National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Adverse Events (1)
- Back Health and Pain (1)
- Brain Injury (1)
- Cancer (11)
- Cancer: Breast Cancer (3)
- Cancer: Colorectal Cancer (2)
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- Cardiovascular Conditions (4)
- Case Study (1)
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- Comparative Effectiveness (3)
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- (-) Imaging (31)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 31 Research Studies DisplayedMa X, Chen Y, Cole SR
A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: accounting for partial verification bias.
In this paper, the authors proposed a novel hybrid Bayesian hierarchical model combining cohort and case-control studies while simultaneously correcting partial verification bias. They presented two case studies on assessing the diagnostic accuracy of gadolinium-enhanced magnetic resonance imaging in detecting lymph node metastases and of adrenal fluorine-18 fluorodeoxyglucose positron emission tomography in characterizing adrenal masses.
AHRQ-funded; HS022900.
Citation: Ma X, Chen Y, Cole SR .
A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: accounting for partial verification bias.
Stat Methods Med Res 2016 Dec;25(6):3015-37. doi: 10.1177/0962280214536703.
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Keywords: Cancer, Diagnostic Safety and Quality, Imaging, Research Methodologies
Kessler R, Stowell JR, Vogel JA
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
The study’s objective was to determine if a simple interventional program would influence the utilization of Picture Archiving and Communication Systems (PACS) in point-of-care ultrasound. It concluded that a simple interventional program for emergency physicians can significantly increase and sustain the utilization of PACS for point-of-care ultrasound.
AHRQ-funded; HS023901.
Citation: Kessler R, Stowell JR, Vogel JA .
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
J Digit Imaging 2016 Dec;29(6):701-05. doi: 10.1007/s10278-016-9893-x.
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Keywords: Emergency Medical Services (EMS), Imaging, Healthcare Utilization, Health Information Technology (HIT)
Henke L, Kashani R, Yang D
Simulated online adaptive magnetic resonance-guided stereotactic body radiation therapy for the treatment of oligometastatic disease of the abdomen and central thorax: characterization of potential advantages.
This study characterized potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. It concluded that online-adaptive MRI-guided SBRT may allow planning target volume dose escalation and/or simultaneous tumor/organ at risk sparing compared with nonadaptive SBRT.
AHRQ-funded; HS022888.
Citation: Henke L, Kashani R, Yang D .
Simulated online adaptive magnetic resonance-guided stereotactic body radiation therapy for the treatment of oligometastatic disease of the abdomen and central thorax: characterization of potential advantages.
Int J Radiat Oncol Biol Phys 2016 Dec 1;96(5):1078-86. doi: 10.1016/j.ijrobp.2016.08.036.
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Keywords: Cancer, Imaging
Thomas GW, Rojas-Murillo S, Hanley JM
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
The researchers determined if 3D radiographic image interpretation can be reliably assessed, and whether this assessment varies by level of training. They concluded that the interpretation of radiographs to discern 3D information is a promising and a relatively unexplored area for surgical skill education and assessment.
AHRQ-funded; HS022077.
Citation: Thomas GW, Rojas-Murillo S, Hanley JM .
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
Iowa Orthop J 2016;36:1-6.
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Keywords: Diagnostic Safety and Quality, Education: Continuing Medical Education, Injuries and Wounds, Imaging, Training
Elmore JG, Cook AJ, Bogart A
Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?
This study aimed to determine whether radiologists who perform well in screening also perform well in interpreting diagnostic mammography. It evaluated the accuracy of 468 radiologists interpreting 2,234,947 screening and 196,164 diagnostic mammograms and found a moderate correlation for radiologists' accuracy when interpreting screening versus their accuracy on diagnostic examinations.
AHRQ-funded; HS010591.
Citation: Elmore JG, Cook AJ, Bogart A .
Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?
Clin Imaging 2016 Nov - Dec;40(6):1096-103. doi: 10.1016/j.clinimag.2016.06.014.
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Keywords: Cancer: Breast Cancer, Diagnostic Safety and Quality, Screening, Imaging, Women, Provider Performance
Murphy DR, Meyer AN, Bhise V
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
A "trigger" algorithm was used to identify delays in follow-up of abnormal chest imaging results in a large national clinical data warehouse of electronic health record (EHR) data. In this study, the authors applied a trigger in a repository hosting EHR data from all Department of Veterans Affairs health-care facilities and analyzed data from seven facilities. The investigators concluded that application of triggers on "big" EHR data may aid in identifying patients experiencing delays in diagnostic evaluation of chest imaging results suspicious for malignancy.
Citation: Murphy DR, Meyer AN, Bhise V .
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
Chest 2016 Sep;150(3):613-20. doi: 10.1016/j.chest.2016.05.001..
Keywords: Imaging, Electronic Health Records (EHRs), Health Information Technology (HIT), Data, Diagnostic Safety and Quality, Cancer
Henry MK, Zonfrillo MR, French B
Hospital variation in cervical spine imaging of young children with traumatic brain injury.
The authors sought to identify child-level and hospital-level factors associated with performance of cervical imaging of children with traumatic brain injury from falls and abusive head trauma. They found no association between annual hospital volume of injured children and cervical imaging performance.
AHRQ-funded; HS024194.
Citation: Henry MK, Zonfrillo MR, French B .
Hospital variation in cervical spine imaging of young children with traumatic brain injury.
Acad Pediatr 2016 Sep-Oct;16(7):684-91. doi: 10.1016/j.acap.2016.01.017.
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Keywords: Brain Injury, Children/Adolescents, Imaging, Hospitals, Practice Patterns
Stillman AE, Gatsonis C, Lima JA
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
This article describes the RESCUE trial, which is based on the hypothesis that coronary computed tomography angiography as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with single photon emission computed tomography myocardial perfusion imaging.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JA .
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
Am Heart J 2016 Sep;179:19-28. doi: 10.1016/j.ahj.2016.06.003.
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Keywords: Comparative Effectiveness, Imaging, Cardiovascular Conditions
Moore CL, Daniels B, Singh D
Ureteral stones: implementation of a reduced-dose CT protocol in patients in the emergency department with moderate to high likelihood of calculi on the basis of STONE score.
The purpose of this paper was to determine if a reduced-dose computed tomography (CT) protocol could effectively help to identify patients in the emergency department (ED) with moderate to high likelihood of calculi who would require urologic intervention within 90 days. The authors found that a CT protocol with over 85% dose reduction can be used in patients with moderate to high likelihood of ureteral stone to safely and effectively identify patients in the ED who will require urologic intervention.
AHRQ-funded; HS018322.
Citation: Moore CL, Daniels B, Singh D .
Ureteral stones: implementation of a reduced-dose CT protocol in patients in the emergency department with moderate to high likelihood of calculi on the basis of STONE score.
Radiology 2016 Sep;280(3):743-51. doi: 10.1148/radiol.2016151691.
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Keywords: Clinical Decision Support (CDS), Emergency Department, Imaging, Patient Safety
Ladapo JA, Blecker S, O'Donnell M
Appropriate use of cardiac stress testing with imaging: a systematic review and meta-analysis.
The authors systematically reviewed studies of appropriate use criteria (AUC), evaluated trends over time, and characterized leading indications for inappropriate testing. They found that rates of appropriate use tend to be lower for stress echocardiography compared to myocardial perfusion imaging, and updated AUC reduced unclassified stress echocardiograms. They concluded that there is no conclusive evidence that AUC improved appropriate use over time.
AHRQ-funded; HS023683.
Citation: Ladapo JA, Blecker S, O'Donnell M .
Appropriate use of cardiac stress testing with imaging: a systematic review and meta-analysis.
PLoS One 2016 Aug 18;11(8):e0161153. doi: 10.1371/journal.pone.0161153.
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Keywords: Cardiovascular Conditions, Decision Making, Imaging, Guidelines
Melnick ER, O'Brien EG, Kovalerchik O
The association between physician empathy and variation in imaging use.
This paper's objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. The authors found that, on the four psychometric scales used, performance was not predictive of risk-adjusted CT utilization in the emergency department. They concluded that the underlying physician-based factors that mediate interphysician variation remain to be clearly identified.
AHRQ-funded; HS021271.
Citation: Melnick ER, O'Brien EG, Kovalerchik O .
The association between physician empathy and variation in imaging use.
Acad Emerg Med 2016 Aug;23(8):895-904. doi: 10.1111/acem.13017.
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Keywords: Decision Making, Emergency Medical Services (EMS), Healthcare Utilization, Imaging, Practice Patterns
Croswell J, Owings J
Screening for breast cancer.
This case study involves a 47-year-old woman who presents to your office for a well-woman visit. She is healthy, takes no medications, and has no health concerns. She has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was negative, and she asks whether she should be screened again this year. The study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Croswell J, Owings J .
Screening for breast cancer.
Am Fam Physician 2016 Jul 15;94(2):143-4.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Women, Imaging, Case Study
John-Baptiste A, Schapira MM, Cravens C
AHRQ Author: John-Baptiste A, Cravens C, Siegel J, Lawrence W
The role of decision models in health care policy: a case study.
In 2009, the Centers for Medicare and Medicaid Services (CMS) underwent a National Coverage Determination on computed tomography colonography (CTC) to screen for colorectal cancer. The Cancer Intervention & Surveillance Network developed decision models to inform this decision. The purpose of this study was to investigate the role of models in this decision. It concluded that decision makers involved in the CTC decision believed in the adequacy of models to inform coverage decisions.
AHRQ-authored.
Citation: John-Baptiste A, Schapira MM, Cravens C .
The role of decision models in health care policy: a case study.
Med Decis Making 2016 Jul;36(5):666-79. doi: 10.1177/0272989x16646732.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Imaging, Policy
McCarthy ML, Shokoohi H
Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial.
Randomized controlled trials report inconsistent findings when comparing the initial success rate of peripheral intravenous cannulation using landmark versus ultrasonography for patients with difficult venous access. This study sought to determine which method was superior for patients with varying levels of intravenous access difficulty. The study concluded that ultrasonographic peripheral intravenous cannulation was advantageous among patients with difficult or moderately difficult intravenous access but was disadvantageous among patients anticipated to have easy access.
AHRQ-funded; HS017957.
Citation: McCarthy ML, Shokoohi H .
Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial.
Ann Emerg Med 2016 Jul;68(1):10-8. doi: 10.1016/j.annemergmed.2015.09.009..
Keywords: Emergency Department, Imaging
Healy MA, Yin H, Reddy RM
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
The researchers sought to evaluate utilization of positron emission tomography (PET) to detect recurrence in asymptomatic patients and relationships with survival for patients with lung and esophageal cancers. Despite statistically significant variation in use of PET to detect tumor recurrence, there was no association with improved two-year survival.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Reddy RM .
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
J Natl Cancer Inst 2016 Jul;108(7). doi: 10.1093/jnci/djv429.
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Keywords: Imaging, Cancer, Cancer: Lung Cancer, Healthcare Utilization
Wang RC, Bent S, Weber E
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
The researchers performed a systematic review of impact analyses on clinical decision rules for pulmonary embolism. They found that among participants with suspected pulmonary embolism, implementation of the Wells criteria was associated with a modest increase in CT angiography yield. They concluded that there is a lack of cluster-randomized trials to confirm the efficacy of clinical decision rules for the diagnosis of pulmonary embolism.
AHRQ-funded; HS021281.
Citation: Wang RC, Bent S, Weber E .
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
Ann Emerg Med 2016 Jun;67(6):693-701.e3. doi: 10.1016/j.annemergmed.2015.11.005.
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Keywords: Clinical Decision Support (CDS), Decision Making, Imaging, Respiratory Conditions
Reeves SL, Madden B, Freed GL
Transcranial doppler screening among children and adolescents with sickle cell anemia.
The study’s objectives were to assess the feasibility of using administrative claims data to identify and describe the receipt of transcranial Doppler (TCD) screening among children and adolescents with sickle cell anemia and to characterize opportunities for intervention. Despite national recommendations, TCD screening rates remain low. Successful strategies to improve TCD screening rates may capitalize on the numerous health care interactions among children and adolescents with sickle cell anemia.
AHRQ-funded; HS020516.
Citation: Reeves SL, Madden B, Freed GL .
Transcranial doppler screening among children and adolescents with sickle cell anemia.
JAMA Pediatr 2016 Jun;170(6):550-6. doi: 10.1001/jamapediatrics.2015.4859.
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Keywords: Children/Adolescents, Imaging, Prevention, Screening
Kim EH, Vetter JM, Kuxhausen AN
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
The researchers evaluated the utilization of follow-up imaging after nephrectomy for renal cell carcinoma (RCC) in nationally representative data. Using Surveillance, Epidemiology, End Results (SEER) data, they found that, in the Medicare population, surveillance imaging is performed in a limited number of patients following nephrectomy for RCC but that increasing tumor stage is predictive of both increased chest and abdominal imaging surveillance.
AHRQ-funded; HS019455.
Citation: Kim EH, Vetter JM, Kuxhausen AN .
Limited use of surveillance imaging following nephrectomy for renal cell carcinoma.
Urol Oncol 2016 May;34(5):237.e11-8. doi: 10.1016/j.urolonc.2015.11.017.
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Keywords: Cancer, Healthcare Utilization, Imaging, Medicare
Mohapatra A, Vemana G, Bhayani S
Trends in the utilization of imaging for upper tract urothelial carcinoma.
The researchers evaluated the changes in use of the different imaging modalities for diagnosing upper tract urothelial carcinoma (UTUC) and assess how these changes have affected tumor stage at the time of surgery. They found trends toward the utilization of newer imaging modalities to diagnose UTUC and more modalities per patient. Endoscopy and retrograde pyelography were associated with smaller tumors, whereas magnetic resonance urography was associated with larger tumors. They recommended further studies to evaluate the utility of the different modalities in diagnosing UTUC.
AHRQ-funded; HS019455.
Citation: Mohapatra A, Vemana G, Bhayani S .
Trends in the utilization of imaging for upper tract urothelial carcinoma.
Urol Oncol 2016 May;34(5):236.e23-8. doi: 10.1016/j.urolonc.2015.12.002.
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Keywords: Cancer, Diagnostic Safety and Quality, Healthcare Utilization, Imaging
Wang RC, Rodriguez RM, Moghadassi M
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. The researchers evaluated the STONE score compared with physician gestalt. They concluded that in its present form, the STONE score lacks sufficient accuracy to allow clinicians to defer CT scan for suspected ureteral stone.
AHRQ-funded; HS021281; HS019312.
Citation: Wang RC, Rodriguez RM, Moghadassi M .
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
Ann Emerg Med 2016 Apr;67(4):423-32.e2. doi: 10.1016/j.annemergmed.2015.08.019.
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Keywords: Decision Making, Diagnostic Safety and Quality, Imaging, Kidney Disease and Health, Practice Patterns
Daniels B, Gross CP, Molinaro A
STONE PLUS: evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography.
This study sought to determine whether renal point-of-care limited ultrasonography (PLUS) used in conjunction with the Sex, Timing, Origin, Nausea, Erythrocytes (STONE) clinical prediction score can aid identification of emergency department (ED) patients with uncomplicated ureteral stone or need for urologic intervention. It concluded that hydronephrosis on renal PLUS modestly improved risk stratification in low- and moderate-risk STONE score patients.
AHRQ-funded; HS018322.
Citation: Daniels B, Gross CP, Molinaro A .
STONE PLUS: evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography.
Ann Emerg Med 2016 Apr;67(4):439-48. doi: 10.1016/j.annemergmed.2015.10.020.
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Keywords: Decision Making, Emergency Department, Imaging, Kidney Disease and Health
Eng J, Wilson RF, Subramaniam RM
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
This review compared contrast-induced nephropathy (CIN) risk for contrast media within and between osmolality classes in patients receiving diagnostic or therapeutic imaging procedures. No differences were found in CIN risk among types of low-osmolar contrast media (LOCM). Iodixanol had a slightly lower risk for CIN than LOCM, but the lower risk did not exceed a criterion for clinical importance.
AHRQ-funded; 290201200007I.
Citation: Eng J, Wilson RF, Subramaniam RM .
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):417-24. doi: 10.7326/m15-1402.
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Keywords: Comparative Effectiveness, Imaging, Risk, Kidney Disease and Health, Adverse Events
Liu S, Wu Y, Wooten HO
Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.
A software tool is developed to predict treatment delivery time for radiation therapy (RT) treatments of patients on ViewRay magnetic resonance image-guided radiation therapy (MR-IGRT) delivery system. This tool is necessary for managing patient treatment scheduling in a clinic. After modeling and quantitative analysis, the researchers proposed an algorithm that is able to predict the ViewRay treatment delivery time with the average prediction error 0.22min or 1.82 percent.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Wooten HO .
Methods to model and predict the ViewRay treatment deliveries to aid patient scheduling and treatment planning.
J Appl Clin Med Phys 2016 Mar 8;17(2):5907.
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Keywords: Cancer, Health Information Technology (HIT), Imaging
Nelson HD, O'Meara ES, Kerlikowske K
Factors associated with rates of false-positive and false-negative results from digital mammography screening: an analysis of registry data.
The researchers sought to determine factors associated with false-positive and false-negative digital mammography results, additional imaging, and biopsies among a general population of women screened for breast cancer. They found that false-positive mammography results and additional imaging are common, particularly for younger women and those with risk factors, whereas biopsies occur less often. Rates of false-negative results are low.
AHRQ-funded; 290201200015I.
Citation: Nelson HD, O'Meara ES, Kerlikowske K .
Factors associated with rates of false-positive and false-negative results from digital mammography screening: an analysis of registry data.
Ann Intern Med 2016 Feb 16;164(4):226-35. doi: 10.7326/m15-0971.
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Keywords: Cancer: Breast Cancer, Cancer, Imaging, Diagnostic Safety and Quality, Women, Screening, Prevention
Acharya S, Fischer-Valuck BW, Kashani R
Online magnetic resonance image guided adaptive radiation therapy: first clinical applications.
The authors demonstrated the feasibility of online adaptive magnetic resonance (MR) image guided radiation therapy (MR-IGRT) with five patients with abdominopelvic malignancies. They successfully implemented online adaptive MR-IGRT with planning and quality assurance workflow suitable for routine clinical application. Clinical trials are in development to formally evaluate adaptive treatments for a variety of disease sites.
AHRQ-funded; HS022888.
Citation: Acharya S, Fischer-Valuck BW, Kashani R .
Online magnetic resonance image guided adaptive radiation therapy: first clinical applications.
Int J Radiat Oncol Biol Phys 2016 Feb;94(2):394-403. doi: 10.1016/j.ijrobp.2015.10.015.
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Keywords: Cancer, Cancer: Colorectal Cancer, Imaging, Workflow