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Fujisaki A, Tsukamoto J, Narimatsu H, Hayashida Y, Todoroki Y, Hirano N, Takeda K, Shin S, Ota S, Anai K, Fukumitsu S, Yoshimatsu Y, Kono Y, Ueno M, Ide S, Murakami Y, Aoki T. Zero Echo Time Magnetic Resonance Imaging; Techniques and Clinical Utility in Musculoskeletal System. J Magn Reson Imaging 2024; 59:32-42. [PMID: 37288953 DOI: 10.1002/jmri.28843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
Zero echo time (ZTE) sequence is recent advanced magnetic resonance technique that utilizes ultrafast readouts to capture signals from short-T2 tissues. This sequence enables T2- and T2* weighted imaging of tissues with short intrinsic relaxation times by using an extremely short TE, and are increasingly used in the musculoskeletal system. We review the imaging physics of these sequences, practical limitations, and image reconstruction, and then discuss the clinical utilities in various disorders of the musculoskeletal system. ZTE can be readily incorporated into the clinical workflow, and is a promising technique to avoid unnecessary radiation exposure, cost, and time-consuming by computed tomography in some cases. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Akitaka Fujisaki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Jun Tsukamoto
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Hidekuni Narimatsu
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiko Hayashida
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yo Todoroki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Natsumi Hirano
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Kazuki Takeda
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Sho Shin
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satoru Ota
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kenta Anai
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Satoshi Fukumitsu
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yuta Yoshimatsu
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yuichiro Kono
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Midori Ueno
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Satoru Ide
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yu Murakami
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
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2
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Abd-Elsayed A, Chitneni A. Basivertebral nerve ablation. VERTEBRAL AUGMENTATION TECHNIQUES 2024:83-88. [DOI: 10.1016/b978-0-323-88226-2.00018-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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3
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Craniocervical Junction and Cervical Spine Anatomy. Neuroimaging Clin N Am 2022; 32:875-888. [DOI: 10.1016/j.nic.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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4
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Anatomy of the Spinal Cord, Coverings, and Nerves. Neuroimaging Clin N Am 2022; 32:903-914. [DOI: 10.1016/j.nic.2022.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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5
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Zhou Y, Qin Y, Mu T, Zheng H, Cai J. Magnetic Resonance Imaging Findings of Intraspinal Tuberculoma in Children. Front Neurol 2022; 13:936837. [PMID: 35983432 PMCID: PMC9378988 DOI: 10.3389/fneur.2022.936837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background and PurposeIntraspinal tuberculoma is a rare disease in children, and its imaging findings have been described in only a few case reports. This study aimed to investigate the magnetic resonance imaging (MRI) features of pediatric intraspinal tuberculoma and to explore the possible pathogenesis of the disease.Materials and MethodsThe clinical and MRI data of 24 child patients with intraspinal tuberculoma (such as 6 cases of intramedullary tuberculoma, 8 cases of intradural extramedullary tuberculoma, and 10 cases of epidural tuberculoma) were retrospectively analyzed. All patients underwent plain and contrast-enhanced MR scans. The diagnosis was confirmed by surgical pathology or by antituberculous treatment and follow-up data.ResultsIntramedullary tuberculoma had a round shape, while intradural extramedullary tuberculoma and epidural tuberculoma presented long-fusiform or en plaque shapes. Regarding MRI signals, intramedullary tuberculoma and extramedullary tuberculoma were mainly isointense on T1-weighted imaging (T1WI) and hypointense or isointense on T2WI. Rim enhancement was observed in intramedullary tuberculoma, and marked homogeneous enhancement was dominant in extramedullary tuberculoma. Ten (10/24) tuberculomas occurred during antituberculous therapy, with intradural extramedullary tuberculoma accounting for 7 cases (7/8), which was significantly more frequent than intramedullary tuberculoma (1/6) or epidural tuberculoma (2/10).ConclusionMRI is important in the diagnosis of intraspinal tuberculoma, which is characterized by isointensity on T1WI, isointensity, or hypointensity on T2WI, and rim or obvious homogeneous enhancement. Some intraspinal tuberculomas, especially intradural extramedullary tuberculomas, might be associated with the “paradoxical response” mechanism during the tuberculosis treatment.
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Affiliation(s)
- Yirui Zhou
- Department of Radiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yong Qin
- Department of Radiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Tong Mu
- Department of Radiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Helin Zheng
- Department of Radiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jinhua Cai
- Department of Radiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Jinhua Cai
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6
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Perez AA, Yoon ES, Iyer S, Lafage V, Sandhu H, Schwab F, Albert TJ, Qureshi S, Kim HJ, Katsuura Y. Computed Tomography and Magnetic Resonance Imaging Overlay in the Spine for Surgical Planning: A Technical Report. HSS J 2022; 18:439-447. [PMID: 35846261 PMCID: PMC9247595 DOI: 10.1177/15563316211039509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/19/2021] [Accepted: 05/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Computed tomography (CT) and magnetic resonance imaging (MRI) studies are used separately for surgical planning of spine surgery. Advanced techniques exist for creating CT-MR fusion images, but at this time these techniques are not easily accessible for large-scale use. TECHNIQUE We propose a simple graphical technique for CT-MR image overlay, for use in the surgical planning of spinal decompression and guidance of intraoperative resection. The proposed technique involves overlaying a single cross-section from anatomically comparable MRI and CT studies on any software with basic image editing functions. RESULTS We demonstrate CT-MR fusion images of 8 patients of the senior author in which the technique was used. We found that it can also be referenced intraoperatively for navigation. CONCLUSIONS Compared to other techniques, our proposed method can be easily implemented by clinicians to create simple CT-MRI fusion images that can be useful for preoperative planning and intraoperative navigation.
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Affiliation(s)
- Alberto A. Perez
- School of Medicine and Public Health,
University of Wisconsin–Madison, Madison, WI, USA
| | - Edward S. Yoon
- Department of Radiology, Hospital for
Special Surgery, New York, NY, USA
| | - Sravisht Iyer
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Virginie Lafage
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Harvinder Sandhu
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Frank Schwab
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Todd J. Albert
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Sheeraz Qureshi
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Han Jo Kim
- Department of Orthopedic Surgery,
Hospital for Special Surgery, New York, NY, USA
| | - Yoshihiro Katsuura
- Department of Orthopedic Spine Surgery,
Adventist Health Howard Memorial, Willits, CA, USA,Yoshihiro Katsuura, MD, Department of
Orthopedic Spine Surgery, Adventist Health Howard Memorial, 3 Marcela Drive,
Suite C, Willits, CA 95490, USA.
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7
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Evaluation of the degenerative lumbar osseous morphology using zero echo time magnetic resonance imaging (ZTE-MRI). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:792-800. [PMID: 35015138 DOI: 10.1007/s00586-021-07099-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/16/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine and compare the performance of zero echo imaging (ZTE) with conventional MRI sequences on lumbar osseous morphology in patients suspected with lumbar degeneration with multi-slice computed tomography (MSCT) as standard reference. METHODS 22 subjects with concerned lumbar degeneration were recruited. All subjects were scanned with ZTE sequence after routine conventional MR sequences on a 3.0 T system and also received MSCT examination. Image quality was assessed. The quantitative and qualitative parameters of lumbar osseous morphology on MSCT, ZTE and MRI images were evaluated by three musculoskeletal radiologists independently. Inter-reader and inter-modality reliability and the difference between the modalities were calculated. RESULTS There was no difference for the osseous parameters between modalities, including axial orientation (p = 0.444), IAD (p = 0.381), lateral recess (p = 0.370), pedicle width (p = 0.067), pedicle height (p = 0.056), and osteophyte grade (p = 0.052). The measurement of the foramina diameter was statistically different between conventional MRI and MSCT (p < 0.05) but not between the MSCT and ZTE (p = 0.660). Conventional MRI was more likely to miss cortical bone abnormalities. ZTE appeared blurrier in cortical bone than MSCT, especially in cases with severe lumbar degeneration. The inter-reader agreement between MSCT and ZTE-MRI was higher than between MSCT and conventional MRI. CONCLUSIONS ZTE-MRI could offer more cortical bone details than conventional MRI images and might be a valid alternative to CT for lumbar osseous morphology assessment to some extent.
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8
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Kronthaler S, Boehm C, Feuerriegel G, Börnert P, Katscher U, Weiss K, Makowski MR, Schwaiger BJ, Gersing AS, Karampinos DC. Assessment of vertebral fractures and edema of the thoracolumbar spine based on water-fat and susceptibility-weighted images derived from a single ultra-short echo time scan. Magn Reson Med 2021; 87:1771-1783. [PMID: 34752650 DOI: 10.1002/mrm.29078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE To develop a methodology to simultaneously perform single echo Dixon water-fat imaging and susceptibility-weighted imaging (SWI) based on a single echo time (TE) ultra-short echo time (UTE) (sUTE) scan to assess vertebral fractures and degenerative bone changes in the thoracolumbar spine. METHODS A methodology was developed to solve the smoothness-constrained inverse water-fat problem to separate water and fat while removing unwanted low-frequency phase terms. Additionally, the corrected UTE phase was used for SWI. UTE imaging (TE: 0.14 ms, 3T MRI) was performed in the lumbar spine of nine patients with vertebral fractures and bone marrow edema (BME). All images were reviewed by two radiologists. Water- and fat-separated images were analyzed in comparison with short-tau inversion recovery (STIR) and with respect to BME visibility. The visibility of fracture lines and cortical outlining of the UTE magnitude images were analyzed in comparison with computed tomography. RESULTS Unwanted phase components, dominated by the B1 phase, were removed from the UTE phase images. The rating of the diagnostic quality of BME visualization showed a high preference for the sUTE-Dixon water- and fat-separated images in comparison with STIR. The UTE magnitude images enabled better visualizing fracture lines compared with STIR and slightly better visibility of cortical outlining. With increasing SWI weighting osseous structures and fatty tissues were enhanced. CONCLUSION The proposed sUTE-Dixon-SWI methodology allows the removal of unwanted low-frequency phases and enables water-fat separation and SWI processing from a single complex UTE image. The methodology can be used for the simultaneous assessment of vertebral fractures and BME of the thoracolumbar spine.
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Affiliation(s)
- Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Christof Boehm
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Georg Feuerriegel
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | | | | | | | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Benedikt J Schwaiger
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
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Schwaiger BJ, Schneider C, Kronthaler S, Gassert FT, Böhm C, Pfeiffer D, Baum T, Kirschke JS, Karampinos DC, Makowski MR, Woertler K, Wurm M, Gersing AS. CT-like images based on T1 spoiled gradient-echo and ultra-short echo time MRI sequences for the assessment of vertebral fractures and degenerative bone changes of the spine. Eur Radiol 2021; 31:4680-4689. [PMID: 33443599 PMCID: PMC8213670 DOI: 10.1007/s00330-020-07597-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/28/2020] [Accepted: 12/03/2020] [Indexed: 12/24/2022]
Abstract
Objectives To evaluate the performance of 3D T1w spoiled gradient-echo (T1SGRE) and ultra-short echo time (UTE) MRI sequences for the detection and assessment of vertebral fractures and degenerative bone changes compared with conventional CT. Methods Fractures (n = 44) and degenerative changes (n = 60 spinal segments) were evaluated in 30 patients (65 ± 14 years, 18 women) on CT and 3-T MRI, including CT-like images derived from T1SGRE and UTE. Two radiologists evaluated morphological features on both modalities: Genant and AO/Magerl classifications, anterior/posterior vertebral height, fracture age; disc height, neuroforaminal diameter, grades of spondylolisthesis, osteophytes, sclerosis, and facet joint degeneration. Diagnostic accuracy and agreement between MRI and CT and between radiologists were assessed using crosstabs, weighted κ, and intraclass correlation coefficients. Image quality was graded on a Likert scale. Results For fracture detection, sensitivity, specificity, and accuracy were 0.95, 0.98, and 0.97 for T1SGRE and 0.91, 0.96, and 0.95 for UTE. Agreement between T1SGRE and CT was substantial to excellent (e.g., Genant: κ, 0.92 [95% confidence interval, 0.83–1.00]; AO/Magerl: κ, 0.90 [0.76–1.00]; osteophytes: κ, 0.91 [0.82–1.00]; sclerosis: κ, 0.68 [0.48–0.88]; spondylolisthesis: ICCs, 0.99 [0.99–1.00]). Agreement between UTE and CT was lower, ranging from moderate (e.g., sclerosis: κ, 0.43 [0.26–0.60]) to excellent (spondylolisthesis: ICC, 0.99 [0.99–1.00]). Inter-reader agreement was substantial to excellent (0.52–1.00), respectively, for all parameters. Median image quality of T1SGRE was rated significantly higher than that of UTE (p < 0.001). Conclusions Morphologic assessment of bone pathologies of the spine using MRI was feasible and comparable to CT, with T1SGRE being more robust than UTE. Key Points • Vertebral fractures and degenerative bone changes can be assessed on CT-like MR images, with 3D T1w spoiled gradient-echo–based images showing a high diagnostic accuracy and agreement with CT. • This could enable MRI to precisely assess bone morphology, and 3D T1SGRE MRI sequences may substitute additional spinal CT examinations in the future. • Image quality and robustness of T1SGRE sequences are higher than those of UTE MRI for the assessment of bone structures.
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Affiliation(s)
- Benedikt J Schwaiger
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany. .,Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Charlotte Schneider
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian T Gassert
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christof Böhm
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Klaus Woertler
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Markus Wurm
- Department of Trauma Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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