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Langenbach IL, Wienemann H, Klein K, Scholtz JE, Pennig L, Langzam E, Pahn G, Holz JA, Maintz D, Naehle CP, Langenbach MC. Coronary calcium scoring using virtual non-contrast reconstructions on a dual-layer spectral CT system: Feasibility in the clinical practice. Eur J Radiol 2023; 159:110681. [PMID: 36592582 DOI: 10.1016/j.ejrad.2022.110681] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/04/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the clinical applicability of a prototype virtual non-contrast (VNC) reconstruction algorithm based on coronary CT angiography (cCTA) to assess calcified coronary plaques by calcium scoring (CACS). METHODS Eighty consecutive patients suspected of coronary artery disease were retrospectively included. All patients underwent a cardiac CT using a dual-layer spectral-detector CT system. The standardized acquisition protocol included unenhanced CACS and cCTA. Datasets were acquired using 120 keV. VNC-reconstructions were calculated from the cCTA images at 2.5 mm (VNC group 1), 2.5 of 0.9 mm (group 2), and 0.9 mm (group 3) slice thickness. We compared the Agatston score and Coronary Artery Calcium Data and Reporting System (CAC-DRS) of all VNC reconstructions with the true non-contrast (TNC)-dataset as the gold standard. RESULTS In total, 73 patients were evaluated. Fifty patients (68.5 %) had a CACS > 0 based on TNC. We found a significant difference in the Agatston score comparing all VNC-reconstructions (1: 1.35, 2: 3.7, 3: 10.4) with the TNC dataset (3.8) (p < 0.001). Correlation analysis of the datasets showed an excellent correlation of the TNC results with the different VNC-reconstructions (r = 0.904-0.974, p < 0.001) with a slope of 1.89-2.53. Mean differences and limits of agreement by Bland-Altman analysis between TNC and group 1 were 83 and -196 to 362, respectively. By using the VNC-reconstructions, in group 1 23 patients (31.5 %), in group 2 10 (13.7 %), and in group 3 23 (31.5 %) were reclassified according to CAC-DRS compared to TNC. Classification according to CAC-DRS revealed a significant difference between TNC and group 1 (p = 0.024) and no significance compared to groups 2 and 3 (p = 0.670 and 0.273). CONCLUSION The investigated VNC reconstruction algorithm of routine cCTA allows the detection and evaluation of coronary calcium burden without the requirement for an additional acquisition of an unenhanced CT scan for CACS and, therefore, a reduction of radiation exposure.
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Affiliation(s)
- I L Langenbach
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - H Wienemann
- Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - K Klein
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - J E Scholtz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Frankfurt, University of Frankfurt, Frankfurt, Germany
| | - L Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - E Langzam
- Philips Healthcare, Best, the Netherlands
| | - G Pahn
- Philips CT Clinical Science, Hamburg, Germany
| | - J A Holz
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - D Maintz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - C P Naehle
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Radiologische Allianz, Hamburg, Germany
| | - M C Langenbach
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Goertz L, Liebig T, Siebert E, Özpeynirci Y, Pennig L, Celik E, Schlamann M, Dorn F, Kabbasch C. Treatment of Proximal Posterior Inferior Cerebellar Artery Aneurysms by Intrasaccular Flow Disruption: A Multicenter Experience. AJNR Am J Neuroradiol 2022; 43:1158-1163. [PMID: 35863779 PMCID: PMC9575426 DOI: 10.3174/ajnr.a7566] [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: 01/24/2022] [Accepted: 05/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Treatment of PICA aneurysms can be technically challenging by either surgical or endovascular means. Our aim was to report our preliminary experience with intrasaccular flow disruption using the Woven EndoBridge (WEB) for the treatment of proximal PICA aneurysms. MATERIALS AND METHODS Sixteen PICA aneurysms treated with the WEB at 3 institutions were retrospectively reviewed. Baseline patient and aneurysm characteristics, procedural specifics, clinical outcomes, and angiographic results were evaluated. RESULTS All aneurysms were located at the proximal, anteromedullary segment of the PICA. Seven aneurysms were ruptured. The median aneurysm size was 3.9 mm (range, 2-12 mm), and all aneurysms were wide-neck. WEB deployment failed in 1 case due to WEB protrusion in a small PICA aneurysm. Additional stent implantation was required for 2 aneurysms to improve intra-aneurysmal WEB positioning. One patient developed a partial posterior cerebral artery territory infarction with transient hemianopsia. Intraoperative rerupture of a ruptured aneurysm could be immediately stopped by WEB deployment due to intrasaccular stasis; however, it might have contributed to a slight disability of the patient. At last angiographic follow-up, 12/15 aneurysms (80%) were completely occluded and 3/15 (20%) had a neck remnant. CONCLUSIONS The preliminary results indicate that WEB treatment of proximal PICA aneurysms is feasible with a reasonable safety and efficacy profile. The advantages of intrasaccular flow disruption include preservation of the PICA, durable aneurysm occlusion, and omission of antiplatelet therapy. The low-profile WEB 17 delivery system might enable navigation to distal PICA aneurysms, which needs to be addressed further.
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Affiliation(s)
- L Goertz
- From the Department of Radiology and Neuroradiology (L.G., L.P., E.C., M.S., C.K.), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - T Liebig
- Department of Neuroradiology (T.L., Y.Ö.), University Hospital Munich, Munich, Germany
| | - E Siebert
- Department of Neuroradiology (E.S.), University Hospital of Berlin (Charité), Berlin, Germany
| | - Y Özpeynirci
- Department of Neuroradiology (T.L., Y.Ö.), University Hospital Munich, Munich, Germany
| | - L Pennig
- From the Department of Radiology and Neuroradiology (L.G., L.P., E.C., M.S., C.K.), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - E Celik
- From the Department of Radiology and Neuroradiology (L.G., L.P., E.C., M.S., C.K.), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - M Schlamann
- From the Department of Radiology and Neuroradiology (L.G., L.P., E.C., M.S., C.K.), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - F Dorn
- Department of Neuroradiology (F.D.), University Hospital Bonn, Bonn, Germany
| | - C Kabbasch
- From the Department of Radiology and Neuroradiology (L.G., L.P., E.C., M.S., C.K.), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
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Huflage H, Luetkens K, Kunz SA, Görtz L, Pennig L, Conrads N, Bley AT, Schmitt R, Grunz PJ. Die radiäre Rekonstruktion isotroper 3D-Sequenzen verbessert die diagnostische Genauigkeit für periphere TFCC-Verletzungen in der MR-Arthrographie des Handgelenks. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- H Huflage
- Universitätsklinikum Würzburg, Inst. f. Diagn. und Interv. Radiologie d, Würzburg
| | - K Luetkens
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Würzburg
| | - S A Kunz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Würzburg
| | - L Görtz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Köln
| | - L Pennig
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Köln
| | - N Conrads
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Würzburg
| | - A T Bley
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Würzburg
| | - R Schmitt
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Würzburg
| | - P J Grunz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Würzburg
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Pennig L, Hoyer U, Lennartz S, Abdullayev N, Fichter F, Persigehl T, Kabbasch C, Weiss K, Borggrefe J. Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) zur Evaluation von Stenosen der proximalen A. carotis interna (ACI) beim akuten ischämischen Schlaganfall. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- L Pennig
- Uniklinik Köln, Inst. f. Diagn. u. Intervent. Radiologie, Köln
| | - U Hoyer
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln
| | - S Lennartz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln
| | - N Abdullayev
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln
| | - F Fichter
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln
| | - T Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln
| | - C Kabbasch
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln, Köln
| | | | - J Borggrefe
- Universitätsinstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Johannes-Wesling Klinikum, Minden
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Zopfs D, Laukamp K, Reimer R, Grosse Hokamp N, Kabbasch C, Borggrefe J, Pennig L, Bunck AC, Schlamann M, Lennartz S. Automated Color-Coding of Lesion Changes in Contrast-Enhanced 3D T1-Weighted Sequences for MRI Follow-up of Brain Metastases. AJNR Am J Neuroradiol 2022; 43:188-194. [PMID: 34992128 PMCID: PMC8985679 DOI: 10.3174/ajnr.a7380] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 10/06/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE MR imaging is the technique of choice for follow-up of patients with brain metastases, yet the radiologic assessment is often tedious and error-prone, especially in examinations with multiple metastases or subtle changes. This study aimed to determine whether using automated color-coding improves the radiologic assessment of brain metastases compared with conventional reading. MATERIALS AND METHODS One hundred twenty-one pairs of follow-up examinations of patients with brain metastases were assessed. Two radiologists determined the presence of progression, regression, mixed changes, or stable disease between the follow-up examinations and indicated subjective diagnostic certainty regarding their decisions in a conventional reading and a second reading using automated color-coding after an interval of 8 weeks. RESULTS The rate of correctly classified diagnoses was higher (91.3%, 221/242, versus 74.0%, 179/242, P < .01) when using automated color-coding, and the median Likert score for diagnostic certainty improved from 2 (interquartile range, 2-3) to 4 (interquartile range, 3-5) (P < .05) compared with the conventional reading. Interrater agreement was excellent (κ = 0.80; 95% CI, 0.71-0.89) with automated color-coding compared with a moderate agreement (κ = 0.46; 95% CI, 0.34-0.58) with the conventional reading approach. When considering the time required for image preprocessing, the overall average time for reading an examination was longer in the automated color-coding approach (91.5 [SD, 23.1] seconds versus 79.4 [SD, 34.7 ] seconds, P < .001). CONCLUSIONS Compared with the conventional reading, automated color-coding of lesion changes in follow-up examinations of patients with brain metastases significantly increased the rate of correct diagnoses and resulted in higher diagnostic certainty.
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Affiliation(s)
- D Zopfs
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - K Laukamp
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - R Reimer
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - N Grosse Hokamp
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - C Kabbasch
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - J Borggrefe
- Department of Radiology (J.B.), Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | - L Pennig
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - A C Bunck
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - M Schlamann
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - S Lennartz
- From the Institute for Diagnostic and Interventional Radiology (D.Z., K.L., R.R., N.G.H., C.K., L.P., A.C.B., M.S., S.L.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Luetkens KS, Huflage H, Kunz AS, Ritschl L, Herbst M, Kappler S, Ergün S, Goertz L, Pennig L, Bley TA, Gassenmaier T, Grunz JP. The effect of tin prefiltration on extremity cone-beam CT imaging with a twin robotic X-ray system. Radiography (Lond) 2021; 28:433-439. [PMID: 34716089 DOI: 10.1016/j.radi.2021.10.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/13/2021] [Accepted: 10/09/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION While tin prefiltration is established in various CT applications, its value in extremity cone-beam CT relative to optimized spectra has not been thoroughly assessed thus far. This study aims to investigate the effect of tin filters in extremity cone-beam CT with a twin-robotic X-ray system. METHODS Wrist, elbow and ankle joints of two cadaveric specimens were examined in a laboratory setup with different combinations of prefiltration (copper, tin), tube voltage and current-time product. Image quality was assessed subjectively by five radiologists with Fleiss' kappa being computed to measure interrater agreement. To provide a semiquantitative criterion for image quality, contrast-to-noise ratios (CNR) were compared for standardized regions of interest. Volume CT dose indices were calculated for a 16 cm polymethylmethacrylate phantom. RESULTS Radiation dose ranged from 17.4 mGy in the clinical standard protocol without tin filter to as low as 0.7 mGy with tin prefiltration. Image quality ratings and CNR for tin-filtered scans with 100 kV were lower than for 80 kV studies with copper prefiltration despite higher dose (11.2 and 5.6 vs. 4.5 mGy; p < 0.001). No difference was ascertained between 100 kV scans with tin filtration and 60 kV copper-filtered scans with 75% dose reduction (subjective: p = 0.101; CNR: p = 0.706). Fleiss' kappa of 0.597 (95% confidence interval 0.567-0.626; p < 0.001) indicated moderate interrater agreement. CONCLUSION Considerable dose reduction is feasible with tin prefiltration, however, the twin-robotic X-ray system's low-dose potential for extremity 3D imaging is maximized with a dedicated low-kilovolt scan protocol in situations without extensive beam-hardening artifacts. IMPLICATIONS FOR PRACTICE Low-kilovolt imaging with copper prefiltration provides a superior trade-off between dose reduction and image quality compared to tin-filtered cone-beam CT scan protocols with higher tube voltage.
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Affiliation(s)
- K S Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - H Huflage
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - A S Kunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - L Ritschl
- X-ray Products - Research & Development, Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany.
| | - M Herbst
- X-ray Products - Research & Development, Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany.
| | - S Kappler
- X-ray Products - Research & Development, Siemens Healthcare GmbH, Siemensstraße 1, 91301, Forchheim, Germany.
| | - S Ergün
- Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.
| | - L Goertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
| | - L Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
| | - T A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - T Gassenmaier
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
| | - J-P Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
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Huflage H, Pennig L, Gietzen C, Bley T, Gassenmaier T, Grunz JP. Prototype Cone-beam CT Scan Mode on a Multipurpose X-ray System: Image Quality in Cadaveric Elbow Scans Compared with Third-generation Dual-source CT. Semin Musculoskelet Radiol 2021. [DOI: 10.1055/s-0041-1731522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pennig L, Shahzad R, Caldeira L, Lennartz S, Thiele F, Goertz L, Zopfs D, Meißner AK, Fürtjes G, Perkuhn M, Kabbasch C, Grau S, Borggrefe J, Laukamp KR. Automated Detection and Segmentation of Brain Metastases in Malignant Melanoma: Evaluation of a Dedicated Deep Learning Model. AJNR Am J Neuroradiol 2021; 42:655-662. [PMID: 33541907 DOI: 10.3174/ajnr.a6982] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Malignant melanoma is an aggressive skin cancer in which brain metastases are common. Our aim was to establish and evaluate a deep learning model for fully automated detection and segmentation of brain metastases in patients with malignant melanoma using clinical routine MR imaging. MATERIALS AND METHODS Sixty-nine patients with melanoma with a total of 135 brain metastases at initial diagnosis and available multiparametric MR imaging datasets (T1-/T2-weighted, T1-weighted gadolinium contrast-enhanced, FLAIR) were included. A previously established deep learning model architecture (3D convolutional neural network; DeepMedic) simultaneously operating on the aforementioned MR images was trained on a cohort of 55 patients with 103 metastases using 5-fold cross-validation. The efficacy of the deep learning model was evaluated using an independent test set consisting of 14 patients with 32 metastases. Manual segmentations of metastases in a voxelwise manner (T1-weighted gadolinium contrast-enhanced imaging) performed by 2 radiologists in consensus served as the ground truth. RESULTS After training, the deep learning model detected 28 of 32 brain metastases (mean volume, 1.0 [SD, 2.4] cm3) in the test cohort correctly (sensitivity of 88%), while false-positive findings of 0.71 per scan were observed. Compared with the ground truth, automated segmentations achieved a median Dice similarity coefficient of 0.75. CONCLUSIONS Deep learning-based automated detection and segmentation of brain metastases in malignant melanoma yields high detection and segmentation accuracy with false-positive findings of <1 per scan.
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Affiliation(s)
- L Pennig
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.)
| | - R Shahzad
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.).,Philips Innovative Technologies (R.S., F.T., M.P.), Aachen, Germany
| | - L Caldeira
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.)
| | - S Lennartz
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.)
| | - F Thiele
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.).,Philips Innovative Technologies (R.S., F.T., M.P.), Aachen, Germany
| | - L Goertz
- Center for Neurosurgery (L.G., G.F., S.G.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - D Zopfs
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.)
| | - A-K Meißner
- Department of Stereotaxy and Functional Neurosurgery (A.-K.M., G.F.), Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - G Fürtjes
- Center for Neurosurgery (L.G., G.F., S.G.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Stereotaxy and Functional Neurosurgery (A.-K.M., G.F.), Center for Neurosurgery, University Hospital Cologne, Cologne, Germany
| | - M Perkuhn
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.).,Philips Innovative Technologies (R.S., F.T., M.P.), Aachen, Germany
| | - C Kabbasch
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.)
| | - S Grau
- Center for Neurosurgery (L.G., G.F., S.G.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - J Borggrefe
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.)
| | - K R Laukamp
- From the Institute for Diagnostic and Interventional Radiology (L.P., R.S., L.C., S.L., F.T., D.Z., M.P., C.K., J.B., K.R.L.) .,Department of Radiology (K.R.L.), University Hospitals Cleveland Medical Center, Cleveland, Ohio.,Department of Radiology (K.R.L.), Case Western Reserve University, Cleveland, Ohio
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Goertz L, Liebig T, Siebert E, Herzberg M, Pennig L, Schlamann M, Borggrefe J, Krischek B, Dorn F, Kabbasch C. Low-Profile Intra-Aneurysmal Flow Disruptor WEB 17 versus WEB Predecessor Systems for Treatment of Small Intracranial Aneurysms: Comparative Analysis of Procedural Safety and Feasibility. AJNR Am J Neuroradiol 2019; 40:1766-1772. [PMID: 31488499 DOI: 10.3174/ajnr.a6183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/14/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE The Woven EndoBridge 17 has recently been introduced to the market for facilitated endovascular treatment of small bifurcation aneurysms (≤7 mm) with low-profile microcatheters. We compared the Woven EndoBridge 17 with its predecessor versions in terms of procedural safety and feasibility. MATERIALS AND METHODS This was a multicenter review of aneurysms ranging from 3 to 7 mm treated with the Woven EndoBridge between 2011 and 2019. Aneurysm characteristics, procedural parameters, and complications were retrospectively compared between treatment with the Woven EndoBridge 17 and a control group that was treated with its predecessor versions, using inverse probability of treatment weighting. RESULTS Thirty-eight aneurysms treated with a Woven EndoBridge 17 (mean size, 4.9 ± 1.5 mm) and 70 treated with a predecessor version of the Woven EndoBridge 17 (mean size, 5.6 ± 1.4 mm) were included. The predecessor version of the Woven EndoBridge 17 had a higher failure rate (10.3%) than the Woven EndoBridge 17 (0%, P = .05). Additional stent placement was performed more often with the predecessor version of the Woven EndoBridge 17 (10.0%) than with the Woven EndoBridge 17 (2.6%, adjusted P = .005). The predecessor version of the Woven EndoBridge 17 was associated with a higher thromboembolic event rate (14.3%) than the Woven EndoBridge 17 (5.3%, adjusted P = .002). Neurologic complications (Woven EndoBridge 17: 2.6%; predecessor version of the Woven EndoBridge 17: 2.9%, adjusted P = 1.0) and immediate complete aneurysm occlusion rates (Woven EndoBridge 17: 57.9%; predecessor version of the Woven EndoBridge 17: 54.3%, adjusted P = .21) did not differ significantly between groups. CONCLUSIONS In the current study, the Woven EndoBridge 17 was associated with a potentially lower thromboembolic event rate than the predecessor version of the Woven EndoBridge 17, without compromising the immediate aneurysm occlusion rate. Long-term clinical and angiographic outcome analysis will be necessary to draw a definite conclusion.
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Affiliation(s)
- L Goertz
- From the Department of Neuroradiology (L.G., L.P., M.S., J.B., C.K.), University Hospital of Cologne, Cologne, Germany .,Center for Neurosurgery (L.G., B.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | - T Liebig
- Department of Neuroradiology (T.L., M.H., F.D.), University Hospital Munich, Munich, Germany
| | - E Siebert
- Department of Neuroradiology (E.S.), University Hospital of Berlin (Charité), Berlin, Germany
| | - M Herzberg
- Department of Neuroradiology (T.L., M.H., F.D.), University Hospital Munich, Munich, Germany
| | - L Pennig
- From the Department of Neuroradiology (L.G., L.P., M.S., J.B., C.K.), University Hospital of Cologne, Cologne, Germany
| | - M Schlamann
- From the Department of Neuroradiology (L.G., L.P., M.S., J.B., C.K.), University Hospital of Cologne, Cologne, Germany
| | - J Borggrefe
- From the Department of Neuroradiology (L.G., L.P., M.S., J.B., C.K.), University Hospital of Cologne, Cologne, Germany
| | - B Krischek
- Center for Neurosurgery (L.G., B.K.), University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | - F Dorn
- Department of Neuroradiology (T.L., M.H., F.D.), University Hospital Munich, Munich, Germany
| | - C Kabbasch
- From the Department of Neuroradiology (L.G., L.P., M.S., J.B., C.K.), University Hospital of Cologne, Cologne, Germany
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Dargel J, Pennig L, Schnurr C, Boese CK, Eysel P, Oppermann J. [Should we use hip-ankle radiographs to assess the coronal alignment after total knee arthroplasty?]. Orthopade 2017; 45:591-6. [PMID: 27246862 DOI: 10.1007/s00132-016-3264-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is no consensus on whether hip-ankle radiographs or rather standardized a‑p knee-radiographs should be used to assess implant position and coronal alignment after total knee arthroplasty (TKA). This study investigates whether implant position and alignment after TKA can reproducibly be assessed using a‑p knee-radiographs rather than hip-ankle radiographs. MATERIALS AND METHODS This study was performed on 100 weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position was assessed on hip-ankle radiographs. The radiographs were then cropped to 80, 60 and 40 % of the leg-length and tibial coronal implant position, and the anatomical axis and a surrogate mechanical axis were obtained. The difference in the alignment parameters between the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated. RESULTS The ICC for measurement of the mechanical femorotibial angle was higher in hip-ankle radiographs (0.95) when compared with a radiograph cropped to 40 % (0.61). There was a significant difference in the mechanical femorotibial angle between hip-ankle radiographs and any cropped radiograph. However, there were no significant differences in coronal implant position and the anatomical femorotibial angle between hip-ankle radiographs and any cropped radiograph. CONCLUSIONS We conclude that standard a‑p knee-radiographs are insufficient to assess the mechanical alignment following TKA. However, standard a‑p knee-radiographs are appropriate to assess the implant position when referenced against the anatomical axes. Weight-bearing hip-ankle radiographs should be questioned as a routine after TKA.
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Affiliation(s)
- J Dargel
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland.
- Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität Köln, Köln, Deutschland.
| | - L Pennig
- Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Universitätsstraße 1, 40225, Düsseldorf, Deutschland
| | - C Schnurr
- St. Vinzenz-Krankenhaus Düsseldorf, Schloßstraße 85, 40477, Düsseldorf, Deutschland
| | - C K Boese
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland
| | - P Eysel
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland
- Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität Köln, Köln, Deutschland
| | - J Oppermann
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland
- Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität Köln, Köln, Deutschland
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Dargel J, Pennig L, Schnurr C, Boese CK, Eysel P, Oppermann J. [Erratum to: Should we use hip-ankle radiographs to assess the coronal alignment after total knee arthroplasty?]. Orthopade 2016; 45:700. [PMID: 27351428 DOI: 10.1007/s00132-016-3297-y] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- J Dargel
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland.
- Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität Köln, Köln, Deutschland.
| | - L Pennig
- Medizinische Fakultät, Julius-Maximilians-Universität Würzburg, Würzburg, Deutschland
| | - C Schnurr
- St. Vinzenz-Krankenhaus Düsseldorf, Düsseldorf, Deutschland
| | - C K Boese
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland
| | - P Eysel
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland
- Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität Köln, Köln, Deutschland
| | - J Oppermann
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland
- Cologne Center for Musculoskeletal Biomechanics, Medizinische Fakultät, Universität Köln, Köln, Deutschland
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