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Kellner E, Sekula P, Lipovsek J, Russe M, Horbach H, Schlett CL, Nauck M, Völzke H, Kroencke T, Bette S, Kauczor HU, Keil T, Pischon T, Heid IM, Peters A, Niendorf T, Lieb W, Bamberg F, Büchert M, Reichardt W, Reisert M, Köttgen A. Imaging Markers Derived From MRI-Based Automated Kidney Segmentation—an Analysis of Data From the German National Cohort (NAKO Gesundheitsstudie). Dtsch Arztebl Int 2024:arztebl.m2024.0040. [PMID: 38530931 DOI: 10.3238/arztebl.m2024.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Population-wide research on potential new imaging biomarkers of the kidney depends on accurate automated segmentation of the kidney and its compartments (cortex, medulla, and sinus). METHODS We developed a robust deep-learning framework for kidney (sub-)segmentation based on a hierarchical, three-dimensional convolutional neural network (CNN) that was optimized for multi-scale problems of combined localization and segmentation. We applied the CNN to abdominal magnetic resonance images from the population-based German National Cohort (NAKO) study. RESULTS There was good to excellent agreement between the model predictions and manual segmentations. The median values for the body-surface normalized total kidney, cortex, medulla, and sinus volumes of 9934 persons were 158, 115, 43, and 24 mL/m2. Distributions of these markers are provided both for the overall study population and for a subgroup of persons without kidney disease or any associated conditions. Multivariable adjusted regression analyses revealed that diabetes, male sex, and a higher estimated glomerular filtration rate (eGFR) are important predictors of higher total and cortical volumes. Each increase of eGFR by one unit (i.e., 1 mL/min per 1.73 m2 body surface area) was associated with a 0.98 mL/m2 increase in total kidney volume, and this association was significant. Volumes were lower in persons with eGFR-defined chronic kidney disease. CONCLUSION The extraction of image-based biomarkers through CNN-based renal sub-segmentation using data from a population-based study yields reliable results, forming a solid foundation for future investigations.
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Laohachewin D, Ruile P, Breitbart P, Minners J, Jander N, Soschynski M, Schlett CL, Neumann FJ, Westermann D, Hein M. Quantification of Aortic Valve Calcification in Contrast-Enhanced Computed Tomography. J Clin Med 2024; 13:2386. [PMID: 38673658 DOI: 10.3390/jcm13082386] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/09/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The goal of our study is to evaluate a method to quantify aortic valve calcification (AVC) in contrast-enhanced computed tomography for patients with suspected severe aortic stenosis pre-interventionally. Methods: A total of sixty-five patients with aortic stenosis underwent both a native and a contrast-enhanced computed tomography (CECT) scan of the aortic valve (45 in the training cohort and 20 in the validation cohort) using a standardized protocol. Aortic valve calcification was semi-automatically quantified via the Agatston score method for the native scans and was used as a reference. For contrast-enhanced computed tomography, a calcium threshold of the Hounsfield units of the aorta plus four times the standard deviation was used. Results: For the quantification of aortic valve calcification in contrast-enhanced computed tomography, a conversion formula (691 + 1.83 x AVCCECT) was derived via a linear regression model in the training cohort. The validation in the second cohort showed high agreement for this conversion formula with no significant proportional bias (Bland-Altman, p = 0.055) and with an intraclass correlation coefficient in the validation cohort of 0.915 (confidence interval 95% 0.786-0.966) p < 0.001. Conclusions: Calcium scoring in patients with aortic valve stenosis can be performed using contrast-enhanced computed tomography with high validity. Using a conversion factor led to an excellent agreement, thereby obviating an additional native computed tomography scan. This might contribute to a decrease in radiation exposure.
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Affiliation(s)
- Danai Laohachewin
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Philipp Ruile
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Philipp Breitbart
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Jan Minners
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Nikolaus Jander
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Franz-Josef Neumann
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
| | - Manuel Hein
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany
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Soschynski M, Capilli F, Taha Hagar M, Ruile P, Hein M, Benndorf M, Taron J, Schlett CL, Bamberg F, Krauss T. Ultrashort VIBE-Dixon versus Cine and late gadolinium enhancement MRI sequences for cardiac thrombus detection. Eur J Radiol 2024; 173:111360. [PMID: 38342061 DOI: 10.1016/j.ejrad.2024.111360] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE To determine the diagnostic accuracy of volumetric interpolated breath-hold examination sequences with fat suppression in Dixon technique (VIBE-Dixon) for cardiac thrombus detection. METHOD From our clinical database, we retrospectively identified consecutive patients between 2014 and 2022 who had definite diagnosis or exclusion of cardiac thrombus confirmed by an independent adjudication committee, serving as the reference standard. All patients received 2D-Cine plus 2D-Late-Gadolinium-Enhancement (Cine + LGE) and VIBE-Dixon sequences. Two blinded readers assessed all images for the presence of cardiac thrombus. The diagnostic accuracy of Cine + LGE and VIBE-Dixon was determined and compared. RESULTS Among 141 MRI studies (116 male, mean age: 61 years) mean image examination time was 28.8 ± 3.1 s for VIBE-Dixon and 23.3 ± 2.5 min for Cine + LGE. Cardiac thrombus was present in 49 patients (prevalence: 35 %). For both readers sensitivity for thrombus detection was significantly higher in VIBE-Dixon compared with Cine + LGE (Reader 1: 96 % vs.73 %, Reader 2: 96 % vs. 78 %, p < 0.01 for both readers), whereas specificity did not differ significantly (Reader 1: 96 % vs. 98 %, Reader 2: 92 % vs. 93 %, p > 0.1). Overall diagnostic accuracy of VIBE-Dixon was higher than for Cine + LGE (95 % vs. 89 %, p = 0.02) and was non-inferior to the reference standard (Delta ≤ 5 % with probability > 95 %). CONCLUSIONS Biplanar VIBE-Dixon sequences, acquired within a few seconds, provided a very high diagnostic accuracy for cardiac thrombus detection. They could be used as stand-alone sequences to rapidly screen for cardiac thrombus in patients not amenable to lengthy acquisition times.
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Affiliation(s)
- Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Fabio Capilli
- Department of Radiology, Neuroradiology and Nuclear Medicine, Medical Center Vest, Ruhr University Bochum, Recklinghausen, Dorstener Straße 151, 45657 Recklinghausen, Germany.
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Philipp Ruile
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Manuel Hein
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Matthias Benndorf
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
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4
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Hagar MT, Kluemper T, Hein M, von Zur Muhlen C, Faby S, Capilli F, Schuppert C, Schmitt R, Ruile P, Westermann D, Schlett CL, Bamberg F, Krauss T, Soschynski M. Photon-counting CT-angiography in pre-TAVR aortic annulus assessment: effects of retrospective vs. prospective ECG-synchronization on prosthesis valve selection. Int J Cardiovasc Imaging 2024; 40:811-820. [PMID: 38360986 DOI: 10.1007/s10554-024-03050-w] [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] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/07/2024] [Indexed: 02/17/2024]
Abstract
To compare the diagnostic value of ultrahigh-resolution CT-angiography (UHR-CTA) compared with high-pitch spiral CTA (HPS-CTA) using a first-generation, dual-source photon-counting CT (PCD-CT) scanner for preprocedural planning of transcatheter aortic valve replacement (TAVR). Clinically referred patients with severe aortic valve stenosis underwent both, retrospective ECG-gated cardiac UHR-CTA (collimation: 120 × 0.2 mm) and prospective ECG-triggered aortoiliac HPS-CTA (collimation: 144 × 0.4 mm, full spectral capabilities) for TAVR planning from August 2022 to March 2023. Radiation dose was extracted from the CT reports, and the effective dose was calculated. Two radiologists analyzed UHR-CTA and HPS-CTA datasets, assessing the image quality of the aortic annulus, with regard to the lumen visibility and margin delineation using a 4-point visual-grading scale (ranges: 4 = "excellent" to 1 = "poor"). Aortic annulus area (AAA) measurements were taken for valve prosthesis sizing, with retrospective UHR-CTA serving as reference standard. A total of 64 patients were included (mean age, 81 years ± 7 SD; 28 women) in this retrospective study. HPS-CTA showed a lower radiation dose, 4.1 mSv vs. 12.6 mSv (p < 0.001). UHR-CTA demonstrated higher image quality to HPS-CTA (median score, 4 [IQR, 3-4] vs. 3 [IQR, 2-3]; p < 0.001). Quantitative assessments of AAA from both CTA datasets were strongly positively correlated (mean 477.4 ± 91.1 mm2 on UHR-CTA and mean 476.5 ± 90.4 mm2 on HPS-CTA, Pearson r2 = 0.857, p < 0.001) with a mean error of 22.3 ± 24.6 mm2 and resulted in identical valve prosthesis sizing in the majority of patients (91%). Patients with lower image quality on HPS-CTA (score value 1 or 2, n = 28) were more likely to receive different sizing recommendations (82%). Both UHR-CTA and HPS-CTA acquisitions using photon-counting CT technology provided reliable aortic annular assessments for TAVR planning. While UHR-CTA offers superior image quality, HPS-CTA is associated with lower radiation exposure. However, severely impaired image quality on HPS-CTA may impact on prosthesis sizing, suggesting that immediate post-scan image evaluations may require complementary UHR-CTA scanning.
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Affiliation(s)
- Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Theresa Kluemper
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Manuel Hein
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Constantin von Zur Muhlen
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthineers AG, 91301, Forchheim, Germany
| | - Fabio Capilli
- Department of Radiology, Neuroradiology and Nuclear Medicine, Medical Center Vest, Ruhr University Bochum, Dorstener Straße 151, 45657, Recklinghausen, Germany
| | - Christopher Schuppert
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Ramona Schmitt
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Ruile
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
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5
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Maushagen J, Addin NS, Schuppert C, Ward-Caviness CK, Nattenmüller J, Adamski J, Peters A, Bamberg F, Schlett CL, Wang-Sattler R, Rospleszcz S. Serum metabolite signatures of cardiac function and morphology in individuals from a population-based cohort. Biomark Res 2024; 12:31. [PMID: 38444025 PMCID: PMC10916302 DOI: 10.1186/s40364-024-00578-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/24/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Changes in serum metabolites in individuals with altered cardiac function and morphology may exhibit information about cardiovascular disease (CVD) pathway dysregulations and potential CVD risk factors. We aimed to explore associations of cardiac function and morphology, evaluated using magnetic resonance imaging (MRI) with a large panel of serum metabolites. METHODS Cross-sectional data from CVD-free individuals from the population-based KORA cohort were analyzed. Associations between 3T-MRI-derived left ventricular (LV) function and morphology parameters (e.g., volumes, filling rates, wall thickness) and markers of carotid plaque with metabolite profile clusters and single metabolites as outcomes were assessed by adjusted multinomial logistic regression and linear regression models. RESULTS In 360 individuals (mean age 56.3 years; 41.9% female), 146 serum metabolites clustered into three distinct profiles that reflected high-, intermediate- and low-CVD risk. Higher stroke volume (relative risk ratio (RRR): 0.53, 95%-CI [0.37; 0.76], p-value < 0.001) and early diastolic filling rate (RRR: 0.51, 95%-CI [0.37; 0.71], p-value < 0.001) were most strongly protectively associated against the high-risk profile compared to the low-risk profile after adjusting for traditional CVD risk factors. Moreover, imaging markers were associated with 10 metabolites in linear regression. Notably, negative associations of stroke volume and early diastolic filling rate with acylcarnitine C5, and positive association of function parameters with lysophosphatidylcholines, diacylphosphatidylcholines, and acylalkylphosphatidylcholines were observed. Furthermore, there was a negative association of LV wall thickness with alanine, creatinine, and symmetric dimethylarginine. We found no significant associations with carotid plaque. CONCLUSIONS Serum metabolite signatures are associated with cardiac function and morphology even in individuals without a clinical indication of CVD.
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Affiliation(s)
- Juliane Maushagen
- Institute of Epidemiology, Helmholtz Munich, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Medical Faculty, Ludwig- Maximilians-Universität (LMU), München, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Nuha Shugaa Addin
- Institute of Epidemiology, Helmholtz Munich, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Medical Faculty, Ludwig- Maximilians-Universität (LMU), München, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Christopher Schuppert
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment, U.S. EPA, Chapel Hill, NC, USA
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Jerzy Adamski
- Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 8 Medical Drive, 117597, Singapore, Singapore
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Munich, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Medical Faculty, Ludwig- Maximilians-Universität (LMU), München, Germany
- German Center for Diabetes Research, DZD, Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK), Munich Heart Alliance, Munich, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Rui Wang-Sattler
- German Center for Diabetes Research, DZD, Neuherberg, Germany
- Institute of Translational Genomics, Helmholtz Munich, Neuherberg, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Munich, Neuherberg, Germany.
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Medical Faculty, Ludwig- Maximilians-Universität (LMU), München, Germany.
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.
- German Center for Cardiovascular Disease Research (DZHK), Munich Heart Alliance, Munich, Germany.
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Czerny M, Grabenwöger M, Berger T, Aboyans V, Della Corte A, Chen EP, Desai ND, Dumfarth J, Elefteriades JA, Etz CD, Kim KM, Kreibich M, Lescan M, Di Marco L, Martens A, Mestres CA, Milojevic M, Nienaber CA, Piffaretti G, Preventza O, Quintana E, Rylski B, Schlett CL, Schoenhoff F, Trimarchi S, Tsagakis K, Siepe M, Estrera AL, Bavaria JE, Pacini D, Okita Y, Evangelista A, Harrington KB, Kachroo P, Hughes GC. EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. Ann Thorac Surg 2024:S0003-4975(24)00077-8. [PMID: 38416090 DOI: 10.1016/j.athoracsur.2024.01.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Martin Czerny
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany; Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany.
| | - Martin Grabenwöger
- Department of Cardiovascular Surgery, Clinic Floridsdorf, Vienna, Austria; Medical Faculty, Sigmund Freud Private University, Vienna, Austria.
| | - Tim Berger
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany; Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Victor Aboyans
- Department of Cardiology, Dupuytren-2 University Hospital, Limoges, France; EpiMaCT, Inserm 1094 & IRD 270, Limoges University, Limoges, France
| | - Alessandro Della Corte
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy; Cardiac Surgery Unit, Monaldi Hospital, Naples, Italy
| | - Edward P Chen
- Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Nimesh D Desai
- Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julia Dumfarth
- University Clinic for Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - John A Elefteriades
- Aortic Institute at Yale New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
| | - Christian D Etz
- Department of Cardiac Surgery, University Medicine Rostock, University of Rostock, Rostock, Germany
| | - Karen M Kim
- Division of Cardiovascular and Thoracic Surgery, The University of Texas at Austin/Dell Medical School, Austin, Texas
| | - Maximilian Kreibich
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany; Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Mario Lescan
- Department of Thoracic and Cardiovascular Surgery, University Medical Centre Tübingen, Tübingen, Germany
| | - Luca Di Marco
- Cardiac Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andreas Martens
- Department of Cardiac Surgery, Klinikum Oldenburg, Oldenburg, Germany; The Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carlos A Mestres
- Department of Cardiothoracic Surgery and the Robert WM Frater Cardiovascular Research Centre, The University of the Free State, Bloemfontein, South Africa
| | - Milan Milojevic
- Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia
| | - Christoph A Nienaber
- Division of Cardiology at the Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Gabriele Piffaretti
- Vascular Surgery Department of Medicine and Surgery, University of Insubria School of Medicine, Varese, Italy
| | - Ourania Preventza
- Division of Cardiothoracic Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Eduard Quintana
- Department of Cardiovascular Surgery, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Bartosz Rylski
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany; Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Freiburg, Freiburg, Germany
| | - Florian Schoenhoff
- Department of Cardiac Surgery, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Santi Trimarchi
- Department of Cardiac Thoracic and Vascular Diseases, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Konstantinos Tsagakis
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Medicine Essen, Essen, Germany
| | - Matthias Siepe
- EACTS Review Coordinator; Department of Cardiac Surgery, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Anthony L Estrera
- STS Review Coordinator; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, Texas
| | - Joseph E Bavaria
- Department of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Davide Pacini
- Division of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna, Bologna, Italy
| | - Yutaka Okita
- Cardio-Aortic Center, Takatsuki General Hospital, Osaka, Japan
| | - Arturo Evangelista
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Vall d'Hebron Institut de Recerca, Barcelona, Spain; Biomedical Research Networking Center on Cardiovascular Diseases, Instituto de Salud Carlos III, Madrid, Spain; Departament of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Instituto del Corazón, Quirónsalud-Teknon, Barcelona, Spain
| | - Katherine B Harrington
- Department of Cardiothoracic Surgery, Baylor Scott and White The Heart Hospital, Plano, Texas
| | - Puja Kachroo
- Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Missouri
| | - G Chad Hughes
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Duke University, Durham, North Carolina
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7
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Czerny M, Grabenwöger M, Berger T, Aboyans V, Della Corte A, Chen EP, Desai ND, Dumfarth J, Elefteriades JA, Etz CD, Kim KM, Kreibich M, Lescan M, Di Marco L, Martens A, Mestres CA, Milojevic M, Nienaber CA, Piffaretti G, Preventza O, Quintana E, Rylski B, Schlett CL, Schoenhoff F, Trimarchi S, Tsagakis K. EACTS/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ. Eur J Cardiothorac Surg 2024; 65:ezad426. [PMID: 38408364 DOI: 10.1093/ejcts/ezad426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/15/2023] [Accepted: 12/19/2023] [Indexed: 02/28/2024] Open
Affiliation(s)
- Martin Czerny
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Martin Grabenwöger
- Department of Cardiovascular Surgery, Clinic Floridsdorf, Vienna, Austria
- Medical Faculty, Sigmund Freud Private University, Vienna, Austria
| | - Tim Berger
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Victor Aboyans
- Department of Cardiology, Dupuytren-2 University Hospital, Limoges, France
- EpiMaCT, Inserm 1094 & IRD 270, Limoges University, Limoges, France
| | - Alessandro Della Corte
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
- Cardiac Surgery Unit, Monaldi Hospital, Naples, Italy
| | - Edward P Chen
- Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Nimesh D Desai
- Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Julia Dumfarth
- University Clinic for Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - John A Elefteriades
- Aortic Institute at Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Christian D Etz
- Department of Cardiac Surgery, University Medicine Rostock, University of Rostock, Rostock, Germany
| | - Karen M Kim
- Division of Cardiovascular and Thoracic Surgery, The University of Texas at Austin/Dell Medical School, Austin, TX, USA
| | - Maximilian Kreibich
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Mario Lescan
- Department of Thoracic and Cardiovascular Surgery, University Medical Centre Tübingen, Tübingen, Germany
| | - Luca Di Marco
- Cardiac Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andreas Martens
- Department of Cardiac Surgery, Klinikum Oldenburg, Oldenburg, Germany
- The Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carlos A Mestres
- Department of Cardiothoracic Surgery and the Robert WM Frater Cardiovascular Research Centre, The University of the Free State, Bloemfontein, South Africa
| | - Milan Milojevic
- Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia
| | - Christoph A Nienaber
- Division of Cardiology at the Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Gabriele Piffaretti
- Vascular Surgery Department of Medicine and Surgery, University of Insubria School of Medicine, Varese, Italy
| | - Ourania Preventza
- Division of Cardiothoracic Surgery, Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | - Eduard Quintana
- Department of Cardiovascular Surgery, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Bartosz Rylski
- Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Freiburg, Freiburg, Germany
| | - Florian Schoenhoff
- Department of Cardiac Surgery, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Santi Trimarchi
- Department of Cardiac Thoracic and Vascular Diseases, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Konstantinos Tsagakis
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University Medicine Essen, Essen, Germany
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8
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Stoecklein VM, Grosu S, Nikolova T, Tonn JC, Zausinger S, Ricke J, Schlett CL, Maurer E, Walter SS, Peters A, Bamberg F, Rospleszcz S, Stoecklein S. Strong Association of Depression and Anxiety With the Presence of Back Pain While Impact of Spinal Imaging Findings is Limited: Analysis of an MRI Cohort Study. J Pain 2024; 25:497-507. [PMID: 37742905 DOI: 10.1016/j.jpain.2023.09.009] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
Development of back pain is multifactorial, and it is not well understood which factors are the main drivers of the disease. We therefore applied a machine-learning approach to an existing large cohort study data set and sought to identify and rank the most important contributors to the presence of back pain amongst the documented parameters of the cohort. Data from 399 participants in the KORA-MRI (Cooperative health research in the region Augsburg-magnetic resonance imaging) (Cooperative Health Research in the Region Augsburg) study was analyzed. The data set included MRI images of the whole body, including the spine, metabolic, sociodemographic, anthropometric, and cardiovascular data. The presence of back pain was one of the documented items in this data set. Applying a machine-learning approach to this preexisting data set, we sought to identify the variables that were most strongly associated with back pain. Mediation analysis was performed to evaluate the underlying mechanisms of the identified associations. We found that depression and anxiety were the 2 most selected predictors for back pain in our model. Additionally, body mass index, spinal canal width and disc generation, medium and heavy physical work as well as cardiovascular factors were among the top 10 most selected predictors. Using mediation analysis, we found that the effects of anxiety and depression on the presence of back pain were mainly direct effects that were not mediated by spinal imaging. In summary, we found that psychological factors were the most important predictors of back pain in our cohort. This supports the notion that back pain should be treated in a personalized multidimensional framework. PERSPECTIVE: This article presents a wholistic approach to the problem of back pain. We found that depression and anxiety were the top predictors of back pain in our cohort. This strengthens the case for a multidimensional treatment approach to back pain, possibly with a special emphasis on psychological factors.
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Affiliation(s)
- Veit M Stoecklein
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Sergio Grosu
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Trayana Nikolova
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | | | - Stefan Zausinger
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elke Maurer
- Department of Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Sven S Walter
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, LMU Munich, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany; German Center for Diabetes Research (DZD), Partner Site Neuherberg, Neuherberg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, LMU Munich, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Sophia Stoecklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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9
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Madrid J, Agarwal P, Müller-Peltzer K, Askani M, Benning L, Selig M, Diehl P, Kalbhenn J, Trummer G, Utzolino S, Wengenmayer T, Busch HJ, Stolz D, Rieg S, Panning M, Schlett CL, Bamberg F, Askani E. Vaccination protects against acute respiratory distress syndrome (ARDS) in hospitalized patients with COVID-19. Clin Exp Med 2024; 24:21. [PMID: 38280024 PMCID: PMC10822002 DOI: 10.1007/s10238-023-01293-w] [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: 12/28/2023] [Indexed: 01/29/2024]
Abstract
This study aimed to analyze the effect of COVID-19 vaccination on the occurrence of ARDS in hospitalized COVID-19 patients. The study population of this retrospective, single-center cohort study consisted of hospitalized COVID-19 patients with known vaccination status and chest computed tomography imaging between July 2021 and February 2022. The impact of vaccination on ARDS in COVID-19 patients was assessed through logistic regression adjusting for demographic differences and confounding factors with statistical differences determined using confidence intervals and effect sizes. A total of 167 patients (69% male, average age 58 years, 95% CI [55; 60], 42% fully vaccinated) were included in the data analysis. Vaccinated COVID-19 patients had a reduced relative risk (RR) of developing ARDS (RR: 0.40, 95% CI [0.21; 0.62]). Consequently, non-vaccinated hospitalized patients had a 2.5-fold higher probability of developing ARDS. This risk reduction persisted after adjusting for several confounding variables (RR: 0.64, 95% CI [0.29; 0.94]) in multivariate analysis. The protective effect of COVID-19 vaccination increased with ARDS severity (RR: 0.61, 95% CI [0.37; 0.92]). Particularly, patients under 60 years old were at risk for ARDS onset and seemed to benefit from COVID-19 vaccination (RR: 0.51, 95% CI [0.20; 0.90]). COVID-19 vaccination showed to reduce the risk of ARDS occurrence in hospitalized COVID-19 patients, with a particularly strong effect in patients under 60 years old and those with more severe ARDS.
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Affiliation(s)
- Julian Madrid
- Department of Cardiology, Pneumology, Angiology, Acute Geriatrics and Intensive Care, Ortenau Klinikum, Klostenstraße 19, 77933, Lahr/Schwarzwald, Germany.
| | - Prerana Agarwal
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Katharina Müller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Marvin Askani
- Department of Protestant Theology, Faculty of Theology, University of Heidelberg, Heidelberg, Germany
| | - Leo Benning
- University Emergency Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mischa Selig
- G.E.R.N. Research Center for Tissue Replacement, Regeneration and Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Diehl
- Department of Cardiology, Pneumology, Angiology, Acute Geriatrics and Intensive Care, Ortenau Klinikum, Klostenstraße 19, 77933, Lahr/Schwarzwald, Germany
| | - Johannes Kalbhenn
- Department of Anesthesiology and Intensive Care Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg Trummer
- Department of Cardiovascular Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Stefan Utzolino
- Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Wengenmayer
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans-Jörg Busch
- University Emergency Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daiana Stolz
- Clinic of Respiratory Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marcus Panning
- Institute of Virology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
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10
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Berger T, Maier A, Kletzer J, Schlett CL, Kondov S, Czerny M, Rylski B, Kreibich M. Radiographic complicated and uncomplicated descending aortic dissections: aortic morphological differences by CT angiography and risk factor analysis. Eur Heart J Cardiovasc Imaging 2024:jeae030. [PMID: 38269622 DOI: 10.1093/ehjci/jeae030] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE To identify radiographic differences between patients with uncomplicated and complicated descending aortic dissections. METHODS Between 04/2009 and 07/2021, 209 patients with acute descending aortic dissections were analyzed as complicated (malperfusion, rupture, diameter progress, and diameter ≥55mm) or uncomplicated. Detailed CTA measurements (slice thickness ≤ 3mm) were taken in multiplanar reconstruction. A composite endpoint (early aortic failure) was defined as reoperation, diameter progression, and early mortality. RESULTS Seventy-seven patients were female (36.8%) (complicated n=27 (36.5%); uncomplicated n=50 (37.0%) p=1.00). Seventy-four (35%) patients were categorized as morphologically complicated, and 135 (65%) as uncomplicated. In patients with complicated dissections, the dissection extended more frequently to the aortic bifurcation (p=0.044), the coeliac trunk (p=0.003), the superior mesenteric artery (p=0.007), and both iliac arteries (p<0.001) originated less frequently from the true lumen. The length of the most proximal communication (entry) in type B aortic dissection was longer, 14.0mm [12.0mm; 27.0mm] vs 6.0mm [4,0mm; 13.0mm] in complicated cases (p=0.005). Identified risk factors for adverse aortic events were connective tissue disease (HR 8.0 (1.9 - 33.7 95%CI HR)) length of the aortic arch (HR 4.7 (1.5 - 15.1 95%CI HR)) a false lumen diameter >19.38mm (HR 3.389 (1.1-10.2 95%CI HR) and origin of the inferior mesenteric artery from the false lumen (HR 4.2 (1.0 - 5.5 95%CI HR)). CONCLUSIONS We identified significant morphological differences and predictors for adverse events in patients presenting complicated and uncomplicated descending dissections. Our morphological findings will help guide future aortic therapies, taking a tailored patient approach.
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Affiliation(s)
- Tim Berger
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Annika Maier
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Joseph Kletzer
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Stoyan Kondov
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Martin Czerny
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Bartosz Rylski
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Maximilian Kreibich
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, University Medical Centre Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
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11
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Hagar MT, Soschynski M, Saffar R, Molina-Fuentes MF, Weiss J, Rau A, Schuppert C, Ruile P, Faby S, Schibilsky D, von Zur Muehlen C, Schlett CL, Bamberg F, Krauss T. Ultra-high-resolution photon-counting detector CT in evaluating coronary stent patency: a comparison to invasive coronary angiography. Eur Radiol 2024:10.1007/s00330-023-10516-3. [PMID: 38177617 DOI: 10.1007/s00330-023-10516-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES To determine the diagnostic accuracy of ultra-high-resolution photon-counting detector CT angiography (UHR PCD-CTA) for evaluating coronary stent patency compared to invasive coronary angiography (ICA). METHODS Consecutive, clinically referred patients with prior coronary stent implantation were prospectively enrolled between August 2022 and March 2023 and underwent UHR PCD-CTA (collimation, 120 × 0.2 mm). Two radiologists independently analyzed image quality of the in-stent lumen using a 5-point Likert scale, ranging from 1 ("excellent") to 5 ("non-diagnostic"), and assessed all coronary stents for the presence of in-stent stenosis (≥ 50% lumen narrowing). The diagnostic accuracy of UHR PCD-CTA was determined, with ICA serving as the standard of reference. RESULTS A total of 44 coronary stents in 18 participants (mean age, 83 years ± 6 [standard deviation]; 12 women) were included in the analysis. In 3/44 stents, both readers described image quality as non-diagnostic, whereas reader 2 noted a fourth stent to have non-diagnostic image quality. In comparison to ICA, UHR PCD-CTA demonstrated a sensitivity, specificity, and accuracy of 100% (95% CI [confidence interval] 47.8, 100), 92.3% (95% CI 79.1, 98.4), and 93.2% (95% CI 81.3, 98.6) for reader 1 and 100% (95% CI 47.8, 100), 87.2% (95% CI 72.6, 95.7), and 88.6% (95% CI 75.4, 96.2) for reader 2, respectively. Both readers observed a 100% negative predictive value (36/36 stents and 34/34 stents). Stent patency inter-reader agreement was 90.1%, corresponding to a substantial Cohen's kappa value of 0.72. CONCLUSIONS UHR PCD-CTA enables non-invasive assessment of coronary stent patency with high image quality and diagnostic accuracy. CLINICAL RELEVANCE STATEMENT Ultra-high-resolution photon-counting detector CT angiography represents a reliable and non-invasive method for assessing coronary stent patency. Its high negative predictive value makes it a promising alternative over invasive coronary angiography for the rule-out of in-stent stenosis. KEY POINTS • CT-based evaluation of coronary stent patency is limited by stent-induced artifacts and spatial resolution. • Ultra-high-resolution photon-counting detector CT accurately evaluates coronary stent patency compared to invasive coronary angiography. • Photon-counting detector CT represents a promising method for the non-invasive rule-out of in-stent stenosis.
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Affiliation(s)
- Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany.
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Ruben Saffar
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Moisés Felipe Molina-Fuentes
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Jakob Weiss
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Alexander Rau
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Christopher Schuppert
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Philipp Ruile
- Department of Cardiology, Faculty of Medicine, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Freiburg, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthcare GmbH, Forchheim, 91301, Germany
| | - David Schibilsky
- Department of Cardiac and Vascular Surgery, Freiburg University, Freiburg, Germany
| | - Constantin von Zur Muehlen
- Department of Cardiology, Faculty of Medicine, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Straße 55, Freiburg im Breisgau, 79106, Germany
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12
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Hagen F, Soschynski M, Weis M, Hagar MT, Krumm P, Ayx I, Taron J, Krauss T, Hein M, Ruile P, von Zur Muehlen C, Schlett CL, Neubauer J, Tsiflikas I, Russe MF, Arnold P, Faby S, Froelich MF, Weiß J, Stein T, Overhoff D, Bongers M, Nikolaou K, Schönberg SO, Bamberg F, Horger M. Photon-counting computed tomography - clinical application in oncological, cardiovascular, and pediatric radiology. ROFO-FORTSCHR RONTG 2024; 196:25-35. [PMID: 37793417 DOI: 10.1055/a-2119-5802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Photon-counting detector computed tomography (PCD-CT) is a promising new technology with the potential to fundamentally change workflows in the daily routine and provide new quantitative imaging information to improve clinical decision-making and patient management. METHOD The contents of this review are based on an unrestricted literature search of PubMed and Google Scholar using the search terms "photon-counting CT", "photon-counting detector", "spectral CT", "computed tomography" as well as on the authors' own experience. RESULTS The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCD-CT allows for the counting of every single photon at the detector level. Based on the identified literature, PCD-CT phantom measurements and initial clinical studies have demonstrated that the new technology allows for improved spatial resolution, reduced image noise, and new possibilities for advanced quantitative image postprocessing. CONCLUSION For clinical practice, the potential benefits include fewer beam hardening artifacts, a radiation dose reduction, and the use of new or combinations of contrast agents. In particular, critical patient groups such as oncological, cardiovascular, lung, and head & neck as well as pediatric patient collectives benefit from the clinical advantages. KEY POINTS · Photon-counting computed tomography (PCD-CT) is being used for the first time in routine clinical practice, enabling a significant dose reduction in critical patient populations such as oncology, cardiology, and pediatrics.. · Compared to conventional CT, PCD-CT enables a reduction in electronic image noise.. · Due to the spectral data sets, PCD-CT enables fully comprehensive post-processing applications.. CITATION FORMAT · Hagen F, Soschynski M, Weis M et al. Photon-counting computed tomography - clinical application in oncological, cardiovascular, and pediatric radiology. Fortschr Röntgenstr 2024; 196: 25 - 34.
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Affiliation(s)
- Florian Hagen
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Meike Weis
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Patrick Krumm
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Isabelle Ayx
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Manuel Hein
- Department of Cardiology & Angiology, University Heart Center Freiburg - Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
| | - Philipp Ruile
- Department of Cardiology & Angiology, University Heart Center Freiburg - Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
| | - Constantin von Zur Muehlen
- Department of Cardiology & Angiology, University Heart Center Freiburg - Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob Neubauer
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ilias Tsiflikas
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Arnold
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
| | - Matthias F Froelich
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jakob Weiß
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Stein
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daniel Overhoff
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Malte Bongers
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Stefan O Schönberg
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
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13
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Schuppert C, Rospleszcz S, Hirsch JG, Hoinkiss DC, Köhn A, von Krüchten R, Russe MF, Keil T, Krist L, Schmidt B, Michels KB, Schipf S, Brenner H, Kröncke TJ, Pischon T, Niendorf T, Schulz-Menger J, Forsting M, Völzke H, Hosten N, Bülow R, Zaitsev M, Kauczor HU, Bamberg F, Günther M, Schlett CL. Automated image quality assessment for selecting among multiple magnetic resonance image acquisitions in the German National Cohort study. Sci Rep 2023; 13:22745. [PMID: 38123791 PMCID: PMC10733361 DOI: 10.1038/s41598-023-49569-1] [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: 07/05/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
In magnetic resonance imaging (MRI), the perception of substandard image quality may prompt repetition of the respective image acquisition protocol. Subsequently selecting the preferred high-quality image data from a series of acquisitions can be challenging. An automated workflow may facilitate and improve this selection. We therefore aimed to investigate the applicability of an automated image quality assessment for the prediction of the subjectively preferred image acquisition. Our analysis included data from 11,347 participants with whole-body MRI examinations performed as part of the ongoing prospective multi-center German National Cohort (NAKO) study. Trained radiologic technologists repeated any of the twelve examination protocols due to induced setup errors and/or subjectively unsatisfactory image quality and chose a preferred acquisition from the resultant series. Up to 11 quantitative image quality parameters were automatically derived from all acquisitions. Regularized regression and standard estimates of diagnostic accuracy were calculated. Controlling for setup variations in 2342 series of two or more acquisitions, technologists preferred the repetition over the initial acquisition in 1116 of 1396 series in which the initial setup was retained (79.9%, range across protocols: 73-100%). Image quality parameters then commonly showed statistically significant differences between chosen and discarded acquisitions. In regularized regression across all protocols, 'structured noise maximum' was the strongest predictor for the technologists' choice, followed by 'N/2 ghosting average'. Combinations of the automatically derived parameters provided an area under the ROC curve between 0.51 and 0.74 for the prediction of the technologists' choice. It is concluded that automated image quality assessment can, despite considerable performance differences between protocols and anatomical regions, contribute substantially to identifying the subjective preference in a series of MRI acquisitions and thus provide effective decision support to readers.
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Affiliation(s)
- Christopher Schuppert
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Susanne Rospleszcz
- Chair of Epidemiology, Institute of Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilians University, Faculty of Medicine, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Jochen G Hirsch
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | | | - Alexander Köhn
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Maximilian F Russe
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Thomas Keil
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karin B Michels
- Institute for Prevention and Cancer Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabine Schipf
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Thomas J Kröncke
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, University of Augsburg, Augsburg, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Biobank Technology Platform, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Jeanette Schulz-Menger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- Department of Cardiology and Nephrology, HELIOS Hospital Berlin-Buch, Berlin, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Maxim Zaitsev
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Matthias Günther
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
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14
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Pichotka MP, Weigt M, Shah MJ, Russe MF, Stein T, Billoud T, Beck J, Straehle J, Schlett CL, Elverfeldt DV, Reisert M. Pilot study on high-resolution radiological methods for the analysis of cerebrospinal fluid (CSF) shunt valves. Z Med Phys 2023:S0939-3889(23)00146-0. [PMID: 38104007 DOI: 10.1016/j.zemedi.2023.11.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Despite their life-saving capabilities, cerebrospinal fluid (CSF) shunts exhibit high failure rates, with a large fraction of failures attributed to the regulating valve. Due to a lack of methods for the detailed analysis of valve malfunctions, failure mechanisms are not well understood, and valves often have to be surgically explanted on the mere suspicion of malfunction. The presented pilot study aims to demonstrate radiological methods for comprehensive analysis of CSF shunt valves, considering both the potential for failure analysis in design optimization, and for future clinical in-vivo application to reduce the number of required shunt revision surgeries. The proposed method could also be utilized to develop and support in situ repair methods (e.g. by lysis or ultrasound) of malfunctioning CSF shunt valves. MATERIALS AND METHODS The primary methods described are contrast-enhanced radiographic time series of CSF shunt valves, taken in a favorable projection geometry at low radiation dose, and the machine-learning-based diagnosis of CSF shunt valve obstructions. Complimentarily, we investigate CT-based methods capable of providing accurate ground truth for the training of such diagnostic tools. Using simulated test and training data, the performance of the machine-learning diagnostics in identifying and localizing obstructions within a shunt valve is evaluated regarding per-pixel sensitivity and specificity, the Dice similarity coefficient, and the false positive rate in the case of obstruction free test samples. RESULTS Contrast enhanced subtraction radiography allows high-resolution, time-resolved, low-dose analysis of fluid transport in CSF shunt valves. Complementarily, photon-counting micro-CT allows to investigate valve obstruction mechanisms in detail, and to generate valid ground truth for machine learning-based diagnostics. Machine-learning-based detection of valve obstructions in simulated radiographies shows promising results, with a per-pixel sensitivity >70%, per-pixel specificity >90%, a median Dice coefficient >0.8 and <10% false positives at a detection threshold of 0.5. CONCLUSIONS This ex-vivo study demonstrates obstruction detection in cerebro-spinal fluid shunt valves, combining radiological methods with machine learning under conditions compatible to future in-vivo application. Results indicate that high-resolution contrast-enhanced subtraction radiography, possibly including time-series data, combined with machine-learning image analysis, has the potential to strongly improve the diagnostics of CSF shunt valve failures. The presented method is in principle suitable for in-vivo application, considering both measurement geometry and radiological dose. Further research is needed to validate these results on real-world data and to refine the employed methods. In combination, the presented methods enable comprehensive analysis of valve failure mechanisms, paving the way for improved product development and clinical diagnostics of CSF shunt valves.
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Affiliation(s)
- Martin P Pichotka
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Moritz Weigt
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mukesch J Shah
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian F Russe
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Stein
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - T Billoud
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob Straehle
- Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominik V Elverfeldt
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Department of Stereotactic and Functional Neurosurgery, Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center of the University of Freiburg, Medical Faculty of the University of Freiburg, Germany
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15
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Soschynski M, Hein M, Capilli F, Hagar MT, Ruile P, Breitbart P, Westermann D, Taron J, Schuppert C, Schlett CL, Bamberg F, Krauss T. Investigation of factors determining haemodynamic relevance of leaflet thrombosis after transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging 2023; 24:1672-1681. [PMID: 37409579 DOI: 10.1093/ehjci/jead156] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/20/2023] [Accepted: 06/25/2023] [Indexed: 07/07/2023] Open
Abstract
AIMS To determine the conditions under which early hypoattenuated leaflet thickening (HALT) after transcatheter aortic valve implantation (TAVI) becomes haemodynamically relevant. METHODS AND RESULTS The study included 100 patients (age: 81.5 ± 5.5 years; female 63%), thereof 50 patients with HALT. After anonymization and randomization, blinded readers measured maximum thrombus thickness per prosthesis (MT_pr) and movement restriction (MR_pr) on electrocardiogram (ECG)-gated whole heart cycle computed tomography angiography. These measurements were compared with echocardiographic mean pressure gradient (mPG), its increase from baseline (ΔmPG), and Doppler velocity index (DVI). Haemodynamic valve deterioration (HVD) was defined as mPG > 20 mmHg. Age, body mass index, valve type, valve size, left ventricular ejection fraction, and atrial fibrillation were considered as influencing factors. Multiple regression analysis revealed that only valve size (P = 0.001) and MT_pr (P = 0.02) had a significant influence on mPG. In an interaction model, valve size moderated the effect of MT_pr on mPG significantly (P = 0.004). Sub-group analysis stratified by valve sizes showed a strong correlation between MT_pr and echocardiographic parameters for 23 mm valves (mPG: r = 0.57, ΔmPG: r = 0.68, DVI: r = 0.55, each with P < 0.001), but neither for 26 nor 29 mm valves (r < 0.2, P > 0.2 for all correlations). Six of seven prostheses with HVD had a 23 mm valve diameter, while one had 29 mm (P = 0.02). CONCLUSION Early HALT rarely causes significant mPG increase. Our study shows that valve size is a key factor influencing the haemodynamic impact of HALT. In small valve sizes, mPG is more likely to increase. Our study is the first to offer in vivo evidence supporting previous in vitro findings on this topic.
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Affiliation(s)
- Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Manuel Hein
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Fabio Capilli
- Department of Radiology, Neuroradiology and Nuclear Medicine, Medical Center Vest, Ruhr University Bochum, Dorstener Straße 151, 45657 Recklinghausen, Germany
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Philipp Ruile
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Philipp Breitbart
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
- Cardiac MR PET CT Program, Massachusetts General-Hospital-Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
| | - Christopher Schuppert
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
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16
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Niedermayer F, Su Y, von Krüchten R, Thorand B, Peters A, Rathmann W, Roden M, Schlett CL, Bamberg F, Nattenmüller J, Rospleszcz S. Trajectories of glycaemic traits exhibit sex-specific associations with hepatic iron and fat content: Results from the KORA-MRI study. Liver Int 2023; 43:2153-2166. [PMID: 37269169 DOI: 10.1111/liv.15635] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/05/2023] [Accepted: 05/25/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) represents a major disease burden in the population. While the bidirectional association between NAFLD and diabetes is established, little is known about the association of hepatic iron content and glycaemia. Moreover, analyses of sex-specific effects and of dynamic changes in glycaemia are scarce. METHODS We investigated 7-year sex-specific trajectories of glycaemia and related traits (HbA1c, fasting glucose, fasting insulin, HOMA-IR, 2-h glucose and cross-sectional 2-h insulin) in a sample from a population-based cohort (N = 365; 41.1% female). Hepatic iron and fat content were assessed by 3T-Magnetic Resonance Imaging (MRI). Two-step multi-level models adjusted for glucose-lowering medication and confounders were applied. RESULTS In women and men, markers of glucose metabolism correlated with hepatic iron and fat content. Deterioration of glycaemia was associated with increased hepatic iron content in men (normoglycaemia to prediabetes: beta = 2.21 s-1 , 95% CI [0.47, 3.95]). Additionally, deterioration of glycaemia (e.g. prediabetes to diabetes: 1.27 log(%), [0.84, 1.70]) and trajectories of glucose, insulin and HOMA-IR were significantly associated with hepatic fat content in men. Similarly, deterioration of glycaemia as well as trajectories of glucose, insulin and HOMA-IR was significantly associated with increased hepatic fat content in women (e.g. trajectory of fasting insulin: 0.63 log(%), [0.36, 0.90]). CONCLUSIONS Unfavourable 7-year trajectories of markers of glucose metabolism are associated with increased hepatic fat content, particularly in women, whereas the association with hepatic iron content was less clear. Monitoring changes of glycaemia in the sub-diabetic range might enable early identification of hepatic iron overload and steatosis.
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Affiliation(s)
- Fiona Niedermayer
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU München, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Yaqi Su
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU München, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Annette Peters
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU München, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK), Munich Heart Alliance, Munich, Germany
| | - Wolfgang Rathmann
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU München, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK), Munich Heart Alliance, Munich, Germany
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17
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Stein T, Taron J, Verloh N, Doppler M, Rau A, Hagar MT, Faby S, Baltas D, Westermann D, Ayx I, Schönberg SO, Nikolaou K, Schlett CL, Bamberg F, Weiss J. Photon-counting computed tomography of coronary and peripheral artery stents: a phantom study. Sci Rep 2023; 13:14806. [PMID: 37684412 PMCID: PMC10491813 DOI: 10.1038/s41598-023-41854-3] [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: 06/02/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Accurate small vessel stent visualization using CT remains challenging. Photon-counting CT (PCD-CT) may help to overcome this issue. We systematically investigate PCD-CT impact on small vessel stent assessment compared to energy-integrating-CT (EID). 12 water-contrast agent filled stents (3.0-8 mm) were scanned with patient-equivalent phantom using clinical PCD-CT and EID-CT. Images were reconstructed using dedicated vascular kernels. Subjective image quality was evaluated by 5 radiologists independently (5-point Likert-scale; 5 = excellent). Objective image quality was evaluated by calculating multi-row intensity profiles including edge rise slope (ERS) and coefficient-of-variation (CV). Highest overall reading scores were found for PCD-CT-Bv56 (3.6[3.3-4.3]). In pairwise comparison, differences were significant for PCD-CT-Bv56 vs. EID-CT-Bv40 (p ≤ 0.04), for sharpness and blooming respectively (all p < 0.05). Highest diagnostic confidence was found for PCD-CT-Bv56 (p ≤ 0.2). ANOVA revealed a significant effect of kernel strength on ERS (p < 0.001). CV decreased with stronger PCD-CT kernels, reaching its lowest in PCD-CT-Bv56 and highest in EID-CT reconstruction (p ≤ 0.05). We are the first study to verify, by phantom setup adapted to real patient settings, PCD-CT with a sharp vascular kernel provides the most favorable image quality for small vessel stent imaging. PCD-CT may reduce the number of invasive coronary angiograms, however, more studies needed to apply our results in clinical practice.
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Affiliation(s)
- Thomas Stein
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Niklas Verloh
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Doppler
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Rau
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
| | - Dimos Baltas
- Division of Medical Physics, Department of Radiation Oncology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, Interdisciplinary Vascular Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Isabelle Ayx
- Department of Radiology and Nuclear Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefan O Schönberg
- Department of Radiology and Nuclear Medicine, Medical Faculty Mannheim, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob Weiss
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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18
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Hagar MT, Soschynski M, Benndorf M, Stein T, Taron J, Schlett CL, Bamberg F, Krauss T. Enhancing Radiation Dose Efficiency in Prospective ECG-Triggered Coronary CT Angiography Using Calcium-Scoring CT. Diagnostics (Basel) 2023; 13:2062. [PMID: 37370957 DOI: 10.3390/diagnostics13122062] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND This study investigates whether the scan length adjustment of prospectively ECG-triggered coronary CT angiography (CCTA) using calcium-scoring CT (CAS-CT) images can reduce overall radiation doses. METHODS A retrospective analysis was conducted on 182 patients who underwent CAS-CT and prospectively ECG-triggered CCTA using a second-generation Dual-Source CT scanner. CCTA planning was based on CAS-CT images, for which simulated scout view planning was performed for comparison. Effective doses were compared between two scenarios: Scenario 1-CAS-CT-derived CCTA + CAS-CT and Scenario 2-scout-view-derived CCTA without CAS-CT. Dose differences were further analyzed with respect to scan mode and body mass index. RESULTS Planning CCTA using CAS-CT led to a shorter scan length than planning via scout view (114.3 ± 9.7 mm vs. 133.7 ± 13.2 mm, p < 0.001). The whole-examination effective dose was slightly lower for Scenario 1 (3.2 [1.8-5.3] mSv vs. 3.4 [1.5-5.9] mSv; p < 0.001, n = 182). Notably, Scenario 1 resulted in a significantly lower radiation dose for sequential scans and obese patients. Only high-pitch spiral CCTA showed dose reduction in Scenario 2. CONCLUSIONS Using CAS-CT for planning prospectively ECG-triggered CCTA reduced the overall radiation dose administered compared to scout view planning without CAS-CT, except for high-pitch spiral CCTA, where a slightly opposite effect was observed.
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Affiliation(s)
- Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
| | - Matthias Benndorf
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Faculty OWL, University of Bielefeld, Klinikum Lippe, 32756 Detmold, Germany
| | - Thomas Stein
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany
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Mueller-Peltzer K, von Krüchten R, Lorbeer R, Rospleszcz S, Schulz H, Peters A, Bamberg F, Schlett CL, Mujaj B. Adipose tissue is associated with kidney function parameters. Sci Rep 2023; 13:9151. [PMID: 37280396 DOI: 10.1038/s41598-023-36390-z] [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] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/02/2023] [Indexed: 06/08/2023] Open
Abstract
Obesity is characterized by the accumulation of adipose tissue in different body compartments. Whether adipose tissue directly affects kidney function is still unknown. We aimed to investigate the role of the adipose tissue and circulating creatinine, cystatin C and kidney function in subjects free of cardio-renal diseases. In the KORA-MRI population-based study, 377 subjects (mean age 56.2 ± 9.2 years; 41.6% female) underwent whole-body 3T-MRI examination. Adipose tissue defined as visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were quantified from T1-DIXON sequence using a semi-automatic algorithm. Serum creatinine and cystatin C were measured using standard laboratory and estimated glomerular filtration rate (e-GFR) was performed based on creatinine (e-GFRcrea), cystatin C (e-GFRcys) and creatinine-cystatin C (e-GFRcc). Linear regression analysis, adjusted for risk factors, was used to investigate the relationship between adipose tissue and circulating creatinine, cystatin C, and kidney function. In multivariate analyses VAT was inversely associated with eGFRcys (ß = - 4.88, p = < 0.001), and positively associated with serum cystatin C (ß = 0.05, p = < 0.001), respectively. No association was found between other adipose parameters such as total adipose tissue (TAT) and subcutaneous adipose tissue (SAT) and serum creatinine, urine microalbumin and eGFRcrea. Stratified analyses according to BMI revealed confirmatory results for category of BMI > 30. VAT is positively associated with serum cystatin C and inversely with eGFR based on cystatin C, suggesting a direct involvement of visceral adipose tissue in increased metabolism of cystatin C and consequently decreased kidney function.
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Affiliation(s)
- Katharina Mueller-Peltzer
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - Susanne Rospleszcz
- Chair of Epidemiology, Medical Faculty, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munchen, Germany
| | - Holger Schulz
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - Annette Peters
- Chair of Epidemiology, Medical Faculty, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munchen, Germany
- German Center for Diabetes Research, München-Neuherberg, Neuherberg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Blerim Mujaj
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
- General Practice, Huisartsenpraktijk, Bremtstraat 116, 9320, Aalst, Belgium.
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Hagar MT, Soschynski M, Saffar R, Rau A, Taron J, Weiss J, Stein T, Faby S, von Zur Muehlen C, Ruile P, Schlett CL, Bamberg F, Krauss T. Accuracy of Ultrahigh-Resolution Photon-counting CT for Detecting Coronary Artery Disease in a High-Risk Population. Radiology 2023; 307:e223305. [PMID: 37338354 DOI: 10.1148/radiol.223305] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background Recently introduced photon-counting CT may improve noninvasive assessment of patients with high risk for coronary artery disease (CAD). Purpose To determine the diagnostic accuracy of ultrahigh-resolution (UHR) coronary CT angiography (CCTA) in the detection of CAD compared with the reference standard of invasive coronary angiography (ICA). Materials and Methods In this prospective study, participants with severe aortic valve stenosis and clinically indicated CT for transcatheter aortic valve replacement planning were consecutively enrolled from August 2022 to February 2023. All participants were examined with a dual-source photon-counting CT scanner using a retrospective electrocardiography-gated contrast-enhanced UHR scanning protocol (tube voltage, 120 or 140 kV; collimation, 120 × 0.2 mm; 100 mL of iopromid; no spectral information). Subjects underwent ICA as part of their clinical routine. A consensus assessment of image quality (five-point Likert scale: 1 = excellent [absence of artifacts], 5 = nondiagnostic [severe artifacts]) and a blinded independent reading for the presence of CAD (stenosis ≥50%) were performed. UHR CCTA was compared with ICA using area under the receiver operating characteristic curve (AUC). Results Among 68 participants (mean age, 81 years ± 7 [SD]; 32 male, 36 female), the prevalence of CAD and prior stent placement was 35% and 22%, respectively. The overall image quality was excellent (median score, 1.5 [IQR, 1.3-2.0]). The AUC of UHR CCTA in the detection of CAD was 0.93 per participant (95% CI: 0.86, 0.99), 0.94 per vessel (95% CI: 0.91, 0.98), and 0.92 per segment (95% CI: 0.87, 0.97). Sensitivity, specificity, and accuracy, respectively, were 96%, 84%, and 88% per participant (n = 68); 89%, 91%, and 91% per vessel (n = 204); and 77%, 95%, and 95% per segment (n = 965). Conclusion UHR photon-counting CCTA provided high diagnostic accuracy in the detection of CAD in a high-risk population, including subjects with severe coronary calcification or prior stent placement. Published under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Williams and Newby in this issue.
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Affiliation(s)
- Muhammad Taha Hagar
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Martin Soschynski
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Ruben Saffar
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Alexander Rau
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Jana Taron
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Jakob Weiss
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Thomas Stein
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Sebastian Faby
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Constantin von Zur Muehlen
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Philipp Ruile
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Christopher L Schlett
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Fabian Bamberg
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
| | - Tobias Krauss
- From the Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg im Breisgau, Germany (M.T.H., M.S., R.S., A.R., J.T., J.W., T.S., C.L.S., F.B., T.K.); Department of Cardiology, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany (C.v.z.M., P.R.); and Department of Computed Tomography, Siemens Healthcare, Forchheim, Germany (S.F.)
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Rau S, Soschynski M, Schlett CL, Hagar MT. Spectral aortoiliac photon-counting CT angiography with minimal quantity of contrast agent. Radiol Case Rep 2023; 18:2180-2182. [PMID: 37101893 PMCID: PMC10123373 DOI: 10.1016/j.radcr.2023.01.066] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 04/28/2023] Open
Abstract
The incidence of vascular and especially aortic pathologies is increasing, which leads to a higher frequency of vascular imaging. As renal pathologies also become more frequent, especially in an aging population, the need for effective preventative scan protocols with reduced contrast material is pressing. An 81-year-old female patient in our institution required a follow-up imaging of an incidental, asymptomatic abdominal aortic aneurysm. Although the patient was suffering from incipient chronic renal failure, a contrast-enhanced aortoiliac computed tomography angiography was performed using a first generation, clinical photon-counting detector computed tomography scanner. This scanner allows a modified scan protocol with a significant reduction of contrast agent while preserving diagnostic confidence. Technically, this is feasible by dual-source spectral image acquisition and dynamic monochromatic reconstruction near the K-edge of Iodine without loss of temporal or spatial resolution. The results are promising, allowing vascular imaging with significantly less risk of renal damage. In this regard, further research into optimal scan-protocols and post-processing is needed.
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Affiliation(s)
- Stephan Rau
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
- Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
- Corresponding author.
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
- Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
- Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
| | - Muhammad T. Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
- Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
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Haueise T, Schick F, Stefan N, Schlett CL, Weiss JB, Nattenmüller J, Göbel-Guéniot K, Norajitra T, Nonnenmacher T, Kauczor HU, Maier-Hein KH, Niendorf T, Pischon T, Jöckel KH, Umutlu L, Peters A, Rospleszcz S, Kröncke T, Hosten N, Völzke H, Krist L, Willich SN, Bamberg F, Machann J. Analysis of volume and topography of adipose tissue in the trunk: Results of MRI of 11,141 participants in the German National Cohort. Sci Adv 2023; 9:eadd0433. [PMID: 37172093 PMCID: PMC10181183 DOI: 10.1126/sciadv.add0433] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This research addresses the assessment of adipose tissue (AT) and spatial distribution of visceral (VAT) and subcutaneous fat (SAT) in the trunk from standardized magnetic resonance imaging at 3 T, thereby demonstrating the feasibility of deep learning (DL)-based image segmentation in a large population-based cohort in Germany (five sites). Volume and distribution of AT play an essential role in the pathogenesis of insulin resistance, a risk factor of developing metabolic/cardiovascular diseases. Cross-validated training of the DL-segmentation model led to a mean Dice similarity coefficient of >0.94, corresponding to a mean absolute volume deviation of about 22 ml. SAT is significantly increased in women compared to men, whereas VAT is increased in males. Spatial distribution shows age- and body mass index-related displacements. DL-based image segmentation provides robust and fast quantification of AT (≈15 s per dataset versus 3 to 4 hours for manual processing) and assessment of its spatial distribution from magnetic resonance images in large cohort studies.
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Affiliation(s)
- Tobias Haueise
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD), Tuebingen, Germany
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Fritz Schick
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD), Tuebingen, Germany
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Norbert Stefan
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD), Tuebingen, Germany
- Department of Internal Medicine, Division of Diabetology, Endocrinology and Nephrology, Eberhard-Karls University Tuebingen, Tuebingen, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob B Weiss
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johanna Nattenmüller
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Katharina Göbel-Guéniot
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Norajitra
- Division of Medical and Biological Informatics, German Cancer Research Center, Heidelberg, Germany
| | - Tobias Nonnenmacher
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Klaus H Maier-Hein
- Division of Medical Image Computing, German Cancer Research Center, Heidelberg, Germany
- Pattern Analysis and Learning Group, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Experimental and Clinical Research Center, A Joint Cooperation Between the Charité Medical Faculty and the Max-Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Core Facility Biobank, Berlin, Germany
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Annette Peters
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
- German Center for Diabetes Research (DZD), Partner Site Neuherberg, Neuherberg, Germany
| | - Susanne Rospleszcz
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Thomas Kröncke
- Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Centre for Advanced Analytics and Predictive Sciences (CAAPS), University Augsburg, Augsburg, Germany
| | - Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Juergen Machann
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD), Tuebingen, Germany
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
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Schlett CL. Kommentar zu HERZ THORAX – Bauchmuskelmasse und kardiovaskuläre Ereignisse. ROFO-FORTSCHR RONTG 2023; 195:367. [PMID: 37100068 DOI: 10.1055/a-2018-1327] [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: 04/28/2023]
Affiliation(s)
- Christopher L Schlett
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Freiburg, Germany
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Askani E, Mueller-Peltzer K, Madrid J, Knoke M, Hasic D, Schlett CL, Bamberg F, Agarwal P. Pulmonary computed tomographic manifestations of COVID-19 in vaccinated and non-vaccinated patients. Sci Rep 2023; 13:6884. [PMID: 37105996 PMCID: PMC10134716 DOI: 10.1038/s41598-023-33942-1] [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] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/21/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to analyze computed tomographic (CT) imaging features of vaccinated and non-vaccinated COVID-19 patients. The study population of this retrospective single-center cohort study consisted of hospitalized COVID-19 patients who received a chest CT at the study site between July 2021 and February 2022. Qualitative scoring systems (RSNA, CO-RADS, COV-RADS), imaging pattern analysis and semi-quantitative scoring of lung changes were assessed. 105 patients (70,47% male, 62.1 ± 16.79 years, 53.3% fully vaccinated) were included in the data analysis. A significant association between vaccination status and the presence of the crazy-paving pattern was observed in univariate analysis and persisted after step-wise adjustment for possible confounders in multivariate analysis (RR: 2.19, 95% CI: [1.23, 2.62], P = 0.024). Scoring systems for probability assessment of the presence of COVID-19 infection showed a significant correlation with the vaccination status in univariate analysis; however, the associations were attenuated after adjustment for virus variant and stage of infection. Semi-quantitative assessment of lung changes due to COVID-19 infection revealed no association with vaccination status. Non-vaccinated patients showed a two-fold higher probability of the crazy-paving pattern compared to vaccinated patients. COVID-19 variants could have a significant impact on the CT-graphic appearance of COVID-19.
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Affiliation(s)
- Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany.
| | - Katharina Mueller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Julian Madrid
- Department of Cardiology, Pneumology, Angiology and Intensive Care, Ortenau Klinikum, Lahr, Germany
| | - Marvin Knoke
- Department of Protestant Theology, Faculty of Theology, University of Heidelberg, Heidelberg, Germany
| | - Dunja Hasic
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Prerana Agarwal
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
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Oerther B, Engel H, Nedelcu A, Schlett CL, Grimm R, von Busch H, Sigle A, Gratzke C, Bamberg F, Benndorf M. Prediction of upgrade to clinically significant prostate cancer in patients under active surveillance: performance of a fully automated AI-algorithm for lesion detection and classification. Prostate 2023; 83:871-878. [PMID: 36959777 DOI: 10.1002/pros.24528] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/18/2023] [Accepted: 03/17/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Multiparametric MRI (MpMRI) improves the detection of aggressive prostate cancer (PCa) subtypes. As cases of active surveillance (AS) increase and tumor progression triggers definitive treatment, we evaluated whether an AI-driven algorithm can detect clinically significant PCa (csPCa) in patients under AS. METHODS Consecutive patients under AS who received mpMRI (PI-RADSv2.1 protocol) and subsequent MR-guided ultrasound fusion (targeted and extensive systematic) biopsy between 2017 and 2020 were retrospectively analyzed. Diagnostic performance of an automated clinically certified AI-driven algorithm was evaluated on both lesion and patient level regarding the detection of csPCa. RESULTS Analysis of 56 patients resulted in 93 target lesions. Patient level sensitivity and specificity of the AI algorithm was 92.5%/31% for the detection of ISUP ≥ 1 and 96.4%/25% for the detection of ISUP ≥ 2, respectively. The only case of csPCa missed by the AI harbored only 1/47 Gleason 7a core (systematic biopsy; previous and subsequent biopsies rendered non-csPCa). CONCLUSIONS AI-augmented lesion detection and PI-RADS scoring is a robust tool to detect progression to clinically significant PCa in patients under AS. Integration in the clinical workflow can serve as reassurance for the reader and streamline reporting, hence improve efficiency and diagnostic confidence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Benedict Oerther
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Hannes Engel
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Andrea Nedelcu
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Christopher L Schlett
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Robert Grimm
- Diagnostic Imaging, Siemens Healthcare GmbH, 91052, Erlangen, Germany
| | | | - August Sigle
- Department of Urology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Christian Gratzke
- Department of Urology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Fabian Bamberg
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
| | - Matthias Benndorf
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, 79106, Freiburg, Germany
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Askani E, Schlett CL, Bamberg F, Agarwal P. [Lesions of the prevascular mediastinum]. Radiologie (Heidelb) 2023; 63:160-171. [PMID: 36797329 DOI: 10.1007/s00117-023-01125-8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/18/2023]
Abstract
CLINICAL/METHODOLOGICAL ISSUE Mediastinal masses are a group of heterogenous lesions which may be a coincidental finding or present with symptoms. More than half of mediastinal lesions are located in the prevascular mediastinum. As these tumors are not often encountered in clinical routine, making a diagnosis with a high degree of confidence may seem challenging. STANDARD RADIOLOGICAL METHODS The latest computed tomography (CT)-based classification of the mediastinal compartments by the International Thymic Malignancy Interest Group (ITMIG) moves away from earlier radiograph-based classification systems and helps to reliably classify tumors based on location, although in some cases the lesion can occupy more than one compartment. PERFORMANCE Radiology plays an important role in the evaluation of anterior mediastinal lesions. Although in some cases imaging features alone allow a diagnosis to be made; in other cases knowledge of important radiological features and their analysis in the context of patient factors like age and duration of symptoms can help to narrow down the differential diagnosis, avoid unnecessary workup, and guide further steps. PRACTICAL RECOMMENDATIONS Computed tomography (CT) is central for the characterization of mediastinal masses in clinical routine. In some situations, like in the case of thymic cysts or thymic hyperplasia, magnetic resonance imaging (MRI) can be used as a noninvasive problem-solving tool.
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Affiliation(s)
- Esther Askani
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Deutschland
| | - Christopher L Schlett
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Deutschland
| | - Fabian Bamberg
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Deutschland
| | - Prerana Agarwal
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Deutschland.
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Kreibich M, Siepe M, Berger T, Beyersdorf F, Soschynski M, Schlett CL, Czerny M, Rylski B. Intervention rates and outcomes in medically managed uncomplicated descending thoracic aortic dissections. J Thorac Cardiovasc Surg 2023; 165:958-965.e4. [PMID: 34001355 DOI: 10.1016/j.jtcvs.2021.03.126] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 03/22/2021] [Accepted: 03/31/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate the long-term incidence and outcome of aortic interventions for medically managed uncomplicated thoracic aortic dissections. METHODS Between January 2012 and December 2018, 91 patients were discharged home with an uncomplicated, medically treated aortic dissection (involving the descending aorta with or without aortic arch involvement, no ascending involvement). After a median period of 4 (first quartile: 2, third quartile: 11) months, 30 patients (33%) required an aortic intervention. Patient characteristics, radiographic, treatment, and follow-up data were compared for patients with and without aortic interventions. A competing risk regression model was analyzed to identify independent predictors of aortic intervention and to predict the risk for intervention. RESULTS Patients who underwent aortic interventions had significantly larger thoracic (P = .041) and abdominal (P = .015) aortic diameters, the dissection was significantly longer (P = .035), there were more communications between both lumina (P = .040), and the first communication was significantly closer to the left subclavian artery (P = .049). A descending thoracic aortic diameter exceeding 45 mm was predictive for an aortic intervention (P = .001; subdistribution hazard ratio: 3.51). The risk for aortic intervention was 27% ± 10% and 36% ± 11% after 1 and 3 years, respectively. Fourteen patients (47%) underwent thoracic endovascular aortic repair, 11 patients (37%) thoracic endovascular aortic repair and left carotid to subclavian bypass, 3 patients (10%) total arch replacement with the frozen elephant trunk technique, and 2 patients (7%) thoracoabdominal aortic replacement. We observed no in-hospital mortality. CONCLUSIONS The need for secondary aortic interventions in patients with initially medically managed, uncomplicated descending aortic dissections is substantial. The full spectrum of aortic treatment options (endovascular, hybrid, conventional open surgical) is required in these patients.
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Affiliation(s)
- Maximilian Kreibich
- Faculty of Medicine, Department of Cardiovascular Surgery, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
| | - Matthias Siepe
- Faculty of Medicine, Department of Cardiovascular Surgery, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Tim Berger
- Faculty of Medicine, Department of Cardiovascular Surgery, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Friedhelm Beyersdorf
- Faculty of Medicine, Department of Cardiovascular Surgery, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Martin Soschynski
- Faculty of Medicine, Department for Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Faculty of Medicine, Department for Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Martin Czerny
- Faculty of Medicine, Department of Cardiovascular Surgery, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Bartosz Rylski
- Faculty of Medicine, Department of Cardiovascular Surgery, University Heart Center Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
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Soschynski M, Bunck AC, Beer M, Kloempken S, Schlett CL, Baeßler B, Kröger JR, Persigehl T, Pinto Dos Santos D, Steinmetz M, Niehaus A, Bamberg F, Ley S, Tiemann K, Beerbaum P, Lotz J, Maintz D, Kloth C, Brunner H, Ritter CO. Structured Reporting in Cross-Sectional Imaging of the Heart: Reporting Templates for CMR Imaging of Ischemia and Myocardial Viability and for Cardiac CT Imaging of Coronary Heart Disease and TAVI Planning. ROFO-FORTSCHR RONTG 2023; 195:293-296. [PMID: 36796410 DOI: 10.1055/a-1981-1196] [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] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Structured reporting allows a high grade of standardization and thus a safe and unequivocal report communication. In the past years, the radiological societies have started several initiatives to base radiological reports on structured reporting rather than free text reporting. METHODS Upon invitation of the working group for Cardiovascular Imaging of the German Society of Radiology, in 2018 an interdisciplinary group of Radiologists, Cardiologists, Pediatric Cardiologists and Cardiothoracic surgeons -all experts on the field of cardiovascular MR and CT imaging- met for interdisciplinary consensus meetings at the University Hospital Cologne. The aim of these meetings was to develop and consent templates for structured reporting in cardiac MR and CT of various cardiovascular diseases. RESULTS Two templates for structured reporting of CMR in ischemia imaging and vitality imaging and two templates for structured reporting of CT imaging for planning Transcatheter Aortic Valve Implantation (TAVI; pre-TAVI-CT) and coronary CT were discussed, consented and transferred to a HTML 5/IHR MRRT compatible format. The templates were made available for free use on the website www.befundung.drg.de. CONCLUSION This paper suggests consented templates in German language for the structured reporting of cross-sectional CMR imaging of ischemia and vitality as well as reporting of CT imaging pre-TAVI and coronary CT. The implementation of these templates is aimed at providing a constant level of high reporting quality and increasing the efficiency of report generation as well as a clinically based communication of imaging results. KEY POINTS · Structured reporting offers a constant level of high reporting quality and increases the efficiency of report generation as well as a clinically based communication of imaging results.. · For the first time templates in German language for the structured reporting of CMR imaging of ischemia and vitality and CT imaging pre-TAVI and coronary CT are reported.. · These templates will be made available on the website www.befundung.drg.de and can be commented via strukturierte-befundung@drg.de.. ZITIERWEISE · Soschynski M, Bunck AC, Beer M et al. Structured Reporting in Cross-Sectional Imaging of the Heart: Reporting Templates for CMR Imaging of Ischemia and Myocardial Viability and for Cardiac CT Imaging of Coronary Heart Disease and TAVI Planning. Fortschr Röntgenstr 2023; DOI: 10.1055/a-1981-1196.
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Affiliation(s)
- Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Meinrad Beer
- Abteilung für Diagnostische und Interventionelle Radiologie, University Hospital Ulm, Germany
| | - Steffen Kloempken
- Abteilung für Diagnostische und Interventionelle Radiologie, University Hospital Ulm, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bettina Baeßler
- Department of Diagnostic and Interventional Radiology, University Hospital Wurzburg, Germany
| | - Jan Robert Kröger
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling Hospital Minden, Germany
| | | | - Daniel Pinto Dos Santos
- Institut für Diagnostische und Interventionelle Radiologie, University Hospital Cologne, Koln, Germany.,Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Johannes Gutenberg Universitat Universitatsmedizin, Mainz, Germany
| | - Michael Steinmetz
- Klinik für Pädiatrische Kardiologie und Intensivmedizin, University Medical Center Göttingen, Gottingen, Germany
| | - Adelheid Niehaus
- Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover Medical School, Hannover, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Ley
- Diagnostic and Interventional Radiology, Artemed SE, Tutzing, Germany
| | - Klaus Tiemann
- Department of Cardiology and Intensive Care, Peter Osypka Heart Center Munich, Hospital Munich South, Munchen, Germany
| | - Philipp Beerbaum
- Clinic for Paediatric Cardiology and Paediatric Critical Care Medicine, Hannover Medical School, Hannover, Germany
| | - Joachim Lotz
- Diagnostic Radiology, University Medical Center Göttingen, Germany
| | | | - Christopher Kloth
- Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Horst Brunner
- Diagnostic and Interventional Radiology, University Hospital Ulm, Germany
| | - Christian O Ritter
- Diagnostic and Interventional Radiology, University Medical Center Göttingen, Gottingen, Germany
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29
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Maurer E, Lorbeer R, Hefferman G, Schlett CL, Peters A, Rospleszcz S, Kiefer LS, Nikolaou K, Bamberg F, Walter SS. Lack of correlation between hip osteoarthritis and anatomical spinopelvic parameters obtained in supine position on MRI. Injury 2023; 54:525-532. [PMID: 36503838 DOI: 10.1016/j.injury.2022.11.056] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/23/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Hip osteoarthritis (HOA) is known to have a multifactorial pathogenesis. Recent studies suggest that spinopelvic alignment may represent an important additional pathogenic abnormality resulting in HOA. This study aims to assess the correlation between spinopelvic parameters (pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and lumbar lordosis (LL)) obtained in the supine position on MRI and HOA, lateral center edge (LCE) angle, and patient reported back pain. METHODS Asymptomatic participants from the whole-body MRI cohort (FF4) from the cross-sectional case-control "Cooperative Health Research in the Region of Augsburg" study (KORA) were included. Whole-body MRI was performed in a standardized fashion in each case, on which hip osteoarthritis (HOA), anatomical spinopelvic parameters and lateral center edge angle were measured. Presence of back pain was assessed using a standardized questionnaire. Correlations were estimated by logistic regression models providing odds ratio. RESULTS Among 340 subjects (mean age 56.3 ± 9.3 years; 56.5% male), HOA was present in 89.1% (male: 87.0%, female: 91.7%, p = 0.17). The LCE angle was 30.0° ± 5.5 (men: 29.8° ± 5.9; women: 30.1° ± 5.1; p = 0.696). Mean PI was 54.0° ± 11.3°, PT was 13.7° ± 5.9°, SS was 40.3° ± 8.8° (significantly smaller in women p<0.05) and LL was 36.4° ± 9.6° (significantly greater in women p<0.05). None of the spinopelvic parameters correlated significantly with hip osteoarthritis or LCE angle. HOA was not correlated with back pain. CONCLUSION Spinopelvic parameters as measured in the supine position on MRI, do not correlate with hip osteoarthritis or lateral center edge angle.
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Affiliation(s)
- Elke Maurer
- Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, Tuebingen 72076, Germany.
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian-University Hospital Marchioninistraße 15, Munich 81377, Germany.
| | - Gerald Hefferman
- Brigham and Women's Hospital, Department of Radiology and Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany.
| | - Annette Peters
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Germany.
| | - Susanne Rospleszcz
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Germany.
| | - Lena S Kiefer
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany.
| | - Konstantin Nikolaou
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany.
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany.
| | - Sven S Walter
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, Tübingen 72076, Germany; Department of Radiology, Division of Musculoskeletal Radiology, NYU Grossman School of Medicine, 660 1st Ave, New York, NY 10016, United States.
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30
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Jung M, Rospleszcz S, Löffler MT, Walter SS, Maurer E, Jungmann PM, Peters A, Nattenmüller J, Schlett CL, Bamberg F, Kiefer LS, Diallo TD. Association of lumbar vertebral bone marrow and paraspinal muscle fat composition with intervertebral disc degeneration: 3T quantitative MRI findings from the population-based KORA study. Eur Radiol 2023; 33:1501-1512. [PMID: 36241920 PMCID: PMC9935727 DOI: 10.1007/s00330-022-09140-4] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/11/2022] [Accepted: 09/05/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the association of lumbar bone marrow adipose tissue fat fraction (BMAT-FF) and paraspinal muscle proton density fat fraction (PDFF) and their interplay with intervertebral disc degeneration (IVDD). METHODS In this retrospective cross-sectional study based on a prospective population-based cohort, BMAT-FF and PDFF of asymptomatic individuals were calculated based on 3T-MRI dual-echo and multi-echo Dixon VIBE sequences. IVDD was assessed at motion segments L1 to L5 and dichotomized based on Pfirrmann grade ≥ 4 and/or presence of other severe degenerative changes or spinal abnormalities at least at one segment. Pearson's correlation coefficients were calculated for BMAT-FF and PDFF. Univariable and multivariable logistic regression models for IVDD were calculated. RESULTS Among 335 participants (mean age: 56.2 ± 9.0 years, 43.3% female), the average BMI was 27.7 ± 4.5 kg/m2 and the prevalence of IVDD was high (69.9%). BMAT-FF and PDFF were significantly correlated (r = 0.31-0.34; p < 0.001). The risk for IVDD increased with higher PDFF (OR = 1.45; CI 1.03, 2.04) and BMAT-FF (OR = 1.56; CI 1.16, 2.11). Pairwise combinations of PDFF and BMAT-FF quartiles revealed a lower risk for IVDD in individuals in the lowest BMAT-FF and PDFF quartile (OR = 0.21; CI 0.1, 0.48). Individuals in the highest BMAT-FF and PDFF quartile showed an increased risk for IVDD (OR = 5.12; CI 1.17, 22.34) CONCLUSION: Lumbar BMAT-FF and paraspinal muscle PDFF are correlated and represent both independent and additive risk factors for IVDD. Quantitative MRI measurements of paraspinal myosteatosis and vertebral bone marrow fatty infiltration may serve as imaging biomarkers to assess the individual risk for IVDD. KEY POINTS • Fat composition of the lumbar vertebral bone marrow is positively correlated with paraspinal skeletal muscle fat. • Higher fat-fractions of lumbar vertebral bone marrow and paraspinal muscle are both independent as well as additive risk factors for intervertebral disc degeneration. • Quantitative magnetic resonance imaging measurements of bone marrow and paraspinal muscle may serve as imaging biomarkers for intervertebral disc degeneration.
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Affiliation(s)
- Matthias Jung
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
| | - Susanne Rospleszcz
- grid.4567.00000 0004 0483 2525Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Oberschleißheim, Germany ,grid.5252.00000 0004 1936 973XDepartment of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
| | - Maximilian T. Löffler
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany ,grid.6936.a0000000123222966Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
| | - Sven S. Walter
- grid.10392.390000 0001 2190 1447Department of Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany ,grid.137628.90000 0004 1936 8753Division of Musculoskeletal Radiology, Department of Radiology, NYU Grossman School of Medicine, 660 1st Ave, New York, NY 10016 USA
| | - Elke Maurer
- grid.482867.70000 0001 0211 6259Department of Trauma and Reconstructive Surgery, BG Unfallklinik, Schnarrenbergstraße 95, 72070 Tuebingen, Germany
| | - Pia M. Jungmann
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Annette Peters
- grid.4567.00000 0004 0483 2525Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Oberschleißheim, Germany ,grid.5252.00000 0004 1936 973XDepartment of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
| | - Johanna Nattenmüller
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Christopher L. Schlett
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Fabian Bamberg
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
| | - Lena S. Kiefer
- grid.10392.390000 0001 2190 1447Department of Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Thierno D. Diallo
- grid.5963.9Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
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Shugaa Addin N, Schlett CL, Bamberg F, Thorand B, Linseisen J, Seissler J, Peters A, Rospleszcz S. Subclinical Cardiovascular Disease Markers in Relation to Serum and Dietary Magnesium in Individuals from the General Population: The KORA-MRI Study. Nutrients 2022; 14:nu14234954. [PMID: 36500983 PMCID: PMC9741061 DOI: 10.3390/nu14234954] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
Several studies have implied a role of magnesium in the development of cardiovascular disease (CVD). Thus, magnesium might serve as a potential risk marker for early CVD. Therefore, we investigated the association of serum magnesium and dietary magnesium intake with markers of subclinical CVD in a population-based study. We used cross-sectional data from the sub-study of the Cooperative Health Research in the Region of Augsburg (KORA-FF4). Markers of subclinical CVD, namely, left and right ventricular structure and function and carotid plaque and carotid wall thickness, were derived by magnetic resonance imaging (MRI). Multivariable-adjusted regression models were applied to assess the relationship between serum and dietary magnesium and MRI-derived subclinical CVD markers. Among 396 included participants (mean age: 56.3 ± 9.2 years; 57.8% male), 181 (45.7%) had low serum magnesium levels (<2.07 mg/dL). Among 311 subjects with complete dietary data (mean age: 56.3 ± 9.1 years; 56.3% male), 154 (49.5%) had low dietary magnesium intake (≤155.2 mg/1000 kcal/day). Serum and dietary magnesium were not correlated (p-value = 0.5). Serum magnesium was significantly associated with presence of carotid plaque (OR 1.62, p-value 0.033). Dietary magnesium was associated with higher left ventricular end-systolic and end-diastolic volume (0.04 mL/m2, 0.06 mL/m2; p-value 0.011, 0.013, respectively), and also with a decrease in left ventricular remodeling index and mean diastolic wall thickness (−0.001 g/mL/m2, −0.002 mm/m2; p-value 0.004, 0.029, respectively). In summary, there was no consistent association of serum and dietary magnesium with imaging markers of subclinical CVD.
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Affiliation(s)
- Nuha Shugaa Addin
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU), 85764 München, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Jakob Linseisen
- Epidemiology, University Hospital of Augsburg, University of Augsburg, 86159 Augsburg, Germany
| | - Jochen Seissler
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
- Diabetes Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, 80336 München, Germany
| | - Annette Peters
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU), 85764 München, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, 80802 München, Germany
| | - Susanne Rospleszcz
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU), 85764 München, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, 80802 München, Germany
- Correspondence: ; Tel.: +49-089-3187-4234
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32
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Danielsson O, Nano J, Pahkala K, Rospleszcz S, Lehtimäki T, Schlett CL, Kähönen M, Bamberg F, Raitakari O, Peters A, Nissinen MJ, Åberg FO. Validity of fatty liver disease indices in the presence of alcohol consumption. Scand J Gastroenterol 2022; 57:1349-1360. [PMID: 35723012 DOI: 10.1080/00365521.2022.2085060] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease frequently coexist. While several blood-based indices exist for the detection of NAFLD, few studies have examined how alcohol use possibly impacts their diagnostic performance. We analysed the effects of alcohol use on the performance of indices for detecting fatty liver disease (FLD). METHODS We included participants from the Cardiovascular Risk in Young Finns Study (Finnish sample) and KORA study (German sample) who underwent abdominal ultrasound or magnetic resonance imaging, respectively, for detection of FLD and had serum analyses available for calculation of Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Lipid Accumulation Product (LAP), and Dallas Steatosis Index (DSI). Alcohol use was estimated by questionnaires as mean daily consumption and binge drinking (Finnish sample only). Predictive performance for FLD was assessed according to alcohol consumption. RESULTS The study included 1426 (Finnish sample) and 385 (German sample) individuals, of which 234 (16%) and 168 (44%) had FLD by imaging. When alcohol consumption was <50 g/day, all indices discriminated FLD with area under the receiver operating characteristics (AUROC) of 0.82-0.88. AUROCs were 0.61-0.66 among heavy drinkers (>50 g/day). AUROCs decreased to 0.74-0.80 in the highest binge-drinking category (>2 times/week). Alcohol use correlated with FLI and LAP (r-range 0.09-0.16, p-range <.001-.02) in both samples and with DSI (r = 0.13, p < .001) in the Finnish sample. CONCLUSIONS Indices perform well and comparably for detection of FLD with alcohol consumption <50 g/day and with different binge-drinking behaviour.
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Affiliation(s)
- Oscar Danielsson
- Clinic of Gastroenterology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Jana Nano
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), partner site Neuherberg, Neuherberg, Germany
| | - Katja Pahkala
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Ltd, Tampere, Finland.,Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research (DZD), partner site Neuherberg, Neuherberg, Germany.,Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Markku J Nissinen
- Clinic of Gastroenterology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Fredrik O Åberg
- Transplantation and Liver Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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Rau A, Soschynski M, Taron J, Ruile P, Schlett CL, Bamberg F, Krauss T. [Artificial intelligence and radiomics : Value in cardiac MRI]. Radiologie (Heidelb) 2022; 62:947-953. [PMID: 36006439 DOI: 10.1007/s00117-022-01060-0] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
CLINICAL/METHODICAL ISSUE Cardiac diseases are the leading cause of death. Many diseases can be specifically treated once a valid diagnosis is established. Cardiac magnetic resonance imaging (MRI) plays a central role in the workup of many cardiac pathologies. However, image acquisition as well as interpretation and related secondary image evaluation are time-consuming and complex. STANDARD RADIOLOGICAL METHODS Cardiac MRI is becoming increasingly established in international guidelines for the evaluation of cardiac function and differential diagnosis of a wide variety of cardiac diseases. METHODOLOGICAL INNOVATIONS Cardiac MRI has limited reproducibility due to the acquisition technique and interpretation of findings with complex secondary measurements. Artificial intelligence techniques and radiomics offer the potential to improve the acquisition, interpretation, and reproducibility of cardiac MRI. PERFORMANCE Research suggests that artificial intelligence and radiomic analysis can improve cardiac MRI in terms of image acquisition and also diagnostic and prognostic value. Furthermore, the implementation of artificial intelligence and radiomics may result in the identification of new biomarkers. ACHIEVEMENTS AND PRACTICAL RECOMMENDATIONS The implementation of artificial intelligence in cardiac MRI has great potential. However, the current level of evidence is still limited in some aspects; in particular there are too few prospective and large multicenter studies available. As a result, the algorithms developed are often not sufficiently validated scientifically and are not yet applied in clinical routine.
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Affiliation(s)
- Alexander Rau
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
| | - Martin Soschynski
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Jana Taron
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Philipp Ruile
- Klinik für Klinik für Kardiologie und Angiologie, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Bad Krozingen, Deutschland
| | - Christopher L Schlett
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Fabian Bamberg
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Tobias Krauss
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
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Soschynski M, Hagen F, Baumann S, Hagar MT, Weiss J, Krauss T, Schlett CL, von zur Mühlen C, Bamberg F, Nikolaou K, Greulich S, Froelich MF, Riffel P, Overhoff D, Papavassiliu T, Schoenberg SO, Faby S, Ulzheimer S, Ayx I, Krumm P. High Temporal Resolution Dual-Source Photon-Counting CT for Coronary Artery Disease: Initial Multicenter Clinical Experience. J Clin Med 2022; 11:jcm11206003. [PMID: 36294324 PMCID: PMC9604695 DOI: 10.3390/jcm11206003] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 09/04/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this paper is to evaluate the diagnostic image quality of spectral dual-source photon-counting detector coronary computed tomography angiography (PCD-CCTA) for coronary artery disease in a multicenter study. The image quality (IQ), assessability, contrast-to-noise ratio (CNR), Agatston score, and radiation exposure were measured. Stenoses were quantified and compared with invasive coronary angiography, if available. A total of 92 subjects (65% male, age 58 ± 14 years) were analyzed. The prevalence of significant coronary artery disease (CAD) (stenosis ≥ 50%) was 17% of all patients, the range of the Agatston score was 0−2965 (interquartile range (IQR) 0−135). The IQ was very good (one, IQR one−two), the CNR was very high (20 ± 10), and 5% of the segments were rated non-diagnostic. The IQ and assessability were higher in proximal coronary segments (p < 0.001). Agatston scores up to 600 did not significantly affect the assessability of the coronary segments (p = 0.3). Heart rate influenced assessability only at a high-pitch mode (p = 0.009). For the invasive coronary angiography (ICA) subgroup (n = nine), the diagnostic performance for CAD per segment was high (sensitivity 92%, specificity 96%), although the limited number of patients who underwent both diagnostic modalities limits the generalization of this finding at this stage. PCD-CCTA provides good image quality for low and moderate levels of coronary calcifications.
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Affiliation(s)
- Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Florian Hagen
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Stefan Baumann
- First Department of Medicine-Cardiology, University Medical Centre Mannheim, and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Jakob Weiss
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Constantin von zur Mühlen
- Department of Cardiology and Angiology I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Simon Greulich
- Department of Cardiology and Angiology, University of Tuebingen, Otfried-Müller-Str. 10, 72076 Tuebingen, Germany
| | - Matthias F. Froelich
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Philipp Riffel
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Daniel Overhoff
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Theano Papavassiliu
- First Department of Medicine-Cardiology, University Medical Centre Mannheim, and DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Stefan O. Schoenberg
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthcare GmbH, 91301 Forchheim, Germany
| | - Stefan Ulzheimer
- Computed Tomography, Siemens Healthcare GmbH, 91301 Forchheim, Germany
| | - Isabelle Ayx
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
- Correspondence: ; Tel.: +49-62-1383-2067
| | - Patrick Krumm
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
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Stoll S, Sowah SA, Fink MA, Nonnenmacher T, Graf ME, Johnson T, Schlett CL, von Stackelberg O, Kirsten R, Bamberg F, Keller J, Ulrich CM, Kaaks R, Kauczor HU, Rengier F, Kühn T, Nattenmüller J. Changes in aortic diameter induced by weight loss: The HELENA trial- whole-body MR imaging in a dietary intervention trial. Front Physiol 2022; 13:976949. [PMID: 36203934 PMCID: PMC9531129 DOI: 10.3389/fphys.2022.976949] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Obesity-related metabolic disorders such as hypertension, hyperlipidemia and chronic inflammation have been associated with aortic dilatation and resulting in aortic aneurysms in many cases. Whether weight loss may reduce the risk of aortic dilatation is not clear. In this study, the diameter of the descending thoracic aorta, infrarenal abdominal aorta and aortic bifurcation of 144 overweight or obese non-smoking adults were measured by MR-imaging, at baseline, and 12 and 50 weeks after weight loss by calorie restriction. Changes in aortic diameter, anthropometric measures and body composition and metabolic markers were evaluated using linear mixed models. The association of the aortic diameters with the aforementioned clinical parameters was analyzed using Spearman`s correlation. Weight loss was associated with a reduction in the thoracic and abdominal aortic diameters 12 weeks after weight loss (predicted relative differences for Quartile 4: 2.5% ± 0.5 and -2.2% ± 0.8, p < 0.031; respectively). Furthermore, there was a nominal reduction in aortic diameters during the 50-weeks follow-up period. Aortic diameters were positively associated with weight, visceral adipose tissue, glucose, HbA1c and with both systolic and diastolic blood pressure. Weight loss induced by calorie restriction may reduce aortic diameters. Future studies are needed to investigate, whether the reduction of aortic diameters via calorie restriction may help to prevent aortic aneurysms.
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Affiliation(s)
- Sibylle Stoll
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Solomon A. Sowah
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Matthias A. Fink
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Tobias Nonnenmacher
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Mirja E. Graf
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Theron Johnson
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Romy Kirsten
- National Center for Tumor Diseases (NCT), Liquid Biobank, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Cornelia M. Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Rudolf Kaaks
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Fabian Rengier
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Johanna Nattenmüller
- Heidelberg University Hospital, Diagnostic and Interventional Radiology, Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology, Medical Center - Faculty of Medicine, University of Freiburg, Freiburg, Germany
- *Correspondence: Johanna Nattenmüller,
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Askani E, Rospleszcz S, Lorbeer R, Kulka C, von Krüchten R, Müller-Peltzer K, Hasic D, Kellner E, Reisert M, Rathmann W, Peters A, Schlett CL, Bamberg F, Storz C. Association of MRI-based adrenal gland volume and impaired glucose metabolism in a population-based cohort study. Diabetes Metab Res Rev 2022; 38:e3528. [PMID: 35303389 DOI: 10.1002/dmrr.3528] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The aim of this study was to assess adrenal gland volume by using magnetic resonance imaging (MRI) and to study its role as an indirect marker of impaired glucose metabolism and hypothalamic-pituitary-adrenal (HPA) axis activation in a population-based cohort. METHODS Asymptomatic participants were enrolled in a nested case-control study and underwent a 3-T MRI, including T1w-VIBE-Dixon sequences. For the assessment of adrenal gland volume, adrenal glands were manually segmented in a blinded fashion. Impaired glucose metabolism was determined using fasting glucose and oral glucose tolerance test. Cardiometabolic risk factors were also obtained. Inter- and intrareader reliability as well as univariate and multivariate associations were derived. RESULTS Among 375 subjects included in the analysis (58.5% male, 56.1 ± 9.1 years), 25.3% participants had prediabetes and 13.6% had type 2 diabetes (T2DM). Total adrenal gland volume was 11.2 ± 4.2 ml and differed significantly between impaired glucose metabolism and healthy controls with largest total adrenal gland volume in T2DM (healthy controls: 10.0 ± 3.9 ml, prediabetes: 12.5 ± 3.8 ml, T2DM: 13.9 ± 4.6 ml; p < 0.001). In the multivariate analysis, association of T2DM and increased adrenal gland volume was independent of age, sex, hypertension, triglycerides and body mass index (BMI), but was attenuated in subjects with prediabetes after adjustment for BMI. CONCLUSIONS T2DM is significantly associated with increased adrenal gland volume by MRI in an asymptomatic cohort, independent of age, sex, dyslipidaemia, hypertension and BMI. Adrenal gland volume may represent an indirect marker of impaired glucose metabolism and HPA axis dysfunction.
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Affiliation(s)
- Esther Askani
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Department of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilans-University Hospital, Munich, Germany
| | - Charlotte Kulka
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Katharina Müller-Peltzer
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Dunja Hasic
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Elias Kellner
- Medical Physics, Department of Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Medical Physics, Department of Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Annette Peters
- Department of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- German Center for Cardiovascular Disease Research (DZHK e.V.), Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Corinna Storz
- Department of Neuroradiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
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Maurer E, Klinger C, Lorbeer R, Hefferman G, Schlett CL, Peters A, Nikolaou K, Bamberg F, Notohamiprodjo M, Walter SS. Association between cardiovascular risk factors and degenerative disc disease of the thoracolumbar spine in the general population: results from the KORA MRI Study. Acta Radiol 2022; 63:750-759. [PMID: 33878932 DOI: 10.1177/02841851211010391] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Little is known about the associations between cardiovascular risk factors (CRF) and disc degeneration (DD). PURPOSE To evaluate the potential association between CRFs and intervertebral DD in a population-based sample. METHODS A total of 400 participants from the community-based KORA-study were assessed in terms of CRFs, specifically obesity, hypertension, diabetes, elevated LDL-c, low HDL-c, elevated triglycerides, smoking status, and alcohol consumption. The patients additionally underwent whole-body magnetic resonance imaging (MRI) using T2-weighted single-shot fast-spin-echo and T1 dual-echo gradient-echo Dixon pulse sequences. Thoracic and lumbar DD were assessed using the Pfirrmann score and for the presence of disc bulging/protrusion. Cross-sectional associations between CRFs and MR-based Pfirrmann score were then analyzed. RESULTS A total of 385 individuals (58.2% men; mean age 56.3 ± 9.2 years) were included. Prevalence of DD was 76.4%. Older age (β = 0.18; 95% CI 0.12-0.25; P < 0.001) and higher body mass index (BMI) (β = 0.19; 95% CI 0.06-0.30; P = 0.003) were significantly associated with DD of the thoracolumbar spine. Diabetes was significantly associated with DD at T7/8 (P = 0.029) and L3/4 (P = 0.017). Hypertension correlated significantly with DD in univariate analysis, but the association did not persist using multivariate analysis (β = 0.53; 95% CI -0.74 to 1.81; P = 0.41). None of the other CRFs (P ≥ 0.11) were associated with advanced DD. Disc bulging was independently associated with hypertension (β = 0.47; 95% CI 0.27-0.81; P = 0.01). CONCLUSION A significant independent association exists between age, BMI, and intervertebral DD. In contrast, there is no significant association between cardiovascular risk factors and DD. Providing strong evidence that the pathologic process undergirding DD is mechanical, rather than microvascular, in nature.
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Affiliation(s)
- Elke Maurer
- Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Christian Klinger
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Gerald Hefferman
- Brigham and Women’s Hospital, Department of Radiology and Harvard Medical School, Boston, MA, USA
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center ‐ University of Freiburg, Freiburg, Germany
| | - Annette Peters
- German Center for Cardiovascular Disease Research, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Cardiovascular Prevention, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Konstantin Nikolaou
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center ‐ University of Freiburg, Freiburg, Germany
| | - Mike Notohamiprodjo
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
- Die Radiologie, Munich, Germany
| | - Sven S Walter
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
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Kiefer LS, Fabian J, Rospleszcz S, Lorbeer R, Machann J, Kraus MS, Fischer M, Roemer F, Rathmann W, Meisinger C, Heier M, Nikolaou K, Peters A, Storz C, Schlett CL, Bamberg F. Population-based cohort imaging: skeletal muscle mass by magnetic resonance imaging in correlation to bioelectrical-impedance analysis. J Cachexia Sarcopenia Muscle 2022; 13:976-986. [PMID: 35080141 PMCID: PMC8977960 DOI: 10.1002/jcsm.12913] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 11/12/2021] [Accepted: 12/06/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Skeletal muscle mass is subjected to constant changes and is considered a good predictor for outcome in various diseases. Bioelectrical-impedance analysis (BIA) and magnetic resonance imaging (MRI) are approved methodologies for its assessment. However, muscle mass estimations by BIA may be influenced by excess intramuscular lipids and adipose tissue in obesity. The objective of this study was to evaluate the feasibility of quantitative assessment of skeletal muscle mass by MRI as compared with BIA. METHODS Subjects from a population-based cohort underwent BIA (50 kHz, 0.8 mA) and whole-body MRI including chemical-shift encoded MRI (six echo times). Abdominal muscle mass by MRI was quantified as total and fat-free cross-sectional area by a standardized manual segmentation-algorithm and normalized to subjects' body height2 (abdominal muscle mass indices: AMMIMRI ). RESULTS Among 335 included subjects (56.3 ± 9.1 years, 56.1% male), 95 (28.4%) were obese (BMI ≥ 30 kg/m2 ). MRI-based and BIA-based measures of muscle mass were strongly correlated, particularly in non-obese subjects [r < 0.74 in non-obese (P < 0.001) vs. r < 0.56 in obese (P < 0.001)]. Median AMMITotal(MRI) was significantly higher in obese as compared with non-obese subjects (3246.7 ± 606.1 mm2 /m2 vs. 2839.0 ± 535.8 mm2 /m2 , P < 0.001, respectively), whereas the ratio AMMIFat-free /AMMITotal (by MRI) was significantly higher in non-obese individuals (59.3 ± 10.1% vs. 53.5 ± 10.6%, P < 0.001, respectively). No significant difference was found regarding AMMIFat-free(MRI) (P = 0.424). In analyses adjusted for age and sex, impaired glucose tolerance and measures of obesity were significantly and positively associated with AMMITotal(MRI) and significantly and inversely with the ratio AMMIFat-free(MRI) /AMMITotal(MRI) (P < 0.001). CONCLUSIONS MRI-based assessment of muscle mass is feasible in population-based imaging and strongly correlated with BIA. However, the observed weaker correlation in obese subjects may explain the known limitation of BIA in obesity and promote MRI-based assessments. Thus, skeletal muscle mass parameters by MRI may serve as practical imaging biomarkers independent of subjects' body weight.
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Affiliation(s)
- Lena S Kiefer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Jana Fabian
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Susanne Rospleszcz
- Department of Epidemiology, Ludwig-Maximilians-University München, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.,German Centre for Cardiovascular Research (DZHK e.V.), Munich, Germany
| | - Jürgen Machann
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases (IDM), Helmholtz Center Munich, University of Tuebingen, Tuebingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Mareen S Kraus
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Marc Fischer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany.,Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Frank Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.,Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Wolfgang Rathmann
- German Center for Diabetes Research (DZD), Neuherberg, Germany.,Institute for Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
| | - Christa Meisinger
- Chair of Epidemiology, Ludwig-Maximilians-University München, UNIKA-T Augsburg, Augsburg, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Annette Peters
- Department of Epidemiology, Ludwig-Maximilians-University München, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Centre for Cardiovascular Research (DZHK e.V.), Munich, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Corinna Storz
- Department of Neuroradiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Soschynski M, Hagar MT, Taron J, Krauss T, Ruile P, Hein M, Nührenberg T, Russe MF, Bamberg F, Schlett CL. Update for the Performance of CT Coronary Angiography. ROFO-FORTSCHR RONTG 2022; 194:613-624. [PMID: 35231938 DOI: 10.1055/a-1747-3554] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Coronary CT angiography (cCTA) is a class 1 recommendation in the current guidelines by the European Society of Cardiology (ESC) for excluding significant coronary artery stenosis. To achieve optimal image quality at a low radiation dose, the imaging physician may choose different acquisition modes. Therefore, the consensus guidelines by the Society of Cardiovascular Computed Tomography (SCCT) provide helpful guidance for this procedure. METHOD The article provides practical recommendations for the application and acquisition of cCTA based on the current literature and our own experience. RESULTS AND CONCLUSION According to current ESC guidelines, cCTA is recommended in symptomatic patients with a low or intermediate clinical likelihood for coronary artery disease. We recommend premedication with beta blockers and nitrates prior to CT acquisition under certain conditions even with the latest CT scanner generations. The most current CT scanners offer three possible scan modes for cCTA acquisition. Heart rate is the main factor for selecting the scan mode. Other factors may be coronary calcifications and body mass index (BMI). KEY POINTS · CCTA is a valid method to exclude coronary artery disease in patients with a low to intermediate clinical likelihood.. · Even with the latest generation CT scanners, premedication with beta blockers and nitrates can improve image quality at low radiation exposure.. · Current CT scanners usually provide retrospective ECG gating and prospective ECG triggering. Dual-source scanners additionally provide a "high pitch" scan mode to scan the whole heart during one heartbeat, which may also be achieved using single-source scanners with broad detectors in some cases.. · Besides the available scanner technology, the choice of scan mode primarily depends on heart rate and heart rate variability (e. g., arrhythmia).. CITATION FORMAT · Soschynski M, Hagar MT, Taron J et al. Update for the Performance of CT Coronary Angiography. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1747-3554.
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Affiliation(s)
- Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany.,Cardiac MR PET CT Program, Massachusetts General-Hospital, Harvard Medical School, Boston, United States
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Philipp Ruile
- Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Germany
| | - Manuel Hein
- Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Germany
| | - Thomas Nührenberg
- Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Germany
| | - Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Germany
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von Krüchten R, Rospleszcz S, Lorbeer R, Hasic D, Peters A, Bamberg F, Schulz H, Karrasch S, Schlett CL. Whole-Body MRI-Derived Adipose Tissue Characterization and Relationship to Pulmonary Function Impairment. Tomography 2022; 8:560-569. [PMID: 35314623 PMCID: PMC8938839 DOI: 10.3390/tomography8020046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 01/10/2023] Open
Abstract
Background: Specification of adipose tissues by whole-body magnetic resonance imaging (MRI) was performed and related to pulmonary function parameters in a population-based cohort. Methods: 203 study participants underwent whole-body MRI and pulmonary function tests as part of the KORA (Cooperative Health Research in the Augsburg Region) MRI study. Both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were derived from the T1-Dixon sequence, and hepatic adipose tissue from the proton density fat fraction (PDFFhepatic). Associations between adipose tissue parameters and spirometric indices such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and Tiffeneau-index (FEV1/FVC) were examined using multivariate linear regression analysis excluding cofounding effects of other clinical parameters. Results: VAT (β = −0.13, p = 0.03) and SAT (β = −0.26, p < 0.001), but not PDFFhepatic were inversely associated with FEV1, while VAT (β = −0.27, p < 0.001), SAT (β = −0.41, p < 0.001), and PDFFhepatic (β = −0.17, p = 0.002) were inversely associated with FVC. PDFFhepatic was directly associated with the Tiffeneau index (β = 2.46, p < 0.001). Conclusions: In the adjusted linear regression model, VAT was inversely associated with all measured spirometric parameters, while PDFFhepatic revealed the strongest association with the Tiffeneau index. Non-invasive adipose tissue quantification measurements might serve as novel biomarkers for respiratory impairment.
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Affiliation(s)
- Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; (S.R.); (A.P.); (H.S.)
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University, 81377 Munich, Germany;
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilians-University Hospital, 80336 Munich, Germany;
| | - Dunja Hasic
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; (S.R.); (A.P.); (H.S.)
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University, 81377 Munich, Germany;
- German Center for Diabetes Research, München-Neuherberg, 85764 Neuherberg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
| | - Holger Schulz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; (S.R.); (A.P.); (H.S.)
| | - Stefan Karrasch
- Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University, 81377 Munich, Germany;
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, 80336 Munich, Germany
- Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich-Neuherberg, 85764 Neuherberg, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (R.v.K.); (D.H.); (F.B.)
- Correspondence: ; Tel.: +49-761-270-38190
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Kari FA, Russe MF, Schlett CL. Magnetic resonance angiography-derived flow parameters to assess thoracic aortic disease risk. Eur J Cardiothorac Surg 2021; 61:403-404. [PMID: 34893800 DOI: 10.1093/ejcts/ezab533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Fabian A Kari
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Medical Center-Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian F Russe
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
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42
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Berger T, Siepe M, Simon B, Beyersdorf F, Chen Z, Kondov S, Schlett CL, Bamberg F, Tarkhnishvili A, Chikvatia S, Czerny M, Rylski B, Kreibich M. Pulmonary artery diameter: means and normal limits-assessment by computed tomography angiography. Interact Cardiovasc Thorac Surg 2021; 34:637-644. [PMID: 34791257 PMCID: PMC9026207 DOI: 10.1093/icvts/ivab308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/08/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tim Berger
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Matthias Siepe
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Björn Simon
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.,Department for Diagnostic and Interventional Radiology, Medical Centre-University of Freiburg, Freiburg, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Zehang Chen
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Stoyan Kondov
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.,Department for Diagnostic and Interventional Radiology, Medical Centre-University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.,Department for Diagnostic and Interventional Radiology, Medical Centre-University of Freiburg, Freiburg, Germany
| | | | - Salome Chikvatia
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Martin Czerny
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Bartosz Rylski
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Maximilian Kreibich
- Department of Cardiovascular Surgery, University Heart Centre Freiburg, Freiburg, Germany.,Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
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Cai X, Rospleszcz S, Mensel B, Schminke U, Kühn JP, Aghdassi AA, Storz C, Lorbeer R, Schlett CL, Rathmann W, Roden M, Hohenester S, Bülow R, Bamberg F, Peters A, Thorand B, Völzke H, Nano J. Association between hepatic fat and subclinical vascular disease burden in the general population. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000709. [PMID: 34593525 PMCID: PMC8487174 DOI: 10.1136/bmjgast-2021-000709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/27/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE It is still controversial if increased hepatic fat independently contributes to cardiovascular risk. We aimed to assess the association between hepatic fat quantified by MRI and various subclinical vascular disease parameters. DESIGN We included two cross-sectional investigations embedded in two independent population-based studies (Study of Health in Pomerania (SHIP): n=1341; Cooperative Health Research in the Region of Augsburg (KORA): n=386). The participants underwent a whole-body MRI examination. Hepatic fat content was quantified by proton-density fat fraction (PDFF). Aortic diameters in both studies and carotid plaque-related parameters in KORA were measured with MRI. In SHIP, carotid intima-media thickness (cIMT) and plaque were assessed by ultrasound. We used (ordered) logistic or linear regression to assess associations between hepatic fat and subclinical vascular disease. RESULTS The prevalence of fatty liver disease (FLD) (PDFF >5.6%) was 35% in SHIP and 43% in KORA. In SHIP, hepatic fat was positively associated with ascending (β, 95% CI 0.06 (0.04 to 0.08)), descending (0.05 (0.04 to 0.07)) and infrarenal (0.02 (0.01 to 0.03)) aortic diameters, as well as with higher odds of plaque presence (OR, 95% CI 1.22 (1.05 to 1.42)) and greater cIMT (β, 95% CI 0.01 (0.004 to 0.02)) in the age-adjusted and sex-adjusted model. However, further adjustment for additional cardiometabolic risk factors, particularly body mass index, attenuated these associations. In KORA, no significant associations were found. CONCLUSIONS The relation between hepatic fat and subclinical vascular disease was not independent of overall adiposity. Given the close relation of FLD with cardiometabolic risk factors, people with FLD should still be prioritised for cardiovascular disease screening.
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Affiliation(s)
- Xinting Cai
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Pettenkofer School of Public Health, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology-IBE, Ludwig-Maximilians-Universitat Munchen, Munich, Germany.,German Center for Cardiovascular Disease Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Birger Mensel
- Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Jens-Peter Kühn
- Institute and Policlinic for Diagnostic and Interventional Radiology, University Hospital Carl-Gustav-Carus, Dresden University of Technology, Dresden, Germany
| | | | - Corinna Storz
- Department of Neuroradiology, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, Munich, Bayern, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Partner site Düsseldorf, German Center for Diabetes Research, Neuherberg, Germany
| | - Michael Roden
- Partner site Düsseldorf, German Center for Diabetes Research, Neuherberg, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute for Clinical Diabetology, German Diabetes Center, German Diabetes Center Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Simon Hohenester
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Cardiovascular Disease Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig Maximilians University Munich, Munich, Germany.,Partner site Munich-Neuherberg, German Center for Diabetes Research, Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.,Partner site Munich-Neuherberg, German Center for Diabetes Research, Neuherberg, Germany
| | - Henry Völzke
- Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Greifswald, Germany.,Partner site Greifswald, German Center for Cardiovascular Disease Research, Greifswald, Germany
| | - Jana Nano
- Institute of Epidemiology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany .,Partner site Munich-Neuherberg, German Center for Diabetes Research, Neuherberg, Germany
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Kiefer LS, Fabian J, Rospleszcz S, Lorbeer R, Machann J, Kraus MS, Roemer F, Rathmann W, Meisinger C, Heier M, Nikolaou K, Peters A, Storz C, Diallo TD, Schlett CL, Bamberg F. Distribution patterns of intramyocellular and extramyocellular fat by magnetic resonance imaging in subjects with diabetes, prediabetes and normoglycaemic controls. Diabetes Obes Metab 2021; 23:1868-1878. [PMID: 33914415 DOI: 10.1111/dom.14413] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/06/2021] [Accepted: 04/26/2021] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the distribution of intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) as well as total fat content in abdominal skeletal muscle by magnetic resonance imaging (MRI) using a dedicated segmentation algorithm in subjects with type 2 diabetes (T2D), prediabetes and normoglycaemic controls. MATERIALS AND METHODS Subjects from a population-based cohort were classified with T2D, prediabetes or as normoglycaemic controls. Total myosteatosis, IMCLs and EMCLs were quantified by multiecho Dixon MRI as proton-density fat-fraction (in %) in abdominal skeletal muscle. RESULTS Among 337 included subjects (median age 56.0 [IQR: 49.0-64.0] years, 56.4% males, median body mass index [BMI]: 27.2 kg/m2 ), 129 (38.3%) were classified with an impaired glucose metabolism (T2D: 49 [14.5%]; prediabetes: 80 [23.7%]). IMCLs were significantly higher than EMCLs in subjects without obesity (5.7% [IQR: 4.8%-7.0%] vs. 4.1% [IQR: 2.7%-5.8%], P < .001), whereas the amounts of IMCLs and EMCLs were shown to be equal and significantly higher in subjects with obesity (both 6.7%, P < .001). Subjects with prediabetes and T2D had significantly higher amounts of IMCLs and EMCLs compared with normoglycaemic controls (P < .001). In univariable analysis, prediabetes and T2D were significantly associated with both IMCLs (prediabetes: β: 0.76, 95% CI: 0.28-1.24, P = .002; T2D: β: 1.56, 95% CI: 0.66-2.47, P < .001) and EMCLs (prediabetes: β: 1.54, 95% CI: 0.56-2.51, P = .002; T2D: β: 2.15, 95% CI: 1.33-2.96, P < .001). After adjustment for age and gender, the association of IMCLs with prediabetes attenuated (P = 0.06), whereas for T2D, both IMCLs and EMCLs remained significantly and positively associated (P < .02). CONCLUSION There are significant differences in the amount and distribution ratio of IMCLs and EMCLs between subjects with T2D, prediabetes and normoglycaemic controls. Therefore, these patterns of intramuscular fat distribution by MRI might serve as imaging biomarkers in both normal and impaired glucose metabolism.
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Affiliation(s)
- Lena S Kiefer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Jana Fabian
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Susanne Rospleszcz
- Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Munich, Germany
| | - Jürgen Machann
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tuebingen, Tuebingen, Germany
- German Center for Diabetes Research (DZD), Tuebingen, Germany
| | - Mareen S Kraus
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Frank Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Wolfgang Rathmann
- German Center for Diabetes Research (DZD), Tuebingen, Germany
- German Diabetes Center, Institute for Biometrics and Epidemiology, Duesseldorf, Germany
| | - Christa Meisinger
- Epidemiology, University Hospital Augsburg, Augsburg, Germany
- German Research Center for Environmental Health, Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Margit Heier
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Annette Peters
- Epidemiology, Ludwig-Maximilians-University München, Munich, Germany
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Munich, Germany
- German Center for Diabetes Research (DZD), Tuebingen, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thierno D Diallo
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Askani E, Rospleszcz S, Rothenbacher T, Wawro N, Messmann H, De Cecco CN, von Krüchten R, Kulka C, Kiefer LS, Rathmann W, Peters A, Schlett CL, Bamberg F, Linseisen J, Storz C. Dietary habits and the presence and degree of asymptomatic diverticular disease by magnetic resonance imaging in a Western population: a population-based cohort study. Nutr Metab (Lond) 2021; 18:73. [PMID: 34271946 PMCID: PMC8283990 DOI: 10.1186/s12986-021-00599-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/17/2021] [Accepted: 07/03/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite the worldwide burden of diverticular disease, the connections between diverticular disease and dietary habits remain poorly understood, particularly in an asymptomatic representative sample. We investigated the association between asymptomatic diverticular disease as assessed by magnetic resonance imaging (MRI) and dietary habits in a Western study cohort. METHODS Participants from a cross-sectional sample of a population-based cohort study underwent whole-body 3T-MRI including an isotropic VIBE-Dixon sequence. The presence and extent of diverticular disease was assessed in blinded fashion. Habitual dietary intake was recorded using a blended approach, applying 24-h food lists and a food-frequency questionnaire. Traditional cardiometabolic risk factors were obtained by interviews and medical examination. Univariate and multivariate associations were calculated. RESULTS A total of 308 subjects were included in this analysis (56% male, 56.4 ± 9.1 years). 39.9% had any form of diverticular disease and 15.3% had advanced asymptomatic diverticular disease. After adjustment for age, sex and total energy intake a higher intake of fiber and vegetables was associated with a lower odds for asymptomatic diverticular disease (fiber: OR 0.68 95% CI [0.48, 0.95]; vegetables: OR 0.72 95% CI [0.53, 0.97]) and an increased intake of meat was associated with an approximately two-fold higher odds for advanced asymptomatic diverticular disease (OR 1.84 95% CI [1.13, 2.99]). However, after additional adjustment for body-mass-index (BMI), alcohol consumption, smoking behavior and physical activity only a high fiber and vegetables intake remained significantly associated with lower odds of asymptomatic diverticular disease. CONCLUSION Our results indicate that a high-fiber diet and increased intake of vegetables is associated with lower odds of having asymptomatic diverticular disease, independent of age, sex, total energy intake, BMI and other life-style factors.
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Affiliation(s)
- Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Susanne Rospleszcz
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany.,Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Theresa Rothenbacher
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Nina Wawro
- Independent Research Group Clinical Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Epidemiology, Ludwig-Maximilians University of Munich, UNIKA-T Augsburg, Augsburg, Germany
| | - Helmut Messmann
- Department of Internal Medicine III, Klinikum Augsburg, Augsburg, Germany
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA, USA
| | - Ricarda von Krüchten
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Charlotte Kulka
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Lena S Kiefer
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
| | - Annette Peters
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany.,Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jakob Linseisen
- Independent Research Group Clinical Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.,Chair of Epidemiology, Ludwig-Maximilians University of Munich, UNIKA-T Augsburg, Augsburg, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
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46
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Walter SS, Lorbeer R, Hefferman G, Schlett CL, Peters A, Rospleszcz S, Nikolaou K, Bamberg F, Notohamiprodjo M, Maurer E. Correlation between thoracolumbar disc degeneration and anatomical spinopelvic parameters in supine position on MRI. PLoS One 2021; 16:e0252385. [PMID: 34106962 PMCID: PMC8189447 DOI: 10.1371/journal.pone.0252385] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/15/2021] [Indexed: 11/18/2022] Open
Abstract
Objective This study aims to investigate the correlation between spinopelvic parameters in supine position (pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL)), disc degeneration and herniation of the thoracolumbar spine, as well as cardiovascular risk factors and back pain in a southern German cohort from the general population. Methods This study is a cross-sectional, case–control study drawn from a prospective cohort of the “Cooperative Health Research in the Region of Augsburg/Kooperative Gesundheitsforschung in der Region Augsburg” study (KORA). In total, 374 participants (mean age 56.4 ± 9.2 years; 57.8% male) from the whole-body MRI cohort (FF4) were included. All participants underwent a standardized whole-body MRI on which disc degeneration of the thoracic and lumbar spine was evaluated using a sequence adapted Pfirrmann score. PI, PT, SS and LL were measured according to the description in the literature, using sagittal imaging. Furthermore, disc bulging and protrusion were assessed. Correlations were estimated by logistic regression models providing odds ratios. Results Mean PI was 54.0° ± 11.1°, PT 13.0° ± 5.8°, SS 40.2° ± 8.8° and LL 36.2° ± 9.6°. SS was greater in men (p<0.05) and lumbar lordosis in women (p<0.001). PT increased by 0.09° per age-year with rising age. Age was not associated with PI, SS and LL. Neither BMI, hypertension, cholesterol, lipid levels, nor physical activity were associated with PI, PT, SS or LL. Diabetes mellitus negatively correlated with SS (β = -4.19; 95%CI -7.31–1.06, p<0.01). Smaller spinopelvic parameters (PI, SS and LL) where significantly (p<0.05) correlated with an increased frequency of disc bulging, as well as a local clustering in the lumbar, but not the thoracic spine. Conclusion In conclusion, spinopelvic parameters, measured in supine position, are significantly correlated with disc bulging alone; there is no significant correlation between supine spinopelvic parameters and disc degeneration, back pain or cardiovascular risk factors.
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Affiliation(s)
- Sven S. Walter
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian-University Hospital Marchioninistraße, Munich, Germany
| | - Gerald Hefferman
- Brigham and Women’s Hospital, Department of Radiology and Harvard Medical School, Boston, MA, United States of America
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center ‐ University of Freiburg, Freiburg, Germany
| | - Anette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center forEnvironmental Health, Neuherberg, Germany
- Medical Faculty, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research (DZD), Partner site Neuherberg, Neuherberg, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center forEnvironmental Health, Neuherberg, Germany
- Medical Faculty, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Konstantin Nikolaou
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center ‐ University of Freiburg, Freiburg, Germany
| | - Mike Notohamiprodjo
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
- Die Radiologie, Munich, Germany
- * E-mail:
| | - Elke Maurer
- Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Germany
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47
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Grosu S, Lorbeer R, Hartmann F, Rospleszcz S, Bamberg F, Schlett CL, Galie F, Selder S, Auweter S, Heier M, Rathmann W, Mueller-Peltzer K, Ladwig KH, Peters A, Ertl-Wagner BB, Stoecklein S. White matter hyperintensity volume in pre-diabetes, diabetes and normoglycemia. BMJ Open Diabetes Res Care 2021; 9:9/1/e002050. [PMID: 34183320 PMCID: PMC8240582 DOI: 10.1136/bmjdrc-2020-002050] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/01/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION As white matter hyperintensities (WMHs) of the brain are associated with an increased risk of stroke, cognitive decline, and depression, elucidating the associated risk factors is important. In addition to age and hypertension, pre-diabetes and diabetes may play important roles in the development of WMHs. Previous studies have, however, shown conflicting results. We aimed to investigate the effect of diabetes status and quantitative markers of glucose metabolism on WMH volume in a population-based cohort without prior cardiovascular disease. RESEARCH DESIGN AND METHODS 400 participants underwent 3 T MRI. WMHs were manually segmented on 3D fluid-attenuated inversion recovery images. An oral glucose tolerance test (OGTT) was administered to all participants not previously diagnosed with diabetes to assess 2-hour serum glucose concentrations. Fasting glucose concentrations and glycated hemoglobin (HbA1c) levels were measured. Zero-inflated negative binomial regression analyses of WMH volume and measures of glycemic status were performed while controlling for cardiovascular risk factors and multiple testing. RESULTS The final study population comprised 388 participants (57% male; age 56.3±9.2 years; n=98 with pre-diabetes, n=51 with diabetes). Higher WMH volume was associated with pre-diabetes (p=0.001) and diabetes (p=0.026) compared with normoglycemic control participants after adjustment for cardiovascular risk factors. 2-hour serum glucose (p<0.001), but not fasting glucose (p=0.389) or HbA1c (p=0.050), showed a significant positive association with WMH volume after adjustment for cardiovascular risk factors. CONCLUSION Our results indicate that high 2-hour serum glucose concentration in OGTT, but not fasting glucose levels, may be an independent risk factor for the development of WMHs, with the potential to inform intensified prevention strategies in individuals at risk of WMH-associated morbidity.
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Affiliation(s)
- Sergio Grosu
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Felix Hartmann
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Franziska Galie
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Sonja Selder
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Sigrid Auweter
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Katharina Mueller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Karl-Heinz Ladwig
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Hospital Rechts der Isar, Technical University Munich, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany
- Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Birgit B Ertl-Wagner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sophia Stoecklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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48
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Beller E, Lorbeer R, Keeser D, Galiè F, Meinel FG, Grosu S, Bamberg F, Storz C, Schlett CL, Peters A, Schneider A, Linseisen J, Meisinger C, Rathmann W, Ertl-Wagner B, Stoecklein S. Significant Impact of Coffee Consumption on MR-Based Measures of Cardiac Function in a Population-Based Cohort Study without Manifest Cardiovascular Disease. Nutrients 2021; 13:nu13041275. [PMID: 33924572 PMCID: PMC8069927 DOI: 10.3390/nu13041275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/17/2021] [Revised: 03/28/2021] [Accepted: 04/06/2021] [Indexed: 12/17/2022] Open
Abstract
Subclinical effects of coffee consumption (CC) with regard to metabolic, cardiac, and neurological complications were evaluated using a whole-body magnetic resonance imaging (MRI) protocol. A blended approach was used to estimate habitual CC in a population-based study cohort without a history of cardiovascular disease. Associations of CC with MRI markers of gray matter volume, white matter hyperintensities, cerebral microhemorrhages, total and visceral adipose tissue (VAT), hepatic proton density fat fraction, early/late diastolic filling rate, end-diastolic/-systolic and stroke volume, ejection fraction, peak ejection rate, and myocardial mass were evaluated by linear regression. In our analysis with 132 women and 168 men, CC was positively associated with MR-based cardiac function parameters including late diastolic filling rate, stroke volume (p < 0.01 each), and ejection fraction (p < 0.05) when adjusting for age, sex, smoking, hypertension, diabetes, Low-density lipoprotein (LDL), triglycerides, cholesterol, and alcohol consumption. CC was inversely associated with VAT independent of demographic variables and cardiovascular risk factors (p < 0.05), but this association did not remain significant after additional adjustment for alcohol consumption. CC was not significantly associated with potential neurodegeneration. We found a significant positive and independent association between CC and MRI-based systolic and diastolic cardiac function. CC was also inversely associated with VAT but not independent of alcohol consumption.
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Affiliation(s)
- Ebba Beller
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, 18057 Rostock, Germany;
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (R.L.); (D.K.); (F.G.); (S.G.); (S.S.)
- Correspondence: ; Tel.: +49-(0)381-494-9201; Fax: +49-(0)381-494-9202
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (R.L.); (D.K.); (F.G.); (S.G.); (S.S.)
| | - Daniel Keeser
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (R.L.); (D.K.); (F.G.); (S.G.); (S.S.)
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians University Hospital LMU, 80336 Munich, Germany
- Munich Center for Neurosciences (MCN)–Brain & Mind, 82152 Planegg-Martinsried, Germany
| | - Franziska Galiè
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (R.L.); (D.K.); (F.G.); (S.G.); (S.S.)
| | - Felix G. Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, 18057 Rostock, Germany;
| | - Sergio Grosu
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (R.L.); (D.K.); (F.G.); (S.G.); (S.S.)
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (F.B.); (C.L.S.)
- University Heart Center Freiburg-Bad Krozingen, 79189 Bad Krozingen, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, 79098 Freiburg, Germany;
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (F.B.); (C.L.S.)
- University Heart Center Freiburg-Bad Krozingen, 79189 Bad Krozingen, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), 85764 Neuherberg, Germany; (A.P.); (A.S.)
- LMU Munich, IBE-Chair of Epidemiology, 85764 Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, 80802 Munich, Germany
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), 85764 Neuherberg, Germany; (A.P.); (A.S.)
| | - Jakob Linseisen
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
- Ludwig-Maximilians Universität München, UNIKA-T Augsburg, 86156 Augsburg, Germany;
| | - Christa Meisinger
- Ludwig-Maximilians Universität München, UNIKA-T Augsburg, 86156 Augsburg, Germany;
| | - Wolfgang Rathmann
- German Diabetes Center, Institute of Biometrics and Epidemiology, Leibniz Institute at Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany;
| | - Birgit Ertl-Wagner
- Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada;
| | - Sophia Stoecklein
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (R.L.); (D.K.); (F.G.); (S.G.); (S.S.)
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Rylski B, Schofer F, Beyersdorf F, Kondov S, Kreibich M, Schlett CL, Czerny M. Aortic Arch Anatomy in Candidates for Aortic Arch Repair. Semin Thorac Cardiovasc Surg 2021; 34:19-26. [PMID: 33713827 DOI: 10.1053/j.semtcvs.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/03/2021] [Accepted: 03/03/2021] [Indexed: 11/11/2022]
Abstract
Detailed knowledge of aortic anatomy is necessary before new prostheses can be developed. Our aim was to provide a thorough analysis of aortic arch anatomy in patients who are potential candidates for arch repair. Patients' charts were screened between 2001 and 2019 for all those with a dissection or aneurysm involving aortic arch. Aortic diameters, segmental lengths, aortic arch type, tortuosity, diameters and length of supraaortic vessels were analyzed via computed tomography angiography. We included 558 patients who underwent thoracic aortic treatment for type A, B, non-A non-B dissection, or aortic arch aneurysm. Incidence of all three arch types was similar in patients with type A dissection. In type B dissection and arch aneurysm patients, arch type III was most commonly observed (47% and 52%, respectively). The left vertebral artery offspring from aortic arch was observed in 6.6%. The mid-ascending aorta and aortic arch were not dilated in type B and non-A non-B dissection patients. The innominate, left common carotid and left subclavian arteries median diameters were 16 (14; 18), 8 (7; 9) and 11 (10; 12) mm, respectively. The median innominate artery length was 37 (30; 44) mm. The median left subclavian artery length was 40 (34; 46) mm. Arch types are distributed differently among patients with various arch pathologies. Patients with aortic dissection type B and non-A non-B have a non-dilated ascending aorta and aortic arch. Aortic arch tortuosity, innominate and left subclavian artery lengths do not differ among aortic pathologies.
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Affiliation(s)
- Bartosz Rylski
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Florian Schofer
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Stoyan Kondov
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Kreibich
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Diagnostic and Interventional Radiology, Heart Center Freiburg University, Freiburg, Germany
| | - Martin Czerny
- Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Lorbeer R, Rospleszcz S, Schlett CL, Rado SD, Thorand B, Meisinger C, Rathmann W, Heier M, Vasan RS, Bamberg F, Peters A, Lieb W. Association of antecedent cardiovascular risk factor levels and trajectories with cardiovascular magnetic resonance-derived cardiac function and structure. J Cardiovasc Magn Reson 2021; 23:2. [PMID: 33390171 PMCID: PMC7780638 DOI: 10.1186/s12968-020-00698-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/29/2020] [Accepted: 12/09/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The association of longitudinal trajectories of cardiovascular risk factors with cardiovascular magnetic resonance (CMR)-measures of cardiac structure and function in the community is not well known. Therefore we aimed to relate risk factor levels from different examination cycles to CMR-measures of the left ventricle (LV) and right ventricle in a population-based cohort. METHODS We assessed conventional cardiovascular disease risk factors in 349 participants (143 women; aged 25-59 years) at three examination cycles (Exam 1 [baseline], at Exam 2 [7-years follow-up] and at Exam 3 [14-years follow-up]) of the KORA S4 cohort and related single-point measurements of individual risk factors and longitudinal trajectories of these risk factors to various CMR-measures obtained at Exam 3. RESULTS High levels of diastolic blood pressure, waist circumference, and LDL-cholesterol at the individual exams were associated with worse cardiac function and structure. Trajectory clusters representing higher levels of the individual risk factors were associated with worse cardiac function and structure compared to low risk trajectory clusters of individual risk factors. Multivariable (combining different risk factors) trajectory clusters were associated with different cardiac parameters in a graded fashion (e.g. decrease of LV stroke volume for middle risk cluster β = - 4.91 ml/m2, 95% CI - 7.89; - 1.94, p < 0.01 and high risk cluster β = - 7.00 ml/m2, 95% CI - 10.73; - 3.28, p < 0.001 compared to the low risk cluster). The multivariable longitudinal trajectory clusters added significantly to explain variation in CMR traits beyond the multivariable risk profile obtained at Exam 3. CONCLUSIONS Cardiovascular disease risk factor levels, measured over a time period of 14 years, were associated with CMR-derived measures of cardiac structure and function. Longitudinal multivariable trajectory clusters explained a greater proportion of the inter-individual variation in cardiac traits than multiple risk factor assessed contemporaneous with the CMR exam.
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Affiliation(s)
- Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany.
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany.
| | - Susanne Rospleszcz
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, Institute of Medical Information Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, University Freiburg, Freiburg, Germany
| | - Sophia D Rado
- Department of Diagnostic and Interventional Radiology, Eberhard Karl University Tübingen, Tübingen, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD E.V.), Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, LMU Munich, UNIKA-T Augsburg, Augsburg, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Düsseldorf, Germany
- Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
| | - Ramachandran S Vasan
- Preventive Medicine and Epidemiology Section, Boston University School of Medicine and Framingham Heart Study, Framingham, MA, USA
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, University Freiburg, Freiburg, Germany
| | - Annette Peters
- German Center for Cardiovascular Disease Research (DZHK E.V.), Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Chair of Epidemiology, Institute of Medical Information Processing, Biometrics and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Diabetes Research (DZD E.V.), Neuherberg, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Kiel University, Kiel, Germany
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