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Ries A, Dorosti T, Thalhammer J, Sasse D, Sauter A, Meurer F, Benne A, Lasser T, Pfeiffer F, Schaff F, Pfeiffer D. Improving image quality of sparse-view lung tumor CT images with U-Net. Eur Radiol Exp 2024; 8:54. [PMID: 38698099 PMCID: PMC11065797 DOI: 10.1186/s41747-024-00450-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/09/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND We aimed to improve the image quality (IQ) of sparse-view computed tomography (CT) images using a U-Net for lung metastasis detection and determine the best tradeoff between number of views, IQ, and diagnostic confidence. METHODS CT images from 41 subjects aged 62.8 ± 10.6 years (mean ± standard deviation, 23 men), 34 with lung metastasis, 7 healthy, were retrospectively selected (2016-2018) and forward projected onto 2,048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, 7 healthy) for a single-blinded multireader study. These slices, for all levels of subsampling, with and without U-Net postprocessing, were presented to three readers. IQ and diagnostic confidence were ranked using predefined scales. Subjective nodule segmentation was evaluated using sensitivity and Dice similarity coefficient (DSC); clustered Wilcoxon signed-rank test was used. RESULTS The 64-projection sparse-view images resulted in 0.89 sensitivity and 0.81 DSC, while their counterparts, postprocessed with the U-Net, had improved metrics (0.94 sensitivity and 0.85 DSC) (p = 0.400). Fewer views led to insufficient IQ for diagnosis. For increased views, no substantial discrepancies were noted between sparse-view and postprocessed images. CONCLUSIONS Projection views can be reduced from 2,048 to 64 while maintaining IQ and the confidence of the radiologists on a satisfactory level. RELEVANCE STATEMENT Our reader study demonstrates the benefit of U-Net postprocessing for regular CT screenings of patients with lung metastasis to increase the IQ and diagnostic confidence while reducing the dose. KEY POINTS • Sparse-projection-view streak artifacts reduce the quality and usability of sparse-view CT images. • U-Net-based postprocessing removes sparse-view artifacts while maintaining diagnostically accurate IQ. • Postprocessed sparse-view CTs drastically increase radiologists' confidence in diagnosing lung metastasis.
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Affiliation(s)
- Annika Ries
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
| | - Tina Dorosti
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany.
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany.
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany.
| | - Johannes Thalhammer
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
| | - Daniel Sasse
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Felix Meurer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Ashley Benne
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
| | - Tobias Lasser
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
- Computational Imaging and Inverse Problems, Department of Computer Science, School of Computation, Information, and Technology, Technical University of Munich, 85748, Garching, Germany
| | - Franz Pfeiffer
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
| | - Florian Schaff
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748, Garching, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
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2
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Jahnen M, Hausler T, Meissner VH, Ankerst DP, Kattan MW, Sauter A, Gschwend JE, Herkommer K. Predicting clinically significant prostate cancer following suspicious mpMRI: analyses from a high-volume center. World J Urol 2024; 42:290. [PMID: 38702557 PMCID: PMC11068682 DOI: 10.1007/s00345-024-04991-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/04/2024] [Indexed: 05/06/2024] Open
Abstract
PURPOSE mpMRI is routinely used to stratify the risk of clinically significant prostate cancer (csPCa) in men with elevated PSA values before biopsy. This study aimed to calculate a multivariable risk model incorporating standard risk factors and mpMRI findings for predicting csPCa on subsequent prostate biopsy. METHODS Data from 677 patients undergoing mpMRI ultrasound fusion biopsy of the prostate at the TUM University Hospital tertiary urological center between 2019 and 2023 were analyzed. Patient age at biopsy (67 (median); 33-88 (range) (years)), PSA (7.2; 0.3-439 (ng/ml)), prostate volume (45; 10-300 (ml)), PSA density (0.15; 0.01-8.4), PI-RADS (V.2.0 protocol) score of index lesion (92.2% ≥3), prior negative biopsy (12.9%), suspicious digital rectal examination (31.2%), biopsy cores taken (12; 2-22), and pathological biopsy outcome were analyzed with multivariable logistic regression for independent associations with the detection of csPCa defined as ISUP ≥ 3 (n = 212 (35.2%)) and ISUP ≥ 2 (n = 459 (67.8%) performed on 603 patients with complete information. RESULTS Older age (OR: 1.64 for a 10-year increase; p < 0.001), higher PSA density (OR: 1.60 for a doubling; p < 0.001), higher PI-RADS score of the index lesion (OR: 2.35 for an increase of 1; p < 0.001), and a prior negative biopsy (OR: 0.43; p = 0.01) were associated with csPCa. CONCLUSION mpMRI findings are the dominant predictor for csPCa on follow-up prostate biopsy. However, PSA density, age, and prior negative biopsy history are independent predictors. They must be considered when discussing the individual risk for csPCa following suspicious mpMRI and may help facilitate the further diagnostical approach.
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Affiliation(s)
- Matthias Jahnen
- Department of Urology, School of Medicine and Health, Technical University of Munich (TUM) Rechts der Isar University Hospital, Ismaningerstr. 22, 81675, Munich, Germany.
| | - Tanja Hausler
- Department of Mathematics, School of Computation, Information, and Technology, Boltzmannstr. 3, 85748, Garching, Germany
| | - Valentin H Meissner
- Department of Urology, School of Medicine and Health, Technical University of Munich (TUM) Rechts der Isar University Hospital, Ismaningerstr. 22, 81675, Munich, Germany
| | - Donna P Ankerst
- Department of Mathematics, School of Computation, Information, and Technology, Boltzmannstr. 3, 85748, Garching, Germany
| | - Michael W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich (TUM) Rechts der Isar University Hospital, Ismaningerstr. 22, 81675, Munich, Germany
| | - Juergen E Gschwend
- Department of Urology, School of Medicine and Health, Technical University of Munich (TUM) Rechts der Isar University Hospital, Ismaningerstr. 22, 81675, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, School of Medicine and Health, Technical University of Munich (TUM) Rechts der Isar University Hospital, Ismaningerstr. 22, 81675, Munich, Germany
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Boschheidgen M, Albers P, Schlemmer HP, Hellms S, Bonekamp D, Sauter A, Hadaschik B, Krilaviciute A, Radtke JP, Seibold P, Lakes J, Arsov C, Gschwend JE, Herkommer K, Makowski M, Kuczyk MA, Wacker F, Harke N, Debus J, Körber SA, Benner A, Kristiansen G, Giesel FL, Antoch G, Kaaks R, Becker N, Schimmöller L. Multiparametric Magnetic Resonance Imaging in Prostate Cancer Screening at the Age of 45 Years: Results from the First Screening Round of the PROBASE Trial. Eur Urol 2024; 85:105-111. [PMID: 37863727 DOI: 10.1016/j.eururo.2023.09.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/05/2023] [Accepted: 09/28/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) has been suggested as a tool for guiding biopsy recommendations in prostate cancer (PC) screening. OBJECTIVE To determine the performance of multiparametric MRI (mpMRI) in young men at age 45 yr who participated in a PC screening trial (PROBASE) on the basis of baseline prostate-specific antigen (PSA). DESIGN, SETTING, AND PARTICIPANTS Participants with confirmed PSA ≥3 ng/ml were offered mpMRI followed by MRI/transrectal ultrasound fusion biopsy (FBx) with targeted and systematic cores. mpMRI scans from the first screening round for men randomised to an immediate PSA test in PROBASE were evaluated by local readers and then by two reference radiologists (experience >10 000 prostate MRI examinations) blinded to the histopathology. The PROBASE trial is registered as ISRCTN37591328 OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The local and reference Prostate Imaging-Data and Reporting System (PI-RADS) scores were compared, and the sensitivity, negative predictive value (NPV), and accuracy were calculated for both readings for different cutoffs (PI-RADS 3 vs 4). RESULTS AND LIMITATIONS Of 186 participants, 114 underwent mpMRI and FBx. PC was detected in 47 (41%), of whom 33 (29%) had clinically significant PC (csPC; International Society of Urological Pathology grade group ≥2). Interobserver reliability between local and reference PI-RADS scores was moderate (k = 0.41). At a cutoff of PI-RADS 4, reference reading showed better performance for csPC detection (sensitivity 79%, NPV 91%, accuracy of 85%) than local reading (sensitivity 55%, NPV 80%, accuracy 68%). Reference reading did not miss any PC cases for a cutoff of PI-RADS <3. If PI-RADS ≥4 were to be used as a biopsy cutoff, mpMRI would reduce negative biopsies by 68% and avoid detection of nonsignificant PC in 71% of cases. CONCLUSIONS Prostate MRI in a young screening population is difficult to read. The MRI accuracy of for csPC detection is highly dependent on reader experience, and double reading might be advisable. More data are needed before MRI is included in PC screening for men at age 45 yr. PATIENT SUMMARY Measurement of prostate specific antigen (PSA) is an effective screening test for early detection of prostate cancer (PC) and can reduce PC-specific deaths, but it can also lead to unnecessary biopsies and treatment. Magnetic resonance imaging (MRI) after a positive PSA test has been proposed as a way to reduce the number of biopsies, with biopsy only recommended for men with suspicious MRI findings. Our results indicate that MRI accuracy is moderate for men aged 45 years but can be increased by a second reading of the images by expert radiologists. For broad application of MRI in routine screening, double reading may be advisable.
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Affiliation(s)
- Matthias Boschheidgen
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Peter Albers
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Susanne Hellms
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - David Bonekamp
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Boris Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (dktk), University Hospital Essen, Essen, Germany
| | - Agne Krilaviciute
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Philipp Radtke
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany
| | - Petra Seibold
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jale Lakes
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany
| | - Christian Arsov
- University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Department of Urology and Paediatric Urology, Elisabeth-Krankenhaus Rheydt, Städtische Kliniken Mönchengladbach GmbH, Mönchengladbach, Germany
| | - Jürgen E Gschwend
- Department of Urology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Marcus Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Markus A Kuczyk
- Department of Urology, Medical University Hannover, Hannover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Nina Harke
- Department of Urology, Medical University Hannover, Hannover, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Ruprecht Karls University, Heidelberg, Germany
| | - Stefan A Körber
- Department of Radiation Oncology, Heidelberg University Hospital, Ruprecht Karls University, Heidelberg, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Frederik L Giesel
- University Dusseldorf, Medical Faculty, Department of Nuclear Medicine, D-40225 Dusseldorf, Germany
| | - Gerald Antoch
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Düsseldorf (CIO ABCD), Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nikolaus Becker
- Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lars Schimmöller
- Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Department of Diagnostic, Interventional Radiology and Nuclear Medicine, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany.
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4
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Ziegelmayer S, Marka AW, Lenhart N, Nehls N, Reischl S, Harder F, Sauter A, Makowski M, Graf M, Gawlitza J. Evaluation of GPT-4's Chest X-Ray Impression Generation: A Reader Study on Performance and Perception. J Med Internet Res 2023; 25:e50865. [PMID: 38133918 PMCID: PMC10770784 DOI: 10.2196/50865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/16/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Exploring the generative capabilities of the multimodal GPT-4, our study uncovered significant differences between radiological assessments and automatic evaluation metrics for chest x-ray impression generation and revealed radiological bias.
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Affiliation(s)
- Sebastian Ziegelmayer
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexander W Marka
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nicolas Lenhart
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nadja Nehls
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefan Reischl
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Felix Harder
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marcus Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Markus Graf
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joshua Gawlitza
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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5
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Kattau M, Willer K, Noichl W, Urban T, Frank M, De Marco F, Schick R, Koehler T, Maack HI, Renger B, Renz M, Sauter A, Leonhardt Y, Fingerle A, Makowski M, Pfeiffer D, Pfeiffer F. X-ray dark-field chest radiography: a reader study to evaluate the diagnostic quality of attenuation chest X-rays from a dual-contrast scanning prototype. Eur Radiol 2023; 33:5549-5556. [PMID: 36806571 PMCID: PMC10326144 DOI: 10.1007/s00330-023-09477-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 12/09/2022] [Accepted: 01/23/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES To compare the visibility of anatomical structures and overall quality of the attenuation images obtained with a dark-field X-ray radiography prototype with those from a commercial radiography system. METHODS Each of the 65 patients recruited for this study obtained a thorax radiograph at the prototype and a reference radiograph at the commercial system. Five radiologists independently assessed the visibility of anatomical structures, the level of motion artifacts, and the overall image quality of all attenuation images on a five-point scale, with 5 points being the highest rating. The average scores were compared between the two image types. The differences were evaluated using an area under the curve (AUC) based z-test with a significance level of p ≤ 0.05. To assess the variability among the images, the distributions of the average scores per image were compared between the systems. RESULTS The overall image quality was rated high for both devices, 4.2 for the prototype and 4.6 for the commercial system. The rating scores varied only slightly between both image types, especially for structures relevant to lung assessment, where the images from the commercial system were graded slightly higher. The differences were statistically significant for all criteria except for the bronchial structures, the cardiophrenic recess, and the carina. CONCLUSIONS The attenuation images acquired with the prototype were assigned a high diagnostic quality despite a lower resolution and the presence of motion artifacts. Thus, the attenuation-based radiographs from the prototype can be used for diagnosis, eliminating the need for an additional conventional radiograph. KEY POINTS • Despite a low tube voltage (70 kVp) and comparably long acquisition time, the attenuation images from the dark-field chest radiography system achieved diagnostic quality for lung assessment. • Commercial chest radiographs obtained a mean rating score regarding their diagnostic quality of 4.6 out of 5, and the grating-based images had a slightly lower mean rating score of 4.2 out of 5. • The difference in rating scores for anatomical structures relevant to lung assessment is below 5%.
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Affiliation(s)
- Margarete Kattau
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany.
| | - Konstantin Willer
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Wolfgang Noichl
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
| | - Theresa Urban
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Manuela Frank
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Fabio De Marco
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
| | - Rafael Schick
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Thomas Koehler
- Philips Research, 22335, Hamburg, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
| | | | - Bernhard Renger
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Martin Renz
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Yannik Leonhardt
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Alexander Fingerle
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Marcus Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
| | - Franz Pfeiffer
- Chair of Biomedical Physics, Munich Institute of Biomedical Engineering & School of Natural Sciences, Technical University of Munich, 85748, Garching, Germany
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
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6
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Herms E, Weirich G, Maurer T, Wagenpfeil S, Preuss S, Sauter A, Heck M, Gärtner A, Hauner K, Autenrieth M, Kübler HP, Holzapfel K, Schwarz-Boeger U, Heemann U, Slotta-Huspenina J, Stock KF. Ultrasound-based "CEUS-Bosniak"classification for cystic renal lesions: an 8-year clinical experience. World J Urol 2023; 41:679-685. [PMID: 35986781 PMCID: PMC10082702 DOI: 10.1007/s00345-022-04094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Renal cysts comprise benign and malignant entities. Risk assessment profits from CT/MRI imaging using the Bosniak classification. While Bosniak-IIF, -III, and -IV cover complex cyst variants, Bosniak-IIF and -III stand out due to notorious overestimation. Contrast-enhanced ultrasound (CEUS) is promising to overcome this deficit but warrants standardization. This study addresses the benefits of a combined CEUS and CT/MRI evaluation of renal cysts. The study provides a realistic account of kidney tumor boards' intricacies in trying to validate renal cysts. METHODS 247 patients were examined over 8 years. CEUS lesions were graded according to CEUS-Bosniak (IIF, III, IV). 55 lesions were resected, CEUS-Bosniak- and CT/MRI-Bosniak-classification were correlated with histopathological diagnosis. Interobserver agreement between the classifications was evaluated statistically. 105 lesions were followed by ultrasound, and change in CEUS-Bosniak-types and lesion size were documented. RESULTS 146 patients (156 lesions) were included. CEUS classified 67 lesions as CEUS-Bosniak-IIF, 44 as CEUS-Bosniak-III, and 45 as CEUS-Bosniak-IV. Histopathology of 55 resected lesions revealed benign cysts in all CEUS-Bosniak-IIF lesions (2/2), 40% of CEUS-Bosniak-III and 8% of CEUS-Bosniak-IV, whereas malignancy was uncovered in 60% of CEUS-Bosniak-III and 92% of CEUS-Bosniak-IV. Overall, CEUS-Bosniak-types matched CT/MRI-Bosniak types in 58% (fair agreement, κ = 0.28). CEUS-Bosniak resulted in higher stages than CT/MRI-Bosniak (40%). Ultrasound follow-up of 105 lesions detected no relevant differences between CEUS-Bosniak-types concerning cysts size. 99% of lesions showed the same CEUS-Bosniak-type. CONCLUSION The CEUS-Bosniak classification is an essential tool in clinical practice to differentiate and monitor renal cystic lesions and empowers diagnostic work-up and patient care.
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Affiliation(s)
- Elena Herms
- Department of Nephrology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Gregor Weirich
- Institute of Pathology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Tobias Maurer
- Department of Urology and Martini-Klinik, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Wagenpfeil
- Institute of Medical Biometry, Epidemiology and Medical Informatics (IMBEI), Saarland University, Campus Homburg, Homburg, Germany
| | - Stephanie Preuss
- Department of Nephrology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Andreas Sauter
- Department of Radiology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Matthias Heck
- Department of Urology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Anita Gärtner
- Department of Anesthesia, Freising University Hospital, Freising, Germany
| | - Katharina Hauner
- Department of Urology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Michael Autenrieth
- Department of Urology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Hubert P Kübler
- Department of Urology, University Hospital Würzburg, Würzburg, Germany
| | | | - Ulrike Schwarz-Boeger
- Medical Controlling, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Uwe Heemann
- Department of Nephrology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Julia Slotta-Huspenina
- Institute of Pathology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany
| | - Konrad Friedrich Stock
- Department of Nephrology, University Hospital MRI-TUM (München Rechts Der Isar), Munich, Germany.
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7
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Matthias M, Sauter A, Winkel D, Wasserthal J, Henkel M, Elyan A, Boll D, Merkle E, Seifert H, Wetterauer C. PROSTAITE one – AI-based prostate volumetry and zonal development. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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8
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Boyer L, Sauter A, Sommer R, Till M, Gelius P, Herrmann-Johns A. Pandemiebedingte Transformationsprozesse partizipativer
Forschungsprojekte – Eine qualitative Studie zu vier
Bewegungsförderungsprojekten aus dem Capital4Health
Forschungsverbund. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- L Boyer
- Universität Regensburg, Medizinische Soziologie, Regensburg,
Deutschland
| | - A Sauter
- Universität Regensburg, Medizinische Soziologie, Regensburg,
Deutschland
| | - R Sommer
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department für Sportwissenschaften und Sport, Erlangen,
Deutschland
| | - M Till
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department für Sportwissenschaften und Sport, Erlangen,
Deutschland
| | - P Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department für Sportwissenschaften und Sport, Erlangen,
Deutschland
| | - A Herrmann-Johns
- Universität Regensburg, Medizinische Soziologie, Regensburg,
Deutschland
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9
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Sauter A, Abu-Omar K, Linder S, Sommer R, Herrmann-Johns A. Resiliente Communities? Eine qualitative Interviewstudie zur
Aufrechterhaltung eines Bewegungsprojektes für Frauen in schwierigen
Lebenslagen (BIG-Projekt) während den ersten beiden Jahren der COVID-19
Pandemie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Sauter
- Universität Regensburg, Professur für Medizinische
Soziologie, Regensburg, Deutschland
| | - K Abu-Omar
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department Sportwissenschaft und Sport, Erlangen, Deutschland
| | - S Linder
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department Sportwissenschaft und Sport, Erlangen, Deutschland
| | - R Sommer
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department Sportwissenschaft und Sport, Erlangen, Deutschland
| | - A Herrmann-Johns
- Universität Regensburg, Professur für Medizinische
Soziologie, Regensburg, Deutschland
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10
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Beck S, Jahn L, Deniffel D, Riederer I, Sauter A, Makowski MR, Pfeiffer D. Iodine images in dual energy CT: A monocentric study benchmarking quantitative iodine concentration values of the healthy liver. PLoS One 2022; 17:e0270805. [PMID: 35834594 PMCID: PMC9282453 DOI: 10.1371/journal.pone.0270805] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 06/17/2022] [Indexed: 12/01/2022] Open
Abstract
Dual energy computed tomography (DECT) allows the quantification of specific materials such as iodine contrast agent in human body tissue, potentially providing additional diagnostic data. Yet full diagnostic value can only be achieved if physiological normal values for iodine concentrations are known. We retrospectively evaluated abdominal DECT scans of 105 patients with healthy liver between March and August 2018 (age 17 to 86 years, 43 female and 62 male). The iodine concentrations within ROIs of the liver parenchyma as well as of the abdominal aorta and main portal vein were obtained. We evaluated the absolute iodine concentration and blood-normalized iodine concentrations relating the measured iodine concentration of the liver parenchyma to those of the supplying vessels. The influence of age and gender on the iodine uptake was assessed. The absolute iodine concentration was significantly different for the male and female cohort, but the difference was eliminated by the blood-normalized values. The average blood-normalized iodine concentrations were 2.107 mg/ml (+/- 0.322 mg/ml), 2.125 mg/ml (+/- 0.426 mg/ml) and 2.103 mg/ml (+/- 0.317 mg/ml) for the portal vein normalized, aorta normalized and mixed blood normalized iodine concentrations, respectively. A significant negative correlation between the patients’ age and the iodine concentration was detected only for the blood-normalized values. A physiological range for iodine concentration in portal venous phase contrast enhanced DECT images can be defined for absolute and blood-normalized values. Deviations of blood-normalized iodine concentration values might be a robust biomarker for diagnostic evaluation. Patient age but not the gender influences the blood-normalized iodine concentrations in healthy liver parenchyma.
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Affiliation(s)
- Stefanie Beck
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
- * E-mail:
| | - Laurenz Jahn
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Dominik Deniffel
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Isabelle Riederer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Marcus R. Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
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Schmid S, Schiller K, Seitz A, Koll F, Beckert F, Korn P, Lewerich J, Maisch P, Sauter A, Rödel C, Flentje M, Riedel T, Combs S, Zengerling F, Bolenz C, Kübler H, Gschwend J, Retz M. RACE IT - A prospective, single arm, multicenter, phase II-trial to assess safety and efficacy of preoperative RAdiation therapy before radical CystEctomy combined with ImmunoTherapy in locally advanced urothelial carcinoma of the bladder (AB 65/18). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00417-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Herms E, Slotta-Huspenin J, Gärtner A, Preuss S, Hauner K, Heck M, Autenrieth M, Maurer T, Kübler H, Holzapfel K, Sauter A, Schwarz-Boeger U, Wagenpfeil S, Heemann U, Stock K. Ultrasound based CEUS-Bosniak classification for cystic renal lesions: An 8-year clinical experience. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00141-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Sauter A, Hochstädt D, Seelig JH, Hansen F, Zeller T. Grundsätzliche Ansätze zur Verbesserung der Ressourceneffizienz in der Metallindustrie. CHEM-ING-TECH 2021. [DOI: 10.1002/cite.202100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andreas Sauter
- Technische Universität Clausthal CUTEC Clausthaler Umwelttechnik Forschungszentrum Leibnizstraße 23 38678 Clausthal-Zellerfeld Deutschland
| | - Daniel Hochstädt
- Technische Universität Clausthal CUTEC Clausthaler Umwelttechnik Forschungszentrum Leibnizstraße 23 38678 Clausthal-Zellerfeld Deutschland
| | - Jan Henning Seelig
- Technische Universität Clausthal CUTEC Clausthaler Umwelttechnik Forschungszentrum Leibnizstraße 23 38678 Clausthal-Zellerfeld Deutschland
| | - Florian Hansen
- Technische Universität Clausthal CUTEC Clausthaler Umwelttechnik Forschungszentrum Leibnizstraße 23 38678 Clausthal-Zellerfeld Deutschland
| | - Torsten Zeller
- Technische Universität Clausthal CUTEC Clausthaler Umwelttechnik Forschungszentrum Leibnizstraße 23 38678 Clausthal-Zellerfeld Deutschland
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14
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Scholz J, Roiser N, Braig EM, Petrich C, Birnbacher L, Andrejewski J, Kimm MA, Sauter A, Busse M, Korbel R, Herzen J, Pfeiffer D. X-ray dark-field radiography for in situ gout diagnosis by means of an ex vivo animal study. Sci Rep 2021; 11:19021. [PMID: 34561476 PMCID: PMC8463704 DOI: 10.1038/s41598-021-98151-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/01/2021] [Indexed: 12/27/2022] Open
Abstract
Gout is the most common form of inflammatory arthritis, caused by the deposition of monosodium urate (MSU) crystals in peripheral joints and tissue. Detection of MSU crystals is essential for definitive diagnosis, however the gold standard is an invasive process which is rarely utilized. In fact, most patients are diagnosed or even misdiagnosed based on manifested clinical signs, as indicated by the unchanged premature mortality among gout patients over the past decade, although effective treatment is now available. An alternative, non-invasive approach for the detection of MSU crystals is X-ray dark-field radiography. In our work, we demonstrate that dark-field X-ray radiography can detect naturally developed gout in animals with high diagnostic sensitivity and specificity based on the in situ measurement of MSU crystals. With the results of this study as a potential basis for further research, we believe that X-ray dark-field radiography has the potential to substantially improve gout diagnostics.
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Affiliation(s)
- Josef Scholz
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany.
| | - Nathalie Roiser
- Clinic for Birds, Small Mammals, Reptiles and Omamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, 85764, Oberschleißheim, Germany
| | - Eva-Maria Braig
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Christian Petrich
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Lorenz Birnbacher
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Jana Andrejewski
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Melanie A Kimm
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
- Department of Radiology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Madleen Busse
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Rüdiger Korbel
- Clinic for Birds, Small Mammals, Reptiles and Omamental Fish, Centre for Clinical Veterinary Medicine, LMU Munich, 85764, Oberschleißheim, Germany
| | - Julia Herzen
- Chair of Biomedical Physics, Department of Physics and Munich School of BioEngineering, Technical University of Munich, James-Franck Str. 1, 85748, Garching, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748, Garching, Germany
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Boyer L, Sauter A, Loss J. Messung von Handlungsmöglichkeiten (capabilities) zur Führung eines aktiven Lebensstil - Entwicklung und Erprobung eines Messinstruments für Senior/innen. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Boyer
- Medizinische Soziologie am Institut für Epidemiologie und Präventivmedizin, Universität Regensburg
| | - A Sauter
- Medizinische Soziologie am Institut für Epidemiologie und Präventivmedizin, Universität Regensburg
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16
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Sauter A, Kikhia S, von Sommoggy J, Loss J. Was beeinflusst Bewegung im Alltag syrischer MigrantInnen in Deutschland– Ergebnisse einer qualitativen Befragung. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Sauter
- Medizinische Soziologie, Universität Regensburg
| | - S Kikhia
- Medizinische Soziologie, Universität Regensburg
| | | | - J Loss
- Medizinische Soziologie, Universität Regensburg
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17
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Maisch P, Lunger L, Düwel C, Schmid SC, Horn T, Gschwend JE, Sauter A, Heck MM. Outcomes of palliative cystectomy in patients with locally advanced pT4 bladder cancer. Urol Oncol 2021; 39:368.e11-368.e17. [PMID: 33431328 DOI: 10.1016/j.urolonc.2020.11.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/13/2020] [Accepted: 11/30/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Radical cystectomy (Cx) is the standard of care for muscle-invasive bladder cancer (BCa). In locally advanced pT4 BCa the oncologic outcome is inexplicit but Cx may be necessary for palliation. OBJECTIVES The aim of this retrospective study was to evaluate the outcomes of Cx performed in patients with locally advanced pT4 BCa and to identify patient subgroups with improved outcome. METHODS Between 2008 and 2017, we identified 76 of 905 patients who underwent Cx for pT4 BCa at a single tertiary referral center. The physical patients' status was estimated according to the American Society of Anesthesiologists (ASA) classification. For the classification of postoperative complication rates, the Clavien-Dindo grading was used. Time-to-event variables with log-rank statistics were calculated with the use of the Kaplan-Meier method. RESULTS Median age was 74 years (range 42-90). Preoperatively, the physical status was estimated poor in 40 (52%) patients (ASA-score of ≥3). Overall, 19 (25%) patients had pT4b BCa, 41 (54%) patients were lymph node positive (c/pN+) and 14 (18%) patients had distant metastases (c/pM+). Within 30 and 90 days after surgery, 21% and 30% of the patients, respectively, developed severe complications (Clavien-Dindo grade ≥3). Overall, 30- and 90-day mortality rates were 9% and 11%, respectively. Moreover, 86% and 75% of patients who died within 30 and 90 days after surgery, respectively, had an ASA-score ≥3. At a median postoperative follow-up of 8 months (range 0-85), 53 (70%) patients have died. During the follow-up period, 46% of the patients died due to progressive disease, 16% died of a noncancer-specific cause, and for 8% of the patients, the reason remains unknown. Median overall survival (OS) and cancer-specific survival were 13.0 and 16.0 months, respectively. In subgroup analyses ASA-score ≥3 and hemoglobin <11.7 g/dl was significantly associated with poor OS. No statistically significant differences were detected between subgroups. CONCLUSION Cx performed in patients with locally advanced pT4 BCa is associated with an increased mortality rate within 90 days postoperatively. Our study revealed that the ASA-score is a relevant and easily available tool to rate the patient´s condition and estimate postoperative outcome.
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Affiliation(s)
- Phillipp Maisch
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany.
| | - Lukas Lunger
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
| | - Charlotte Düwel
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
| | - Sebastian C Schmid
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
| | - Thomas Horn
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
| | - Andreas Sauter
- Department of Radiology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
| | - Matthias M Heck
- Department of Urology, Technical University of Munich, Rechts der Isar Medical Center, Munich, Germany
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18
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Sauter A, Wittekindt O, Dietl P, Schmidt. H. WS07.6 Aquaporin 3 modulates transepithelial fluid resorption upon exposure of airway epithelia to hyperosmotic solutions. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)00956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Multhoff G, Seier S, Stangl S, Sievert W, Shevtsov M, Werner C, Pockley AG, Blankenstein C, Hildebrandt M, Offner R, Ahrens N, Kokowski K, Hautmann M, Rödel C, Fietkau R, Lubgan D, Huber R, Hautmann H, Duell T, Molls M, Specht H, Haller B, Devecka M, Sauter A, Combs SE. Targeted Natural Killer Cell-Based Adoptive Immunotherapy for the Treatment of Patients with NSCLC after Radiochemotherapy: A Randomized Phase II Clinical Trial. Clin Cancer Res 2020; 26:5368-5379. [PMID: 32873573 DOI: 10.1158/1078-0432.ccr-20-1141] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/15/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Non-small cell lung cancer (NSCLC) is a fatal disease with poor prognosis. A membrane-bound form of Hsp70 (mHsp70) which is selectively expressed on high-risk tumors serves as a target for mHsp70-targeting natural killer (NK) cells. Patients with advanced mHsp70-positive NSCLC may therefore benefit from a therapeutic intervention involving mHsp70-targeting NK cells. The randomized phase II clinical trial (EudraCT2008-002130-30) explores tolerability and efficacy of ex vivo-activated NK cells in patients with NSCLC after radiochemotherapy (RCT). PATIENTS AND METHODS Patients with unresectable, mHsp70-positive NSCLC (stage IIIa/b) received 4 cycles of autologous NK cells activated ex vivo with TKD/IL2 [interventional arm (INT)] after RCT (60-70 Gy, platinum-based chemotherapy) or RCT alone [control arm (CTRL)]. The primary objective was progression-free survival (PFS), and secondary objectives were the assessment of quality of life (QoL, QLQ-LC13), toxicity, and immunobiological responses. RESULTS The NK-cell therapy after RCT was well tolerated, and no differences in QoL parameters between the two study arms were detected. Estimated 1-year probabilities for PFS were 67% [95% confidence interval (CI), 19%-90%] for the INT arm and 33% (95% CI, 5%-68%) for the CTRL arm (P = 0.36, 1-sided log-rank test). Clinical responses in the INT group were associated with an increase in the prevalence of activated NK cells in their peripheral blood. CONCLUSIONS Ex vivo TKD/IL2-activated, autologous NK cells are well tolerated and deliver positive clinical responses in patients with advanced NSCLC after RCT.
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Affiliation(s)
- Gabriele Multhoff
- Department Radiation Oncology, Klinikum rechts der Isar, TU München, (TUM), Munich, Germany. .,Radiation Immuno-Oncology, Center for Translational Cancer Research TUM (TranslaTUM), Munich, Germany
| | - Sophie Seier
- Department Radiation Oncology, Klinikum rechts der Isar, TU München, (TUM), Munich, Germany
| | - Stefan Stangl
- Radiation Immuno-Oncology, Center for Translational Cancer Research TUM (TranslaTUM), Munich, Germany
| | - Wolfgang Sievert
- Radiation Immuno-Oncology, Center for Translational Cancer Research TUM (TranslaTUM), Munich, Germany
| | - Maxim Shevtsov
- Radiation Immuno-Oncology, Center for Translational Cancer Research TUM (TranslaTUM), Munich, Germany.,Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia
| | - Caroline Werner
- Radiation Immuno-Oncology, Center for Translational Cancer Research TUM (TranslaTUM), Munich, Germany
| | - A Graham Pockley
- John van Geest Cancer Research Centre, Nottingham Trent University, Nottingham, United Kingdom; and multimmune GmbH, Munich, Germany
| | | | | | - Robert Offner
- Department of Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Norbert Ahrens
- Department of Transfusion Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Konrad Kokowski
- Pneumology and Pneumologic Oncology, Klinikum Bogenhausen, Munich, Germany
| | - Matthias Hautmann
- Department of Radiation Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Claus Rödel
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Frankfurt, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Dorota Lubgan
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rudolf Huber
- Division of Respiratory Medicine and Thoracic Oncology Centre Munich and Thoracic Oncology Centre Munich, University München, LMU, Munich, Germany
| | - Hubert Hautmann
- Pneumology Group Med I, Klinikum rechts der Isar, TUM, Munich, Germany
| | - Thomas Duell
- Asklepios Lung Hospital München-Gauting, Thoracal Pneumology, LMU, Munich, Germany
| | - Michael Molls
- Department Radiation Oncology, Klinikum rechts der Isar, TU München, (TUM), Munich, Germany
| | - Hanno Specht
- Department Radiation Oncology, Klinikum rechts der Isar, TU München, (TUM), Munich, Germany
| | - Bernhard Haller
- Institute of Medical Informatics, Statistics and Epidemiology, TUM, Munich, Germany
| | - Michal Devecka
- Department Radiation Oncology, Klinikum rechts der Isar, TU München, (TUM), Munich, Germany
| | | | - Stephanie E Combs
- Department Radiation Oncology, Klinikum rechts der Isar, TU München, (TUM), Munich, Germany.,Institute of Radiation Medicine (IRM), Helmholtz Zentrum München (HMGU), Neuherberg, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Germany
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20
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Deniffel D, Sauter A, Fingerle A, Rummeny EJ, Makowski MR, Pfeiffer D. Improved differentiation between primary lung cancer and pulmonary metastasis by combining dual-energy CT-derived biomarkers with conventional CT attenuation. Eur Radiol 2020; 31:1002-1010. [PMID: 32856165 PMCID: PMC7813728 DOI: 10.1007/s00330-020-07195-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/26/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To assess the clinical utility of dual-energy CT (DE-CT)-derived iodine concentration (IC) and effective Z (Zeff) in addition to conventional CT attenuation (HU) for the discrimination between primary lung cancer (LC) and pulmonary metastases (PM) from different primary malignancies. METHODS DE-CT scans of 79 patients with LC (3 histopathologic subgroups) and 89 patients with PM (5 histopathologic subgroups) were evaluated. Quantitative IC, Zeff, and conventional HU values were extracted and normalized to the thoracic aorta. Differences between groups were assessed by pairwise Welch's t test. Correlation and linear regression analyses were used to examine the relationship of imaging parameters in LC and PM. Diagnostic accuracy was measured by the area under receiver operator characteristic curve (AUC) and validated based on resampling methods. RESULTS Significant differences between subgroups of LC and PMs were noted for all imaging parameters, with the highest number of significant pairs for IC. In univariate analysis, only IC was a significant diagnostic feature for discriminating LC from PM (p = 0.03). All quantitative imaging parameters correlated significantly (p < 0.0001, respectively), with the highest correlation between IC and Zeff (r = 0.91), followed by IC and HU (r = 0.76) and Zeff and HU (r = 0.73). Diagnostic models combining IC or Zeff with HU (IC+HU: AUC = 0.73; Zeff+HU: AUC = 0.69; IC+Zeff+HU: AUC = 0.73) were not significantly different and outperformed individual parameters (IC: AUC = 0.57; Zeff: AUC = 0.57; HU: AUC = 0.55) in diagnostic accuracy (p < 0.05, respectively). CONCLUSION DE-CT-derived IC or Zeff and conventional HU represent complementary imaging parameters, which, if used in combination, may improve the differentiation between LC and PM. KEY POINTS • Individual quantitative imaging parameters derived from DE-CT (iodine concentration, effective Z) and conventional CT (HU) provide complementary diagnostic information for the differentiation of primary lung cancer and pulmonary metastases. • A combination of conventional HU and DE-CT parameters enhances the diagnostic utility of individual parameters.
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Affiliation(s)
- Dominik Deniffel
- Department of Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, ON, Canada
| | - Andreas Sauter
- Department of Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Alexander Fingerle
- Department of Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Ernst J Rummeny
- Department of Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Marcus R Makowski
- Department of Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Daniela Pfeiffer
- Department of Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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21
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Beck S, Sellerer T, Mechlem K, Bodden J, Meurer F, Sauter A, Herzen J, Pfeiffer F, Pfeiffer D. Photon-counting spectral basis component material decomposition for musculoskeletal radiographs. Sci Rep 2020; 10:13889. [PMID: 32807855 PMCID: PMC7431848 DOI: 10.1038/s41598-020-70363-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/08/2020] [Indexed: 11/09/2022] Open
Abstract
As a very fast and non-invasive examination, conventional X-ray radiography is well established as the first line diagnostic imaging method of the human bone system. While major bone injuries such as fractures and dislocations are usually easily detectable on conventional X-ray images, more subtle injuries such as microfractures are often missed, leading to mistreatment and potential long-term consequences. The technology of Photon-Counting Dual-Energy Radiography (PCDER) yields the possibility to decompose conventional X-ray images into basis material images such as bone- and soft-tissue-equivalence images. The obtained basis material images offer significant advantages in terms of image contrast and image details over the raw attenuation image which shows an overlap of bone and soft tissue. Whereas the advantages of bone- and soft-tissue-equivalence images have been broadly discussed referring to bone subtraction images in the detection of pulmonary diseases, this method has not been considered for the analysis of musculoskeletal images until present. In this study we show that basis component equivalence images have high potential to improve the diagnostic accuracy of the detection of minor bone lesions during clinical trauma imaging. A reader study performed by three experienced radiologists compares the image quality of basis material images to a standard radiograph image of a non-fractured cadaveric hand.
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Affiliation(s)
- Stefanie Beck
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany.
| | - Thorsten Sellerer
- Chair of Biomedical Physics, Department of Physics and Munich School of Bioengineering, Technical University of Munich, 85748, Garching, Germany
| | - Korbinian Mechlem
- Chair of Biomedical Physics, Department of Physics and Munich School of Bioengineering, Technical University of Munich, 85748, Garching, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Felix Meurer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
| | - Julia Herzen
- Chair of Biomedical Physics, Department of Physics and Munich School of Bioengineering, Technical University of Munich, 85748, Garching, Germany
| | - Franz Pfeiffer
- Chair of Biomedical Physics, Department of Physics and Munich School of Bioengineering, Technical University of Munich, 85748, Garching, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts Der Isar, Technical University of Munich, 81675, Munich, Germany
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22
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Derfuss T, Weber M, Hughes R, Eggebrecht J, Wang Q, Sauter A, Koendgen H, Hauser S, Bar-Or A, Hartung H. P36 Serum immunoglobulin levels and risk of serious infections in the pivotal phase III trials of ocrelizumab in multiple sclerosis and their open-label extensions. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Imhoff FB, Funke V, Muench LN, Sauter A, Englmaier M, Woertler K, Imhoff AB, Feucht MJ. Correction to: The complexity of bony malalignment in patellofemoral disorders: femoral and tibial torsion, trochlear dysplasia, TT-TG distance, and frontal mechanical axis correlate with each other. Knee Surg Sports Traumatol Arthrosc 2020; 28:905. [PMID: 31227864 DOI: 10.1007/s00167-019-05564-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The original article can be found online.
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Affiliation(s)
- Florian B Imhoff
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Victor Funke
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Lukas N Muench
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Ismaningerstr 22, Munich, 81675, Germany
| | - Maximilian Englmaier
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Ismaningerstr 22, Munich, 81675, Germany
| | - Klaus Woertler
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Ismaningerstr 22, Munich, 81675, Germany
| | - Andreas B Imhoff
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany.
| | - Matthias J Feucht
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
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24
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Schmid SC, Koll FJ, Rödel C, Maisch P, Sauter A, Beckert F, Seitz A, Kübler H, Flentje M, Chun F, Combs SE, Schiller K, Gschwend JE, Retz M. Radiation therapy before radical cystectomy combined with immunotherapy in locally advanced bladder cancer - study protocol of a prospective, single arm, multicenter phase II trial (RACE IT). BMC Cancer 2020; 20:8. [PMID: 31900121 PMCID: PMC6942254 DOI: 10.1186/s12885-019-6503-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 12/26/2019] [Indexed: 01/27/2023] Open
Abstract
Background Patients with locally advanced bladder cancer (cT3/4 cN0/N+ cM0) have a poor prognosis despite radical surgical therapy and perioperative chemotherapy. Preliminary data suggest that the combination of radiation and immunotherapy does not lead to excess toxicity and may have synergistic (abscopal) anti-tumor effects. We hypothesize that the combined preoperative application of the PD-1 checkpoint-inhibitor Nivolumab with concomitant radiation therapy of the bladder and pelvic region followed by radical cystectomy with standardized lymphadenectomy is safe and feasible and might improve outcome for patients with locally advanced bladder cancer. Methods Study design: “RACE IT” (AUO AB 65/18) is an investigator initiated, prospective, multicenter, open, single arm phase II trial sponsored by Technical University Munich. Study drug and funding are provided by the company Bristol-Myers Squibb. Study treatment: Patients will receive Nivolumab 240 mg i.v. every 2 weeks for 4 cycles preoperatively with concomitant radiation therapy of bladder and pelvic region (max. 50.4 Gy). Radical cystectomy with standardized bilateral pelvic lymphadenectomy will be performed between week 11–15. Primary endpoint: Rate of patients with completed treatment consisting of radio-immunotherapy and radical cystectomy at the end of week 15. Secondary endpoints: Acute and late toxicity, therapy response and survival (1 year follow up). Main inclusion criteria: Patients with histologically confirmed, locally advanced bladder cancer (cT3/4, cN0/N+), who are ineligible for neoadjuvant, cisplatin-based chemotherapy or who refuse neoadjuvant chemotherapy. Main exclusion criteria: Patients with metastatic disease (lymph node metastasis outside pelvis or distant metastasis) or previous chemo-, immune- or radiation therapy. Planned sample size: 33 patients, interim analysis after 11 patients. Discussion This trial aims to evaluate the safety and feasibility of the combined approach of preoperative PD-1 checkpoint-inhibitor therapy with concomitant radiation of bladder and pelvic region followed by radical cystectomy. The secondary objectives of therapy response and survival are thought to provide preliminary data for further clinical evaluation after successful completion of this trial. Recruitment has started in February 2019. Trial registration Protocol Code RACE IT: AB 65/18; EudraCT: 2018–001823-38; Clinicaltrials.gov: NCT03529890; Date of registration: 27 June 2018.
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Affiliation(s)
- Sebastian C Schmid
- Department of Urology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Florestan J Koll
- Department of Urology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Claus Rödel
- Department of Radiation Oncology, University of Frankfurt, Frankfurt, Germany
| | - Philipp Maisch
- Department of Urology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - Franziska Beckert
- Department of Urology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Anna Seitz
- Department of Urology, University of Würzburg, Würzburg, Germany
| | - Hubert Kübler
- Department of Urology, University of Würzburg, Würzburg, Germany
| | - Michael Flentje
- Department of Radiation Oncology, University of Würzburg, Würzburg, Germany
| | - Felix Chun
- Department of Urology, University of Frankfurt, Frankfurt, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany.,Helmholtz Zentrum München (HMGU), Institute of Radiation Medicine (IRM), Deutsches Konsortium für Translationale Krebsforschung (NeoDKTK) Partner Site Munich, Oberschleißheim, Germany
| | - Kilian Schiller
- Department of Radiation Oncology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany.,Helmholtz Zentrum München (HMGU), Institute of Radiation Medicine (IRM), Deutsches Konsortium für Translationale Krebsforschung (NeoDKTK) Partner Site Munich, Oberschleißheim, Germany
| | - Jürgen E Gschwend
- Department of Urology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Margitta Retz
- Department of Urology, School of Medicine, Rechts der Isar Medical Center, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
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25
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Nadjiri J, Zaschka AL, Straeter AS, Sauter A, Englmaier M, Weis F, Laugwitz KL, Rummeny EJ, Pfeiffer D, Rasper M. Evaluation of a shortened cardiac MRI protocol for left ventricular examinations: diagnostic performance of T1-mapping and myocardial function analysis. BMC Med Imaging 2019; 19:57. [PMID: 31340756 PMCID: PMC6657063 DOI: 10.1186/s12880-019-0358-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background In this study we sought to retrospectively evaluate whether a very brief cardiac magnetic resonance imaging (CMR) protocol sufficiently distinguishes patients with relevant myocardial changes with need for further examination from healthy subjects. Methods Patients with clinical indication for CMR (n = 160) were included in the study. Patients were categorized into two groups depending on presence of left ventricular (LV) dysfunction. ROC-analysis was done for results of T1-, T2- mapping and extracellular volume evaluation in patients without LV dysfunction. Binary endpoint was correctly depicted pathology of the conventional qualitative CMR techniques and report. Results In the patient cohort without LV dysfunction (49%), AUC for T1 mapping was 82% (p < 0.001), 60% for T2 mapping (p = 0.1) and 79% for ECV (p < 0.001). T1 mapping was significantly superior to T2 mapping to rule out left ventricular pathology (p = 0.012). Sensitivity for the combined use of T1 mapping and sBTFE cine imaging was 98%; the negative predictive value was 90%. In 49 patients (30%) full protocol CMR did not provide any additional information; T1 mapping correctly detected 57% of the subjects from this group who would not benefit from additional CMR. Conclusion A shortened CMR protocol comprising T1 mapping and LV-function analysis seems suitable to rule out myocardial alterations. Every third patient of the study population did not benefit from full contrast enhanced CMR. The shortened protocol correctly identified every fifth patient who would not benefit but no relevant pathologic findings with the obligation for treatment were missed.
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Affiliation(s)
- Jonathan Nadjiri
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Anna-Lena Zaschka
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Alexandra S Straeter
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Maximilian Englmaier
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Weis
- Department of Cardiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Karl-Ludwig Laugwitz
- Department of Cardiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Michael Rasper
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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26
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Jilg S, Rassner M, Maier J, Waldeck S, Kehl V, Follo M, Philipp U, Sauter A, Specht K, Mitschke J, Lange T, Bauer S, Jost PJ, Peschel C, Duyster J, Gaiser T, Hohenberger P, Bubnoff N. Circulating
cKIT
and
PDGFRA
DNA indicates disease activity in Gastrointestinal Stromal Tumor (GIST). Int J Cancer 2019; 145:2292-2303. [DOI: 10.1002/ijc.32282] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/10/2019] [Accepted: 03/05/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Stefanie Jilg
- III Medical Department for Hematology and Oncology, Klinikum Rechts der IsarTechnische Universität München Munich Germany
| | - Michael Rassner
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
| | - Jacqueline Maier
- Center for Internal Medicine, Department of Hematology/Oncology and HemostaseologyUniversity of Leipzig Leipzig Germany
| | - Silvia Waldeck
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
- German Cancer Consortium (DKTK) partner site Freiburg and German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of BiologyUniversity of Freiburg Freiburg Germany
| | - Victoria Kehl
- Institute for Medical Informatics, Statistics, and Epidemiology, Klinikum Rechts der IsarTechnische Universität München Munich Germany
| | - Marie Follo
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
| | - Ulrike Philipp
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der IsarTechnische Universität München Munich Germany
| | - Katja Specht
- Institute of Pathology, Klinikum Rechts der IsarTechnische Universität München Munich Germany
| | - Jan Mitschke
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
- German Cancer Consortium (DKTK) partner site Freiburg and German Cancer Research Center (DKFZ) Heidelberg Germany
| | | | - Sebastian Bauer
- Sarcoma Center, West German Cancer CenterUniversity Hospital Essen, University Duisburg‐Essen Essen Germany
| | - Philipp J. Jost
- III Medical Department for Hematology and Oncology, Klinikum Rechts der IsarTechnische Universität München Munich Germany
| | - Christian Peschel
- III Medical Department for Hematology and Oncology, Klinikum Rechts der IsarTechnische Universität München Munich Germany
| | - Justus Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
- German Cancer Consortium (DKTK) partner site Freiburg and German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Timo Gaiser
- Institute of Pathology, University Medical Center MannheimRuprecht‐Karl University of Heidelberg Mannheim Germany
| | - Peter Hohenberger
- Division of Surgical Oncology and Thoracic SurgeryUniversity Medical Center Mannheim, Ruprecht‐Karl University of Heidelberg Mannheim Germany
| | - Nikolas Bubnoff
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
- German Cancer Consortium (DKTK) partner site Freiburg and German Cancer Research Center (DKFZ) Heidelberg Germany
- Department of Hematology and Oncology, Medical CenterUniversity of Schleswig Holstein Lübeck Germany
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Sauter A, Koehler T, Brendel B, Aichele J, Neumann J, Noël PB, Rummeny EJ, Muenzel D. CT pulmonary angiography: dose reduction via a next generation iterative reconstruction algorithm. Acta Radiol 2019; 60:478-487. [PMID: 29933714 DOI: 10.1177/0284185118784976] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Computed tomography pulmonary angiography (CTPA) is the standard imaging modality for detection or rule out of pulmonary embolism (PE); however, radiation exposure is a serious concern. With iterative reconstruction algorithms a distinct dose reduction could be achievable. PURPOSE To evaluate a next generation iterative reconstruction algorithm for detection or rule-out of PE in simulated low-dose CTPA. MATERIAL AND METHODS Low-dose CT datasets with 50%, 25%, and 12.5% of the original tube current were simulated based on CTPA examinations of 92 patients with suspected PE. All datasets were reconstructed with two reconstruction algorithms: standard filtered back-projection (FBP) and iterative model reconstruction (IMR). In total, 736 CTPA datasets were evaluated by three blinded radiologists regarding image quality, diagnostic confidence, and detectability of PE. Furthermore, contrast-to-noise ratio (CNR) was calculated. RESULTS Images reconstructed with IMR showed better detectability of PE than images reconstructed with FBP, especially at lower dose levels. With IMR, sensitivity was over 95% for central and segmental PE down to a dose level of 25%. Significantly higher subjective image quality was shown at lower dose levels (25% and 12.5%) for IMR images whereas it was higher for FBP images at higher dose levels. FBP was rated as showing less artificial image appearance. CNR was significantly higher with IMR at all dose levels. CONCLUSION By using IMR, a dose reduction of up to 50% while maintaining satisfactory image quality seems feasible in standard clinical situations, resulting in a mean effective dose of 1.38 mSv for CTPA.
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Affiliation(s)
- Andreas Sauter
- Department of diagnostic and interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Koehler
- Philips GmbH Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - Bernhard Brendel
- Philips GmbH Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - Juliane Aichele
- Department of diagnostic and interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Neumann
- Department of diagnostic and interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Peter B Noël
- Department of diagnostic and interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ernst J Rummeny
- Department of diagnostic and interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Daniela Muenzel
- Department of diagnostic and interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
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28
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Deniffel D, Sauter A, Dangelmaier J, Fingerle A, Rummeny EJ, Pfeiffer D. Differentiating intrapulmonary metastases from different primary tumors via quantitative dual-energy CT based iodine concentration and conventional CT attenuation. Eur J Radiol 2019; 111:6-13. [DOI: 10.1016/j.ejrad.2018.12.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/30/2018] [Accepted: 12/13/2018] [Indexed: 11/27/2022]
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Sauter A, Loss J. Bewegungsbezogene Capabilities zur Führung eines aktiven Lebensstils bei Studierenden und Auszubildenden – Ergebnisse einer qualitativen Befragung. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Sauter
- Institut für Epidemiologie und Präventivmedizin/Universität Regensburg, Medizinische Soziologie, Regensburg, Deutschland
| | - J Loss
- Institut für Epidemiologie und Präventivmedizin/Universität Regensburg, Medizinische Soziologie, Regensburg, Deutschland
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Metz B, Sauter A, Strobl H, Tittlbach S, Loss J. Multiplikatoren in Gemeindearbeitskreisen – Motive verschiedener Akteure in der partizipativen Planung und Umsetzung von Bewegungsangeboten. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B Metz
- Universität, Medizinische Soziologie, Regensburg, Deutschland
| | - A Sauter
- Universität, Medizinische Soziologie, Regensburg, Deutschland
| | - H Strobl
- Universität, Institut für Sportwissenschaft, Bayreuth, Deutschland
| | - S Tittlbach
- Universität, Institut für Sportwissenschaft, Bayreuth, Deutschland
| | - J Loss
- Universität, Medizinische Soziologie, Regensburg, Deutschland
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31
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Dangelmaier J, Schwaiger BJ, Gersing AS, Kopp FF, Sauter A, Renz M, Riederer I, Braren R, Pfeiffer D, Fingerle A, Rummeny EJ, Noël PB. Dual layer computed tomography: Reduction of metal artefacts from posterior spinal fusion using virtual monoenergetic imaging. Eur J Radiol 2018; 105:195-203. [PMID: 30017279 DOI: 10.1016/j.ejrad.2018.05.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 05/07/2018] [Accepted: 05/31/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION To evaluate the clinical potential of dual layer computed tomography (DLCT) for posterior fusions of the thoracic and lumbar spine and determine the optimal keV-settings for an improved overall image quality and effective reduction of metal artefacts affecting the implant inheriting vertebral body, the spinal canal, the paravertebral muscle and aorta. METHODS AND MATERIALS Twenty patients with posterior thoracic and lumbar spinal fusion, who underwent a 120kVp- DLCT scan were included in this study. Two independent readers evaluated axial 0.9 mm slides with soft tissue and bone window settings. Image quality of the conventional scan was compared to virtual monoenergetic images (VMI) at 40, 60, 80, 100,120, 140, 160, 180 and 200 keV. Diagnostic image quality was assessed on a four point Likert-scale overall, as well as specifically for the implant inheriting bone, paravertebral muscle, spinal canal or aorta. The Hounsfield Units (HU) of the area with the most pronounced streak artefact as well as HU of a reference area containing fat and muscle were documented for each keV-setting and compared to the conventional image. SNR and CNR were calculated for each of the four anatomic areas. Statistical analysis was conducted for the total collective and separately for the thoracic and lumbar spine level. RESULTS Starting from 80 keV qualitative analysis revealed significant improvement of overall image quality and benefit for each tissue separately compared to the conventional images (CI) (p-values in the range from <0.001 to 0.005). 180 keV was considered the optimal monoenergetic setting regarding the overall image quality. For the assessment of the implant inheriting bone, the spinal canal, paravertebral muscle and aorta 200, 180, 160 and 180 keV were rated to be the most sufficient. Our results reveal high inter-reader agreement for qualitative evaluations (intra-class correlation coefficients >0.927; p < 0.05). HU values within the most pronounced streak artefact increased significantly with higher keV (p < 0.001), while there was no significant alteration of HU within the reference area. A decrease in SNR and CNR for higher VMI was revealed by our results. CONCLUSION VMIs of higher energies provide significant reduction of metallic artefacts from posterior spinal fusions. Dedicated keV settings to evaluate either the implant inheriting bone, the spinal canal,adjacent muscle or aorta - structures, which are frequently of particular interest after posterior spinal fusion - are recommended. In addition, an optimal keV for an improved overall image quality is proposed.
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Affiliation(s)
- Julia Dangelmaier
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.
| | - Benedikt J Schwaiger
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Felix F Kopp
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Andreas Sauter
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Martin Renz
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Isabelle Riederer
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Rickmer Braren
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany; Department of Physics & Munich School of BioEngineering, Technical University of Munich, James-Franck-Straße 1 85748, Garching, Germany
| | - Alexander Fingerle
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany; Department of Physics & Munich School of BioEngineering, Technical University of Munich, James-Franck-Straße 1 85748, Garching, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Peter B Noël
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany; Department of Physics & Munich School of BioEngineering, Technical University of Munich, James-Franck-Straße 1 85748, Garching, Germany
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Ehn S, Sellerer T, Muenzel D, Fingerle AA, Kopp F, Duda M, Mei K, Renger B, Herzen J, Dangelmaier J, Schwaiger BJ, Sauter A, Riederer I, Renz M, Braren R, Rummeny EJ, Pfeiffer F, Noël PB. Assessment of quantification accuracy and image quality of a full-body dual-layer spectral CT system. J Appl Clin Med Phys 2018; 19:204-217. [PMID: 29266724 PMCID: PMC5768037 DOI: 10.1002/acm2.12243] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 10/24/2017] [Accepted: 11/02/2017] [Indexed: 11/20/2022] Open
Abstract
The performance of a recently introduced spectral computed tomography system based on a dual-layer detector has been investigated. A semi-anthropomorphic abdomen phantom for CT performance evaluation was imaged on the dual-layer spectral CT at different radiation exposure levels (CTDIvol of 10 mGy, 20 mGy and 30 mGy). The phantom was equipped with specific low-contrast and tissue-equivalent inserts including water-, adipose-, muscle-, liver-, bone-like materials and a variation in iodine concentrations. Additionally, the phantom size was varied using different extension rings to simulate different patient sizes. Contrast-to-noise (CNR) ratio over the range of available virtual mono-energetic images (VMI) and the quantitative accuracy of VMI Hounsfield Units (HU), effective-Z maps and iodine concentrations have been evaluated. Central and peripheral locations in the field-of-view have been examined. For all evaluated imaging tasks the results are within the calculated theoretical range of the tissue-equivalent inserts. Especially at low energies, the CNR in VMIs could be boosted by up to 330% with respect to conventional images using iDose/spectral reconstructions at level 0. The mean bias found in effective-Z maps and iodine concentrations averaged over all exposure levels and phantom sizes was 1.9% (eff. Z) and 3.4% (iodine). Only small variations were observed with increasing phantom size (+3%) while the bias was nearly independent of the exposure level (±0.2%). Therefore, dual-layer detector based CT offers high quantitative accuracy of spectral images over the complete field-of-view without any compromise in radiation dose or diagnostic image quality.
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Affiliation(s)
- Sebastian Ehn
- Chair of Biomedical PhysicsDepartment of Physics and Munich School of BioEngineeringTechnical University of MunichGarchingGermany
| | - Thorsten Sellerer
- Chair of Biomedical PhysicsDepartment of Physics and Munich School of BioEngineeringTechnical University of MunichGarchingGermany
| | - Daniela Muenzel
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Alexander A. Fingerle
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Felix Kopp
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Manuela Duda
- Chair of Biomedical PhysicsDepartment of Physics and Munich School of BioEngineeringTechnical University of MunichGarchingGermany
| | - Kai Mei
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Bernhard Renger
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Julia Herzen
- Chair of Biomedical PhysicsDepartment of Physics and Munich School of BioEngineeringTechnical University of MunichGarchingGermany
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Julia Dangelmaier
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Benedikt J. Schwaiger
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Andreas Sauter
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Isabelle Riederer
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Martin Renz
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Rickmer Braren
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Ernst J. Rummeny
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Franz Pfeiffer
- Chair of Biomedical PhysicsDepartment of Physics and Munich School of BioEngineeringTechnical University of MunichGarchingGermany
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
| | - Peter B. Noël
- Chair of Biomedical PhysicsDepartment of Physics and Munich School of BioEngineeringTechnical University of MunichGarchingGermany
- Department of diagnostic and interventional RadiologyTechnical University of MunichMunichGermany
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Sauter A, Rüter J, Lindacher V, Loss J. Können in kooperativen Planungsgruppen Kapazitäten zur Bewegungsförderung aufgebaut werden? – Ergebnisse aus einem Forschungsverbund. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Sauter
- Universität Regensburg, Medizinische Soziologie, Regensburg
| | - J Rüter
- Universität Regensburg, Medizinische Soziologie, Regensburg
| | - V Lindacher
- Universität Regensburg, Medizinische Soziologie, Regensburg
| | - J Loss
- Universität Regensburg, Medizinische Soziologie, Regensburg
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Sauter A, Rüter J, Lindacher V, Loss J. Bewegungsbezogene Capabilities zur Führung eines aktiven Lebensstils im Alter – Ergebnisse einer qualitativen Befragung. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Sauter
- Universität Regensburg, Medizinische Soziologie, Regensburg
| | - J Rüter
- Universität Regensburg, Medizinische Soziologie, Regensburg
| | - V Lindacher
- Universität Regensburg, Medizinische Soziologie, Regensburg
| | - J Loss
- Universität Regensburg, Medizinische Soziologie, Regensburg
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Riederer I, Sauter A, Renz M, Dangelmaier J, Kirschke J, Fingerle A, Rummeny E, Noel P, Muenzel D. Dual-layer Spektral-CT versus MRT bei der Differenzierung zwischen Hämorrhagie und Kontrastmittelextravasation nach mechanischer Rekanalisation. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- I Riederer
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und Interventionelle Radiologie, München
| | - A Sauter
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
| | - M Renz
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
| | - J Dangelmaier
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
| | - J Kirschke
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Neuroradiologie, München
| | - A Fingerle
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
| | - E Rummeny
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
| | - P Noel
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
| | - D Muenzel
- Klinikum rechts der Isar, Technische Universität München, Diagnostische und interventionelle Radiologie, München
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Dangelmaier J, Schwaiger B, Renz M, Sauter A, Riederer I, Münzel D, Braren R, Fingerle A, Rummeny E, Noël P. Dual-Layer Spectral Computed Tomografy: Reduction of metallic artefacts from posterior spinal fusions using virtual monoenergetic imaging. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Dangelmaier
- Klinikum rechts der Isar der Technischen Universität München, Institut für diagnostische und interventionelle Radiologie, München
| | - B Schwaiger
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - M Renz
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - A Sauter
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - I Riederer
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - D Münzel
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - R Braren
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie
| | - A Fingerle
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - E Rummeny
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie, München
| | - P Noël
- Klinikum Rechts der Isar der TU München, Diagnostische und Interventionelle Radiologie
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Thaiss W, Haberland U, Kaufmann S, Kloth C, Preibsch H, Ketelsen D, Nikolaou K, Horger M, Sauter A. Therapieansprechen nach TACE im HCC: Vergleich der Iod-Konzentration mit Perfusions-CT und RECIST/mRECIST. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- W Thaiss
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - U Haberland
- Siemens Healthcare GmbH, Diagnostic Imaging, Computed Tomografy, Research & Development, Forchheim
| | - S Kaufmann
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - C Kloth
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - H Preibsch
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - D Ketelsen
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - K Nikolaou
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - M Horger
- Radiologische Universitätsklinik Tübingen, Diagnostische und Interventionelle Radiologie, Tübingen
| | - A Sauter
- Universitätsspital Basel, Klinik für Radiologie und Nuklearmedizin, Abteilung Nuklearmedizin, Basel
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Hoopmann M, Kagan KO, Sauter A, Abele H, Wagner P. Comparison of Errors of 35 Weight Estimation Formulae in a Standard Collective. Geburtshilfe Frauenheilkd 2016; 76:1172-1179. [PMID: 27904167 DOI: 10.1055/s-0042-118598] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Issue: The estimation of foetal weight is an integral part of prenatal care and obstetric routine. In spite of its known susceptibility to errors in cases of underweight or overweight babies, important obstetric decisions depend on it. In the present contribution we have examined the accuracy and error distribution of 35 weight estimation formulae within the normal weight range of 2500-4000 g. The aim of the study was to identify the weight estimation formulae with the best possible correspondence to the requirements of clinical routine. Materials and Methods: 35 clinically established weight estimation formulae were analysed in 3416 foetuses with weights between 2500 and 4000 g. For this we determined and compared the mean percentage error (MPE), the mean absolute percentage error (MAPE), and the proportions of estimates within the error ranges of 5, 10, 20 and 30 %. In addition, separate regression lines were calculated for the relationship between estimated and actual birth weights for the weight range 2500-4000 g. The formulae were thus examined for possible inhomogeneities. Results: The lowest MPE were achieved with the Hadlock III and V formulae (0.8 %, STW 9.2 % or, respectively, -0.8 %, STW 10.0 %). The lowest absolute error (6.6 %) as well as the most favourable frequency distribution in cases below 5 % and 10 % error (43.9 and 77.5) were seen for the Halaska formula. In graphic representations of the regression lines, 16 formulae revealed a weight overestimation in the lower weight range and an underestimation in the upper range. 14 formulae gave underestimations and merely 5 gave overestimations over the entire tested weight range. Conclusion: The majority of the tested formulae gave underestimations of the actual birth weight over the entire weight range or at least in the upper weight range. This result supports the current strategy of a two-stage weight estimation in which a formula is first chosen after a pre-estimation of the weight range.
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Affiliation(s)
- M Hoopmann
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - K O Kagan
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - A Sauter
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - H Abele
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
| | - P Wagner
- Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany
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Sauter A, Koehler T, Fingerle AA, Brendel B, Richter V, Rasper M, Rummeny EJ, Noël PB, Münzel D. Ultra Low Dose CT Pulmonary Angiography with Iterative Reconstruction. PLoS One 2016; 11:e0162716. [PMID: 27611830 PMCID: PMC5017721 DOI: 10.1371/journal.pone.0162716] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 08/26/2016] [Indexed: 01/01/2023] Open
Abstract
Objective Evaluation of a new iterative reconstruction algorithm (IMR) for detection/rule-out of pulmonary embolism (PE) in ultra-low dose computed tomography pulmonary angiography (CTPA). Methods Lower dose CT data sets were simulated based on CTPA examinations of 16 patients with pulmonary embolism (PE) with dose levels (DL) of 50%, 25%, 12.5%, 6.3% or 3.1% of the original tube current setting. Original CT data sets and simulated low-dose data sets were reconstructed with three reconstruction algorithms: the standard reconstruction algorithm “filtered back projection” (FBP), the first generation iterative reconstruction algorithm iDose and the next generation iterative reconstruction algorithm “Iterative Model Reconstruction” (IMR). In total, 288 CTPA data sets (16 patients, 6 tube current levels, 3 different algorithms) were evaluated by two blinded radiologists regarding image quality, diagnostic confidence, detectability of PE and contrast-to-noise ratio (CNR). Results iDose and IMR showed better detectability of PE than FBP. With IMR, sensitivity for detection of PE was 100% down to a dose level of 12.5%. iDose and IMR showed superiority to FBP regarding all characteristics of subjective (diagnostic confidence in detection of PE, image quality, image noise, artefacts) and objective image quality. The minimum DL providing acceptable diagnostic performance was 12.5% (= 0.45 mSv) for IMR, 25% (= 0.89 mSv) for iDose and 100% (= 3.57 mSv) for FBP. CNR was significantly (p < 0.001) improved by IMR compared to FBP and iDose at all dose levels. Conclusion By using IMR for detection of PE, dose reduction for CTPA of up to 75% is possible while maintaining full diagnostic confidence. This would result in a mean effective dose of approximately 0.9 mSv for CTPA.
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Affiliation(s)
- Andreas Sauter
- Department of diagnostic and interventional Radiology, Technische Universität München, Munich, Germany
| | - Thomas Koehler
- Philips GmbH, Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - Alexander A Fingerle
- Department of diagnostic and interventional Radiology, Technische Universität München, Munich, Germany
| | - Bernhard Brendel
- Philips GmbH, Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - Vivien Richter
- Department of diagnostic and interventional Radiology, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Michael Rasper
- Department of diagnostic and interventional Radiology, Technische Universität München, Munich, Germany
| | - Ernst J Rummeny
- Department of diagnostic and interventional Radiology, Technische Universität München, Munich, Germany
| | - Peter B Noël
- Department of diagnostic and interventional Radiology, Technische Universität München, Munich, Germany.,Lehrstuhl für Biomedizinische Physik, Physik-Department & Institut für Medizintechnik, Technische Universität München, Garching, Germany
| | - Daniela Münzel
- Department of diagnostic and interventional Radiology, Technische Universität München, Munich, Germany
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Sauter A, Mc Duffie Y, Boehm H, Martinez A, Spatz JP, Appel S. Surface-mediated priming during in vitro generation of monocyte-derived dendritic cells. Scand J Immunol 2015; 81:56-65. [PMID: 25376441 DOI: 10.1111/sji.12246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/16/2014] [Accepted: 10/21/2014] [Indexed: 11/28/2022]
Abstract
Ex vivo-generated human dendritic cells (DC) are most commonly generated from monocytes using standard cell culture dishes. To elucidate the effect of the plastic surface during the differentiation process, we compared a standard adhesive plastic dish with four different mainly non-adherent surfaces. Untouched monocytes were cultured for 3 days in the presence of IL-4 and GM-CSF. Time-lapse videos were recorded, and the phenotype of the cells was analysed by flow cytometry. The cytokine profiles were analysed using a 25-plex cytokine assay. The use of non-adherent surfaces led to a significant reduction in expression of CD14 and CD38, and a significant increase in expression of CD86 compared to standard culture dishes. Expression levels of DC-SIGN and PD-L2 were reduced significantly on cells cultured on non-adherent surfaces. The cytokine production was independent on the surface used. The surface-mediated priming should therefore be considered when aiming to induce specific immune responses. This is especially important with regard to DC-based immunotherapy, where an adjustment of the surface during the DC generation process might have highly beneficial effects.
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Affiliation(s)
- A Sauter
- Department of Biomedicine, University of Bergen, Bergen, Norway
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Kaufmann S, Horger M, Schulze M, Spira D, Sauter A. Comparison of volume perfusion computed tomography (VPCT) and contrast-enhanced ultrasound (CEUS) for assessment of therapeutic effect of transarterial chemoembolisation (TACE). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schulze M, Spira D, Claussen CD, Sauter A, Mayer F, Horger M. Characterization of incidental cardiac masses in oncological patients using a new CT-based tumor volume perfusion technique. Acta Radiol 2013; 54:895-903. [PMID: 23828946 DOI: 10.1177/0284185113488020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cardiac masses are challenging for non-invasive diagnostic procedures and therapy, respectively. In tumor patients differentiation between primary or secondary cardiac neoplasm and thrombus is a frequent and knowingly difficult task to manage. To avoid complex and unnecessary surgical diagnostic procedures non-invasive methods are in favor. For initiation of adequate therapy and evaluation of prognosis, however, early and reliable diagnosis is mandatory. So far, echocardiography and magnetic resonance imaging represent the mainstay for cardiac imaging diagnosis. Recently, the new technique of CT-based tumor volume perfusion (VPCT) measurement has advanced to a potent, reliable, and easy to perform alternative for cardiac imaging. The purpose of this study was to review the existing spectrum of diagnostic modalities for characterization of cardiac masses in an oncologic patient cohort with emphasis on their strengths and limitations and to present the benefit from using the novel technique called VPCT for this purpose.
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Affiliation(s)
- M Schulze
- Department of Diagnostic and Interventional Radiology
| | - D Spira
- Department of Diagnostic and Interventional Radiology
| | - CD Claussen
- Department of Diagnostic and Interventional Radiology
| | - A Sauter
- Department of Diagnostic and Interventional Radiology
| | - F Mayer
- Department of Internal Medicine-Oncology, Eberhard-Karls-University, Tübingen, Germany
| | - M Horger
- Department of Diagnostic and Interventional Radiology
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Spira D, Grünwald L, Vogel W, Sauter A, Spira SM, Claussen CD, Horger M. Die Volumen-Perfusions-CT (VPCT) erkennt Chemotherapie-induzierte Perfusionsänderungen bei Lymphomen in der Interim-Situation. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bendtsen TF, Soeballe K, Petersen EM, Moriggl B, Sauter A, Strid J, Boerglum J. Ultrasound Guided Single Injection Lumbosacral Plexus Blockade For Hip Surgery Anaesthesia. Br J Anaesth 2013. [DOI: 10.1093/bja/el_9982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Betz MJ, Hatiboglu N, Mauracher B, Hadaschik D, Sauter A, Demmelmair H, Koletzko B, Beuschlein F, Slawik M. Mc2 receptor knockdown modulates differentiation and lipid composition in adipocytes. Horm Metab Res 2012; 44:670-5. [PMID: 22723268 DOI: 10.1055/s-0032-1314854] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The melanocortin system is involved in central and peripheral regulation of energy homeostasis. In adipocytes, the melanocortin 2 receptor (MC2R) transmits ACTH-dependent signaling and its expression rises substantially during adipocyte differentiation. An in vitro system of retrovirally expressed shRNA directed against Mc2r mRNA in 3T3-L1 cells was established and effects of Mc2r knockdown (kd) in comparison to cells expressing non-targeting shRNA (control) were explored in differentiated adipocytes. Morphology, gene expression, lipolysis and fatty acid composition were analyzed. While gross morphology was unchanged extractable amount of lipids was reduced to 70-80% in kd cell lines (p<0.01). Moreover, expression changes of Pparγ2, aP2, and Pref1 indicated reduced differentiation in Mc2r kd cells. Intriguingly, not only ACTH, but also norepinephrine stimulated lipolysis were substantially reduced demonstrating functional significance of MC2R for general lipolysis pathway. Analysis of fatty acid composition in triglyceride and phospholipid fractions showed a lowered ratio of C16:1/C16:0 and C18:1/C18:0, but increased concentrations of arachidonic acid upon Mc2r knockdown. Reduction of mono-unsaturated fatty acids (MUFAs) was associated with lower expression of stearoyl-Coenzyme A desaturase 1 and 2 in kd cells (21 ± 8% vs. 100 ± 13%, p=0.01 and 32 ± 3% vs. 100 ± 15%, p=0.046). Conversely, high doses of ACTH resulted in gene expression changes, mirroring Mc2r knockdown (higher Pparγ2, Scd1, Hsl expression). MC2R plays an important role for regular lipolytic function and lipid composition in 3T3-L1 adipocytes. Of interest, desaturase expression was reduced and MUFA content accordingly altered in kd cells.
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Affiliation(s)
- M J Betz
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Munich, Germany
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Schulze M, Spira D, Sauter A, Claussen CD, Brechtel K, Horger M. CT basierte Volumenperfusion (VPCT) als neue Methode zur unmittelbaren Evaluation der TACE bei hepatozellulärem Karzinom (HCC). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kaufmann S, Thomas C, Sauter A, Spira D, Ketelsen D, Brodoefel H, Claussen CD, Heuschmid M. Dual-Energy-CT: Virtuell-native versus native CT-Bildgebung des Abdomens. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schultz JD, Stegmüller M, Faber A, Thorn C, Hörmann K, Nowack R, Sauter A. Complementary and Alternative Medications Consumed by Patients With Head and Neck Carcinoma: A Pilot Study in Germany. Nutr Cancer 2012; 64:377-85. [DOI: 10.1080/01635581.2012.655400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Schultz JD, Sommer JU, Hoedt S, Erben P, Hofheinz RD, Faber A, Thorn C, Hörmann K, Sauter A. Chemotherapeutic alteration of β-catenin and c-kit expression by imatinib in p16-positive squamous cell carcinoma compared to HPV-negative HNSCC cells in vitro. Oncol Rep 2011; 27:270-80. [PMID: 21993766 DOI: 10.3892/or.2011.1499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 09/01/2011] [Indexed: 11/06/2022] Open
Abstract
The most common neoplasm arising in the upper aerodigestive tract is head and neck squamous cell carcinoma (HNSCC). Tumor growth, invasion and systemic dissemination is a multistep process of dysregulated cellular signaling pathways and an altered cell-cell and cell-matrix interaction. Aberrant Wnt/β-catenin signaling is linked to tumor development and dissemination in several tumor entities. β-catenin is a multifunctional protein within the canonical Wnt pathway, which is an important factor for reducing cell-cell adhesion in malignant tissue and for triggering cell cycle progression and unscheduled proliferation. Another pivotal factor in carcinogenesis is the tyrosine kinase receptor c-kit, which in the case of dysregulated expression is associated with neoplastic transformation in epithelial tissue. This study evaluates the expression pattern of secreted and nuclear β-catenin and c-kit in p16-positive and HPV-negative squamous cell carcinomas (SCC) and the vulnerability of therapy with the tyrosine kinase inhibitor imatinib as a potential targeted treatment modality compared to platinum-based chemotherapeutic drugs. The different squamous tumor cell lines were incubated with increasing concentrations of carboplatin (3 or 7.5 µmol/ml) and imatinib (18 or 30 µmol/ml). ELISA and immunohistochemical methods were carried out after 48, 72, 120, 192 and 240 h. We detected a reliable trend towards significantly decreased cytosolic and nuclear β-catenin and c-kit expression levels in p16-positive SCC and non-HPV HNSCC cells induced by imatinib exposure for an extended incubation period, whereas platinum-based agents had no or, at best, a slight influence. Virus-transformed squamous cell carcinoma (CERV196) cells were characterized by a reduced susceptibility to an imatinib-altered β-catenin expression. Further studies are planned to investigate this observance in HPV-positive HNSCC in vitro. The implementation of a selective molecular therapy in established chemotherapeutic regimes may enhance the efficacy of platinum-based chemotherapy without increased toxicity and could thus improve the clinical outcome in HNSCC, irrespective of the HPV status.
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Affiliation(s)
- J D Schultz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
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