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Torkel Brismar disputerade 1999 på avhandlingen Assessment of skeletal structure by MR relaxometry där en ny metod att utvärdera skelettets tredimensionella mikrostruktur utvecklades och utvärderades experimentellt och kliniskt. Han är administrativt och medicinskt ansvarig för de radiologiska delarna av kliniska prövningar på röntgenkliniken på Karolinska Huddinge.

Utbildning

Undervisningsområde
Torkel Brismar ansvarade för röntgenkursen på Naprapathögskolan år 2000-2006 och undervisar medicine kandidater i radiologi och anlitas ofta som föreläsare om radiologiska metoder att utvärdera benskörhet. Han har två huvudhandledda doktorander och flera bihandledda doktorander.

Forskningsbeskrivning

Forskningsområden

Screening av osteoporos (benskörhet)
Benskörhet är en behandlingsbar sjukdom som orsakar stort lidande och leder till en markant ökad dödlighet. I detta projekt studerar vi om det är möjligt att genomföra massundersökningar (screena) för osteoporos för att kunna påvisa sjukdomen i ett tidigt skede. I kliniskt bruk används idag en mer komplicerad och dyrbar utrustning för att diagnosticera osteoporos. Metoden kräver speciellt tränad personal och är därför bara tillgänglig på universitetsjukhusen eller större osteoporoscentra. Vi utvärderar därför två alternativa metoder att påvisa osteoporos. I den ena metoden studeras bentätheten av mellanhandens ben (så kallad DXR analys). Dessa bilder kan samlas in vid mammografiscreening och då patienten kommer för undersökning av misstänkt handledsfraktur. I ett annat projekt utvärderar vi en mindre utrustning där man analyserar bentätheten i hälbenet (calcaneus). denna utrustning vore idealisk för mindre sjukvårdsebnheter, såsom vårdcentraler och mindre ostopedmottagningar. För tillfället drivs tre större projekt/ avhandlingsarbeten i tre studier som omfattar mellan 4.000 och 21.000 patienter.

Utveckling av theranostica (diagnostiskt läkemedel som kan behandla sjukdom)
I ett EU projekt (samarbete Italien, Tyskland, Irland och Sverige) studerar vi möjligheten att använda bubblor tillverkade av poly-vinylalkohol som kontrastmedel vid ultraljud, MRT och nuklearmedicinska undersökningar. Till bubblorna kopplar vi ligander för att öka bindningen till sjuk vävnad. Bubblorna blir då målsökande och får en högre lokal koncentration, vilket gör det lättare att se skillnad på sjukt och friskt. Genom att ladda bubblorna med läkemedel kan man sedan teoretiskt få en högre lokal koncentration i den sjuka vävnaden. Detta skulle kunna användas för att ge höga lokala doser av tex cellgifter utan att få så mycket biverkningar i den friska vävnaden. Dessa försök bedrivs på ett mycket tidigt stadium (preklinisk nivå). Optimal dos, biologisk halveringstid och affinitet till sjuk vävnad är några av de parametrar som studeras. Doktorand och post-doc kommer att rekryteras i detta projekt.

Tredimensionell visualisering
I denna forskningslinje bistår jag främst andra forskare med problemlösning vad gäller kvantifiering av mätparametrar. Dessa spänner över ganska stora områden, såsom segmentering av fett och muskelmassa, hjärtats kranskärl, volumetri av levervävnad, läkning av hälsenor samt utvärdering av knäproteser.

Publikationer

Arterio-portal shunts in the cirrhotic liver: perfusion computed tomography for distinction of arterialized pseudolesions from hepatocellular carcinoma
Fischer Ma, Marquez Hp, Gordic S, Leidner B, Klotz E, Aspelin P, et al
European radiology 2017;27(3):1074-1080

Does statins promote vascular calcification in chronic kidney disease?
Chen Z, Qureshi Ar, Parini P, Hurt-camejo E, Ripsweden J, Brismar Tb, et al
European journal of clinical investigation 2017;47(2):137-148

Dynamic Evaluation of Liver Volume and Function in Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy
Sparrelid E, Jonas E, Tzortzakakis A, Dahlén U, Murquist G, Brismar T, et al
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2017;():-

In Vivo Drug Delivery Performance of Lipiodol-Based Emulsion or Drug-Eluting Beads in Patients with Hepatocellular Carcinoma
Lilienberg E, Dubbelboer Ir, Karalli A, Axelsson R, Brismar Tb, Ebeling Barbier C, et al
Molecular pharmaceutics 2017;14(2):448-458

Rescue ALPPS is efficient and safe after failed portal vein occlusion in patients with colorectal liver metastases
Sparrelid E, Gilg S, Brismar Tb, Lundell L, Isaksson B
Langenbeck's archives of surgery 2017;402(1):69-75

Bone mineral density of extremities is associated with coronary calcification and biopsy-verified vascular calcification in living-donor renal transplant recipients
Chen Z, Sun J, Haarhaus M, Barany P, Wennberg L, Ripsweden J, et al
Journal of bone and mineral metabolism 2016;():-

Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence
Jefferson A, Leonard H, Siafarikas A, Woodhead H, Fyfe S, Ward Lm, et al
PloS one 2016;11(2):e0146824-

Digital X-ray radiogrammetry in the study of osteoporotic fractures: Comparison to dual energy X-ray absorptiometry and FRAX
Kälvesten J, Lui Ly, Brismar T, Cummings S
Bone 2016;86():30-5

Positron Emission Tomography to Assess the Outcome of Intraportal Islet Transplantation
Eriksson O, Selvaraju R, Eich T, Willny M, Brismar Tb, Carlbom L, et al
Diabetes 2016;65(9):2482-9

Predicting Trabecular Bone Stiffness from Clinical Cone-Beam CT and HR-pQCT Data; an In Vitro Study Using Finite Element Analysis
Klintström E, Klintström B, Moreno R, Brismar Tb, Pahr Dh, Smedby Ö
PloS one 2016;11(8):e0161101-

Renal versus splenic maximum slope based perfusion CT modelling in patients with portal-hypertension
Fischer Ma, Brehmer K, Svensson A, Aspelin P, Brismar Tb
European radiology 2016;26(11):4030-4036

Sarcopenic obesity: A probable risk factor for dose limiting toxicity during neo-adjuvant chemotherapy in oesophageal cancer patients
Anandavadivelan P, Brismar Tb, Nilsson M, Johar Am, Martin L
Clinical nutrition (Edinburgh, Scotland) 2016;35(3):724-30

T2 * relaxation time in Achilles tendinosis and controls and its correlation with clinical score
Gärdin A, Rasinski P, Berglund J, Shalabi A, Schulte H, Brismar Tb
Journal of magnetic resonance imaging : JMRI 2016;43(6):1417-22

The effect of arm positioning on timing and enhancement of intravenous contrast media at coronary computed tomography angiography
Svensson A, Cederlund K, Aspelin P, Nyman U, Brismar Tb
Acta radiologica (Stockholm, Sweden : 1987) 2016;57(9):1049-55

Vertebral bone density associates with coronary artery calcification and is an independent predictor of poor outcome in end-stage renal disease patients
Chen Z, Qureshi Ar, Ripsweden J, Wennberg L, Heimburger O, Lindholm B, et al
Bone 2016;92():50-57

Fluorescence labeled microbubbles for multimodal imaging
Barrefelt Å, Zhao Y, Larsson Mk, Egri G, Kuiper Rv, Hamm J, et al
Biochemical and biophysical research communications 2015;464(3):737-42

GLUCOCORTICOIDS AND SARCOIDOSIS: A LONGITUDINAL STUDY ON THE EFFECTS ON CORTICAL AND TRABECULAR BONE
Brismar Tb, Shams S, Berinder K, Berlin M, Udden J, Brismar K, et al
SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2015;32(1):63-9

Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study
Thor D, Brismar Tb, Fischer Ma
Medical physics 2015;42(9):5100-9

Mammography and osteoporosis screening--clinical risk factors and their association with digital X-ray radiogrammetry bone mineral density
Wilczek Ml, Nielsen C, Kälvesten J, Algulin J, Brismar Tb
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry 2015;18(1):22-9

Neither endothelial function nor carotid artery intima-media thickness predicts coronary computed tomography angiography plaque burden in clinically healthy subjects: a cross-sectional study
Brolin Eb, Agewall S, Brismar Tb, Caidahl K, Tornvall P, Cederlund K
BMC cardiovascular disorders 2015;15():63-

Perfusion computed tomography for detection of hepatocellular carcinoma in patients with liver cirrhosis
Fischer Ma, Kartalis N, Grigoriadis A, Loizou L, Stål P, Leidner B, et al
European radiology 2015;25(11):3123-32

Prevalence of Myocardial Bridging in Patients With Myocardial Infarction and Nonobstructed Coronary Arteries
Brolin Eb, Brismar Tb, Collste O, Y-hassan S, Henareh L, Tornvall P, et al
The American journal of cardiology 2015;116(12):1833-9

Visualization of dialysis fistula by computed tomography using time-resolved 3D volume rendering
Svensson A, Fischer Ma, Cederlund K, Aspelin P, Leidner B, Brismar Tb
Annals of vascular surgery 2015;29(3):573-7

Automatic individualized contrast medium dosage during hepatic computed tomography by using computed tomography dose index volume (CTDI(vol))
Svensson A, Björk J, Cederlund K, Aspelin P, Nyman U, Brismar Tb
European radiology 2014;24(8):1959-63

Coronary plaque burden, as determined by cardiac computed tomography, in patients with myocardial infarction and angiographically normal coronary arteries compared to healthy volunteers: a prospective multicenter observational study
Brolin Eb, Jernberg T, Brismar Tb, Daniel M, Henareh L, Ripsweden J, et al
PloS one 2014;9(6):e99783-

DYNAMIC MR IMAGING, BIODISTRIBUTION AND PHARMACOKINETICS OF POLYMER SHELLED MICROBUBBLES CONTAINING SPION
Barrefelt A, Paradossi G, Asem H, Margheritelli S, Saghafian M, Oddo L, et al
NANO 2014;9(6):-

Potential sources of quantification error when retrospectively assessing metacarpal bone loss from historical radiographs by using digital X-ray radiogrammetry: an experimental study
Kälvesten J, Brismar Tb, Persson A
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry 2014;17(1):104-8

Time-resolved computed tomography of the liver: retrospective, multi-phase image reconstruction derived from volumetric perfusion imaging
Fischer Ma, Leidner B, Kartalis N, Svensson A, Aspelin P, Albiin N, et al
European radiology 2014;24(1):151-61

Trabecular bone histomorphometric measurements and contrast-to-noise ratio in CBCT
Klintström E, Smedby O, Klintström B, Brismar Tb, Moreno R
Dento maxillo facial radiology 2014;43(8):20140196-

Trabecular bone structure parameters from 3D image processing of clinical multi-slice and cone-beam computed tomography data
Klintström E, Smedby O, Moreno R, Brismar Tb
Skeletal radiology 2014;43(2):197-204

Biodistribution, kinetics, and biological fate of SPION microbubbles in the rat
Barrefelt Å, Saghafian M, Kuiper R, Ye F, Egri G, Klickermann M, et al
International journal of nanomedicine 2013;8():3241-54

Digital X-ray radiogrammetry of hand or wrist radiographs can predict hip fracture risk--a study in 5,420 women and 2,837 men
Wilczek Ml, Kälvesten J, Algulin J, Beiki O, Brismar Tb
European radiology 2013;23(5):1383-91

Dynamic contrast enhanced magnetic resonance imaging in chronic Achilles tendinosis
Gärdin A, Brismar Tb, Movin T, Shalabi A
BMC medical imaging 2013;13():39-

Multimodality imaging using SPECT/CT and MRI and ligand functionalized 99mTc-labeled magnetic microbubbles
Barrefelt Aa, Brismar Tb, Egri G, Aspelin P, Olsson A, Oddo L, et al
EJNMMI research 2013;3(1):12-

Adipose tissue volume is decreased in recently diagnosed cancer patients with cachexia
Agustsson T, Wikrantz P, Rydén M, Brismar T, Isaksson B
Nutrition (Burbank, Los Angeles County, Calif.) 2012;28(9):851-5

Hepatic contrast medium enhancement at computed tomography and its correlation with various body size measures
Svensson A, Nouhad J, Cederlund K, Aspelin P, Nyman U, Björk J, et al
Acta radiologica (Stockholm, Sweden : 1987) 2012;53(6):601-6

Magnetite Nanoparticles Can Be Coupled to Microbubbles to Support Multimodal Imaging
Brismar Tb, Grishenkov D, Gustafsson B, Harmark J, Barrefelt A, Kothapalli Svvn, et al
BIOMACROMOLECULES 2012;13(5):1390-9

Manganese chloride tetrahydrate (CMC-001) enhanced liver MRI: evaluation of efficacy and safety in healthy volunteers
Albiin N, Kartalis N, Bergquist A, Sadigh B, Brismar Tb
Magma (New York, N.Y.) 2012;25(5):361-8

MRI of colorectal cancer liver metastases: comparison of orally administered manganese with intravenously administered gadobenate dimeglumine
Brismar Tb, Kartalis N, Kylander C, Albiin N
EUROPEAN RADIOLOGY 2012;22(3):633-41

Quantifying differences in hepatic uptake of the liver specific contrast agents Gd-EOB-DTPA and Gd-BOPTA: a pilot study
Leinhard Od, Dahlstrom N, Kihlberg J, Sandstrom P, Brismar Tb, Smedby O, et al
EUROPEAN RADIOLOGY 2012;22(3):642-53

In vitro contrast-enhanced ultrasound measurements of capillary microcirculation: Comparison between polymer- and phospholipid-shelled microbubbles
Grishenkov D, Kari L, Brodin La, Brismar Tb, Paradossi G
ULTRASONICS 2011;51(1):40-8

The added value of contrast-enhanced ultrasound in patients with colorectal cancer undergoing preoperative evaluation with extensive gadobenate dimeglumine liver MRI
Kartalis N, Brismar Tb, Mihocsa L, Isaksson B, Albiin N
EUROPEAN RADIOLOGY 2011;21(10):2067-73

A novel haplo-identical adoptive CTL therapy as a treatment for EBV-associated lymphoma after stem cell transplantation
Uhlin M, Okas M, Gertow J, Uzunel M, Brismar Tb, Mattsson J
CANCER IMMUNOLOGY IMMUNOTHERAPY 2010;59(3):473-7

Calcaneal BMD Obtained by Dual X-Ray and Laser Predicts Future Hip Fractures-A Prospective Study on 4 398 Swedish Women
Brismar Tb, Janszky I, Toft Li
Journal of osteoporosis 2010;2010():875647-

[Hardly deep venous thrombosis with normal D-dimer. A sensitive method reduces the need for leg phlebography, according to a retrospective study]
Noel R, Aspelin P, Brismar Tb
Lakartidningen 2010;107(3):108-9

Impact on image quality and radiation exposure in coronary CT angiography: 100 kVp versus 120 kVp
Ripsweden J, Brismar Tb, Holm J, Melinder A, Mir-akbari H, Nilsson T, et al
ACTA RADIOLOGICA 2010;51(8):903-9

Pancreatic duct changes are not associated with early signs of chronic pancreatitis at magnetic resonance imaging (MRI) in patients with primary sclerosing cholangitis
Said K, Albiin N, Lindberg B, Brismar Tb, Karrar A, Permert J, et al
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 2010;45(7-8):980-6

CHARACTERIZATION OF ACOUSTIC PROPERTIES OF PVA-SHELLED ULTRASOUND CONTRAST AGENTS: LINEAR PROPERTIES (PART I)
Grishenkov D, Pecorari C, Brismar Tb, Paradossi G
ULTRASOUND IN MEDICINE AND BIOLOGY 2009;35(7):1127-38

CHARACTERIZATION OF ACOUSTIC PROPERTIES OF PVA-SHELLED ULTRASOUND CONTRAST AGENTS: ULTRASOUND-INDUCED FRACTURE (PART II)
Grishenkov D, Pecorari C, Brismar Tb, Paradossi G
ULTRASOUND IN MEDICINE AND BIOLOGY 2009;35(7):1139-47

Is Training Essential for Interpreting Cardiac Computed Tomography?
Ripsweden J, Mir-akbari H, Brolin Eb, Brismar T, Nilsson T, Rasmussen E, et al
ACTA RADIOLOGICA 2009;50(2):194-200

Liver Vessel Enhancement by Gd-BOPTA and Gd-EOB-DTPA: A Comparison in Healthy Volunteers
Brismar Tb, Dahlstrom N, Edsborg N, Persson A, Smedby O, Albiin N
ACTA RADIOLOGICA 2009;50(7):709-15

Calcaneus BMD short-term precision in young and elderly subjects using the DXL Calscan
Toft Llm, Brismar Tb
JOURNAL OF CLINICAL DENSITOMETRY 2008;11(2):309-12

Polymer microbubbles as diagnostic and therapeutic gas delivery device
Cavalieri F, Finelli I, Tortora M, Mozetic P, Chiessi E, Polizio F, et al
CHEMISTRY OF MATERIALS 2008;20(10):3254-3258

Contrast-enhanced magnetic resonance cholangiography with Gd-BOPTA and Gd-EOB-DTPA in healthy subjects
Dahlstrom N, Persson A, Albiin N, Smedby O, Brismar Tb
ACTA RADIOLOGICA 2007;48(4):362-8

Analysis of skeletal microstructure with clinical multislice CT
Petersson J, Brismar T, Smedby O
MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION - MICCAI 2006, PT 2 2006;:880-7

Combined treatment with exercise training and acarbose improves metabolic control and cardiovascular risk factor profile in subjects with mild type 2 diabetes
Wagner H, Degerblad M, Thorell A, Nygren J, Stahle A, Kuhl J, et al
DIABETES CARE 2006;29(7):1471-7

Exercise training decreases the concentration of malonyl-CoA and increases the expression and activity of malonyl-CoA decarboxylase in human muscle
Kuhl Je, Ruderman Nb, Musi N, Goodyear Lj, Patti Me, Crunkhorn S, et al
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM 2006;290(6):E1296-303

[Measuring methods in research and everyday routines]
Brismar Tb
Lakartidningen 2006;103(40):2988-9

Standardized volume rendering for magnetic resonance angiography measurements in the abdominal aorta
Persson A, Brismar Tb, Lundstrom C, Dahlstrom N, Othberg F, Smedby O
ACTA RADIOLOGICA 2006;47(2):172-8

Three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective analysis of feasibility and adverse reaction to contrast material
Persson A, Dahlström N, Smedby O, Brismar Tb
BMC medical imaging 2006;6():1-

Volume rendering of three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective study
Persson A, Dahlstrom N, Smedby O, Brismar Tb
BRITISH JOURNAL OF RADIOLOGY 2005;78(936):1078-85

Effects of oral contraceptives on body composition and physical performance in female athletes
Rickenlund A, Carlstrom K, Ekblom B, Brismar Tb, Von Schoultz B, Hirschberg Al
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 2004;89(9):4364-70

Volume rendering compared with maximum intensity projection for magnetic resonance angiography measurements of the abdominal aorta
Persson A, Dahlstrom N, Engellau L, Larsson Em, Brismar Tb, Smedby O
ACTA RADIOLOGICA 2004;45(4):453-9

Hyperandrogenicity is an alternative mechanism underlying oligomenorrhea or amenorrhea in female athletes and may improve physical performance
Rickenlund A, Carlstrom K, Ekblom B, Brismar Tb, Von Schoultz B, Hirschberg Al
FERTILITY AND STERILITY 2003;79(4):947-55

Evaluation of trabecular bone orientation in wrists of young volunteers using MR relaxometry and high resolution MRI
Brismar Tb, Budinsky L, Majumdar S
NONINVASIVE ASSESSMENT OF TRABECULAR BONE ARCHITECTURE AND THE COMPETENCE OF BONE 2001;:1-7

MR relaxometry of lumbar spine, hip, and calcaneus in healthy premenopausal women: relationship with dual energy X-ray absorptiometry and quantitative ultrasound
Brismar Tb
EUROPEAN RADIOLOGY 2000;10(8):1215-21

Orientation of trabecular bone in human vertebrae assessed by MRI
Brismar Tb, Karlsson M, Li Tq, Ringertz H
EUROPEAN RADIOLOGY 1999;9(4):643-7

The correlation between R2 ' and bone mineral measurements in human vertebrae: an in vitro study
Brismar Tb, Karlsson M, Li Tq, Ringertz H
EUROPEAN RADIOLOGY 1999;9(1):141-4

Growth hormone treatment of children with Prader-Willi syndrome affects linear growth and body composition favourably
Lindgren Ac, Hagenas L, Muller J, Blichfeldt S, Rosenborg M, Brismar T, et al
ACTA PAEDIATRICA 1998;87(1):28-31

Serum levels of insulin-like growth factor binding proteins (IGFBP)-4 and -5 correlate with bone mineral density in growth hormone (GH)-deficient adults and increase with GH replacement therapy
Thoren M, Hilding A, Brismar T, Magnusson P, Degerblad M, Larsson L, et al
JOURNAL OF BONE AND MINERAL RESEARCH 1998;13(5):891-9

Total body bone mineral measurements in children with Prader-Willi syndrome: the influence of the skull's bone mineral content per area (BMA) and of height
Brismar Tb, Lindgren Ac, Ringertz H, Rosenborg M, Ritzen Me
PEDIATRIC RADIOLOGY 1998;28(1):38-42

Effects of growth hormone treatment on growth and body composition in Prader-Willi syndrome: A preliminary report
Lindgren Ac, Hagenas L, Muller J, Blichfeldt S, Rosenborg M, Brismar T, et al
ACTA PAEDIATRICA 1997;:60-2

Experimental correlation between T2* and ultimate compressive strength in lumbar porcine vertebrae
Brismar Tb, Hindmarsh T, Ringertz H
ACADEMIC RADIOLOGY 1997;4(6):426-30

Gradient-echo magnetic resonance signal decay in a porcine vertebral body model: Influence of chemical shift
Brismar Tb, Ringertz H
ACADEMIC RADIOLOGY 1997;4(1):43-8

Effect of bone density of the head on total body DEXA measurements in 100 healthy Swedish women
Brismar Tb, Ringertz H
ACTA RADIOLOGICA 1996;37(1):101-6

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