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Aim:Studying the use of Aperture Shape Controller (ASC) and Convergence Mode (CM) in Eclipse (Varian Medical System) in terms of plan quality and complexity of volumetric modulated arc therapy (VMAT).Materials and methods:Forty VMAT plans were re-optimised for the prostate, prostate + lymph nodes, breast and head & neck patients retrospectively, changing the ASC settings (off, moderate, very high) and CM settings (off, on and extended).Results:Using ‘on’ or ‘extended’ CM increased plan quality in terms of planning target volume homogeneity and low-dose spread to the organs at risk (OAR). ‘Extended’ CM increased the optimisation time 4·3-fold compared to ‘on’, and deteriorated the plan quality in several simple planning cases. ‘Moderate’ ASC decreased plan complexity with minor effect on plan quality compared to ‘off’, but ‘very high’ ASC had larger adverse dosimetric effects. However, the ASC decreased the plan complexity only if the CM was turned ‘on’.Findings:Using ‘on’ CM increases the plan quality but using ‘extended’ CM is not recommended. The ‘moderate’ ASC decreased complexity without significant adverse effects on plan quality, and even ‘very high’ ASC may be used when plan simplicity is prioritised. However, if CM is not used, the ASC should also be turned off.

Vuonna 2015 Eurooppaan pyrki Lähi-idästä ja Pohjois-Afrikasta historiallisen suuri joukko turvapaikanhakijoita, pakolaisia ja siirtolaisia. Osa heistä päätyi suuntaamaan Suomeen Pohjois-Ruotsin ja Venäjän rajojen yli. Lapin sodan aikaan, vuonna 1944, pakolaisvirta kulki toiseen suuntaan: Suomesta Ruotsiin. Artikkeli tarkastelee taideteosta, jossa rinnastetaan nämä kaksi aikatasoa ja tapahtumakulkua.Minna Rainion ja Mark Robertsin lyhytelokuva They Came in Crowded Boats and Trains (2017 Suomi) kuvaa ”pohjoista” osin uudesta näkökulmasta. Elokuvan päähenkilöt, reaalielämässään itse turvapaikanhakijoita, ovat lukuisten mediaesitysten kehyksessä tunnistettavasti ”eteläisiä” hahmoja pohjoisessa maisemassa. Teoksen kertojaääni taas lukee otteita pohjoissuomalaisten pakolaisten kirjeistä ja päiväkirjoista seitsemänkymmenen vuoden takaa.Teoksessa menneisyyden ja nykyisyyden tapahtumat asettuvat ajan ja paikan ylittävään dialogiin. Kysymme artikkelissa, millainen kulttuurinen muisti ja kuvasto on rakentunut evakkouden ympärille ja miten Rainion ja Robertsin teos asettuu suhteessa siihen. Onko kahden aikakauden pakolaiskuvien välillä löydettävissä samanlaisuutta tai eroja? Analysoimme teoksessa rakentuvia suhteita ja asetelmia, kuten eri ajassa matkaavien pakolaisten eroja, erilaisuutta ja vertaisuutta, mutta myös elokuvassa rakentuvaa tietoisuutta suhteessa pakolaisuutta määrittäviin valtarakenteisiin ja historiallisiin rinnastuksiin.Escape from the North and to the North: Two Temporal Levels of Exile in the short film They Came in Crowded Boats and TrainsIn 2015 a historically vast number of refugees, asylum seekers and immigrants strived towards Europe from the Middle East and North Africa. Some of them ended up arriving in Finland, crossing the borders from either Northern Sweden or Russia. During the Lapland War, in 1944, the stream of refugees went to the opposite direction: from Finland to Sweden. In our article, we discuss a work of art, which draws a parallel between these two temporal levels and historical events. Minna Rainio and Mark Roberts’s short film They Came in Crowded Boats and Trains (2017 Finland) describes “the North” partly from a new perspective. The protagonists of the film, asylum seekers in their personal life, are in the framework of countless media representations recognizable as “southern” figures in a northern landscape. The voiceover in the film, however, reads excerpts from letters and diaries of northern Finnish refugees or evacuees from 70 years ago.In the film the events of past and present are situated in a dialogue, which transgresses both time and place. In the article we ask what kind of cultural memory and imagery has been constructed around being evacuated in 1944, and how Rainio and Roberts’ film situates itself in connection with this memory and imagery. How are the refugees represented in the film, and what kinds of similarities and differences are there to be found between the refugee representations of the two different eras? What kinds of associations, insights, and maybe even objections or criticisms the film evokes? Our article analyzes relations constructed in the narration: differences and similarities represented between refugees traveling in different times, but also the consciousness built in the film in relation to existing power structures and historical parallels defining what it means to be a refugee.

In the Fall of 1990, somewhere in New York’s West Village, I entered a porn store to buy an album of Tom of Finland’s Kake comics, Kake in the Wild West, which had caught my eye when walking by the...

Purpose Surface guided radiotherapy (SGRT) is reported as a feasible setup technique for whole‐breast radiotherapy in deep inspiration breath hold (DIBH), but position errors of bony structures related to deeper parts of the target are not fully known. The aim of this study was to estimate patient setup accuracy and margins obtained with two different SGRT workflows with and without daily kV‐ and/or MV‐based image guidance (IGRT). Methods A total of 50 breast cancer patients were treated in DIBH, using SGRT for the patient setup, and IGRT for isocenter corrections. The patients were treated at two different departments, one using AlignRT® (25 patients) and the other using Catalyst™ (25 patients). Inter‐fractional position errors were analyzed retrospectively in orthogonal and tangential setup images, and analyzed with and without IGRT. Results In the orthogonal kV‐kV images, the systematic residual errors of the bony structures were ≤ 3 mm in both groups with SGRT‐only. When fine‐adjusted by daily IGRT, the errors decreased to ≤ 2 mm; except for the shoulder joint. The residual errors of the ribs in tangential images were between 1 and 2 mm with both workflows. The heart planning margins were between 3 and 7 mm. Conclusions The frequency of IGRT may be considerably reduced with a well‐planned SGRT‐workflow for whole‐breast DIBH with residual errors ≤ 3 mm. This accuracy can be further improved with an IGRT scheme.

Studying setup accuracy in breast cancer patients with axillary lymph node inclusion in deep inspiration breath-hold (DIBH) after patient setup with surface-guided radiotherapy (SGRT) and image-guided radiotherapy (IGRT). Breast cancer patients (N = 51) were treated (50 Gy in 25 fractions) with axillary lymph nodes within the planning target volume (PTV). Patient setup was initiated with tattoos and lasers, and further adjusted with SGRT. The DIBH guidance was based on SGRT. Orthogonal and/or tangential imaging was analyzed for residual position errors of bony landmarks, the breath-hold level (BHL), the skin outline, and the heart; and setup margins were calculated for the PTV. The calculated PTV margins were 4.3 to 6.3 and 2.8 to 4.6 mm before and after orthogonal imaging, respectively. The residual errors of the heart were 3.6 ± 2.2 mm and 2.5 ± 2.4 mm before and 3.0 ± 2.5 and 2.9 ± 2.3 mm after orthogonal imaging in the combined anterior-posterior/lateral and the cranio-caudal directions, respectively, in tangential images. The humeral head did not benefit from daily IGRT, but SGRT guided it to the correct location. We presented a slightly complicated but highly accurate workflow for DIBH treatments. The residual position errors after both SGRT and IGRT were excellent compared to previous literature. With well-planned SGRT, IGRT brings only slight improvements to systematic accuracy. However, with the calculated PTV margins and the number of outliers, imaging cannot be omitted despite SGRT, unless the PTV margins are re-evaluated.

Non

Background: Setup accuracy within adjuvant radiotherapy of breast cancer treated in free breathing is well studied, but a comparison of the typical regions of interest (ROI) used in surface guided radiation therapy (SGRT) does not exist. The aim of this study was to estimate the setup accuracy obtained with differently shaped ROIs in SGRT. Materials and methods: A total of 573 orthogonal image pairs were analyzed from free breathing breast patients in two groups: positioning using AlignRT® surface guidance system (Group A, n = 20), and setup using conventional laser and tattoo setup (Group L, n = 20). For SGRT, three different setup ROIs were used: a Breast-shaped, O-shaped and T-shaped (B-O and T-ROI). We evaluated the isocenter-, rotation-, pitch and arm position accuracy and residual errors for the chest wall and shoulder joint in kV orthogonal and tangential setup images with laser or SGRT-based setup. Results: Less isocenter variance was found in Group A than in Group L. Rotations and posture errors were larger in group L than in Group A (p ≤ 0.05). Rotation error was smaller with T-shaped ROI than with O-or B-shape (p = 0.01–0.04). Conclusion: Setup with AlignRT® improves reproducibility compared to laser setup. Between the different ROI shapes only small differences were found in the patient posture or the isocenter position in the images. The T-ROI is recommended to set up the chest wall bony structure and an additional B-ROI may be used to fine-tune the soft tissue accuracy publishedVersion

The aim of this study was to investigate prostate radiotherapy techniques for the patients with hip prosthesis in 4 different field setups. Volumetric Modulated Arc Therapy (VMAT) technique was used in 4 different cases: (1) using full VMAT arcs (VMAT_F); (2) same arcs as in case 1 but with avoidance sectors (VMAT_ASEC); (3) as case 2 but with the addition of a lateral static field through the prosthesis (VMAT_ASEC+STAT); (4) as in case 1 but with an automated structure avoidance option to avoid irradiation through the prosthesis (VMAT_ASTR). Fifteen previously treated prostate patients were retrospectively selected to this study. Treatment plans were created for all patients using all 4 techniques. The potential prosthesis misalignment in the treatment setup was modeled by moving the prosthesis 0.5, 1.0, and 1.5 cm ventrally and dorsally and recalculating the plans in each case. For VMAT_ASEC, the dose parameters for organs at risk were the highest and the dose coverage of the target volume was the poorest when compared to the other techniques. For VMAT_ASEC+STAT, the movement of the prosthesis changed the target dose distribution the most. VMAT_F and VMAT_ASTR fulfilled the planning criteria the best, even when the prosthesis was misaligned. VMAT_F radiated through the prosthesis more than VMAT_ASTR and increased the dose near the prosthesis surface when compared to VMAT_ASTR. VMAT_ASTR and VMAT_F were the most robust techniques for the patients with the hip prosthesis considering plan quality and the effect of positioning errors. The increased prosthesis surface dose with VMAT_F and possible dose calculation uncertainties favors the use of VMAT_ASTR.

To investigate the near-surface doses and target coverage in modulated arc radiotherapy (RT) of the breast or chest wall in two treatment planning systems (TPS) in the presence of soft tissue deformations. This retrospective study consisted of 10 breast cancer patients with axillary lymph node inclusion. For each case, five RT plans were created: (1) tangential 3D conformal field-in-field (FinF) technique; (2) 200° to 240° arcs with optimization bolus (OB) in Eclipse (EB); (3) 243° to 250° arcs with an 8-mm OB in Monaco (MB); (4) 243° to 250° arcs with automatic skin flash tool (ASF) in Monaco TPS (MA); (5) 243° to 250° arcs with both ASF and OB in Monaco (MAB). Soft tissue deformation was simulated by editing CT-images with 4-, 8-, and 12-mm swelling and recalculating the dose. The increasing swelling from 0 to 12 mm caused the coverage (V95%) in clinical target volume to decrease from 96% ± 2% to 90% ± 6% for the FinF plans. For volumetric-modulated arc therapy (VMAT), the coverage decreased from 99% ± 1% to 92% ± 4% in the EB plans, and from 97% ± 1% to 68% ± 8%, 85% ± 6%, and 86% ± 5% for MA, MB, and MAB, respectively. The mean dose in the surface extending from 0 to 3 mm from the skin decreased on average 5%, 17%, 20%, 15%, and 8% in FinF, EB, MA, MB, and MAB, respectively. In the Monaco plans, the use of an OB(+ASF) provided better target coverage and lower dose maxima despite of tissue swelling than the ASF alone. With modulated arc therapy, we recommend the use of an OB instead of or in addition to the ASF. The use of 8 mm OB with VMAT plans is robust to account deformations extending outside up to 8mm. If soft tissue deformation is larger than 8 mm, the need for replanning should be evaluated.

The aim of this study was to find an optimal optimization skin flash thickness in volumetric modulated arc radiotherapy of the breast in consideration of soft tissue deformations during the treatment course. Ten breast radiotherapy patients with axillary lymph node inclusion were retrospectively planned with volumetric modulated arc radiotherapy technique. The plans were optimized with the planning target volume (PTV) extending outside the skin contour by 0, 5, 7, and 10 mm; and with optimization boluses of 3 or 5 mm on the extended PTV. The final dose was calculated without the bolus. The plans were compared in terms of PTV homogeneity and conformity, and dose minima and maxima. The doses to organs at risk were also evaluated. The doses were recalculated in real patient geometries based on cone beam computed tomography (CBCT) images captured 3 to 6 times during each patient's treatment course. The optimization to the PTV without the PTV extension resulted in the best CTV coverage in the original plans (V95% = 98.0% ± 1.2%). However, when these plans were studied in real CBCT-based patient geometries, the CTV V95% was compromised (94.6% ± 8.3%). In addition, for the surface (4 mm slap inside the PTV 4 mm below the body contour) dose V95% was reduced from the planned 74.7% ± 7.5% to the recalculated 65.5% ± 11.5%. Optimization with an 8-mm bolus to a PTV with 5-mm extension was the most robust choice to ensure the CTV and surface dose coverage (recalculated V95% was 95.2% ± 6.4% and 74.6% ± 8.4%, respectively). In cases with the largest observed deformations, even a 10-mm PTV extension did not suffice to cover the target. Optimization with a 5-mm PTV extension and an 8-mm optimization bolus improved the surface dose and slightly improved the CTV dose when compared to no extension plans. For deformations over 1 cm, no benefit was seen in PTV extensions and replanning is recommended. Frequent tangential and CBCT imaging should be used during treatment course to detect potential large anatomical changes.

In this article, identity politics is understood as a form of politics stressing collective but malleable group identities as the basis of political action. This notion of identity politics also allows thinking of identity as intersectional. The focus of this article, and a problem related to identity politics, is that when discussed in the context of the neoliberal order, identity politics has a tendency to become harnessed by the ethos of vulnerability. Some implications of the 'vulnerabilizisation' are considered in the field of education, which is a field currently thoroughly affected by neoliberalism. Therefore, it is also important to look closer at the relationship between identity politics and the ethos of vulnerability. In addition, we re-consider poststructuralist thinking as a theoretical and political approach to see what it can offer in terms of re-thinking identity politics and in analyzing the ethos of vulnerability. When categories of vulnerability keep expanding into various psycho-emotional vulnerabilities defining subjects that can be known and spoken about, it is crucial to ask whether we regard these changes as educationally and politically progressive. The article discusses some problematic policies in educational environments and the phenomenon of trigger warnings.

Intersectionality has been a debated concept in recent critical studies. It has been both hailed as the most important contribution to gender studies, and criticized for being an academic buzzword. In our chapter, however, we aim to focus on the potential productive power intersectionality might still have, for example, when critically applied to the narratives of cultural homogeneity and the ‘ordinariness’ of the majority. The narrative of Nordic societal homogeneity is often constructed as unitary and unchanging – the sphere of the ordinary. The white Nordic majority has become the norm against which the other, presented as in need of emancipation, is defined, read and interpreted. In such thinking, both ‘the majority’ and ‘the margin’ are stabilized constructs, even though they both remain inherently multifaceted and ambivalent. We turn the intersectional lens to the ‘homogenous commonplace’ by discussing on which conditions intersectionality could be turned towards the majority, or ‘the ordinary’. After that, we discuss intersectionality ‘in commonplace action’, by outlining a case study: the explicitly intersectional politics of the Feminist Party in Finland, founded in 2016.

Purpose To investigate different volumetric modulated arc therapy (VMAT) field designs for lymph node positive breast cancer patients when compared to conventional static fields and standard VMAT designs. Methods Nineteen breast cancer patients with lymph node involvement (eleven left and eight right sided) were retrospectively analyzed with different arc designs. Proposed split arc designs with total rotations of 2 × 190° and 2 × 240° were compared to conventional field in field (FinF) and previously published non-split arc techniques with the same amount of total rotations. Results All VMAT plans were superior in dose conformity, when compared to the FinF plans. Split arc design decreased significantly ipsilateral lung dose and heart V5Gy for both left and right sided cases, when compared to non-split VMAT designs. For left sided cases no significant differences were seen in contralateral lung mean dose or V5Gy between different VMAT designs. For right sided cases the contralateral lung dose V5Gy was significantly higher in split VMAT group, when compared to non-split VMAT designs. The contralateral breast dose V5Gy increased significantly for split VMAT plans for both sides, when compared to non-split VMAT designs or FinF plans. Conclusions The proposed split VMAT technique was shown to be superior to previously published non-split VMAT and conventional FinF techniques significantly reducing dose to the ipsilateral lung and heart. However, this came with the expense of an increase in the dose to the contralateral breast and for right-sided cases to the contralateral lung.

The potential of diffusion tensor imaging (DTI) indices and volumes of focal lesions on conventional magnetic resonance imaging to predict conversion to multiple sclerosis (MS) was analyzed in subjects with clinically isolated syndrome (CIS) over 4 years. Twenty patients with CIS and 10 healthy controls were included in the study. The data showed an association between the volumes of T1 and fluid-attenuated inversion recovery (FLAIR) lesions and conversion to MS (T1: P =.02; FLAIR: P =.02). The worsening of DTI indices (mean diffusivity and fractional anisotropy) was primarily seen in patients progressing to MS, but clear-cut association with conversion could not be detected.

The objective of this study was to modify volumetric modulated arc therapy (VMAT) design for breast irradiation with axillary lymph node involvement to enhance normal tissue sparing while maintaining good planning target volume (PTV) coverage. Four VMAT plans were generated retrospectively for 10 patients with breast cancer for comparison. First, 2 partial arcs with an avoidance sector (Pavoid) for the lung and the heart were created. Second, a split-arc design with 2 partial arcs was used, changing the collimator angle by splitting the arcs in the middle, resulting in 4 partial arcs (Psplit). Third, the arc angles in the Psplit were modified to emphasize tangential directions, corresponding to the avoidance sector in Pavoid, resulting in 2 lateral and 2 anterior partial arcs. Furthermore, a fifth arc was added to ensure the coverage of axillary lymph nodes (Ptang). Fourth, one of the anterior arcs was removed to limit the number of arcs during treatment (Ptang-1). PTV coverage was the highest in Psplit with a V90%(PTV) of 98.4 ± 0.6%. Also the dose homogeneity and conformity were the best (p

Gendered and sexualized abuse and other forms of violence are visibly present in the culture of the third millennium. Especially bodies that are gendered as female are – both dead and alive – objects of multiple forms of abuse and violence in the texts and imageries of contemporary culture. Men, on the other hand, are often represented as abusive towards women and as the violent gender or, as targets of other men’s violence. Structural violence has also an impact on many areas of everyday life, and it is materialized in, for example discrimination and inequality.Gender and Violence: The Ethics and Politics of Reading scrutinizes gendered violence as a complex phenomenon of contemporary culture. The authors study the ways in which ways representations of violence can be read, viewed and received. They also discuss what kind of politics the violent representations implement and actualize, and how they affect their audience.Gender and Violence takes a critical stance on the intersections of gender, power, and violence in literature, film, television and the internet. The analysis focuses on, for example, sci-fi, Nordic Noir and North American comedy series, poems, young adult literature (YA) and nationalist blog texts. The book presents both Finnish and international academic discussions, in which researchers in the fields of gender studies, arts and literature, and cultural studies challenge contemporary English abstract 279 understanding of gender, sexuality, power, and violence. Moreover, Gender and Violence provides tools for critical discussions on violence and in-depth scrutiny about its cost on all of us. Gender and Violence is an anthology of academic research articles. It works well as an academic textbook, but it also provides timely and new knowledge for everyone interested in questions of gender and violence – phenomena that touch upon all of us.

Rationale and Objectives The aim of this study was to examine changes of brain iron content and diffusion patterns longitudinally in early-stage Parkinson's disease (PD) patients using T2- and T2*-based magnetic resonance imaging (MRI) over 2-year follow-up. Materials and Methods We imaged 32 PD patients with tremor and 19 healthy controls. A follow-up study (median 25 months, range 22–31 months) was accomplished for 25 patients (men:women = 11:14; age range 44–87 years, median 73 years). All patients and healthy volunteers underwent clinical, neuropsychological, and MRI examinations on the same day. Three different MRI sequences were used and their results were compared: T2-weighted imaging, susceptibility-weighted imaging, and T2* mapping. Additionally, we evaluated diffusion tensor data between groups using tract-based spatial statistics. Results Over the 2-year follow-up, the iron-related relaxation increased in the globus pallidus anterior and the caudate nucleus and slightly in the substantia nigra pars compacta (SNc). In the globus pallidus anterior and medial SNc, the change was associated with mild cognitive impairment. In the caudate nucleus, the increase was pronounced in patients with disease onset at 67 years or older. In the SNc, medial transverse relaxation was increased, and in the thalamus, it was decreased, in patients with PD compared with healthy volunteers at 2-year follow-up. Tract-based spatial statistical data did not differ between groups based on gender or Unified Parkinson's Disease Rating Scale, but a slight tendency to decreasing fractional anisotropy ( P Conclusions PD-related changes were found in putative iron content over 2 years. Although mild in the initial stages, these changes were consistent over MRI sequences. Rather than correlating with disease duration, the rate of changes was associated with individual characters, such as cognitive decline and age.

We studied nonheme iron in Parkinson's disease (PD) using clinically available MRI in 36 patients and 21 healthy volunteers. The subjects underwent thorough clinical investigation, including 3-T MRI. Quantitative R2* was able to reflect symptoms of PD. In addition, the clinically used susceptibility-weighted imaging differentiated between controls and patients, whereas T2-weighted imaging did not. Disease-related changes were present not only in substantia nigra but also in globus pallidus. Such changes are associated with neurodegeneration, reflecting the severity of motor impairment.

The purpose of this study was to analyze the lesion brightness (image contrast) in multiple MRI sequences in patients with relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS), and clinically isolated syndrome (CIS); and to correlate the lesion contrast with lesion volumes and neurological disability. MRI ex- amination at 1.5 T was performed on 80 patients with RRMS, SPMS, PPMS, or CIS. The protocol included T1- and T2-weighted spin echo (SE), fluid attenuated inversion recovery (FLAIR), T1-weighted SE with magnetization transfer preparation, and diffusion weighted imaging (DWI). Contrast was measured between MS lesions and normal appearing white matter. Lesion volume was calculated in T1-weighted- and FLAIR-images. All patients were examined neurologically including evaluation of expanded disability status scale (EDSS) score. Lesion contrast correlated with total brain lesion volume (p = 0.000 - 0.040). In patients with low EDSS, three sequences were able to differentiate between CIS and RRMS. SPMS and PPMS were separated by DWI. Lesion contrast correlated with EDSS score on T1-weighted imaging, with or without magnetization transfer preparation. Patient age correlated with lesion contrasts. Contrast measurements seem limited in radiological and clinical diagnosis of MS in reference to disease course, its activity and progression. The differentiation between MS subgroups might improve at 3 T and could help in leading to earlier treatment of the disease.

Background Computed tomography (CT) is generally used in the evaluation of the treatment response of non-Hodgkin's lymphoma (NHL) patients. Instead of morphological images, positron emission tomography (PET) shows metabolic information that is connected to tumor activity, cell proliferation rate, and, thus, prognosis. Purpose To determine the prognostic value of PET for tumor volume reduction measured by CT and magnetic resonance imaging (MRI) along with clinical characteristics in NHL patients. Material and Methods We imaged 21 B-cell type NHL patients using whole-body 18F-FDG-PET at the onset and the completion of treatment and at six-month follow-up. The maximum standardized uptake value (SUVmax) was calculated. Morphological tumor volume calculations were assessed using both MRI and CT. Additionally, patients underwent thorough clinical examination including several laboratory tests. Results A high SUVmax was able to predict significant tumor volume reduction at the beginning of treatment, but the relation to pure tumor volume was poor. Conclusion The SUVmax values derived from FDG-PET seemed to correlate with volume changes but not with their absolute values or laboratory tests. Unlike MRI and CT, FDG-PET showed the disappearance of active tumors after treatment.

Rationale and Objectives Early-stage diagnosis of Parkinson’s disease (PD) is essential in making decisions related to treatment and prognosis. However, there is no specific diagnostic test for the diagnosis of PD. The aim of this study was to evaluate the role of texture analysis (TA) of magnetic resonance images in detecting subtle changes between the hemispheres in various brain structures in patients with early symptoms of parkinsonism. In addition, functional TA parameters for detecting textural changes are presented. Materials and Methods Fifty-one patients with symptoms of PD and 20 healthy controls were imaged using a 3-T magnetic resonance device. Co-occurrence matrix–based TA was applied to detect changes in textures between the hemispheres in the following clinically interesting areas: dentate nucleus, basilar pons, substantia nigra, globus pallidus, thalamus, putamen, caudate nucleus, corona radiata, and centrum semiovale. The TA results were statistically evaluated using the Mann-Whitney U test. Results The results showed interhemispheric textural differences among the patients, especially in the area of basilar pons and midbrain. Concentrating on this clinically interesting area, the four most discriminant parameters were defined: co-occurrence matrix correlation, contrast, difference variance, and sum variance. With these parameters, differences were also detected in the dentate nucleus, globus pallidus, and corona radiata. Conclusions On the basis of this study, interhemispheric differences in the magnetic resonance images of patients with PD can be identified by the means of co-occurrence matrix–based TA. The detected areas correlate with the current pathophysiologic and neuroanatomic knowledge of PD.

As a cultural and societal system with a hegemonic status, heterosexuality is often represented and imagined as not only normal and ideal but also as fixed and monolithic. There are, however, possibilities for queering heterosexuality from within. This paper considers the ways in which heterosexuality is made into a norm through reiterative visual performatives, but also the ways in which normative heterosexuality is challenged. It is my aim to show that ostensible ‘wrongdoings’, forms of ‘unhappiness’, or ‘infelicities’ within heterosexuality may very well form viable performatives of gender and sexuality.

Objectives:To compare quantitatively T2- and T2*-based magnetic resonance imaging sequences in patients with symptoms of Parkinson disease and to evaluate the information content of those sequences regarding brain iron concentration.Materials and Methods:We imaged 51 patients with symptoms of Parkin

Objectives: To evaluate the prognostic significance of tumor volume in computed tomographic (CT) images of non-Hodgkin lymphoma patients. To compare CT volumes with those measured by magnetic resonance imaging (MRI). Methods: Twenty-five patients with B cell-type non-Hodgkin lymphoma (16 men, 9 women, age range, 48-77 years) were imaged with CT at 5 time points. The volumes and volume reductions were associated with clinical characteristics and treatment outcome. The CT-derived tumor volumes were correlated with MRI volumes derived earlier for the same patients. Results: Good agreement was found between 1-dimensional (1D), 2D, and 3D analyses. The CT-derived median tumor volumes were 306 cm 3 , 174 cm 3 , 75 cm 3 , 28 cm 3 , and 15 cm 3 at the 5 time points. These volumes were found to associate, for example, with mortality and tumor malignancy. The CT-based tumor volumes showed good correlation with MRI. Conclusions: Tumor volume quantification is a powerful tool that associates with clinical characteristics and treatment outcome.

The aim of this study was to evaluate diffusion tensor imaging (DTI) indices in the corpus callosum and pyramidal tract in normal-appearing white matter (NAWM) and the caudate nucleus and thalamus in deep grey matter (NADGM) in all MS subtypes and clinically isolated syndrome (CIS). Furthermore, it was determined whether these metrics are associated with clinical measures and the serum levels of candidate immune biomarkers. Apparent diffusion coefficients (ADC) values were significantly higher than in controls in all six studied NAWM regions in SPMS, 4/6 regions in RRMS and PPMS and 2/6 regions in CIS. In contrast, decreased fractional anisotropy (FA) values in comparison to controls were detected in 2/6 NAWM regions in SPMS and 1/6 in RRMS and PPMS. In RRMS, the level of neurological disability correlated with thalamic FA values (r=0.479,P=0.004). In chronic progressive subtypes and CIS, ADC values of NAWM and NADGM were associated with the levels of MIF, sFas, and sTNF-α. Our data indicate that DTI may be useful in detecting pathological changes in NAWM and NADGM in MS patients and that these changes are related to neurological disability.

The outcome of 103 pregnancies in 64 women with constant hyperprolactinemia was evaluated. Seventy-eight pregnancies had been induced with bromocriptine and 25 occurred without any treatment. In all, 66% of the pregnancies ended in delivery, 17% in miscarriage, 10% in tubal pregnancy and 7% in induced abortion. The pregnancy of women with untreated hyperprolactinemia was more frequently ectopic when compared to those in women treated by bromocriptine. Obstetric complications as well as signs of tumoral enlargement during pregnancy were rare in hyperprolactinemic women treated or untreated with bromocriptine. Untreated hyperprolactinemia as a risk factor in tubal pregnancy is proposed.

Early-stage diagnosis of Parkinson's disease (PD) is essential in making decisions related to treatment and prognosis. However, there is no specific diagnostic test for the diagnosis of PD. The aim of this study was to evaluate the role of texture analysis (TA) of magnetic resonance images in detecting subtle changes between the hemispheres in various brain structures in patients with early symptoms of parkinsonism. In addition, functional TA parameters for detecting textural changes are presented.Fifty-one patients with symptoms of PD and 20 healthy controls were imaged using a 3-T magnetic resonance device. Co-occurrence matrix-based TA was applied to detect changes in textures between the hemispheres in the following clinically interesting areas: dentate nucleus, basilar pons, substantia nigra, globus pallidus, thalamus, putamen, caudate nucleus, corona radiata, and centrum semiovale. The TA results were statistically evaluated using the Mann-Whitney U test.The results showed interhemispheric textural differences among the patients, especially in the area of basilar pons and midbrain. Concentrating on this clinically interesting area, the four most discriminant parameters were defined: co-occurrence matrix correlation, contrast, difference variance, and sum variance. With these parameters, differences were also detected in the dentate nucleus, globus pallidus, and corona radiata.On the basis of this study, interhemispheric differences in the magnetic resonance images of patients with PD can be identified by the means of co-occurrence matrix-based TA. The detected areas correlate with the current pathophysiologic and neuroanatomic knowledge of PD.

To compare quantitatively T2- and T2*-based magnetic resonance imaging sequences in patients with symptoms of Parkinson disease and to evaluate the information content of those sequences regarding brain iron concentration.We imaged 51 patients with symptoms of Parkinson disease on 3-T magnetic resonance imaging with T2-weighted sampling perfection with application optimized contrasts using different flip-angle evolution (SPACE), fluid attenuation inversion recovery (FLAIR)-SPACE, susceptibility-weighted imaging (SWI), and parametric T2* sequence (MapIt). Signal analysis was performed in 22 regions of interest in the brain.Correlations (r2 = 0.82...0.96) with brain iron concentration were excellent. Contrast and tissue separability ratios were best in the T2* maps and FLAIR-SPACE, respectively. Good correlations of contrast were reached between SWI and both T2-weighted SPACE and FLAIR-SPACE. Their relation to quantitative T2* values was reminiscent of a quadratic curve shape. However, separation into gray and white matter revealed a linear positive and negative correlation, respectively.SWI showed potential in differentiating illnesses characterized by brain iron deposition. Closely similar information was given by T2-weighted SPACE and FLAIR-SPACE, whereas other sequence comparisons revealed dispersion from intersequence agreement.

Background Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. Methods The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acute phase (within 3-4 hours) and magnetic resonance imaging (MRI) in the chronic phase (follow-up at 12 months, with a range of 8-27 months). The chronic-phase fractional anisotropy (FA) and mean diffusivity (MD) values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10) were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Results Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. Conclusions A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations.

The purpose of this study is to evaluate the time course of early chemotherapy response in patients with aggressive non-Hodgkin's lymphoma (NHL) by magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT).Eight patients with histologically proven aggressive NHL were imaged by MRI and PET/CT before treatment (E1), 1 week (E2), and two cycles (E3) after chemotherapy.The mean tumor volume on MRI was 276 mL at baseline; it decreased 58% at E2 (p 0.05) and 65% further at E3 (p 0.05), giving a total decrease of 84% (p 0.05). All the imaged pre-therapy tumors were strongly positive on PET/CT, with a mean maximum standardized uptake value (SUV(max)) of 20. The SUV(max) decreased 60% at E2 (p 0.05) and 59% further at E3 (p 0.05), giving a total decrease of 83% (p 0.05). The active tumor burden (mean 229 mL) decreased 66% at E2 (p 0.05). The tumor volume on MRI correlated with the active tumor volume on fused PET/CT images in the same region of interest at both E1 and E2 (r = 0.88, p 0.01, respectively).Standard chemotherapy causes rapid decrease of both tumor metabolic activity and volume as early as 1 week, which continues to decline during therapy. Both volumetric MRI and PET/CT are valuable tools for early treatment response evaluation of aggressive NHL.

Objective: The aim of this study was to determine the volume of non―Hodgkin lymphomas (NHLs) using semiautomatic segmentation and to correlate these results with clinical findings, treatment, and prognosis in patients with B-cell―type NHL. Methods: For this study, 29 patients with NHL underwent magnetic resonance imaging at 5 time points after onset of disease. Volumetric analysis of the tumors was accomplished with semiautomatic segmentation by the Anatomatic software. Results: The median tumor volumes from the first to the fifth examination were 468, 256, 90, 38, and 33 cm 3 . Good correlation with 1-dimensional and 2-dimensional measures, used as standard methods in response categorization, was found. Surprisingly, volume reductions in excess of 239 cm 3 after only 1 week of chemotherapy decreased the survival probability. Conclusions: Volume measurements seem to be highly informative for prognosis in the very early stages of treatment for patients with NHL.

Clear standards are lacking in the imaging modalities of the deficit in mild traumatic brain injury (MTBI) patients. The purpose of this study is to compare the image quality by signal distribution between 1.5 Tesla and 3 Tesla MRI in turbo spin echo (TSE) and gradient echo (GRE) images in normal hospital settings and to find preferences for which field to use in MTBI patients. We studied 40 MTBI patients with TSE and GRE; 20 patients were imaged at 1.5 T and 20 at 3 T. The imaging parameters were optimized separately for the two scanners. Histograms of the signal distribution in 22 ROIs were fitted to a 1-peak Gaussian model and the resulting peak positions were scaled in respect to the peak positions of genu of the corpus callosum and the caudate nuclei. Correlation of the contrast of the ROIs in reference to genu of the corpus callosum between both the two scanners and the two imaging sequences was good. Image contrast was similar at both in the TSE images; in the GRE images contrast improved from 1.5 T to 3 T. However, based on peak positions and widths, a slight drawback in the separability between the ROIs was observed when 1.5 T MRI was replaced by 3 T. No clear improvement in tissue contrast or separability of 3 T was found compared to 1.5 T. Imaging of MTBI with 3 T should therefore be based on other advantages of high-field imaging, such as improved SNR and spatial resolution.

The need for quantitative image analysis, especially for MR images, is increasing because of the promising results in diagnosis and follow up of various clinical treatments. This document describes briefly a new software project targeted to computer aided diagnosis. The research focus has been in image segmentation, texture analysis, and volumetric analysis. The developed software enables boundary based segmentation algorithms, and provides interfaces for further analysis of the data. The software is based on two previously started software projects of our research group: Anatomatic+ and Segmentator. The new software has an intuitive user interface and is fast enough for use in medical scientific and practical work.

Artikkeli tarkastelee queeria ajallisena ilmiönä ja kysyy mitä queer-ajattelu ja aktivismi ovat yhteiskunnallisesti ja kulttuurisesti ”parantaneet” tai korjanneet. Läpikäydyt esimerkit paikantuvat yhdysvaltalaiseen ja suomalaiseen lähihistoriaan sekä muutoksiin sukupuoli- ja seksuaalivähemmistöjen asemassa. Kirjoittaja kysyy miten reilu neljännesvuosisata, jonka voi sanoa pitäneen sisällään normaaliutta queeriyttäneitä aikoja, on vaikuttanut esimerkiksi kulttuurisiin representaatioihin ja joihinkin oikeuksiin mainituissa konteksteissa. Entä onko queer-keskustelussa itsessään näiden aikojen jälkeen korjaamisen varaa? Teoreettisesti artikkeli keskustelee erityisesti Eve Kosofsky Sedgwickin ja Sara Ahmedin ajattelun kanssa. Sedgwick näyttäytyy tekstissä yhtäältä queerin ajallisuuden, toisaalta reparatiivisuuden tai korjaavuuden teoreetikkona, Ahmed puolestaan pervon affektiivisuuden ja queerin potentiaalin haurauden ajattelijana. Kirjoittaja kyseenalaistaa myös queerin ulossulkevuuden ja ”oikeanlaisten” queer-subjektien ja objektien määrittymisen sekä homo–hetero-vastakkainasettelun hedelmällisyyden queerin ajattelun ja toiminnan lähtökohtana. Ylpeyden, häpeän takaisinottamisen ja enemmistöltä saadun tunnustuksen jälkeen artikkeli perää queerin tai pervouden parantumattomuutta ja parantumatonta määrittelemättömyyttä.

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