) at each centre completed both assessments, with their results used for subsequent evaluation. Overall, there was a significant improvement from pre- (4.92 ±2.41) to post-course scores (6.77 ±1.46), p500 MRIs reported) experience (6.83 ±2.48 to 7.67 ±0.82, p=0.339). Conclusions A dedicated prostate MRI teaching course combining didactic lectures and hands-on workshops significantly improved short-term theoretical knowledge of the technique for clinicians with differing levels of experience.Author TB receives research was supported by the NIHR Cambridge Biomedical Research Centre (NIHR203312). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. TB also acknowledges support from Cancer Research UK (Cambridge Imaging Centre grant number C197/A16465), the Engineering and Physical Sciences Research Council Imaging Centre in Cambridge and Manchester, and the Cambridge Experimental Cancer Medicine Centre

Interactive training workshop to improve prostate mpMRI knowledge: results from the ESOR Nicholas Gourtsoyiannis teaching fellowship

Abstract Purpose Prostate MRI is established for the investigation of patients presenting with suspected early prostate cancer. Outcomes are dependent on both image quality and interpretation. This study assessed the impact of an educational intervention on participants’ theoretical knowledge of the technique. Methods Eighty-one clinicians from two centers with varying experience in prostate MRI participated. Baseline knowledge was assessed with 10 written and image-based multiple-choice questions (MCQs) prior to a course including didactic lectures and hands-on interactive workshops on prostate MRI interpretation. Post-course, participants completed a second 10-question MCQ test, matched by format, themes, and difficulty, to assess for any improvement in knowledge and performance. Results were assessed using the Wilcoxon rank sum test, and the Wilcoxon signed-rank test for paired data. Results Thirty-nine participants, including 25/49 (51.0%) and 14/32 (43.8%) at each center completed both assessments, with their results used for subsequent evaluation. Overall, there was a significant improvement from pre- (4.92 ± 2.41) to post-course scores (6.77 ± 1.46), p  500 MRIs reported) experience (6.83 ± 2.48 to 7.67 ± 0.82, p = 0.339). Conclusions A dedicated prostate MRI teaching course combining didactic lectures and hands-on workshops significantly improved short-term theoretical knowledge of the technique for clinicians with differing levels of experience. Critical relevance statement A dedicated teaching course significantly improved theoretical knowledge of the technique particularly for clinicians with less reporting experience and a lower baseline knowledge. The multiple-choice questions format mapped improved performance and may be considered as part of future MRI certification initiatives. Key points • Prostate MRI knowledge is important for image interpretation and optimizing acquisition sequences. • A dedicated teaching course significantly improved theoretical knowledge of the technique. • Improved performance was more apparent in clinicians with less reporting experience and a lower baseline knowledge. Graphical Abstrac

Interactive training workshop to improve prostate mpMRI knowledge: results from the ESOR Nicholas Gourtsoyiannis teaching fellowship

Acknowledgements: The Authors would like to thank Professor Valérie Vilgrain (ESOR Scientific / Educational Director), Ms. Brigitte Lindlbauer (ESOR Administrative Director), Mrs. Isabella Davicino (ESOR Scholarship/Fellowship Coordinator) and the whole ESOR team for their support.: Purpose: Prostate MRI is established for the investigation of patients presenting with suspected early prostate cancer. Outcomes are dependent on both image quality and interpretation. This study assessed the impact of an educational intervention on participants’ theoretical knowledge of the technique. Methods: Eighty-one clinicians from two centers with varying experience in prostate MRI participated. Baseline knowledge was assessed with 10 written and image-based multiple-choice questions (MCQs) prior to a course including didactic lectures and hands-on interactive workshops on prostate MRI interpretation. Post-course, participants completed a second 10-question MCQ test, matched by format, themes, and difficulty, to assess for any improvement in knowledge and performance. Results were assessed using the Wilcoxon rank sum test, and the Wilcoxon signed-rank test for paired data. Results: Thirty-nine participants, including 25/49 (51.0%) and 14/32 (43.8%) at each center completed both assessments, with their results used for subsequent evaluation. Overall, there was a significant improvement from pre- (4.92 ± 2.41) to post-course scores (6.77 ± 1.46), p 500 MRIs reported) experience (6.83 ± 2.48 to 7.67 ± 0.82, p = 0.339). Conclusions: A dedicated prostate MRI teaching course combining didactic lectures and hands-on workshops significantly improved short-term theoretical knowledge of the technique for clinicians with differing levels of experience. Critical relevance statement: A dedicated teaching course significantly improved theoretical knowledge of the technique particularly for clinicians with less reporting experience and a lower baseline knowledge. The multiple-choice questions format mapped improved performance and may be considered as part of future MRI certification initiatives. Key points: • Prostate MRI knowledge is important for image interpretation and optimizing acquisition sequences. • A dedicated teaching course significantly improved theoretical knowledge of the technique. • Improved performance was more apparent in clinicians with less reporting experience and a lower baseline knowledge. Graphical Abstract

Technical note : adapting a GE SIGNA PET/MR scanner for radiotherapy

Purpose: Simultaneous collection of PET and MR data for radiotherapy purposes are useful for, for example, target definition and dose escalations. However, a prerequisite for using PET/MR in the radiotherapy workflow is the ability to image the patient in treatment position. The aim of this work was to adapt a GE SIGNA PET/MR scanner to image patients for radiotherapy treatment planning and evaluate the impact on signal-to-noise (SNR) of the MR images, and the accuracy of the PET attenuation correction. Method: A flat tabletop and a coil holder were developed to image patients in the treatment position, avoid patient contour deformation, and facilitate attenuation correction of flex coils. Attenuation corrections for the developed hardware and an anterior array flex coil were also measured and implemented to the PET/MR system to minimize PET quantitation errors. The reduction of SNR in the MR images due to the added distance between the coils and the patient was evaluated using a large homogenous saline-doped water phantom, and the activity quantitation errors in PET imaging were evaluated with and without the developed attenuation corrections. Result: We showed that the activity quantitation errors in PET imaging were within ±5% when correcting for attenuation of the flat tabletop, coil holder, and flex coil. The SNR of the MRI images were reduced to 74% using the tabletop, and 66% using the tabletop and coil holders. Conclusion: We present a tabletop and coil holder for an anterior array coil to be used with a GE SIGNA PET/MR scanner, for scanning patients in the radiotherapy work flow. Implementing attenuation correction of the added hardware from the radiotherapy setup leads to acceptable PET image quantitation. The drop in SNR in MR images may require adjustment of the imaging protocols