Summary: Additional variables for a nationwide hip fracture registry must be carefully chosen to prevent unnecessary registry load. A registry pilot in seven hospitals resulted in recommending... Show moreSummary: Additional variables for a nationwide hip fracture registry must be carefully chosen to prevent unnecessary registry load. A registry pilot in seven hospitals resulted in recommending polypharmacy, serum hemoglobin at admittance, and questions screening for risk of delirium to be used in case-mix correction and for development of quality indicators. Purpose: Clinical registries help improve the quality of care but come at the cost of registration load. Datasets should therefore be as compact as possible; however, variables are usually chosen empirically. This study aims to evaluate potential variables with additional value to improve the nationwide Dutch Hip Fracture Audit (DHFA). Methods: An expert panel selected eleven new variables for the DHFA, which were tested in a prospective cohort of all hip fracture patients treated in 2018 and 2019 in seven pilot hospitals participating in the DHFA. The association of these eleven variables with complications, mortality, and functional outcomes at 3 months was analyzed using multivariable logistic regression analysis. Based on the results, a proposal for variables to add to the dataset of the DHFA was made. Results: In 4.904 analyzed patients, three tested variables had significant associations (p < 0.01) with outcomes: polypharmacy with complications (aOR 1.34), serum hemoglobin at admittance with complications (aOR 0.63) and mortality (aOR for 30-day mortality 0.78), and a set of questions screening for risk of delirium with complications in general (aOR 1.55), e.g., delirium (aOR 2.98), and decreased functional scores at three months (aOR 1.98). Conclusion: This study assesses potential new variables for a hip fracture registry. Based on the results of this study, we recommend polypharmacy, serum hemoglobin at admittance, and questions screening for risk of delirium to be used in case-mix correction and for the development of quality indicators. Incorporating these variables in the DHFA dataset may contribute to better and clinically relevant quality indicators. Show less
Purpose: To utilize navigated mandibular (reconstructive) surgery, accurate registration of the preoperative CT scan with the actual patient in the operating room (OR) is required. In this phantom... Show morePurpose: To utilize navigated mandibular (reconstructive) surgery, accurate registration of the preoperative CT scan with the actual patient in the operating room (OR) is required. In this phantom study, the feasibility of a noninvasive hybrid registration method is assessed. This method consists of a point registration with anatomic landmarks for initialization and a surface registration using the bare mandibular bone surface for optimization. Methods: Three mandible phantoms with reference notches on two osteotomy planes were 3D printed. An electromagnetic tracking system in combination with 3D Slicer software was used for navigation. Different configurations, i.e., different surface point areas and number and configuration of surface points, were tested with a dentate phantom (A) in a metal-free environment. To simulate the intraoperative environment and different anatomies, the registration procedure was also performed with an OR bed using the dentate phantom and two (partially) edentulous phantoms with atypical anatomy (B and C). The accuracy of the registration was calculated using the notches on the osteotomy planes and was expressed as the target registration error (TRE). TRE values of less than 2.0 mm were considered as clinically acceptable. Results: In all experiments, the mean TRE was less than 2.0 mm. No differences were found using different surface point areas or number or configurations of surface points. Registration accuracy in the simulated intraoperative setting was-mean (SD)-0.96 (0.22), 0.93 (0.26), and 1.50 (0.28) mm for phantom A, phantom B, and phantom C. Conclusion: Hybrid registration is a noninvasive method that requires only a small area of the bare mandibular bone surface to obtain high accuracy in phantom setting. Future studies should test this method in clinical setting during actual surgery. Show less
Adapting a radiotherapy treatment plan to the daily anatomy is a crucial task to ensure adequate irradiation of the target without unnecessary exposure of healthy tissue.This adaptation can be... Show moreAdapting a radiotherapy treatment plan to the daily anatomy is a crucial task to ensure adequate irradiation of the target without unnecessary exposure of healthy tissue.This adaptation can be performed by automatically generating contours of the daily anatomy together with fast re-optimization of the treatment plan. These measurescan compensate for the daily variation and ensure the delivery of the prescribed dose distribution at small margins and high robustness settings. In this thesis, we focused on developing a deep learning-based methodology for automatic contouring for real-time adaptive radiotherapy either guided by CT or MR imaging modalities Show less
This dissertation provides a comparative study on the rationale of publicity in the law of corporeal movables and claims. It examines possession, notification, and documental recordation as a means... Show moreThis dissertation provides a comparative study on the rationale of publicity in the law of corporeal movables and claims. It examines possession, notification, and documental recordation as a means of publicity by paying attention to English law, German law, and Dutch law. In this dissertation, a system of registration is argued to be introduced in the transaction concerning corporeal movables and claims. In the end, some proposals are made for Chinese law. Show less
Shahzad, R.; Tao, Q.; Dzyubachyk, O.; Staring, M.; Lelieveldt, B.P.F.; Geest, R.J. van der 2017
In this dissertation we developed a number of automatic methods for multi-modal data registration, mainly between mass spectrometry imaging, imaging microscopy, and the Allen Brain Atlas. We... Show moreIn this dissertation we developed a number of automatic methods for multi-modal data registration, mainly between mass spectrometry imaging, imaging microscopy, and the Allen Brain Atlas. We have shown the importance of these methods for performing large scale preclinical biomarker discovery investigations for neurological disorders. We have also proposed a data-driven approach to stratify patients’ tumor tissues into molecularly distinct tumor subpopulations and automatically identify those tumor subpopulations that drive patient outcome. Show less
The main goal of this thesis was to develop methods for automated segmentation, registration and classification of the carotid artery vessel wall and plaque components using multi-sequence MR... Show moreThe main goal of this thesis was to develop methods for automated segmentation, registration and classification of the carotid artery vessel wall and plaque components using multi-sequence MR vessel wall images to assess atherosclerosis. First, a general introduction into atherosclerosis and different stages of the disease were described including the importance to differentiate between stable and vulnerable plaques. Several non-invasive imaging techniques were discussed and the advantages of multi-sequence MRI were highlighted. Different novel automated image segmentation and registration techniques for analysis of the MRI images have been developed. A 3D vessel model to automatically segment the vessel wall was presented. Automated image registration was applied to correct for patient movement during the acquisition of an MRI scan and between MRI scans. The last topic is the automatic classification of the different plaque components which can be present inside the vessel wall. All techniques were developed and validated using relevant patient data and reference standards. The work presented is an important contribution to the automated analysis of multi-sequence MR vessel wall imaging of the carotid artery. These techniques can speed up the current manual analysis and are potentially more accurate and more reproducible. Show less
Dzyubachyk, O.; Blaas, J.; Botha, C.P.; Staring, M.; Reijnierse, M.; Bloem, J.L.; ... ; Lelieveldt, B.P.F. 2013
In this thesis, several strategies are presented that aim to facilitate the analysis and visualization of whole-body in vivo data of small animals. Based on the particular challenges for image... Show moreIn this thesis, several strategies are presented that aim to facilitate the analysis and visualization of whole-body in vivo data of small animals. Based on the particular challenges for image processing, when dealing with whole-body follow-up data, we addressed several aspects in this thesis. The developed methods are tailored to handle data of subjects with significantly varying posture and address the large tissue heterogeneity of entire animals. In addition, we aim to compensate for lacking tissue contrast by relying on approximation of organs based on an animal atlas. Beyond that, we provide a solution to automate the combination of multimodality, multidimensional data. Show less
