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Suárez V, Picotin R, Fassbender R, Gramespacher H, Haneder S, Persigehl T, Todorova P, Hackl MJ, Onur OA, Richter N, Burst V. Chronic Hyponatremia and Brain Structure and Function Before and After Treatment. Am J Kidney Dis 2024:S0272-6386(24)00001-5. [PMID: 38184092 DOI: 10.1053/j.ajkd.2023.11.007] [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: 05/24/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 01/08/2024]
Abstract
RATIONALE & OBJECTIVE Hyponatremia is the most common electrolyte disorder and is associated with significant morbidity and mortality. This study investigated neurocognitive impairment, brain volume, and alterations in magnetic resonance imaging (MRI)-based measures of cerebral function in patients before and after treatment for hyponatremia. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS Patients with presumed chronic hyponatremia without signs of hypo- or hypervolemia treated in the emergency department of a German tertiary-care hospital. EXPOSURE Hyponatremia (ie, plasma sodium concentration [Na+]<125mmol/L) before and after treatment leading to [Na+]>130mmol/L. OUTCOMES Standardized neuropsychological testing (Mini-Mental State Examination, DemTect, Trail Making Test A/B, Beck Depression Inventory, Timed Up and Go) and resting-state MRI were performed before and after treatment of hyponatremia to assess total brain and white and gray matter volumes as well as neuronal activity and its synchronization. ANALYTICAL APPROACH Changes in outcomes after treatment for hyponatremia assessed using bootstrapped confidence intervals and Cohen d statistic. Associations between parameters were assessed using correlation analyses. RESULTS During a 3.7-year period, 26 patients were enrolled. Complete data were available for 21 patients. Mean [Na+]s were 118.4mmol/L before treatment and 135.5mmol/L after treatment. Most measures of cognition improved significantly. Comparison of MRI studies showed a decrease in brain tissue volumes, neuronal activity, and synchronization across all gray matter after normalization of [Na+]. Volume effects were particularly prominent in the hippocampus. During hyponatremia, synchronization of neuronal activity was negatively correlated with [Na+] (r=-0.836; 95% CI, -0.979 to-0.446) and cognitive function (Mini-Mental State Examination, r=-0.523; 95% CI, -0.805 to-0.069; DemTect, r=-0.744; 95% CI, -0.951 to-0.385; and Trail Making Test A, r=0.692; 95% CI, 0.255-0.922). LIMITATIONS Small sample size, insufficient quality of several MRI scans as a result of motion artifact. CONCLUSIONS Resolution of hyponatremia was associated with improved cognition and reductions in brain volumes and neuronal activity. Impaired cognition during hyponatremia is closely linked to increased neuronal activity rather than to tissue volumes. Furthermore, the hippocampus appears to be particularly susceptible to hyponatremia, exhibiting pronounced changes in tissue volume. PLAIN-LANGUAGE SUMMARY Hyponatremia is a common clinical problem, and patients often present with neurologic symptoms that are at least partially reversible. This study used neuropsychological testing and magnetic resonance imaging to examine patients during and after correction of hyponatremia. Treatment led to an improvement in patients' cognition as well as a decrease in their brain volumes, spontaneous neuronal activity, and synchronized neuronal activity between remote brain regions. Volume effects were particularly prominent in the hippocampus, an area of the brain that is important for the modulation of memory. During hyponatremia, patients with the lowest sodium concentrations had the highest levels of synchronized neuronal activity and the poorest cognitive test results.
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Affiliation(s)
- Victor Suárez
- Department II of Internal Medicine (Nephrology, Rheumatology, Diabetes, and General Internal Medicine) and Center for Molecular Medicine Cologne, Cologne, Germany; Emergency Department, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Rosanne Picotin
- Department of Neurology, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ronja Fassbender
- Department of Neurology, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Hannes Gramespacher
- Department of Neurology, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Stefan Haneder
- Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Polina Todorova
- Department II of Internal Medicine (Nephrology, Rheumatology, Diabetes, and General Internal Medicine) and Center for Molecular Medicine Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Matthias Johannes Hackl
- Department II of Internal Medicine (Nephrology, Rheumatology, Diabetes, and General Internal Medicine) and Center for Molecular Medicine Cologne, Cologne, Germany; Emergency Department, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Oezguer A Onur
- Department of Neurology, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Nils Richter
- Department of Neurology, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Volker Burst
- Department II of Internal Medicine (Nephrology, Rheumatology, Diabetes, and General Internal Medicine) and Center for Molecular Medicine Cologne, Cologne, Germany; Emergency Department, University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
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Ries C, Baltin CT, Haneder S, Eysel P, Hellmich M, Boese CK. Dual-scale single marker calibration for digital templating of total hip arthroplasty in standing radiographs: a prospective clinical study. Arch Orthop Trauma Surg 2023; 143:1817-1824. [PMID: 35099608 PMCID: PMC10030446 DOI: 10.1007/s00402-022-04355-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 01/06/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE Accuracy of calibration of radiographs significantly influences the quality of digital templating for total hip arthroplasty (THA). The standard of care is calibration with external calibration markers (ECM). This method is associated with significant errors. Dual-scale single marker (DSSM) calibration methods may improve accuracy. The present prospective observational study is the first to analyze the application of a DSSM method in standing pelvis radiographs. METHODS 100 patients with unilateral THA underwent antero-posterior pelvis radiographs with ECM and DSSM. The hip components were used as reference calibration factor (internal calibration factor; ICM). Absolute differences of calibration factors for ECM and DSSM from ICM were calculated. Absolute relative deviations (ARD) were calculated. Subgroup analysis for sex and WHO BMI category was performed. Furthermore, patients reported subjective comfort for each marker using a 10-point scale and choosing the preferred marker. RESULTS Maximum magnification factor differences from the ICM were 23.3% and 9.5% and mean absolute differences were 12.5% and 2.1% for the ECM and DSSM, respectively. ARD from ICM was significantly lower for DSSM compared to ECM (p < 0.001). Absolute differences increased with BMI category using ECM; calibration by DSSM was consistent in all subgroups. Patients preferred DSSM over ECM (n = 53) or were indifferent (n = 20). Comfort was rated significantly higher for DSSM versus ECM (p < 0.001). CONCLUSION DSSM method showed superior results in comparison to the ECM method for calibration of digital radiographs. DSSM could be used to improve digital templating in standing radiographs.
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Affiliation(s)
- Christian Ries
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christoph Tobias Baltin
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 24, 50931, Cologne, Germany
| | - Stefan Haneder
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50931, Cologne, Germany
| | - Peer Eysel
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 24, 50931, Cologne, Germany
| | - Martin Hellmich
- IMSB, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Christoph Kolja Boese
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 24, 50931, Cologne, Germany.
- Division of Orthopaedics, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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Siedek F, Große-Hokamp N, Weiss K, Maintz D, Sonnabend K, Persigehl T, Haneder S. Compressed sense (CS) ermöglicht Scanzeitreduktion von Sequenzen zur Metallartefaktreduktion (MARS) sowie weitere Artefaktabnahme gegenüber MARS ohne CS. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749807] [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: 11/06/2022]
Affiliation(s)
- F Siedek
- Universitätsklinik Köln, Inst. f. Diagn. u. Interv. Radiologie, Köln
| | | | | | - D Maintz
- Radiologie, Uniklinik Köln, Köln
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Reimer PR, Klein K, Rinneburger M, Zopfs D, Lennartz S, Salem J, Heidenreich A, Maintz D, Haneder S, Große-Hokamp N. Rekonstruktionsalgorithmus, Bildreformatierung, Schichtdicke und Fenstereinstellung: Auswirkungen auf Größenmessungen von Nierensteinen in der Computertomographie. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749906] [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)
- P R Reimer
- Uniklinik Köln, Diagnostische und Interventionelle Radiologie, Köln
| | - K Klein
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
| | - M Rinneburger
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
| | - D Zopfs
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
| | - S Lennartz
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
| | - J Salem
- Klinik für Urologie, Uniklinik Köln, Köln
| | | | - D Maintz
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
| | - S Haneder
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
| | - N Große-Hokamp
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln
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Reimer RP, Klein K, Rinneburger M, Zopfs D, Lennartz S, Salem J, Heidenreich A, Maintz D, Haneder S, Große Hokamp N. Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings. Sci Rep 2021; 11:16437. [PMID: 34385563 PMCID: PMC8361194 DOI: 10.1038/s41598-021-95962-z] [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: 01/13/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022] Open
Abstract
Computed tomography in suspected urolithiasis provides information about the presence, location and size of stones. Particularly stone size is a key parameter in treatment decision; however, data on impact of reformatation and measurement strategies is sparse. This study aimed to investigate the influence of different image reformatations, slice thicknesses and window settings on stone size measurements. Reference stone sizes of 47 kidney stones representative for clinically encountered compositions were measured manually using a digital caliper (Man-M). Afterwards stones were placed in a 3D-printed, semi-anthropomorphic phantom, and scanned using a low dose protocol (CTDIvol 2 mGy). Images were reconstructed using hybrid-iterative and model-based iterative reconstruction algorithms (HIR, MBIR) with different slice thicknesses. Two independent readers measured largest stone diameter on axial (2 mm and 5 mm) and multiplanar reformatations (based upon 0.67 mm reconstructions) using different window settings (soft-tissue and bone). Statistics were conducted using ANOVA ± correction for multiple comparisons. Overall stone size in CT was underestimated compared to Man-M (8.8 ± 2.9 vs. 7.7 ± 2.7 mm, p < 0.05), yet closely correlated (r = 0.70). Reconstruction algorithm and slice thickness did not significantly impact measurements (p > 0.05), while image reformatations and window settings did (p < 0.05). CT measurements using multiplanar reformatation with a bone window setting showed closest agreement with Man-M (8.7 ± 3.1 vs. 8.8 ± 2.9 mm, p < 0.05, r = 0.83). Manual CT-based stone size measurements are most accurate using multiplanar image reformatation with a bone window setting, while measurements on axial planes with different slice thicknesses underestimate true stone size. Therefore, this procedure is recommended when impacting treatment decision.
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Affiliation(s)
- Robert Peter Reimer
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Konstantin Klein
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Miriam Rinneburger
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - David Zopfs
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Simon Lennartz
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA, 02114, USA
| | - Johannes Salem
- Department of Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Axel Heidenreich
- Department of Urology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - David Maintz
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Stefan Haneder
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Nils Große Hokamp
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Rassweiler-Seyfried MC, Otto C, Haneder S, Riffel P, Stein J, Ritter M. Impact of Multiparametric Stone Measurement in Noncontrast Computer Tomography on Ureterorenoscopic Stone Removal. Urol Int 2021; 105:600-604. [PMID: 33915535 DOI: 10.1159/000515646] [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: 10/02/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Low-dose computer tomography (NCCT) is the standard imaging modality for patients with acute flank pain with a suspicion of urolithiasis. The stone size is usually measured 2D by a radiologist. We compared 3D stone measurement using different windows to the 2D measurement and evaluated the clinical impact on ureterorenoscopic stone removal (URS). METHODS One hundred sixty-four patients (201 stones) with a preoperative NCCT, following a URS within 4 weeks, were included in this study. Stone location, number and size of stones, operating time, and laser lithotripsy were documented. Stones were measured in 3D using bone and soft tissue window. The maximum diameter was compared to the radiological report. The U test, Kruskal-Wallis, and regression were used for statistical analyses. RESULTS Almost two-thirds (64.68%; 130 stones) of stone measurements in 3D with the bone window were lower than the radiologist reports in 2D. One-third (34.83%; 70 stones) of stone measurements were higher and 0.5% (1 stone) reported the same size. Using the 3D soft tissue window, 81.09% (163 stones), 17.91% (37 stones), and 1% (2 stones) of stones were measured bigger, smaller, or had the same measurement results, respectively. In the clinical setting, we could calculate a cutoff for laser lithotripsy at a maximum stone diameter of 5.70 mm (p < 0.01) with the 3D and 6.01 mm with the 2D measurements, respectively, and found a significant correlation between maximum stone diameter and operating time (p < 0.01) and number of stones and operating time (p < 0.01 with and p = 0.02 without laser). CONCLUSION 3D stone measurement with bone window seems to be more accurate than 2D measurement, but 2D is sufficient for planning stone treatment.
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Affiliation(s)
- Marie-Claire Rassweiler-Seyfried
- Department of Urology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Corinna Otto
- Department of Pediatrics, Marienhaus Hospital St. Elisabeth Neuwied, Neuwied, Germany
| | - Stefan Haneder
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Philipp Riffel
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Johannes Stein
- Department of Urology, University Hospital of Bonn, Bonn, Germany
| | - Manuel Ritter
- Department of Urology, University Hospital of Bonn, Bonn, Germany
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Bratke G, Rau R, Kabbasch C, Zäske C, Maintz D, Haneder S, Große Hokamp N, Persigehl T, Siedek F, Weiss K. Speeding up the clinical routine: Compressed sensing for 2D imaging of lumbar spine disc herniation. Eur J Radiol 2021; 140:109738. [PMID: 33945923 DOI: 10.1016/j.ejrad.2021.109738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Increasing economic pressure and patient demands for comfort require an ever-increasing acceleration of scan times without compromising diagnostic certainty. This study tested the new acceleration technique Compressed SENSE (CS-SENSE) as well as different reconstruction methods for the lumbar spine. METHODS In this prospective study, 10 volunteers and 14 patients with lumbar disc herniation were scanned using a sagittal 2D T2 turbo spin echo (TSE) sequence applying different acceleration factors of SENSE and CS-SENSE. Gradient echo (GRE), autocalibration (CS-Auto) and TSE prescans were tested for reconstruction. Images were analysed by two readers regarding anatomical delineation, diagnostic certainty (for patients only) and image quality as well as objectively calculating the root mean square error (RMSE), structural similarity index (SSIM), SNR and CNR. The Friedman test and Chi-squared were used for ordinal, ANOVA for repeated measurements and Tukey Kramer test for continuous data. Cohen's kappawas calculated for interreader reliability. RESULTS CS-SENSE outperformed SENSE and CS-Auto regarding RMSE (e.g. CS-SENSE 1.5: 43.03 ± 11.64 versus SENSE 1.5: 80.41 ± 17.66; p = 0.0038) and SSIM as well as in the subjective rating for CS-SENSE 3 TSE. In the patient setting image quality was unchanged in all subjective criteria up to CS-SENSE 3 TSE (all p > 0.05) compared to standard T2 with 43 % less scan time while the GRE prescan only allowed a reduction of 32 %. CONCLUSION Combining a TSE prescan with CS-SENSE enables significant scan time reductions with unchanged ratings for lumbar spine disc herniation making this superior to the currently used SENSE acceleration or GRE reconstructions.
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Affiliation(s)
- Grischa Bratke
- Department of Radiology, University of Cologne, Cologne, Germany.
| | - Robert Rau
- Department of Radiology, Kantonsspital Graubünden, Chur, Switzerland
| | | | - Charlotte Zäske
- Department of Radiology, University of Cologne, Cologne, Germany
| | - David Maintz
- Department of Radiology, University of Cologne, Cologne, Germany
| | - Stefan Haneder
- Department of Radiology, University of Cologne, Cologne, Germany
| | | | | | - Florian Siedek
- Department of Radiology, University of Cologne, Cologne, Germany
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Zopfs D, Große Hokamp N, Reimer R, Bratke G, Maintz D, Bruns C, Mallmann C, Persigehl T, Haneder S, Lennartz S. Value of spectral detector CT for pretherapeutic, locoregional assessment of esophageal cancer. Eur J Radiol 2020; 134:109423. [PMID: 33302024 DOI: 10.1016/j.ejrad.2020.109423] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/27/2020] [Revised: 11/01/2020] [Accepted: 11/14/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE To investigate the diagnostic value of spectral detector dual-energy CT-derived low-keV virtual monoenergetic images (VMI) and iodine overlays (IO) for locoregional, pretherapeutic assessment of esophageal cancer. METHOD 74 patients with biopsy-proven esophageal cancer who underwent pre-therapeutic, portal-venous-phase staging examinations of the chest and abdomen were retrospectively included. Quantitative image analysis was performed ROI-based within the tumor, healthy esophageal wall, peri-esophageal lymph nodes, azygos vein, aorta, liver, diaphragm, and mediastinal fat. Two radiologists evaluated delineation of the primary tumor and locoregional lymph nodes, assessment of the celiac trunk and diagnostic certainty regarding tumor infiltration in conventional images (CI), VMI from 40 to 70 keV and IO. Moreover, presence/absence of advanced tumor infiltration (T3/T4) was determined binary using all available images. RESULTS VMI40-60keV showed significantly higher attenuation and signal-to-noise ratio compared to CI for all assessed ROIs, peaking at VMI40keV (p < 0.05). Contrast-to-noise ratio of tumor/esophagus (VMI40keV/CI: 7.7 ± 4.7 vs. 2.3 ± 1.5), tumor/diaphragm (VMI40keV/CI: 9.0 ± 5.5 vs. 2.2 ± 1.7) and tumor/liver (4.3 ± 5.5 vs. 1.9 ± 2.1) were all significantly higher compared to CI (p < 0.05). Qualitatively, lymph node delineation and diagnostic certainty regarding tumor infiltration received highest ratings both in IO and VMI40keV, whereas vascular assessment was rated highest in VMI40keV and primary tumor delineation in IO. Sensitivity/Specificity/Accuracy for detecting advanced tumor infiltration using the combination of CI, VMI40-70keV and IO was 42.4 %/82.0 %/56.3 %. CONCLUSIONS IO and VMI40-60keV improve qualitative assessment of the primary tumor and depiction of lymph nodes and vessels at pretherapeutic SDCT of esophageal cancer patients yet do not mitigate the limitations of CT in determining tumor infiltration.
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Affiliation(s)
- David Zopfs
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Nils Große Hokamp
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Robert Reimer
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Grischa Bratke
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - David Maintz
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Christiane Bruns
- Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpener Str. 32, 50937, Cologne, Germany
| | - Christoph Mallmann
- Department of General, Visceral and Cancer Surgery, University of Cologne, Kerpener Str. 32, 50937, Cologne, Germany
| | - Thorsten Persigehl
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Stefan Haneder
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Simon Lennartz
- University Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany; Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 270, Boston, MA, 02114, USA.
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Iuga AI, Abdullayev N, Weiss K, Haneder S, Brüggemann-Bratke L, Maintz D, Rau R, Bratke G. Accelerated MRI of the knee. Quality and efficiency of compressed sensing. Eur J Radiol 2020; 132:109273. [DOI: 10.1016/j.ejrad.2020.109273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/26/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
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Zopfs D, Graffe J, Reimer RP, Schäfer S, Persigehl T, Maintz D, Borggrefe J, Haneder S, Lennartz S, Große Hokamp N. Quantitative distribution of iodinated contrast media in body computed tomography: data from a large reference cohort. Eur Radiol 2020; 31:2340-2348. [PMID: 32997173 PMCID: PMC7979665 DOI: 10.1007/s00330-020-07298-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/27/2020] [Accepted: 09/15/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Dual-energy computed tomography allows for an accurate and reliable quantification of iodine. However, data on physiological distribution of iodine concentration (IC) is still sparse. This study aims to establish guidance for IC in abdominal organs and important anatomical landmarks using a large cohort of individuals without radiological tumor burden. METHODS Five hundred seventy-one oncologic, portal venous phase dual-layer spectral detector CT studies of the chest and abdomen without tumor burden at time point of imaging confirmed by > 3-month follow-up were included. ROI were placed in parenchymatous organs (n = 25), lymph nodes (n = 6), and vessels (n = 3) with a minimum of two measurements per landmark. ROI were placed on conventional images and pasted to iodine maps to retrieve absolute IC. Normalization to the abdominal aorta was conducted to obtain iodine perfusion ratios. Bivariate regression analysis, t tests, and ANOVA with Tukey-Kramer post hoc test were used for statistical analysis. RESULTS Absolute IC showed a broad scatter and varied with body mass index, between different age groups and between the sexes in parenchymatous organs, lymph nodes, and vessels (range 0.0 ± 0.0 mg/ml-6.6 ± 1.3 mg/ml). Unlike absolute IC, iodine perfusion ratios did not show dependency on body mass index; however, significant differences between the sexes and age groups persisted, showing a tendency towards decreased perfusion ratios in elderly patients (e.g., liver 18-44 years/≥ 64 years: 0.50 ± 0.11/0.43 ± 0.10, p ≤ 0.05). CONCLUSIONS Distribution of IC obtained from a large-scale cohort is provided. As significant differences between sexes and age groups were found, this should be taken into account when obtaining quantitative iodine concentrations and applying iodine thresholds. KEY POINTS • Absolute iodine concentration showed a broad variation and differed between body mass index, age groups, and between the sexes in parenchymatous organs, lymph nodes, and vessels. • The iodine perfusion ratios did not show dependency on body mass index while significant differences between sexes and age groups persisted. • Provided guidance values may serve as reference when aiming to differentiate healthy and abnormal tissue based on iodine perfusion ratios.
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Affiliation(s)
- David Zopfs
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Josefine Graffe
- Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Robert Peter Reimer
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | | | - Thorsten Persigehl
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - David Maintz
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Jan Borggrefe
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Stefan Haneder
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Simon Lennartz
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nils Große Hokamp
- University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
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11
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Bratke G, Haneder S, Wegmann K, Iuga AI. [Lower leg, ankle and foot]. Radiologe 2020; 60:532-540. [PMID: 32112155 DOI: 10.1007/s00117-020-00664-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CLINICAL/METHODICAL ISSUE Bipedal locomotion means high mechanical stress on the lower extremities and susceptibility to fractures. On the one hand, these can be the result of a one-time traumatic stress in the context of high speed traumas or falls, but can also result from repetitive microtraumas with subsequent stress fractures. STANDARD RADIOLOGICAL METHODS For all fracture entities and localizations, X‑ray diagnostics is the basic modality. METHODICAL INNOVATIONS For optimal surgical reconstruction of intra-articular fractures or in complex fracture configurations, computed tomography should be generously used to improve postoperative outcome. PERFORMANCE The classification of the individual fractures should enable standardised further therapy planning, especially with regard to conventional or surgical treatment. ACHIEVEMENTS The combination of X‑ray, magnetic resonance imaging and computed tomography makes a reliable diagnosis regarding foot fractures possible. PRACTICAL RECOMMENDATIONS Important for the use of individual classification systems is always, in addition to clinical relevance, the safe and equal understanding of the individual types and degrees by the radiologist and the referring colleague.
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Affiliation(s)
- G Bratke
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - S Haneder
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - K Wegmann
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Köln, Deutschland
| | - A-I Iuga
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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12
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Persigehl T, Baumhauer M, Baeßler B, Beyer LP, Bludau M, Bruns C, Bunck AC, Germer CT, Grenacher L, Hackländer T, Haneder S, Heinrich S, Heusch P, Hoffmann M, Juchems MS, Kröger JR, Kotter E, Layer G, Maintz D, Menke J, Palmowski M, Pantelis D, Pinto Dos Santos D, Popp FC, Schäfer N, Schlemmer HP, Schreyer AG, Siedek F, Stippel D, Völker M, Waldschmidt DT, Weber TF, von Winterfeld M, Wybranski C, Zander T, Wessling J. Structured Reporting of Solid and Cystic Pancreatic Lesions in CT and MRI: Consensus-Based Structured Report Templates of the German Society of Radiology (DRG). ROFO-FORTSCHR RONTG 2020; 192:641-656. [PMID: 32615626 DOI: 10.1055/a-1150-8217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Radiological reports of pancreatic lesions are currently widely formulated as free texts. However, for optimal characterization, staging and operation planning, a wide range of information is required but is sometimes not captured comprehensively. Structured reporting offers the potential for improvement in terms of completeness, reproducibility and clarity of interdisciplinary communication. METHOD Interdisciplinary consensus finding of structured report templates for solid and cystic pancreatic tumors in computed tomography (CT) and magnetic resonance imaging (MRI) with representatives of the German Society of Radiology (DRG), German Society for General and Visceral Surgery (DGAV), working group Oncological Imaging (ABO) of the German Cancer Society (DKG) and other radiologists, oncologists and surgeons. RESULTS Among experts in the field of pancreatic imaging, oncology and pancreatic surgery, as well as in a public online survey, structured report templates were developed by consensus. These templates are available on the DRG homepage under www.befundung.drg.de and will be regularly revised to the current state of scientific knowledge by the participating specialist societies and responsible working groups. CONCLUSION This article presents structured report templates for solid and cystic pancreatic tumors to improve clinical staging (cTNM, ycTNM) in everyday radiology. KEY POINTS · Structured report templates offer the potential of optimized radiological reporting with regard to completeness, reproducibility and differential diagnosis.. · This article presents consensus-based, structured reports for solid and cystic pancreatic lesions in CT and MRI.. · These structured reports are available open source on the homepage of the German Society of Radiology (DRG) under www.befundung.drg.de.. CITATION FORMAT · Persigehl T, Baumhauer M, Baeßler B et al. Structured Reporting of Solid and Cystic Pancreatic Lesions in CT and MRI: Consensus-Based Structured Report Templates of the German Society of Radiology (DRG). Fortschr Röntgenstr 2020; 192: 641 - 655.
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Affiliation(s)
| | | | - Bettina Baeßler
- Department of Radiology, University of Cologne, Germany.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Switzerland
| | | | - Marc Bludau
- General, Visceral and Cancer Surgery, University of Cologne, Germany
| | - Christiane Bruns
- General, Visceral and Cancer Surgery, University of Cologne, Germany
| | | | - Christoph-Thomas Germer
- Department of General, Visceral, Vascular and Pediatric Surgery, Würzburg University Hospital, Würzburg, Germany
| | - Lars Grenacher
- Imaging and Prevention Center, Conradia Radiology Munich, Germany
| | - Thomas Hackländer
- Department of Radiology, HELIOS-Universitätsklinikum Wuppertal, Germany
| | | | - Stefan Heinrich
- General, Visceral and Transplantation Surgery, Mainz University, Mainz, Germany
| | - Philipp Heusch
- Department of Radiology, University Hospital Düsseldorf, Germany
| | - Matthias Hoffmann
- Department of General and Visceral Surgery, Raphaelsklinik Münster, Germany
| | | | | | - Elmar Kotter
- Department of Radiology, Freiburg University Hospital, Freiburg, Germany
| | - Günter Layer
- Department of Radiology, Hospital Ludwigshafen, Germany
| | - David Maintz
- Department of Radiology, University of Cologne, Germany
| | - Jan Menke
- Department of Diagnostic Radiology, University Hospital Göttingen, Germany
| | - Moritz Palmowski
- Department of Radiology, Radiology Baden-Baden, Baden-Baden, Germany.,Institute of Experimental Molecular Imaging (ExMI), RTW Aachen, Germany
| | | | | | | | - Nico Schäfer
- Department of Surgery, Hospital Leverkusen, Germany
| | | | - Andreas G Schreyer
- Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg a. d. Havel, Germany
| | | | - Dirk Stippel
- Department of General, Visceral and Cancer Surgery, University of Cologne, Germany
| | - Martin Völker
- DRG, German Roentgen Society "Deutsche Röntgengesellschaft", Berlin, Germany
| | | | | | | | | | - Thomas Zander
- Department of Internal Medicine, University of Cologne, Germany
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13
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Al-Baldawi Y, Große Hokamp N, Haneder S, Steinhauser S, Püsken M, Persigehl T, Maintz D, Wybranski C. Virtual mono-energetic images and iterative image reconstruction: abdominal vessel imaging in the era of spectral detector CT. Clin Radiol 2020; 75:641.e9-641.e18. [PMID: 32362502 DOI: 10.1016/j.crad.2020.03.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/27/2020] [Indexed: 12/29/2022]
Abstract
AIM To compare the quality of virtual mono-energetic (VMI) and polychromatic images reconstructed with hybrid iterative (PCIHIR) or model-based reconstruction (PCIMBR) derived from dual-layer spectral detector computed tomography (SDCT) in arterial phase images to visualise the aorta and abdominal main branches. MATERIAL AND METHODS A retrospective review of 50 patients with abdominal arterial phase scans was undertaken. Attenuation, intraluminal noise, and signal-/contrast-to-noise ratio (S-/CNR) were assessed in the PCIHIR, PCIMBR and VMI40keV, VMI70keV, and VMI100keV images. Contrast, noise, and visualization of soft-plaque, and macro-/micro-calcifications were scored in a blinded reading by two radiologists. RESULTS VMI40keV yielded highest S-/CNR (p≤0.001). VMI70keV and PCIMBR showed comparable SNR (p≥0.999) and yielded higher SNR than PCIHIR. VMI70keV yielded higher CNR than PCIHIR (p<0.001) and PCIMBR (p<0.045). VMI100keV yielded lowest CNR (p≤0.001) and SNR (p≥0.104). In the subjective analysis, VMI40keV outperformed PCIMBR for contrast and noise, PCIMBR scored better than VMI70keV, and the latter scored better than PCIHIR for these categories (all p<0.001). PCIMBR was superior for depiction of soft-plaque and micro-calcifications (p<0.001). VMI100keV visualized micro-calcifications second best (p<0.001) and matched PCIMBR for the depiction of macro-calcifications (p>0.999), while VMI40keV scored second best for depiction of soft-plaque (p<0.020). CONCLUSIONS VMI40keV and VMI70keV yield better S-/CNR than PCIHIR and PCIMBR; however, PCIMBR visualized arteriosclerotic plaques best, followed by VMI40keV for depiction of soft-plaque and VMI100keV for macro- and micro-calcification. Based on the present findings, PCIMBR on conventional CT and VMI40keV supplemented by VMI100keV on SDCT are recommended for the diagnostic assessment of abdominal arteries.
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Affiliation(s)
- Y Al-Baldawi
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - N Große Hokamp
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - S Haneder
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - S Steinhauser
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Medical Statistics and Computational Biology, Cologne, Germany
| | - M Püsken
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - T Persigehl
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - D Maintz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
| | - C Wybranski
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
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14
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Große Hokamp N, Eck B, Siedek F, Pinto Dos Santos D, Holz JA, Maintz D, Haneder S. Quantification of metal artifacts in computed tomography: methodological considerations. Quant Imaging Med Surg 2020; 10:1033-1044. [PMID: 32489927 DOI: 10.21037/qims.2020.04.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/20/2022]
Abstract
Numerous methods for artifact quantification in computed tomography (CT) imaging have been suggested. This study evaluated their utility with regards to correspondence with visual artifact perception and reproducibility. Two titanium rods (5 and 10 mm) were examined with 25 different scanning- and image-reconstruction parameters resulting in different types and extents of artifacts. Four radiologists evaluated every image against each other using an in-house developed software. Rating was repeated two times (2,400 comparisons = 2 times × 4 readers × 300 comparisons). Rankings were combined to obtain a reference ranking. Proposed approaches for artifact quantification include manual measurement of attenuation, standard deviation and noise and sophisticated algorithm-based approaches within the image- and frequency-domain. Two radiologists conducted manual measurements twice while the aforementioned algorithms were implemented within the Matlab-Environment allowing for automated image analysis. The reference ranking was compared to all aforementioned methods for artifact quantification to identify suited approaches. Besides visual analysis, Kappa-statistics and intraclass correlation coefficients (ICC) were used. Intra- and Inter-reader agreements of visual artifact perception were excellent (ICC 0.85-0.92). No quantitative method was able to represent the exact ranking of visually perceived artifacts; however, ICC for manual measurements were low (ICC 0.25-0.97). The method that showed best correspondence and reproducibility used a Fourier-transformed linear ROI and lower-end frequency bins. Automated measurements of artifact extent should be preferred over manual measurements as the latter show a limited reproducibility. One method that allows for automated quantification of such artefacts is made available as an electronic supplement.
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Affiliation(s)
- Nils Große Hokamp
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Radiology, Case Western Reserve University, Cleveland, OH, USA.,Department of Radiology, University Hospitals Medical Center, Cleveland, OH, USA
| | - Brendan Eck
- Department of Radiology, Case Western Reserve University, Cleveland, OH, USA
| | - Florian Siedek
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Daniel Pinto Dos Santos
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jasmin A Holz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefan Haneder
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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15
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Wybranski C, Siedek F, Damm R, Gazis A, Wenzel O, Haneder S, Persigehl T, Steinhauser S, Pech M, Fischbach F, Fischbach K. Respiratory motion artefacts in Gd-EOB-DTPA (Primovist/Eovist) and Gd-DOTA (Dotarem)-enhanced dynamic phase liver MRI after intensified and standard pre-scan patient preparation: A bi-institutional analysis. PLoS One 2020; 15:e0230024. [PMID: 32196535 PMCID: PMC7083299 DOI: 10.1371/journal.pone.0230024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 11/25/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022] Open
Abstract
Objective The objective of this study is to evaluate if intensified pre-scan patient preparation (IPPP) that comprises custom-made educational material on dynamic phase imaging and supervised pre-imaging breath-hold training in addition to standard informative conversation with verbal explanation of breath-hold commands (standard pre-scan patient preparation–SPPP) might reduce the incidence of gadoxetate disodium (Gd-EOB-DTPA)-related transient severe respiratory motion (TSM) and severity of respiratory motion (RM) during dynamic phase liver MRI. Material and methods In this bi-institutional study 100 and 110 patients who received Gd-EOB-DTPA for dynamic phase liver MRI were allocated to either IPPP or SPPP at site A and B. The control group comprised 202 patients who received gadoterate meglumine (Gd-DOTA) of which each 101 patients were allocated to IPPP or SPPP at site B. RM artefacts were scored retrospectively in dynamic phase images (1: none– 5: extensive) by five and two blinded readers at site A and B, respectively, and in the hepatobiliary phase of the Gd-EOB-DTPA-enhanced scans by two blinded readers at either site. Results The incidence of TSM was 15% at site A and 22.7% at site B (p = 0.157). IPPP did not reduce the incidence of TSM in comparison to SPPP: 16.7% vs. 21.6% (p = 0.366). This finding was consistent at site A: 12% vs. 18% (p = 0.401) and site B: 20.6% vs. 25% (p = 0.590). The TSM incidence in patients with IPPP and SPPP did not differ significantly between both sites (p = 0.227; p = 0.390). IPPP did not significantly mitigate RM in comparison to SPPP in any of the Gd-EOB-DTPA-enhanced dynamic phases and the hepatobiliary phase in patients without TSM (all p≥0.072). In the Gd-DOTA control group on the other hand, IPPP significantly mitigated RM in all dynamic phases in comparison to SPPP (all p≤0.031). Conclusions We conclude that Gd-EOB-DTPA-related TSM cannot be mitigated by education and training and that Gd-EOB-DTPA-related breath-hold difficulty does not only affect the subgroup of patients with TSM or exclusively the arterial phase as previously proposed.
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Affiliation(s)
- Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- * E-mail:
| | - Robert Damm
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Angelos Gazis
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Ortrud Wenzel
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Susanne Steinhauser
- Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
| | - Katharina Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany
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16
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Große Hokamp N, Lennartz S, Salem J, Pinto Dos Santos D, Heidenreich A, Maintz D, Haneder S. Dose independent characterization of renal stones by means of dual energy computed tomography and machine learning: an ex-vivo study. Eur Radiol 2019; 30:1397-1404. [PMID: 31773296 DOI: 10.1007/s00330-019-06455-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 07/26/2019] [Accepted: 09/12/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To predict the main component of pure and mixed kidney stones using dual-energy computed tomography and machine learning. METHODS 200 kidney stones with a known composition as determined by infrared spectroscopy were examined using a non-anthropomorphic phantom on a spectral detector computed tomography scanner. Stones were of either pure (monocrystalline, n = 116) or compound (dicrystalline, n = 84) composition. Image acquisition was repeated twice using both, normal and low-dose protocols, respectively (ND/LD). Conventional images and low and high keV virtual monoenergetic images were reconstructed. Stones were semi-automatically segmented. A shallow neural network was trained using data from ND1 acquisition split into training (70%), testing (15%) and validation-datasets (15%). Performance for ND2 and both LD acquisitions was tested. Accuracy on a per-voxel and a per-stone basis was calculated. RESULTS Main components were: Whewellite (n = 80), weddellite (n = 21), Ca-phosphate (n = 39), cysteine (n = 20), struvite (n = 13), uric acid (n = 18) and xanthine stones (n = 9). Stone size ranged from 3 to 18 mm. Overall accuracy for predicting the main component on a per-voxel basis attained by ND testing dataset was 91.1%. On independently tested acquisitions, accuracy was 87.1-90.4%. CONCLUSIONS Even in compound stones, the main component can be reliably determined using dual energy CT and machine learning, irrespective of dose protocol. KEY POINTS • Spectral Detector Dual Energy CT and Machine Learning allow for an accurate prediction of stone composition. • Ex-vivo study demonstrates the dose independent assessment of pure and compound stones. • Lowest accuracy is reported for compound stones with struvite as main component.
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Affiliation(s)
- Nils Große Hokamp
- Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Simon Lennartz
- Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne, Cologne, Germany
| | - Johannes Salem
- Faculty of Medicine and University Hospital Cologne, Department of Urology, University of Cologne, Cologne, Germany
| | - Daniel Pinto Dos Santos
- Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Axel Heidenreich
- Faculty of Medicine and University Hospital Cologne, Department of Urology, University of Cologne, Cologne, Germany
| | - David Maintz
- Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Stefan Haneder
- Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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El Kayal N, Lennartz S, Ekdawi S, Holz J, Slebocki K, Haneder S, Wybranski C, Mohallel A, Eid M, Grüll H, Persigehl T, Borggrefe J, Maintz D, Heneweer C. Value of spectral detector computed tomography for assessment of pancreatic lesions. Eur J Radiol 2019; 118:215-222. [DOI: 10.1016/j.ejrad.2019.07.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 01/05/2023]
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18
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Große Hokamp N, Gilkeson R, Jordan M, Laukamp K, Neuhaus VF, Haneder S, Halliburton S, Gupta A. Virtual monoenergetic images from spectral detector CT as a surrogate for conventional CT images: Unaltered attenuation characteristics with reduced image noise. Eur J Radiol 2019; 117:49-55. [DOI: 10.1016/j.ejrad.2019.05.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/23/2019] [Accepted: 05/25/2019] [Indexed: 10/26/2022]
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19
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Iuga AI, Doerner J, Siedek F, Haneder S, Byrtus J, Luetkens JA, Maintz D, Hickethier T. Computed tomography pulmonary angiograms using a novel dual-layer spectral detector: Adjusted window settings are essential for diagnostic image quality. Medicine (Baltimore) 2019; 98:e16606. [PMID: 31415352 PMCID: PMC6831234 DOI: 10.1097/md.0000000000016606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine optimal window settings for conventional polyenergetic and virtual monoenergetic images derived from computed tomography pulmonary angiogram (CTPA) examinations of a novel dual-layer spectral detector computed tomography system (DLCT). METHODS Monoenergetic (40 keV) and polyenergetic images of 50 CTPA examinations were calculated and the best individual window width and level (W/L) values were manually assessed. Optimized values were obtained afterwards based on regression analysis. Diameters of standardized pulmonary artery segments and subjective image quality parameters were evaluated and compared. RESULTS Attenuation and contrast-to-noise values were higher in monoenergetic than in polyenergetic images (P≤.001). Averaged best individual W/L for polyenergetic and monoenergetic were 1020/170 and 2070/480 HU, respectively.All adjusted W/L-settings varied significantly compared to standard settings (700/100 HU) and obtained higher subjective image quality scores. A systematic overestimation of artery diameters for standard window settings in monoenergetic images was observed. CONCLUSIONS Appropriate W/L-settings are required to assess polyenergetic and monoenergetic CTPA images of a novel DLCT. W/L-settings of 1020/170 HU and 2070/480 HU were found to be the best averaged values for polyenergetic and monoenergetic CTPA images, respectively.
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Affiliation(s)
- Andra-Iza Iuga
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Jonas Doerner
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Jonathan Byrtus
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Julian A. Luetkens
- Institute of Diagnostic and Interventional Radiology, University of Bonn, Bonn, Germany
| | - David Maintz
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
| | - Tilman Hickethier
- Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
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20
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Meyer MM, Schmidt A, Benrath J, Konstandin S, Pilz LR, Harrington MG, Budjan J, Meyer M, Schad LR, Schoenberg SO, Haneder S. Cerebral sodium ( 23Na) magnetic resonance imaging in patients with migraine - a case-control study. Eur Radiol 2019; 29:7055-7062. [PMID: 31264011 DOI: 10.1007/s00330-019-06299-1] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/21/2019] [Accepted: 06/03/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Evaluation of MRI-derived cerebral 23Na concentrations in patients with migraine in comparison with healthy controls. MATERIALS AND METHODS In this case-control study, 24 female migraine patients (mean age, 34 ± 11 years) were enrolled after evaluation of standardized questionnaires. Half (n = 12) of the cohort suffered from migraine, the other half was impaired by both migraine and tension-type headaches (TTH). The combined patient cohort was matched to 12 healthy female controls (mean age, 34 ± 11 years). All participants underwent a cerebral 23Na-magnetic resonance imaging examination at 3.0 T, which included a T1w MP-RAGE sequence and a 3D density-adapted, radial gradient echo sequence for 23Na imaging. Circular regions of interests were placed in predetermined anatomic regions: cerebrospinal fluid (CSF), gray and white matter, brain stem, and cerebellum. External 23Na reference phantoms were used to calculate the total 23Na tissue concentrations. Pearson's correlation, Kendall Tau, and Wilcoxon rank sum test were used for statistical analysis. RESULTS 23Na concentrations of all patients in the CSF were significantly higher than in healthy controls (p < 0.001). The CSF of both the migraine and mixed migraine/TTH group showed significantly increased sodium concentrations compared to the control group (p = 0.007 and p < 0.001). Within the patient cohort, a positive correlation between pain level and TSC in the CSF (r = 0.62) could be observed. CONCLUSION MRI-derived cerebral 23Na concentrations in the CSF of migraine patients were found to be statistically significantly higher than in healthy controls. KEY POINTS • Cerebral sodium MRI supports the theory of ionic imbalances and may aid in the challenging pathophysiologic understanding of migraine. • Case-control study shows significantly higher sodium concentrations in cerebrospinal fluid of migraineurs. • Cerebral sodium MRI may become a non-invasive imaging tool for drugs to modulate sodium, and hence migraine, on a molecular level, and influence patient management.
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Affiliation(s)
- Melissa M Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Alexander Schmidt
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Justus Benrath
- Clinic for Anaesthesiology and Operative Intensive Care, University of Heidelberg, Mannheim, Germany
| | | | - Lothar R Pilz
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Mathias Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Stefan Haneder
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
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21
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Lennartz S, Abdullayev N, Zopfs D, Borggrefe J, Neuhaus VF, Persigehl T, Haneder S, Große Hokamp N. Intra-individual consistency of spectral detector CT-enabled iodine quantification of the vascular and renal blood pool. Eur Radiol 2019; 29:6581-6590. [DOI: 10.1007/s00330-019-06266-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 01/15/2023]
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22
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Meyer MM, Haneder S, Konstandin S, Budjan J, Morelli JN, Schad LR, Kerl HU, Schoenberg SO, Kabbasch C. Repeatability and reproducibility of cerebral 23Na imaging in healthy subjects. BMC Med Imaging 2019; 19:26. [PMID: 30943911 PMCID: PMC6446283 DOI: 10.1186/s12880-019-0324-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 03/11/2019] [Indexed: 02/04/2023] Open
Abstract
Background Initial reports of 23Na magnetic resonance imaging (MRI) date back to the 1970s. However, methodological challenges of the technique hampered its widespread adoption for many years. Recent technical developments have overcome some of these limitations and have led to more optimal conditions for 23Na-MR imaging. In order to serve as a reliable tool for the assessment of clinical stroke or brain tumor patients, we investigated the repeatability and reproducibility of cerebral sodium (23Na) imaging in healthy subjects. Methods In this prospective, IRB approved study 12 consecutive healthy volunteers (8 female, age 31 ± 8.3) underwent three cerebral 23Na-MRI examinations at 3.0 T (TimTrio, Siemens Healthineers) distributed between two separate visits with an 8 day interval. For each scan a T1w MP-RAGE sequence for anatomical referencing and a 3D-density-adapted, radial GRE-sequence for 23Na-imaging were acquired using a dual-tuned (23Na/1H) head-coil. On 1 day, these scans were repeated consecutively; on the other day, the scans were performed once. 23Na-sequences were reconstructed according to the MP-RAGE sequence, allowing direct cross-referencing of ROIs. Circular ROIs were placed in predetermined anatomic regions: gray and white matter (GM, WM), head of the caudate nucleus (HCN), pons, and cerebellum. External 23Na-reference phantoms were used to calculate the tissue sodium content. Results Excellent correlation was found between repeated measurements on the same day (r2 = 0.94), as well as on a different day (r2 = 0.86). No significant differences were found based on laterality other than in the HCN (63.1 vs. 58.7 mmol/kg WW on the right (p = 0.01)). Pronounced inter-individual differences were identified in all anatomic regions. Moderate to good correlation (0.310 to 0.701) was found between the readers. Conclusion Our study has shown that intra-individual 23Na-concentrations in healthy subjects do not significantly differ after repeated scans on the same day and a pre-set time interval. This confirms the repeatability and reproducibility of cerebral 23Na-imaging. However, with manual ROI placement in predetermined anatomic landmarks, fluctuations in 23Na-concentrations can be observed.
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Affiliation(s)
- Melissa M Meyer
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,Institute of Diagnostic and Interventional Radiology, University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - John N Morelli
- St. John's Medical Center, 1923 South Utica Ave, Tulsa, OK, 74104, USA
| | - Lothar R Schad
- Department of Computer Assisted Clinical Medicine, Heidelberg University, Mannheim, Germany
| | - Hans U Kerl
- Department of Neuroradiology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Christoph Kabbasch
- Institute of Diagnostic and Interventional Radiology, University Hospital Cologne, University of Cologne, Cologne, Germany
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23
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Michels S, Heydt C, van Veggel B, Deschler-Baier B, Pardo N, Monkhorst K, Rüsseler V, Stratmann J, Griesinger F, Steinhauser S, Kostenko A, Diebold J, Fassunke J, Fischer R, Engel-Riedel W, Gautschi O, Geissinger E, Haneder S, Ihle MA, Kopp HG, de Langen AJ, Martinez-Marti A, Nogova L, Persigehl T, Plenker D, Puesken M, Rodermann E, Rosenwald A, Scheel AH, Scheffler M, Spengler W, Seggewiss-Bernhardt R, Brägelmann J, Sebastian M, Vrugt B, Hellmich M, Sos ML, Heukamp LC, Felip E, Merkelbach-Bruse S, Smit EF, Büttner R, Wolf J. Genomic Profiling Identifies Outcome-Relevant Mechanisms of Innate and Acquired Resistance to Third-Generation Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy in Lung Cancer. JCO Precis Oncol 2019; 3:1800210. [PMID: 32914023 PMCID: PMC7446436 DOI: 10.1200/po.18.00210] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2018] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective in acquired resistance (AR) to early-generation EGFR TKIs in EGFR-mutant lung cancer. However, efficacy is marked by interindividual heterogeneity. We present the molecular profiles of pretreatment and post-treatment samples from patients treated with third-generation EGFR TKIs and their impact on treatment outcomes. METHODS Using the databases of two lung cancer networks and two lung cancer centers, we molecularly characterized 124 patients with EGFR p.T790M-positive AR to early-generation EGFR TKIs. In 56 patients, correlative analyses of third-generation EGFR TKI treatment outcomes and molecular characteristics were feasible. In addition, matched post-treatment biopsy samples were collected for 29 patients with progression to third-generation EGFR TKIs. RESULTS Co-occurring genetic aberrations were found in 74.4% of EGFR p.T790-positive samples (n = 124). Mutations in TP53 were the most frequent aberrations detected (44.5%; n = 53) and had no significant impact on third-generation EGFR TKI treatment. Mesenchymal-epithelial transition factor (MET) amplifications were found in 5% of samples (n = 6) and reduced efficacy of third-generation EGFR TKIs significantly (eg, median progression-free survival, 1.0 months; 95% CI, 0.37 to 1.72 v 8.2 months; 95% CI, 1.69 to 14.77 months; P ≤ .001). Genetic changes in the 29 samples with AR to third-generation EGFR TKIs were found in EGFR (eg, p.T790M loss, acquisition of p.C797S or p.G724S) or in other genes (eg, MET amplification, KRAS mutations). CONCLUSION Additional genetic aberrations are frequent in EGFR-mutant lung cancer and may mediate innate and AR to third-generation EGFR TKIs. MET amplification was strongly associated with primary treatment failure and was a common mechanism of AR to third-generation EGFR TKIs. Thus, combining EGFR inhibitors with TKIs targeting common mechanisms of resistance may delay AR.
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Affiliation(s)
| | - Carina Heydt
- University Hospital of Cologne, Cologne, Germany
| | | | - Barbara Deschler-Baier
- University Hospital of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Nuria Pardo
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - Kim Monkhorst
- Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Jan Stratmann
- University Hospital of Frankfurt, Frankfurt, Germany
| | - Frank Griesinger
- Pius Hospital Oldenburg and Lung Cancer Network NOWEL, Oldenburg, Germany
| | | | | | | | | | | | | | | | - Eva Geissinger
- University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | | | | | - Hans-Georg Kopp
- Robert Bosch Centrum für Tumorerkrankungen, Stuttgart, Germany
| | | | | | - Lucia Nogova
- University Hospital of Cologne, Cologne, Germany
| | | | | | | | - Ernst Rodermann
- Private practice in Hematology and Oncology, Troisdorf, Germany
| | - Andreas Rosenwald
- University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | | | | | | | | | - Johannes Brägelmann
- University Hospital of Cologne, Cologne, Germany.,University of Cologne, Cologne, Germany
| | | | - Bart Vrugt
- University Hospital Zurich, Zurich, Switzerland
| | | | - Martin L Sos
- University Hospital of Cologne, Cologne, Germany.,University of Cologne, Cologne, Germany
| | - Lukas C Heukamp
- Hematopathology Hamburg and Lung Cancer Network NOWEL, Hamburg, Germany
| | | | | | - Egbert F Smit
- Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Jürgen Wolf
- University Hospital of Cologne, Cologne, Germany
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24
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Chon SH, Timmermann F, Dratsch T, Schuelper N, Plum P, Berlth F, Datta RR, Schramm C, Haneder S, Späth MR, Dübbers M, Kleinert J, Raupach T, Bruns C, Kleinert R. Serious Games in Surgical Medical Education: A Virtual Emergency Department as a Tool for Teaching Clinical Reasoning to Medical Students. JMIR Serious Games 2019; 7:e13028. [PMID: 30835239 PMCID: PMC6423463 DOI: 10.2196/13028] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 12/06/2018] [Revised: 01/21/2019] [Accepted: 02/17/2019] [Indexed: 12/27/2022] Open
Abstract
Background Serious games enable the simulation of daily working practices and constitute a potential tool for teaching both declarative and procedural knowledge. The availability of educational serious games offering a high-fidelity, three-dimensional environment in combination with profound medical background is limited, and most published studies have assessed student satisfaction rather than learning outcome as a function of game use. Objective This study aimed to test the effect of a serious game simulating an emergency department (“EMERGE”) on students’ declarative and procedural knowledge, as well as their satisfaction with the serious game. Methods This nonrandomized trial was performed at the Department of General, Visceral and Cancer Surgery at University Hospital Cologne, Germany. A total of 140 medical students in the clinical part of their training (5th to 12th semester) self-selected to participate in this experimental study. Declarative knowledge (measured with 20 multiple choice questions) and procedural knowledge (measured with written questions derived from an Objective Structured Clinical Examination station) were assessed before and after working with EMERGE. Students’ impression of the effectiveness and applicability of EMERGE were measured on a 6-point Likert scale. Results A pretest-posttest comparison yielded a significant increase in declarative knowledge. The percentage of correct answers to multiple choice questions increased from before (mean 60.4, SD 16.6) to after (mean 76.0, SD 11.6) playing EMERGE (P<.001). The effect on declarative knowledge was larger in students in lower semesters than in students in higher semesters (P<.001). Additionally, students’ overall impression of EMERGE was positive. Conclusions Students self-selecting to use a serious game in addition to formal teaching gain declarative and procedural knowledge.
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Affiliation(s)
- Seung-Hun Chon
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | | | | | - Nikolai Schuelper
- Department of Haematology and Medical Oncology, University Medical Centre Göttingen, Göttingen, Germany
| | - Patrick Plum
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Felix Berlth
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Rabi Raj Datta
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Christoph Schramm
- Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Martin Richard Späth
- Department II of Internal Medicine and Center for Molecular Medicine, University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases, University of Cologne, Cologne, Germany
| | - Martin Dübbers
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Julia Kleinert
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Tobias Raupach
- Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany.,Division of Medical Education Research and Curriculum Development, University Medical Centre Göttingen, Göttingen, Germany
| | - Christiane Bruns
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Robert Kleinert
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
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25
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Braun F, Suarez V, Dinter J, Haneder S, Quaas A, Benzing T, Nierhoff D, Müller RU. Successful use of TNFα blockade in a severe case of idiopathic non-granulomatous ulcerative jejunoileitis associated with thrombotic thrombocytopenic purpura. BMJ Open Gastroenterol 2019; 6:e000252. [PMID: 30899536 PMCID: PMC6398868 DOI: 10.1136/bmjgast-2018-000252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/18/2018] [Revised: 12/26/2018] [Accepted: 01/01/2019] [Indexed: 12/03/2022] Open
Abstract
We describe the case of 50-year-old female patient who presented with severe gastrointestinal symptoms and progressive weight loss of unknown origin. Shortly after admission, she developed an acute flare of thrombotic thrombocytopaenic purpura (TTP) that had to be treated by plasma exchange therapy and rituximab administration. While the signs of TTP subsided, the gastrointestinal symptoms worsened with abdominal cramps, massive gastric retention, malnourishment and a stenosis due to extensive inflammation and wall thickening of the small bowel. Extensive diagnostic efforts yielded no specific cause, so the patient-based on the histopathological findings-was diagnosed with idiopathic non-granulomatous ulcerative jejunoileitis. Following a highly complicated clinical course over several months, successful remission of the inflammatory activity and recovery of the patient could be obtained by TNF-alpha blockade.
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Affiliation(s)
- Fabian Braun
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Victor Suarez
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Johanna Dinter
- Department of Gastroenterology and Hepatology, University of Cologne, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Alexander Quaas
- Department of Pathology, University of Cologne, Cologne, Germany
| | - Thomas Benzing
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Dirk Nierhoff
- Department of Gastroenterology and Hepatology, University of Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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26
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Lennartz S, Le Blanc M, Zopfs D, Große Hokamp N, Abdullayev N, Laukamp KR, Haneder S, Borggrefe J, Maintz D, Persigehl T. Dual-Energy CT-derived Iodine Maps: Use in Assessing Pleural Carcinomatosis. Radiology 2019; 290:796-804. [PMID: 30644812 DOI: 10.1148/radiol.2018181567] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the use of spectral CT for differentiation between noncalcified benign pleural lesions and pleural carcinomatosis. Materials and Methods In this retrospective study, patients who underwent contrast agent-enhanced late venous phase spectral CT of the chest between June 1, 2016, and July 1, 2018 with histopathologic and/or imaging confirmation of noncalcified pleural lesions were evaluated. Conventional images, iodine overlay (IO) images, and virtual monoenergetic images at 40 keV (hereafter, VMI40keV) were reconstructed from contrast-enhanced spectral chest CT. Four blinded radiologists determined lesion presence and indicated lesion conspicuity and diagnostic certainty. Hounsfield unit attenuation from conventional images and iodine concentration (IC) (in milligrams per milliliter) from IO images were determined. Area under the receiver operating characteristics curve determined thresholds for quantitative lesion differentiation and cutoff values were validated in an independent data set. Results Eighty-four patients were included (mean age, 66.2 years; 54 men and 30 women; 44 patients with cancer with confirmed pleural carcinomatosis and 40 patients with benign pleural lesions). The area under the receiver operating characteristics curve for IC was greater than that of conventional Hounsfield units (0.96 vs 0.91; P ≤ .05, respectively). The optimal IC threshold was 1.3 mg/mL, with comparable sensitivity and specificity when applied to the test data set. The sensitivities to depict pleural carcinomatosis with spectral reconstructions versus conventional CT were 96% (199 of 208) and 83% (172 of 208), respectively, with specificities of 84% (161 of 192) and 63% (120 of 192), respectively (P ≤ .001 each). Conclusion Compared with conventional images, spectral CT with iodine maps improved both quantitative and qualitative determination of pleural carcinomatosis versus noncalcified benign pleural lesions. © RSNA, 2019 See also the editorial by K. S. Lee and H. Y. Lee .
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Affiliation(s)
- Simon Lennartz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Markus Le Blanc
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - David Zopfs
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Nils Große Hokamp
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Nuran Abdullayev
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Kai Roman Laukamp
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Stefan Haneder
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Jan Borggrefe
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - David Maintz
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
| | - Thorsten Persigehl
- From the Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany (S.L., M.L.B., D.Z., N.G.H., N.A., K.R.L., S.H., J.B., D.M., T.P.); and Department of Radiology, Case Western Reserve University and University Hospitals, Cleveland, Ohio (N.G.H., K.R.L.)
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Haneder S, Siedek F, Doerner J, Pahn G, Grosse Hokamp N, Maintz D, Wybranski C. Thoracic-abdominal imaging with a novel dual-layer spectral detector CT: intra-individual comparison of image quality and radiation dose with 128-row single-energy acquisition. Acta Radiol 2018; 59:1458-1465. [PMID: 29569933 DOI: 10.1177/0284185118762611] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND A novel, multi-energy, dual-layer spectral detector computed tomography (SDCT) is commercially available now with the vendor's claim that it yields the same or better quality of polychromatic, conventional CT images like modern single-energy CT scanners without any radiation dose penalty. PURPOSE To intra-individually compare the quality of conventional polychromatic CT images acquired with a dual-layer spectral detector (SDCT) and the latest generation 128-row single-energy-detector (CT128) from the same manufacturer. MATERIAL AND METHODS Fifty patients underwent portal-venous phase, thoracic-abdominal CT scans with the SDCT and prior CT128 imaging. The SDCT scanning protocol was adapted to yield a similar estimated dose length product (DLP) as the CT128. Patient dose optimization by automatic tube current modulation and CT image reconstruction with a state-of-the-art iterative algorithm were identical on both scanners. CT image contrast-to-noise ratio (CNR) was compared between the SDCT and CT128 in different anatomic structures. Image quality and noise were assessed independently by two readers with 5-point-Likert-scales. Volume CT dose index (CTDIvol), and DLP were recorded and normalized to 68 cm acquisition length (DLP68). RESULTS The SDCT yielded higher mean CNR values of 30.0% ± 2.0% (26.4-32.5%) in all anatomic structures ( P < 0.001) and excellent scores for qualitative parameters surpassing the CT128 (all P < 0.0001) with substantial inter-rater agreement (κ ≥ 0.801). Despite adapted scan protocols the SDCT yielded lower values for CTDIvol (-10.1 ± 12.8%), DLP (-13.1 ± 13.9%), and DLP68 (-15.3 ± 16.9%) than the CT128 (all P < 0.0001). CONCLUSION The SDCT scanner yielded better CT image quality compared to the CT128 and lower radiation dose parameters.
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Affiliation(s)
- Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Jonas Doerner
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Gregor Pahn
- Philips CT Clinical Science, Hamburg, Germany
| | - Nils Grosse Hokamp
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - David Maintz
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
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Bratke G, Rau R, Weiss K, Kabbasch C, Sircar K, Morelli JN, Persigehl T, Maintz D, Giese D, Haneder S. Accelerated MRI of the Lumbar Spine Using Compressed Sensing: Quality and Efficiency. J Magn Reson Imaging 2018; 49:e164-e175. [PMID: 30267462 DOI: 10.1002/jmri.26526] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 07/02/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Decreasing MRI scan time is a key factor to increase patient comfort and compliance as well as the productivity of MRI scanners. PURPOSE/HYPOTHESIS Compressed sensing (CS) should significantly accelerate 3D scans. This study evaluated the clinical application and cost effectiveness of accelerated 3D T2 sequences of the lumbar spine. STUDY TYPE Prospective, cross-sectional, observational. POPULATION Twenty healthy volunteers and 10 patients. FIELD STRENGTH/SEQUENCE A 3D T2 TSE sequence, identical 3D sequences with three different parallel imaging and CS accelerating factors, and 2D TSE sequences as a clinical reference were obtained on a 3T scanner. ASSESSMENT Three readers evaluated the sequences for delineation of anatomical structures and image quality. A quantitative analysis consisting of root mean square error, structural similarity index, signal-to-noise ratio, and contrast-to-noise ratio were performed. The scan times were used to calculate cost differences for each sequence. STATISTICAL TESTS An analysis of variance with repeated measurements and the Friedman test were used to test for potential differences between the sequences. Post-hoc analysis was made with the chi-squared and Tukey-Kramer test. RESULTS CS with factor 4.5 results in unchanged image quality compared to the T2 TSE for volunteers and patients (overall image impression: 4.75 vs. 4.20 [P = 0.73] and 4.90 vs. 4.47 [P = 0.44]). The CS 4.5 scan is 167 seconds (-39%) faster than the 3D and 216.5 seconds (-45%) faster than the 2D sequences. No significant differences was found for the diagnostic certainty in the volunteers and patients between 2D TSE and 3D CS 4.5 (P = 0.89 and P = 0.43). A reduction of scan time to 148 seconds (CS 8) was still rated acceptable for most diagnosis. DATA CONCLUSION CS accelerates the 3D T2 without compromising image quality. The 3D sequences offer comparable diagnostic quality to the clinical 2D standard with less scan time (-45%), potentially increasing the productivity of MRI scanners. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019;49:e164-e175.
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Affiliation(s)
- Grischa Bratke
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Robert Rau
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | | | | | - Krishnan Sircar
- Department of Orthopedics, University Hospital Cologne, Cologne, Germany
| | | | | | - David Maintz
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Daniel Giese
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Stefan Haneder
- Department of Radiology, University Hospital Cologne, Cologne, Germany
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Boese CK, Wilhelm S, Haneder S, Lechler P, Eysel P, Bredow J. Influence of calibration on digital templating of hip arthroplasty. Int Orthop 2018; 43:1799-1805. [PMID: 30132182 DOI: 10.1007/s00264-018-4120-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/15/2018] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Digital templating for total joint replacement is the current standard. For image calibration, external calibration markers (ECM) are used. However, there are concerns regarding the precision of the method. This study aimed to identify the direct influence of calibration errors on digital templating. PATIENTS AND METHODS A retrospective analysis of 100 post-operative radiographs with unilateral total hip arthroplasty was performed. The magnification factor of the ECM and of the internal prosthetic femoral head (ICM) as a reference value was calculated for each radiograph. Two blinded observers performed templating of the contralateral hip using a randomized list for all radiographs and both markers. The component size templated by the ECM magnification was compared to the reference by the ICM magnification. RESULTS Mean magnification factors of ICM and ECM differed significantly (p = 0.006). The absolute difference was 5.2% (range 0.0-23.3%, SD 4.8%). Templating of the acetabular or the femoral component showed no significant differences (p = 0.120, p = 0.599). Differences of more than one size were found in 26% of the acetabular components and 14% of the femoral components and differences over two sizes in 10% respectively 3%. Correlation coefficients for magnification error and size differences of acetabular components were - 0.645 (p < 0.001) and for the femoral component - 0.607 (p < 0.001). INTERPRETATION The calibration error of external calibration markers in digital templating for hip replacement influences component sizes significantly. Thus, correct positioning of ECM is of utmost importance.
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Affiliation(s)
- Christoph Kolja Boese
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany.
| | - Sebastian Wilhelm
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Philipp Lechler
- Center of Orthopedic and Trauma Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Peer Eysel
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany
| | - Jan Bredow
- Department of Spine Surgery, Schön Klinik Düsseldorf, Düsseldorf, Germany.,Center for Orthopedics, Schön Klinik Düsseldorf SE & Co. KG, Am Heerdter Krankenhaus 2, 40549, Düsseldorf, Germany
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Große Hokamp N, Höink AJ, Doerner J, Jordan DW, Pahn G, Persigehl T, Maintz D, Haneder S. Assessment of arterially hyper-enhancing liver lesions using virtual monoenergetic images from spectral detector CT: phantom and patient experience. Abdom Radiol (NY) 2018; 43:2066-2074. [PMID: 29185013 DOI: 10.1007/s00261-017-1411-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [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] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate a benefit from virtual monoenergetic reconstructions (VMIs) for assessment of arterially hyper-enhancing liver lesions in phantom and patients and to compare hybrid-iterative and spectral image reconstructions of conventional images (CI-IR and CI-SR). METHODS All imaging was performed on a SDCT (Philips Healthcare, Best, The Netherlands). Images of a non-anthropomorphic phantom with a lesion-mimicking insert (containing iodine in water solution) and arterial-phase images from contrast-enhanced patient examinations were evaluated. VMIs (40-200 keV, 10 keV increment), CI-IR, and CI-SR were reconstructed using different strengths of image denoising. ROIs were placed in lesions, liver/matrix, muscle; signal-to-noise, contrast-to-noise, and lesion-to-liver ratios (SNR, CNR, and LLR) were calculated. Qualitatively, 40, 70, and 110 keV and CI images were assessed by two radiologists on five-point Likert scales regarding overall image quality, lesion assessment, and noise. RESULTS In phantoms, SNR was increased threefold by VMI40keV compared with CI-IR/SR (5.8 ± 1.1 vs. 18.8 ± 2.2, p ≤ 0.001), while no difference was found between CI-IR and CI-SR (p = 1). Denoising was capable of noise reduction by 40%. In total, 20 patients exhibiting 51 liver lesions were assessed. Attenuation was the highest in VMI40keV, while image noise was comparable to CI-IR resulting in a threefold increase of CNR/LLR (CI-IR 1.3 ± 0.8/4.4 ± 2.0, VMI40keV: 3.8 ± 2.7/14.2 ± 7.5, p ≤ 0.001). Subjective lesion delineation was the best in VMI40keV image (p ≤ 0.01), which also provided the lowest perceptible noise and the best overall image quality. CONCLUSIONS VMIs improve assessment of arterially hyper-enhancing liver lesions since they increase lesion contrast while maintaining low image noise throughout the entire keV spectrum. These data suggest that to consider VMI screening after arterially hyper-enhancing liver lesions.
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Affiliation(s)
- N Große Hokamp
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA.
- Department of Radiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - A J Höink
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - J Doerner
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - D W Jordan
- Department of Radiology, University Hospitals Cleveland, Cleveland, OH, USA
- Department of Radiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - G Pahn
- Philips Clinical Science CT, Hamburg, Germany
| | - T Persigehl
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - D Maintz
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - S Haneder
- Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Siedek F, Giese D, Weiss K, Ekdawi S, Brinkmann S, Schroeder W, Bruns C, Chang DH, Persigehl T, Maintz D, Haneder S. 4D flow MRI for the analysis of celiac trunk and mesenteric artery stenoses. Magn Reson Imaging 2018; 53:52-62. [PMID: 30008436 DOI: 10.1016/j.mri.2018.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/24/2018] [Revised: 05/31/2018] [Accepted: 06/28/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE This study aims to assess the feasibility of 4D flow MRI measurements in complex vascular territories; namely, the celiac artery (CA) and superior mesenteric artery (SMA). MATERIALS AND METHODS In this prospective study, 22 healthy volunteers and 10 patients were scanned at 3 T. Blood flow parameters were compared between healthy volunteers and patients with stenosis of the CA and/or SMA as a function of stenosis grade characterized by prior contrast-enhanced computed tomography (CE-CT). The 4D flow MRI acquisition covered the CA, SMA and adjusting parts of the abdominal aorta (AO). Measurements of velocity- (peak velocity [PV], average velocity [AV]) and volume-related parameters (peak flow [PF], stroke volume [SV]) were conducted. Further, stenosis grade and wall shear stress in the CA, SMA and AO were evaluated. RESULTS In patients, prior evaluation by CE-CT revealed 11 low- and 5 mid-grade stenoses of the CA and/or SMA. PV and AV were significantly higher in patients than in healthy volunteers [PV: p < 0.0001; AV: p = 0.03, p < 0.001]. PF and SV did not differ significantly between healthy volunteers and patients; however, a trend towards lower PF and SV could be detected in patients with mid-grade stenoses. Comparison of 4D flow MRI with CE-CT revealed a strong positive correlation in estimated degree of stenosis (CA: r = 0.86, SMA: r = 0.98). Patients with mid-grade stenoses had a significantly higher average WSS magnitude (AWM) than healthy volunteers (p = 0.02). CONCLUSION This feasibility study suggests that 4D flow MRI is a viable technique for the evaluation of complex flow characteristics in small vessels such as the CA and SMA. 4D flow MRI approves comparable to the morphologic assessment of complex vascular territories using CE-CT but, in addition, offers the functional evaluation of flow parameters that goes beyond the morphology.
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Affiliation(s)
- Florian Siedek
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
| | - Daniel Giese
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Kilian Weiss
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Philips Healthcare Germany, Hamburg, Germany
| | - Sandra Ekdawi
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Sebastian Brinkmann
- Department of General, Visceral and Tumor Surgery, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Wolfgang Schroeder
- Department of General, Visceral and Tumor Surgery, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Christiane Bruns
- Department of General, Visceral and Tumor Surgery, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - De-Hua Chang
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - David Maintz
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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Boese CK, Wilhelm S, Haneder S, Lechler P, Eysel P, Bredow J. Dual-position calibration markers for total hip arthroplasty: theoretical comparison to fixed calibration and single marker method. Int Orthop 2018; 43:589-595. [PMID: 29922839 DOI: 10.1007/s00264-018-4034-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/12/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Digital templating is considered a standard for total hip arthroplasty. Different means for the necessary calibration of radiographs are known. While single marker calibration with radiopaque spheres is the most common, it is associated with possible significant deviations from the true magnification of the hip. Notably, fixed magnification factors showed better results. Therefore, a dual-position calibration marker method was simulated and compared to the established methods. METHODS First, an empirical fixed magnification factor was identified and applied to a series of radiographs. Second, three magnification factors were generated based on sagittal patient data of 398 CT scans. These methods were compared to the fixed factor. RESULTS The fixed factor was 122.6%. In the clinical application, the error of the fixed factor was 2.5% while the error of the single marker was 5.2%. In the CT cohort, the mean reference factor was 120.5% in females and 120.3% in males. The reference factor was compared to sex-specific means, sex-specific linear functions, and sex-specific cubic functions. The best results were found for the linear regression model with a mean difference of 0.8% from the reference value. No proportional bias was found (p = 0.623). CONCLUSION The simulation of the dual-position marker method using the linear regression model showed promising results, superior to all other methods. In future studies, its clinical application should be tested.
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Affiliation(s)
- Christoph Kolja Boese
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany.
| | - Sebastian Wilhelm
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Philipp Lechler
- Center of Orthopedic and Trauma Surgery, University of Giessen and Marburg, Marburg, Germany
| | - Peer Eysel
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany
| | - Jan Bredow
- Department of Spine Surgery, Schön Klinik Düsseldorf, Düsseldorf, Germany.,Center for Orthopedics, Schön Klinik Düsseldorf SE & Co. KG, Am Heerdter Krankenhaus 2, 40549, Düsseldorf, Germany
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Houbois C, Haneder S, Merkt M, Morelli JN, Schmidt M, Hellmich M, Mueller RU, Wahba R, Maintz D, Puesken M. Can computed tomography volumetry of the renal cortex replace MAG3-scintigraphy in all patients for determining split renal function? Eur J Radiol 2018; 103:105-111. [DOI: 10.1016/j.ejrad.2018.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/06/2018] [Accepted: 04/16/2018] [Indexed: 11/16/2022]
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Chang DH, Brinkmann S, Smith L, Becker I, Schroeder W, Hoelscher AH, Haneder S, Maintz D, Spiro JE. Calcification score versus arterial stenosis grading: comparison of two CT-based methods for risk assessment of anastomotic leakage after esophagectomy and gastric pull-up. Ther Clin Risk Manag 2018; 14:721-727. [PMID: 29713180 PMCID: PMC5909785 DOI: 10.2147/tcrm.s157352] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Indexed: 12/17/2022] Open
Abstract
Purpose Anastomotic leakage is a major surgical complication following esophagectomy and gastric pull-up. Specific risk factors such as celiac trunk (TC) stenosis and high calcification score of the aorta have been identified, but no data are available on their relative prognostic values. This retrospective study aimed to compare and evaluate calcification score versus stenosis quantification with regards to prognostic impact on anastomotic leakage. Patients and methods Preoperative contrast-enhanced computed tomography scans of 164 consecutive patients with primary esophageal cancer were evaluated by two radiologists to apply a calcification score (0–3 scale) assessing the aorta, the celiac axis and the right and left postceliac arteries. Concurrently, the presence and degree of stenosis of TC and superior mesenteric artery were recorded for stenosis quantification. Results Anastomotic leakage was noted in 14/164 patients and 12/14 showed stenosis of TC (n=11). The presence of TC stenosis was found to have a significant impact on anastomotic healing (p=0.004). The odds ratio for the prediction of anastomotic leakage by the degree of stenosis was 1.04 (95% CI, 1.02–1.07). Ten of 14 patients had aortic calcification scores of 1 or 2, but calcification scores of the aorta, the celiac axis and the right and left postceliac arteries did not correlate with the corresponding TC stenosis values and showed no influence on patient outcome as defined by the occurrence of anastomotic insufficiency (p=0.565, 0.855, 0.518 and 1.000, respectively). Inter-reader reliability of computed tomography analysis and absolute agreement on calcium scoring was mostly over 90%. No significant differences in preoperative comorbidities and patient characteristics were found between those with and without anastomotic leakage. Conclusion Measurement of TC stenosis in preoperative contrast-enhanced computed tomography scans proved to be more reliable than calcification scores in predicting anastomotic leakage and should, therefore, be used in the risk assessment of patients undergoing esophagectomy and gastric pull-up.
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Affiliation(s)
- De-Hua Chang
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Sebastian Brinkmann
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | - Lucy Smith
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Canada
| | - Ingrid Becker
- Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Wolfgang Schroeder
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne, Germany
| | | | - Stefan Haneder
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Judith Eva Spiro
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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Siedek F, Persigehl T, Mueller RU, Burst V, Benzing T, Maintz D, Haneder S. Assessing renal changes after remote ischemic preconditioning (RIPC) of the upper extremity using BOLD imaging at 3T. MAGMA 2017; 31:367-374. [PMID: 29063424 DOI: 10.1007/s10334-017-0658-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Acute kidney injury (AKI) is an important risk factor for a number of adverse outcomes including end-stage renal disease and cardiovascular morbidity and mortality. Whilst many clinical situations that can induce AKI are known-e.g. drug toxicity, contrast agent exposure or ischemia during surgery-targeted preventive or therapeutic measures are still lacking. As to renoprotective strategies, remote ischemic preconditioning (RIPC) is one of the most promising novel approaches and has been examined by a number of clinical trials. The aim of this study was to use blood oxygenation level-dependent (BOLD) MRI as a surrogate parameter to assess the effect of RIPC in healthy volunteers. MATERIALS AND METHODS In this IRB-approved, prospective study, 40 healthy volunteers were stratified with 20 undergoing an RIPC procedure (i.e. RIPC group) with a transient ischemia of the right arm, and 20 undergoing a sham procedure. Before and after the procedure, both kidneys of all participants were scanned using a 12-echo mGRE sequence for functional BOLD imaging at 3T. For each volunteer, 180 ROIs were placed in the cortex and the medulla of the kidneys. Ultimately, R2* values, which have an inverse correlation with the oxygenation level of tissue, were averaged for the RIPC and control groups. RESULTS Following intervention, mean R2* values significantly decreased in the RIPC group in both the cortex (18.6 ± 2.3 vs. 17.5 ± 1.7 Hz; p = 0.0047) and medulla (34 ± 5.2 vs. 32.2 ± 4.2 Hz; p = 0.0001). However, no significant differences were observed in the control group. CONCLUSION RIPC can be non-invasively assessed in healthy volunteers using BOLD MRI at 3T, demonstrating a higher oxygen content in kidney tissue. This study presents a first-in-man trial establishing a quantifiable readout of RIPC and its effects on kidney physiology. BOLD measurements may advance clinical trials in further evaluating RIPC for future clinical care.
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Affiliation(s)
- Florian Siedek
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Thorsten Persigehl
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Roman-Ulrich Mueller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Volker Burst
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Thomas Benzing
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - David Maintz
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
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Doerner J, Wybranski C, Byrtus J, Houbois C, Hauger M, Heneweer C, Siedek F, Hickethier T, Große Hokamp N, Maintz D, Haneder S. Intra-individual comparison between abdominal virtual mono-energetic spectral and conventional images using a novel spectral detector CT. PLoS One 2017; 12:e0183759. [PMID: 28837641 PMCID: PMC5570320 DOI: 10.1371/journal.pone.0183759] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 08/10/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To quantitatively and qualitatively assess abdominal arterial and venous phase contrast-enhanced spectral detector computed tomography (SDCT) virtual mono-energetic (MonoE) datasets in comparison to conventional CT reconstructions provided by the same system. MATERIALS AND METHODS Conventional and MonoE images at 40-120 kilo-electron volt (keV) levels with a 10 keV increment as well as 160 and 200 keV were reconstructed in abdominal SDCT datasets of 55 patients. Attenuation, image noise, and contrast- / signal-to-noise ratios (CNR, SNR) of vessels and solid organs were compared between MonoE and conventional reconstructions. Two readers assessed contrast conditions, detail visualization, overall image quality and subjective image noise with both, fixed and adjustable window settings. RESULTS Attenuation, CNR and SNR of vessels and solid organs showed a stepwise increase from high to low keV reconstructions in both contrast phases while image noise stayed stable at low keV MonoE reconstruction levels. Highest levels were found at 40 keV MonoE reconstruction (p<0.001), respectively. Solid abdominal organs showed a stepwise decrease from low to high energy levels in regard to attenuation, CNR and SNR with significantly higher values at 40 and 50 keV, compared to conventional images. The 70 keV MonoE was comparable to conventional poly-energetic reconstruction (p≥0.99). Subjective analysis displayed best image quality for the 70 keV MonoE reconstruction level in both phases at fixed standard window presets and at 40 keV if window settings could be adjusted. CONCLUSION SDCT derived low keV MonoE showed markedly increased CNR and SNR values due to constantly low image noise values over the whole energy spectrum from 40 to 200 keV.
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Affiliation(s)
- Jonas Doerner
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
- * E-mail:
| | - Christian Wybranski
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Jonathan Byrtus
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Christian Houbois
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Myriam Hauger
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Carola Heneweer
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Florian Siedek
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Tilman Hickethier
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Nils Große Hokamp
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - David Maintz
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
| | - Stefan Haneder
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany
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Bartram MP, Mishra T, Reintjes N, Fabretti F, Gharbi H, Adam AC, Göbel H, Franke M, Schermer B, Haneder S, Benzing T, Beck BB, Müller RU. Characterization of a splice-site mutation in the tumor suppressor gene FLCN associated with renal cancer. BMC Med Genet 2017; 18:53. [PMID: 28499369 PMCID: PMC5429543 DOI: 10.1186/s12881-017-0416-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/04/2017] [Indexed: 01/24/2023]
Abstract
Background Renal cell carcinoma is among the most prevalent malignancies. It is generally sporadic. However, genetic studies of rare familial forms have led to the identification of mutations in causative genes such as VHL and FLCN. Mutations in the FLCN gene are the cause of Birt-Hogg-Dubé syndrome, a rare tumor syndrome which is characterized by the combination of renal cell carcinoma, pneumothorax and skin tumors. Methods Using Sanger sequencing we identify a heterozygous splice-site mutation in FLCN in lymphocyte DNA of a patient suffering from renal cell carcinoma. Furthermore, both tumor DNA and DNA from a metastasis are analyzed regarding this mutation. The pathogenic effect of the sequence alteration is confirmed by minigene assays and the biochemical consequences on the protein are examined using TALEN-mediated transgenesis in cultured cells. Results Here we describe an FLCN mutation in a 55-year-old patient who presented himself with progressive weight loss, bilateral kidney cysts and renal tumors. He and members of his family had a history of recurrent pneumothorax during the last few decades. Histology after tumor nephrectomy showed a mixed kidney cancer consisting of elements of a chromophobe renal cell carcinoma and dedifferentiated small cell carcinoma component. Subsequent FLCN sequencing identified an intronic c.1177-5_-3delCTC alteration that most likely affected the correct splicing of exon 11 of the FLCN gene. We demonstrate skipping of exon 11 to be the consequence of this mutation leading to a shift in the reading frame and the insertion of a premature stop codon. Interestingly, the truncated protein was still expressed both in cell culture and in tumor tissue, though it was strongly destabilized and its subcellular localization differed from wild-type FLCN. Both, altered protein stability and subcellular localization could be partly reversed by blocking proteasomal and lysosomal degradation. Conclusions Identification of disease-causing mutations in BHD syndrome requires the analysis of intronic sequences. However, biochemical validation of the consecutive alterations of the resulting protein is especially important in these cases. Functional characterization of the disease-causing mutations in BHD syndrome may guide further research for the development of novel diagnostic and therapeutic strategies. Electronic supplementary material The online version of this article (doi:10.1186/s12881-017-0416-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Malte P Bartram
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Tripti Mishra
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Nadine Reintjes
- Institute of Human Genetics, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Francesca Fabretti
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Hakam Gharbi
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Alexander C Adam
- Department of Pathology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Heike Göbel
- Department of Pathology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Mareike Franke
- Department of Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Dr. Hancken Clinic, Harsefelder Str. 8, 21680, Stade, Germany
| | - Bernhard Schermer
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,Systems Biology of Ageing Cologne (Sybacol), University of Cologne, Cologne, Germany
| | - Stefan Haneder
- Department of Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Thomas Benzing
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,Systems Biology of Ageing Cologne (Sybacol), University of Cologne, Cologne, Germany
| | - Bodo B Beck
- Institute of Human Genetics, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. .,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany. .,Systems Biology of Ageing Cologne (Sybacol), University of Cologne, Cologne, Germany.
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Haneder S, Heneweer C, Siedek F, Große Hokamp N, Maintz D, Wybranski C. Thorako-abdominelles Staging mit einem neuen Dual-Layer CT: Intra-individueller Vergleich der Strahlendosis und der Bildqualität mit 64- und 128-Zeilen Single-Energy CTs. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S Haneder
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - C Heneweer
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - F Siedek
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - N Große Hokamp
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - D Maintz
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - C Wybranski
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
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Dörner J, Byrtus J, Hauger M, Große Hokamp N, Hubois C, Hickethier T, Wybranski C, Maintz D, Haneder S. Systematische Evaluation virtuell monoenergetischer Bilder aus Spectral Detector CT Daten in der Bildgebung des Abdomens in venöser Kontrastmittelphase: erste in-vivo Ergebnisse. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Dörner
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - J Byrtus
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - M Hauger
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - N Große Hokamp
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - C Hubois
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - T Hickethier
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - C Wybranski
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - D Maintz
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - S Haneder
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
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40
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Ong M, Schmidt A, Konstandin S, Benrath J, Eisele P, Schad L, Schönberg S, Haneder S. Cerebrale Natrium (23Na)-Bildgebung in Migränepatienten. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Ong
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | - A Schmidt
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | | | - J Benrath
- Universitätsmedizin Mannheim, Klinik für Anästhesiologie und Operative Intensivmedizin, Mannheim
| | - P Eisele
- Universitätsmedizin Mannheim, Neurologische Klinik, Mannheim
| | - L Schad
- Universitätsmedizin Mannheim, Computer Assisted Clinical Medicine, Mannheim
| | - S Schönberg
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | - S Haneder
- Universitätsklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
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Ong M, Schmidt A, Hausmann D, Schönberg S, Haneder S. Doppelresonante (23Na/1 H) vs. klinische 1 H Schädel-MRT Spule – Intraindividueller Vergleich der Bildqualität an gesunden Probanden. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Ong
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | - A Schmidt
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | - D Hausmann
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | - S Schönberg
- Universitätsmedizin Mannheim, Institut für klinische Radiologie und Nuklearmedizin, Mannheim
| | - S Haneder
- Universitätsklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
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Siedek F, Giese D, Weiss K, Brinkmann S, Schröder W, Maintz D, Haneder S. Beschleunigte 4D-MR-Phasenkontrastflussmessung zur Analyse flussdynamischer Prozesse im Truncus coeliacus und der Arteria mesenterica superior. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- F Siedek
- Uniklinik Köln, Radiologie, Köln
| | - D Giese
- Uniklinik Köln – Institut für Diagnostische und Interventionelle Radiologie, MRI-Physics, Köln
| | - K Weiss
- Uniklinik Köln – Institut für Diagnostische und Interventionelle Radiologie, MRI-Physics, Köln
| | - S Brinkmann
- Uniklinik Köln – Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Köln
| | - W Schröder
- Uniklinik Köln – Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Köln
| | - D Maintz
- Uniklinik Köln – Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - S Haneder
- Uniklinik Köln – Institut für Diagnostische und Interventionelle Radiologie, Köln
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Houbois C, Püsken M, Merkt M, Hellmich M, Mainz D, Haneder S. Kann die Nierenkortexvolumetrie anhand von CT Datensätzen die MAG3-Szintigrafie zur Beurteilung der seitengetrennten Nierenfunktion ersetzen? ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Houbois
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - M Püsken
- Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - M Merkt
- Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - M Hellmich
- Institut für Medizinische Statistik, Informatik und Epidemiologie, Köln
| | - D Mainz
- Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - S Haneder
- Institut für Diagnostische und Interventionelle Radiologie, Köln
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Budjan J, Benck U, Lammert A, Ong MM, Mircheva M, Diehl S, Konstandin S, Schad LR, Krämer BK, Schoenberg SO, Haneder S. Renal Denervation in Patients with Resistant Hypertension-Assessment by 3T Renal 23Na-MRI: Preliminary Results. In Vivo 2016; 30:657-662. [PMID: 27566087] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/05/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND/AIM Renal denervation (RDN) has been considered a promising therapy option for patients suffering from therapy-resistant hypertension. Besides, in blood-pressure regularization, the kidneys play a fundamental role in sodium ((23)Na) homeostasis. This study assesses the effect of RDN on renal (23)Na concentration using (23)Na magnetic resonance imaging (MRI). PATIENTS AND METHODS Two patients with therapy-resistant hypertension underwent RDN. (23)Na-MRI, (1)H-MRI, including diffusion weighted imaging (DWI), as well as endothelial dysfunction assessment, were performed 1 day prior, as well as 1, 30 and 90 days after RDN. RESULTS The renal corticomedullary (23)Na gradient did not change after RDN for all time points. Additionally, functional imaging and retinal vessel parameters were not influenced by RDN. Results regarding blood pressure changes and arterial stiffness, as well as patients' clinical outcome, were heterogeneous. CONCLUSION RDN does not seem to alter renal (23)Na concentration gradients, as measured by MRI.
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Affiliation(s)
- Johannes Budjan
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Urs Benck
- Fifth Department of Internal Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexander Lammert
- Fifth Department of Internal Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Melissa M Ong
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Miryana Mircheva
- Fifth Department of Internal Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Steffen Diehl
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simon Konstandin
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Mannheim, Germany MR-Imaging and Spectroscopy, Faculty 01 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Mannheim, Germany
| | - Bernhard K Krämer
- Fifth Department of Internal Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Haneder
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Department of Radiology, University Hospital of Cologne, Cologne, Germany
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Trattnig S, Bogner W, Gruber S, Szomolanyi P, Juras V, Robinson S, Zbýň Š, Haneder S. Clinical applications at ultrahigh field (7 T). Where does it make the difference? NMR Biomed 2016; 29:1316-34. [PMID: 25762432 DOI: 10.1002/nbm.3272] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [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: 10/02/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 05/11/2023]
Abstract
Presently, three major MR vendors provide commercial 7-T units for clinical research under ethical permission, with the number of operating 7-T systems having increased to over 50. This rapid increase indicates the growing interest in ultrahigh-field MRI because of improved clinical results with regard to morphological as well as functional and metabolic capabilities. As the signal-to-noise ratio scales linearly with the field strength (B0 ) of the scanner, the most obvious application at 7 T is to obtain higher spatial resolution in the brain, musculoskeletal system and breast. Of specific clinical interest for neuro-applications is the cerebral cortex at 7 T, for the detection of changes in cortical structure as a sign of early dementia, as well as for the visualization of cortical microinfarcts and cortical plaques in multiple sclerosis. In the imaging of the hippocampus, even subfields of the internal hippocampal anatomy and pathology can be visualized with excellent resolution. The dynamic and static blood oxygenation level-dependent contrast increases linearly with the field strength, which significantly improves the pre-surgical evaluation of eloquent areas before tumor removal. Using susceptibility-weighted imaging, the plaque-vessel relationship and iron accumulation in multiple sclerosis can be visualized for the first time. Multi-nuclear clinical applications, such as sodium imaging for the evaluation of repair tissue quality after cartilage transplantation and (31) P spectroscopy for the differentiation between non-alcoholic benign liver disease and potentially progressive steatohepatitis, are only possible at ultrahigh fields. Although neuro- and musculoskeletal imaging have already demonstrated the clinical superiority of ultrahigh fields, whole-body clinical applications at 7 T are still limited, mainly because of the lack of suitable coils. The purpose of this article was therefore to review the clinical studies that have been performed thus far at 7 T, compared with 3 T, as well as those studies performed at 7 T that cannot be routinely performed at 3 T. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Gruber
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Pavol Szomolanyi
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Sciences, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Vladimir Juras
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Sciences, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Simon Robinson
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Štefan Zbýň
- High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Stefan Haneder
- Vascular and Abdominal Imaging, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
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Budjan J, Sauter EA, Morelli JN, Nolden M, Fetzer A, Pilz L, Reichert M, Brandt T, Hansmann J, Haneder S, Rathmann N, Diehl SJ, Meinzer HP, Schoenberg SO, Attenberger UI. Semi-automatic Volumetric Measurement of Treatment Response in Hepatocellular Carcinoma After Trans-arterial Chemoembolization. Anticancer Res 2016; 36:4353-4358. [PMID: 27466556] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
AIM To perform a quantitative, volumetric analysis of therapeutic effects of trans-arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients. PATIENTS AND METHODS Entire tumor volume and a subset of hypervascular tumor portions were analyzed pre- and post-TACE in magnetic resonance imaging datasets of 22 HCC patients using a semi-automated segmentation and evaluation tool from the Medical Imaging Interaction Toolkit. Results were compared to mRECIST measurements and inter-reader variability was assessed. RESULTS Mean total tumor volume increased statistical significantly after TACE (84.6 ml pre- vs. 97.1 ml post-TACE, p=0.03) while hypervascular tumor volume decreased from 9.1 ml pre- to 3.7 ml post-TACE (p=0.0001). Likewise, mRECIST diameters decreased significantly after therapy (44.2 vs. 15.4 mm). In the inter-reader assessment, overlap errors were 12.3-17.7% for entire and 36.3-64.2% for the enhancing tumor volume. CONCLUSION Quantification of therapeutic changes after TACE therapy is feasible using a semi-automated segmentation and evaluation tool. Following TACE, hypervascular tumor volume decreases significantly.
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Affiliation(s)
- Johannes Budjan
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Elke A Sauter
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Marco Nolden
- Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany
| | - Andreas Fetzer
- Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany
| | - Lothar Pilz
- Department of Biostatistics, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim, Germany
| | - Miriam Reichert
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Theresa Brandt
- Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany
| | - Jan Hansmann
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Haneder
- University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Nils Rathmann
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Steffen J Diehl
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hans-Peter Meinzer
- Division of Medical and Biological Informatics, German Cancer Research Centre, Heidelberg, Germany
| | - Stefan O Schoenberg
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrike I Attenberger
- Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Schrittenlocher S, Hiss S, Haneder S, Otte M, Luers JC, Steven P. Einseitiges Papillenödem aufgrund von ipsilateraler Mukozele. Klin Monbl Augenheilkd 2016; 233:1378-1380. [DOI: 10.1055/s-0042-102962] [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]
Affiliation(s)
| | - S. Hiss
- Institut für Diagnostische und Interventionelle Radiologie, Universität zu Köln, Medizinische Fakultät
| | - S. Haneder
- Institut für Diagnostische und Interventionelle Radiologie, Universität zu Köln, Medizinische Fakultät
| | - M. Otte
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universität zu Köln, Medizinische Fakultät
| | - J.-C. Luers
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universität zu Köln, Medizinische Fakultät
| | - P. Steven
- Zentrum für Augenheilkunde, Universitätsklinik Köln
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Haneder S, Tummetott D, Riffel P, Michaely H, Schönberg S, Büttner S, Birck A, Siedek F. DWI bei M. Crohn: Möglichkeiten der Differenzierung zwischen akuter und chronischer Entzündung? ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Zöllner FG, Konstandin S, Lommen J, Budjan J, Schoenberg SO, Schad LR, Haneder S. Quantitative sodium MRI of kidney. NMR Biomed 2016; 29:197-205. [PMID: 25728879 DOI: 10.1002/nbm.3274] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 10/02/2014] [Revised: 01/13/2015] [Accepted: 01/25/2015] [Indexed: 05/25/2023]
Abstract
One of the main tasks of the human kidneys is to maintain the homeostasis of the body's fluid and electrolyte balance by filtration of the plasma and excretion of the end products. Herein, the regulation of extracellular sodium in the kidney is of particular importance. Sodium MRI ((23)Na MRI) allows for the absolute quantification of the tissue sodium concentration (TSC) and thereby provides a direct link between TSC and tissue viability. Renal (23)Na MRI can provide new insights into physiological tissue function and viability thought to differ from the information obtained by standard (1)H MRI. Sodium imaging has the potential to become an independent surrogate biomarker not only for renal imaging, but also for oncology indications. However, this technique is now on the threshold of clinical implementation. Numerous, initial pre-clinical and clinical studies have already outlined the potential of this technique; however, future studies need to be extended to larger patient groups to show the diagnostic outcome. In conclusion, (23)Na MRI is seen as a powerful technique with the option to establish a non-invasive renal biomarker for tissue viability, but is still a long way from real clinical implementation.
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Affiliation(s)
- Frank G Zöllner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simon Konstandin
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- MR-Imaging and Spectroscopy, Faculty 01 (Physics/Electrical Engineering), University of Bremen, Bremen, Germany
| | - Jonathan Lommen
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Haneder
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
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Otto M, Färber J, Haneder S, Michaely H, Kienle P, Hasenberg T. Postoperative changes in body composition--comparison of bioelectrical impedance analysis and magnetic resonance imaging in bariatric patients. Obes Surg 2015; 25:302-9. [PMID: 25096342 DOI: 10.1007/s11695-014-1382-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) result in a marked reduction of body fat and also visceral fat (VF) decrease up to 36 % in 16 weeks. This leads to positive effects on cardiometabolic risks, which are known to be correlated with the occurrence of VF. This study analyzed the validity of bioelectrical impedance analysis (BIA) for determining VF in the postoperative course. In addition, magnetic resonance imaging (MRI) was performed for prediction of whole VF in bariatric patients on the basis of a single slice. METHODS Eighteen patients, who underwent RYGB (18), were included in this study. MRI and BIA measurements were performed 1 day before surgery, as well as 6, 12, and 24 weeks after surgery. RESULTS During the postoperative observation period, we found a significant decrease of both subcutaneous fat (SF) and VF. SF measured by MRI was highly correlated with the level of body fat shown by BIA. In contrast, the VF volume, as determined by MRI, showed no correlation with the body fat measured by BIA. In addition, we were able to show a significant correlation between MRI measured VF volume and the particular single-layer fat area. CONCLUSIONS Compared to the widely used bioelectrical impedance analysis to measure changes in body composition after bariatric procedures, a single-layer MRI was superior in determining VF. Single-layer MRI may be a better tool to recognize changes of VF after bariatric procedures.
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Affiliation(s)
- Mirko Otto
- UMM, University Medical Center Mannheim, Department of Surgery, Heidelberg University, Mannheim, Germany,
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