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Koch A, Gruber-Rouh T, Zangos S, Eichler K, Vogl T, Basten L. Radiation protection in CT-guided interventions: does real-time dose visualisation lead to a reduction in radiation dose to participating radiologists? A single-centre evaluation. Clin Radiol 2024; 79:e785-e790. [PMID: 38388255 DOI: 10.1016/j.crad.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/04/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024]
Abstract
AIM To evaluate if real-time dose visualisation during computed tomography (CT)-guided interventions leads to a reduction in radiation dose to participating radiologists. MATERIALS AND METHODS The individual radiation dose radiologists are exposed to during CT interventions was measured using dedicated dosimeters (RaySafe i2-system, Unfors RaySafe GmbH, Billdal, Sweden) worn over the usual radiation protective apron. Initially, only the total radiation dose was measured, without visualisation (control group). In the following study period, the radiation dose was shown to participants on a live screen in real-time (experimental group). In both groups, the dose was recorded in 1-second intervals. The results collected were evaluated by comparison using descriptive statistics and mixed-effect models. In particular, the variables experience, gender, role, and position during the intervention were analysed. RESULTS In total, 517 measurements of 304 interventions (n=249 with and n=268 without live screen) performed by 29 radiologists acting as interventionalists or assistants were analysed. All CT-guided interventions were performed percutaneously, the majority of which (n=280) were microwave ablations (MWA). Radiation doses in the group without visualisation were comparable with usual dose rates for the corresponding intervention type. The mean total radiation dose was reduced by 58.1% (11.6 versus 4.86 μSv) in the experimental group (p=0.034). The highest reduction of 78.5% (15.55 versus 3.35 μSv) was observed in radiologists with the role of assistant (p=0.002). Sub-analysis showed significant dose reduction (p<0.0001) for the use of live screen in general; considering all variables, the role "assistant" alone had a statistically significant influence (p=0.002). CONCLUSION The real-time visualisation of active radiation dose during CT interventions leads to a relevant reduction in radiation dose to participating radiologists.
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Affiliation(s)
- A Koch
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - T Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - S Zangos
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - K Eichler
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - T Vogl
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany
| | - L Basten
- Department of Diagnostic and Interventional Radiology, Frankfurt-University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany.
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Juergens LJ, Thalhammer A, Gruber-Rouh T, Koch V, Vogl TJ, Martin SS. Coil embolization of a fistula from the right inferior phrenic artery to the right pulmonary artery with involvement of further arteries: A rare case report. J Radiol Case Rep 2023; 17:22-28. [PMID: 38098960 PMCID: PMC10718308 DOI: 10.3941/jrcr.v17i8.4972] [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] [Indexed: 12/17/2023] Open
Abstract
A 51-year-old female patient was presenting dyspnea for more than a year with no previous lung infections or surgery. Initially, a diagnostic computed tomography was made, showing a rare arterio-arterial malformation between the right inferior phrenic and right pulmonary artery leading into a vascular bundle in the middle lung lobe. Due to the patients' dyspnea and massive extent of malformation, the indication for transcatheter arterial embolization was made. The first transcatheter arterial embolization procedure involved the inferior phrenic and a selective branch of the internal thoracic artery. Interventional angiography as well as computed tomography revealed further extend of the malformation showing a connection of right lateral thoracic, hepatic, and inferior epigastric artery to the fistula. After one month, a second transcatheter arterial embolization of these arteries as well as a second approach of the proximal internal thoracic artery was performed. In the follow-up the patient described a substantial improvement of her dyspnea and showed no signs of infections. A phrenic artery to pulmonary artery fistula is an extremely rare case occurring congenital or acquired. Patients may be asymptomatic or present, among others, dyspnea, hemoptysis, pulmonary infections and congestive heart failure. Symptomatic patients require treatment using transcatheter arterial embolization or surgical resection. The patient had dyspnea and a substantial extent of malformation with possibly complicated clinical course. The recommended less invasive treatment using transcatheter arterial embolization was successfully performed. In conclusion, our patient represented a rare congenital case of systemic and pulmonary artery communication, which we were able to treat sufficiently with coil embolization.
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Affiliation(s)
- L J Juergens
- Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Germany
| | - A Thalhammer
- Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Germany
| | - T Gruber-Rouh
- Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Germany
| | - V Koch
- Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Germany
| | - T J Vogl
- Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Germany
| | - S S Martin
- Goethe University Frankfurt, University Hospital, Department of Diagnostic and Interventional Radiology, Germany
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Vogl JT, Adwan H, Trojan J, Naguib N, Gruber-Rouh T. Mikrowellenablation (MWA) von kleinen (≤ 2 cm) hepatozellulären Karzinomen (HCC): Evaluation vonTherapieansprechens und Überlebensrate. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749825] [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: 11/07/2022]
Affiliation(s)
- J T Vogl
- Klinikum der Johann-Wolfgang-Goethe Universität, Institut f. Diagn. u. Intervent. Radiologie, Frankfurt a. M
| | - H Adwan
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - J Trojan
- Medizinische Klinik I, Uniklinik Frankfurt, Frankfurt am Main
| | - N Naguib
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - T Gruber-Rouh
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
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Vogl JT, Var V, Basten L, Gruber-Rouh T. CT-gesteuerte Mikrowellenablation von malignen Lungenläsionen: Die Rolle der diffusionsgewichtetem MRT und des apparenten Diffusionskoeffizienten bei der Vorhersage des Therapieerfolgs. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749837] [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)
- J T Vogl
- Klinikum der Johann-Wolfgang-Goethe Universität, Institut f. Diagn. u. Intervent. Radiologie, Frankfurt a. M
| | - V Var
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - L Basten
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - T Gruber-Rouh
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
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Vogl JT, Freichel J, Bechstein W, Gruber-Rouh T, Zeuzem S. Interventionelle Behandlungoptionen beim hepatozellulären Karzinom (HCC): Monozentrische Evaluation über einen Zeitraum von 27 Jahren. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749835] [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)
- J T Vogl
- Klinikum der Johann-Wolfgang-Goethe Universität, Institut f. Diagn. u. Intervent. Radiologie, Frankfurt a. M
| | - J Freichel
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - W Bechstein
- Zentrum für Chirurgie, Uniklinik Frankfurt, Frankfurt am Main
| | - T Gruber-Rouh
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - S Zeuzem
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
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Vogl JT, Adwan H, Trojan J, Gruber-Rouh T. Therapieansprechen und Überlebensraten bei der Behandlung des hepatozellulären Karzinoms (HCC) mittels thermischer Ablation: Laserinduzierte Thermotherapie (LITT) versus Mikrowellenablation (MWA). ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749826] [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)
- J T Vogl
- Klinikum der Johann-Wolfgang-Goethe Universität, Institut f. Diagn. u. Intervent. Radiologie, Frankfurt a. M
| | - H Adwan
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
| | - J Trojan
- Medizinische Klinik I, Uniklinik Frankfurt, Frankfurt am Main
| | - T Gruber-Rouh
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Frankfurt, Frankfurt am Main
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Vogl TJ, Langenbach MC, Hammerstingl R, Albrecht MH, Chatterjee AR, Gruber-Rouh T. Evaluation of two different transarterial chemoembolization protocols using Lipiodol and degradable starch microspheres in therapy of hepatocellular carcinoma: a prospective trial. Hepatol Int 2021; 15:685-694. [PMID: 34043158 PMCID: PMC8286929 DOI: 10.1007/s12072-021-10193-8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/17/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND This prospective randomized trial is designed to compare the performance of conventional transarterial chemoembolization (cTACE) using Lipiodol-only with additional use of degradable starch microspheres (DSM) for hepatocellular carcinoma (HCC) in BCLC-stage-B based on metric tumor response. METHODS Sixty-one patients (44 men; 17 women; range 44-85) with HCC were evaluated in this IRB-approved HIPPA compliant study. The treatment protocol included three TACE-sessions in 4-week intervals, in all cases with Mitomycin C as a chemotherapeutic agent. Multiparametric magnetic resonance imaging (MRI) was performed prior to the first and 4 weeks after the last TACE. Two treatment groups were determined using a randomization sheet: In 30 patients, TACE was performed using Lipiodol only (group 1). In 31 cases Lipiodol was combined with DSMs (group 2). Response according to tumor volume, diameter, mRECIST criteria, and the development of necrotic areas were analyzed and compared using the Mann-Whitney-U, Kruskal-Wallis-H-test, and Spearman-Rho. Survival data were analyzed using the Kaplan-Meier estimator. RESULTS A mean overall tumor volume reduction of 21.45% (± 62.34%) was observed with an average tumor volume reduction of 19.95% in group 1 vs. 22.95% in group 2 (p = 0.653). Mean diameter reduction was measured with 6.26% (± 34.75%), for group 1 with 11.86% vs. 4.06% in group 2 (p = 0.678). Regarding mRECIST criteria, group 1 versus group 2 showed complete response in 0 versus 3 cases, partial response in 2 versus 7 cases, stable disease in 21 versus 17 cases, and progressive disease in 3 versus 1 cases (p = 0.010). Estimated overall survival was in mean 33.4 months (95% CI 25.5-41.4) for cTACE with Lipiosol plus DSM, and 32.5 months (95% CI 26.6-38.4), for cTACE with Lipiodol-only (p = 0.844), respectively. CONCLUSIONS The additional application of DSM during cTACE showed a significant benefit in tumor response according to mRECIST compared to cTACE with Lipiodol-only. No benefit in survival time was observed.
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Affiliation(s)
- T J Vogl
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai, 760590, Frankfurt am Main, Germany
| | - M C Langenbach
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai, 760590, Frankfurt am Main, Germany
| | - R Hammerstingl
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai, 760590, Frankfurt am Main, Germany
| | - M H Albrecht
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai, 760590, Frankfurt am Main, Germany
| | - A R Chatterjee
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - T Gruber-Rouh
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai, 760590, Frankfurt am Main, Germany.
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Gruber-Rouh T, Eichler K, Vogl TJ, Yel I, Beeres M, Langenbach MC. Corrigendum to: "Re: CT-guided percutaneous biopsy of suspect pancreatic lesions: radiological and clinical outcome" [74 (11) e7-e12]. Clin Radiol 2021; 76:474.e1. [PMID: 33814121 DOI: 10.1016/j.crad.2021.03.004] [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: 11/30/2022]
Affiliation(s)
- T Gruber-Rouh
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590, Frankfurt am Main, Germany.
| | - K Eichler
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590, Frankfurt am Main, Germany
| | - T J Vogl
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590, Frankfurt am Main, Germany
| | - I Yel
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590, Frankfurt am Main, Germany
| | - M Beeres
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590, Frankfurt am Main, Germany
| | - M C Langenbach
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590, Frankfurt am Main, Germany
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Arendt CT, Eichler K, Mack MG, Leithner D, Zhang S, Block KT, Berdan Y, Sader R, Wichmann JL, Gruber-Rouh T, Vogl TJ, Hoelter MC. Comparison of contrast-enhanced videofluoroscopy to unenhanced dynamic MRI in minor patients following surgical correction of velopharyngeal dysfunction. Eur Radiol 2020; 31:76-84. [PMID: 32740819 DOI: 10.1007/s00330-020-07098-9] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/02/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare dynamic magnetic resonance imaging (MRI) with videofluoroscopy (VFS) regarding image quality and assessment of gap size between soft palate (SP) and posterior pharyngeal wall (PPW) in children and adolescents following surgical correction of velopharyngeal dysfunction (VPD). METHODS Twenty-one patients undergoing unenhanced 3-T MRI and contrast-enhanced VFS were included in this IRB-approved prospective study. The MRI scan protocol comprised refocused gradient-echo sequences in transverse and sagittal planes during speech, with TE 1.97 ms, TR 3.95 ms, flip angle 8°, matrix size 128 × 128, and 5-mm slice thickness. Radial k-space sampling and sliding window reconstruction were used to achieve an image acquisition rate of 28 frames per second (fps). VFS with 30 fps was similarly performed in both planes. Closure of the velopharyngeal port during phonation was evaluated by two experienced radiologists. RESULTS Eleven (52.4%) patients displayed a complete closure, whereas ten (47.6%) patients showed a post-operative gap during speech. VFS and MRI equally identified the cases with persistent or recurrent VPD. Differences in SP-PPW distance between VFS (3.9 ± 1.6 mm) and MRI (4.1 ± 1.5 mm) were not statistically significant (p = 0.5). The subjective overall image quality of MRI was rated inferior (p < 0.001) compared with VFS, with almost perfect inter-rater agreement (κ = 0.90). The presence of susceptibility artifacts did not limit anatomical measurements. CONCLUSION Dynamic MRI is equally reliable as VFS to assess persistent or recurrent inadequate velum closure in patients following surgical treatment of VPD. KEY POINTS • Unenhanced 3-T dynamic MRI and contrast-enhanced videofluoroscopy are equally useful for the identification of patients with incomplete velopharyngeal closure during speech. • MRI using refocused gradient-echo acquisition with radial k-space sampling and sliding window reconstruction generates diagnostic images with 28 frames per second. • MRI can offer a radiation-free alternative to currently established videofluoroscopy for young patients.
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Affiliation(s)
- C T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - K Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - M G Mack
- Radiology Munich, Munich, Germany
| | - D Leithner
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - S Zhang
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - K T Block
- Department of Radiology, University Hospital Basel, Basel, Switzerland
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Y Berdan
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - R Sader
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J L Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - T Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - T J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - M C Hoelter
- Institute for Neuroradiology, University Hospital Frankfurt, Frankfurt am Main, Germany
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Gruber-Rouh T, Langenbach MC, Eichler K, Vogl TJ, Yel I, Beeres M. CT-guided percutaneous biopsy of suspect pancreatic lesions: radiological and clinical outcome. Clin Radiol 2019; 74:899.e7-899.e12. [PMID: 31495545 DOI: 10.1016/j.crad.2019.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/19/2019] [Indexed: 12/19/2022]
Abstract
AIM To evaluate the clinical utility of computed tomography (CT)-guided percutaneous biopsies of suspect pancreatic lesions regarding safety, efficiency, radiation dose, intervention time, diagnostic yield, and complications. MATERIALS AND METHODS Between 2015 and 2018, 48 patients (18 female, 30 male; mean age: 64.2 years) with suspect pancreatic lesions underwent CT-guided percutaneous biopsy. Ultrasound-guided biopsy of all lesions was not possible or without any result. CT-guided interventions were compared according to the following intervention parameters: radiation dose, procedure duration, number of needle correction scans. Evaluation criteria included technical success as well as major and minor complications according to the Society of Interventional Radiology. RESULTS Biopsies were performed successfully in 100% of patients. No major side effects occurred during intervention. As a minor complication, 29.2% showed focal haemorrhage. Seventy-seven percent of lesions had a malignant appearance, and benign inflammatory lesions were found in 23%. The mean size of the target lesions was 2.9 cm (range: 0.7-2.3 cm). The mean target access path within the patient was 8 cm (range: 3-14 cm). The duration to completion was 12 minutes (range: 3 minutes 30 seconds to 30 minutes). The dose-length product of the intervention was 89.5 mGy·cm (range: 11-350 mGy·cm). The average number needle correction scans was 31.1 (range: 6-36). CONCLUSION CT-guided biopsy of suspect pancreatic lesions is an efficient and safe method. It can be performed within short intervention times and low radiation exposure for differentiation of unclear lesions.
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Affiliation(s)
- T Gruber-Rouh
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany.
| | - M C Langenbach
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - K Eichler
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - T J Vogl
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - I Yel
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - M Beeres
- Institute for Diagnostic and Interventional Radiology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
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Arendt C, Leithner D, Wichmann J, Czwikla R, Vogl T, Gruber-Rouh T. Nephroprotektive Methoden zur Evaluation von Gefäßstenosen bei Patienten mit chronischer Niereninsuffizienz: eine Vergleichsstudie zwischen der kontrastmittelfreien QISS-MRA und der invasiven CO2-DSA. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600228] [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 Arendt
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt, Zentrum der Radiologie, Frankfurt am Main
| | - D Leithner
- Universitätsklinikum Frankfurt, Diagnostische und Interventionelle Radiologie, Frankfurt am Main
| | - J Wichmann
- Universitätsklinikum Frankfurt, Diagnostische und Interventionelle Radiologie, Frankfurt am Main
| | - R Czwikla
- Universitätsklinikum Frankfurt, Diagnostische und Interventionelle Radiologie, Frankfurt am Main
| | - T Vogl
- Universitätsklinikum Frankfurt, Diagnostische und Interventionelle Radiologie, Frankfurt am Main
| | - T Gruber-Rouh
- Universitätsklinikum Frankfurt, Diagnostische und Interventionelle Radiologie, Frankfurt am Main
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Vogl T, Langenbach M, Gruber-Rouh T, Hammerstingl R. Prospektive randomisierte FAST II-Studie: Tumoransprechen beim hepatozellulären Karzinom (HCC) nach transarterieller Chemoembolisation (TACE) mit zwei verschiedenen Protokollen mittels MRT. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600306] [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)
- T Vogl
- Uniklinik Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt a.M
| | - M Langenbach
- Uniklinik Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
| | - T Gruber-Rouh
- Uniklinik Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
| | - R Hammerstingl
- Uniklinik Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
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Albrecht MH, Bodelle B, Varga-Szemes A, Dewes P, Bucher AM, Ball BD, De Cecco CN, Schoepf UJ, Zhu X, Zangos S, Gruber-Rouh T, Wichmann JL, Lehnert T, Vogl TJ. Intra-individual comparison of CAIPIRINHA VIBE technique with conventional VIBE sequences in contrast-enhanced MRI of focal liver lesions. Eur J Radiol 2016; 86:20-25. [PMID: 28027748 DOI: 10.1016/j.ejrad.2016.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/20/2016] [Accepted: 10/22/2016] [Indexed: 01/18/2023]
Abstract
PURPOSE To evaluate the impact of controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) volume interpolated breath-hold examination (VIBE) magnetic resonance imaging (MRI) technique on image quality, reader confidence, and inter-observer agreement for the assessment of focal liver lesions in comparison with the standard VIBE approach. MATERIAL AND METHODS In this IRB-approved intra-individual comparison study, abdominal arterial and portal-venous contrast-enhanced MRI studies were retrospectively analyzed in 38 patients with malignant liver lesions. Each patient underwent both CAIPIRINHA and conventional VIBE 3T MRI within 3 months, showing stable disease. Images were evaluated using 5-point rating scales by two blinded radiologists with more than 20 and 5 years of experience in MRI, respectively. Readers scored dignity of liver lesions and assessed which liver segments were affected by malignancy (ranging from 1=definitely benign/not affected to 5=definitely malignant/affected by malignancy). Readers also rated overall image quality, sharpness of intrahepatic veins, and diagnostic confidence (ranging from 1=poor to 5=excellent). RESULTS Reviewers achieved a higher inter-observer reliability using CAIPIRINHA when they reported which liver segments were affected by malignancy compared to traditional VIBE series (κ=0.62 and 0.54, respectively, p<0.05). Similarly, CAIPIRINHA showed a slightly higher inter-rater agreement for the dignity of focal liver lesions versus the standard VIBE images (κ=0.50 and 0.49, respectively, p<0.05). CAIPIRINHA series also scored higher in comparison to standard VIBE sequences (mean scores: image quality, 4.2 and 3.5; sharpness of intrahepatic vessels, 3.8 and 3.2, respectively, p<0.05) for both reviewers and allowed for higher subjective diagnostic confidence (ratings, 3.8 and 3.2, respectively, p<0.05). CONCLUSION Compared to the standard VIBE approach, CAIPIRINHA VIBE technique provides improved image quality and sharpness of intrahepatic veins, as well as higher diagnostic confidence. Additionally, this technique allows for higher inter-observer agreement when reporting focal liver lesions for both dignity and allocation.
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Affiliation(s)
- M H Albrecht
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany; Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC, USA.
| | - B Bodelle
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - A Varga-Szemes
- Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC, USA.
| | - P Dewes
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - A M Bucher
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - B D Ball
- Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC, USA.
| | - C N De Cecco
- Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC, USA.
| | - U J Schoepf
- Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC, USA.
| | - X Zhu
- Shihezi University, Department of Psychology, Beisi Road, Xinjiang, China.
| | - S Zangos
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - T Gruber-Rouh
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - J L Wichmann
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - T Lehnert
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
| | - T J Vogl
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Frankfurt,Germany.
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Gruber-Rouh T, Schulz B, Eichler K, Naguib NNN, Vogl TJ, Zangos S. Radiation dose and quickness of needle CT-interventions using a laser navigation system (LNS) compared with conventional method. Eur J Radiol 2015. [PMID: 26210096 DOI: 10.1016/j.ejrad.2015.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to analyse the radiation dose and quickness of needle interventions using a Laser Navigation System (LNS-group) compared with conventional method (control-group). MATERIALS AND METHODS In this prospective, randomized, comparative study 58 patients (19 females, 39 males; mean age, 62.9 years) were punctured either with LNS (n=29) or with conventional method with a skin mark of the puncture site (n=29). In the LNS method the puncture site was marked with laser without additional CT. Thoracic and abdominal intervention was performed in 30 and 28 patients, respectively. Radiation dose and time of the procedures were analysed. Statistical significance was calculated according to the Mann-Whitney-U-test. RESULTS Mean target access path in the patients of the LNS group was 6.0 cm (range, 3.0-10.1cm) and in the control group 6.0 cm (range, 1.0-10.3 cm). Time duration of complete intervention in the LNS group was 20:25 min (range, 07:00-34:00 min) and in the control group 28:00 min (range, 13:00-51:00 min). The dose-length-product (DLP) of intervention scan of the LNS group was 42.3 mGy cm (range, 10-125 mGy cm), and of the control group 59.7 mGy cm (range, 25-176.42 mGy cm). CONCLUSION Using the LNS for CT-guided interventions results in faster intervention time with a lower dose.
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Affiliation(s)
- T Gruber-Rouh
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - B Schulz
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - K Eichler
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Nagy N N Naguib
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany; Department of Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - T J Vogl
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - S Zangos
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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Nour-Eldin Mohammed N, Lehnert T, Naguib N, Gruber-Rouh T, Emam A, Alsubhi A, Vogl T. Pneumothorax Complicating Coaxial and Non-Coaxial CT-Guided Lung Biopsy: Comparative Analysis. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551040] [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: 10/23/2022]
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Nour-Eldin M, Naguib N, Lehnert T, Gruber-Rouh T, Vogl TJ. MRI Chest Parameters Used in the Assessment of Tumor Response Post Microwave Ablation of Pulmonary Metastases. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Eichler K, Zangos S, Gruber-Rouh T, Vogl TJ, Mack MG. MR-guided laser-induced thermotherapy (LITT) in patients with liver metastases of uveal melanoma. J Eur Acad Dermatol Venereol 2014; 28:1756-60. [PMID: 24593299 DOI: 10.1111/jdv.12405] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/19/2014] [Indexed: 01/13/2023]
Abstract
PURPOSE Evaluation of the local tumour control rate and survival data for magnetic resonance (MR) imaging-guided laser ablation of uveal malignant melanoma liver metastases by using laser-induced interstitial thermotherapy (LITT). MATERIALS AND METHODS The LITT was performed in 18 patients with liver metastases (n = 44) from uveal malignant melanoma. All patients tolerated this intervention well. With the Kaplan-Meier method, the survival rates were calculated. Indications for the procedure were defined for patients with no more than five metastases, none of which were larger than 5 cm in diameter: The Indication for LITT treatment were recurrent liver metastases after partial liver resection (22%), locally non-resectable tumours (17%) or metastases in both liver lobes (61%). RESULTS The mean survival rate for all treated patients was 3.6 years (95% CI: 2.19, 5.06). We started the calculation on the date of diagnosis of the metastases treated with LITT. The median survival was 1.83 years; 1-year survival, 88%; 3-year survival 47%, 5-year survival 17%. Calculated after the first LITT treatment the median survival was 2.8 years (95% CI: 1.0, 5.0). 10 patients were treated by transarterial chemoembolization before LITT. CONCLUSION MR-guided LITT treatment shows a high local tumour control and survival rates in patients with liver metastases of uveal malignant melanoma.
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Affiliation(s)
- K Eichler
- Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt, Germany
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Eichler K, Dufas T, Hammerstingl R, Gruber-Rouh T, Vogl T, Zangos S. Hepatic Arterial Infusion with Irinotecan in Patients with Liver Metastases of Colorectal Cancer: Results of an Extended Phase I Study. Chemotherapy 2013; 59:66-73. [DOI: 10.1159/000348579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 02/03/2013] [Indexed: 01/22/2023]
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Naguib NN, Hey C, Gruber-Rouh T, Nour-Eldin NE, Lehnert T, Marc H, Vogl T. Three Dimensional and Multiplanar Reconstruction of the Internal Auditory Canal using High Resolution MR-Imaging: Assessment of the Size of the Cochlear Nerve in Patients with Hearing Loss. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schulz B, Eichler K, Siebenhandl P, Gruber-Rouh T, Czerny C, Vogl TH, Zangos S. Genauigkeit von Roboter assistierten Nadelinterventionen unter Verwendung einer modernen 3D-Interventionssuite - Eine Phantomstudie. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gruber-Rouh T, Beeres M, Naguib N, Lehnert T, Nour-Eldin NE, Vogl TJ, Jacobi V. Therapeutische Wirksamkeit der Lymphografie bei postoperativen Lymphleckagen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Eichler KE, Zangos S, Gruber-Rouh T, Mack MG, Vogl TJ. Radiofrequenz (RF)-Kyphoplastie zur Behandlung von osteoporotischen Sacrum-Insuffizienzfrakturen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vogl T, Naguib N, Lehnert T, Nour Eldin NE, Eichler K, Zangos S, Gruber-Rouh T. Repetitive transarterielle Chemoembolisation (TACE) bei der Behandlung von Lebermetastasen bei Magenkarzinom: Lokale Tumorkontrolle und Überlebensraten. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Naguib NN, Nour-Eldin NE, Gruber-Rouh T, Lehnert T, Hammerstingl R, Zangos S, Vogl T. Analysis of the Origin of the Uterine Artery in Females using 3D Reconstructed Contrast Enhanced MR Angiography before Uterine Artery Embolization: Where to look for it when you do not find it. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nour-Eldin Mohammed N, Nguib N, Zangos S, Lehnert T, Gruber-Rouh T, Vogl TJ. MRI Chest Assessment of Tumor Response Post Microwave Ablation of Pulmonary Metastases. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gruber-Rouh T, Naguib N, Eichler K, Lehnert T, Harth M, Zangos S, Beeres M, Nour-Eldin N, Vogl TJ. Transarterielle Chemoembolisation (TACE) von hepatozellulärem Karzinom (HCC): Vergleich des Therapieansprechens der Lipiodol- und Lipiodol plus Microsphären-Gruppen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Naguib NN, Nour-Eldin NE, Gruber-Rouh T, Lehnert T, Hammerstingl R, Vogl T. Adding the Third Dimension to High Resolution MR-Imaging of the Inner Ear: An Answer waiting for a question. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zangos S, Eichler K, Kronreif G, Roden MV, Schmidt R, Czerny C, Schulz B, Gruber-Rouh T, Nour-Eldin NA, Vogl TJ. Kombination der C-Arm CT mit einem neuen computerunterstützten Positionierungssystem für die Durchführung von minimalinvasive Wirbelsäuleninterventionen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zangos S, Loos G, Schulz B, Eichler K, Gruber-Rouh T, Siebenhandl P, Naguib NN, Nour-Eldin NE, Vogl TJ. Vergleich verschiedener Workstations für die Planung von endoluminaler thorakaler Aortenstentimplantation. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Naguib NNN, Nour-Eldin NEA, Serag-Eldin F, Mazloum YZ, Agameya AF, Abou-Seif S, Etaby AN, Lehnert T, Gruber-Rouh T, Zangos S, Ackermann H, Vogl TJ. Role of uterine artery Doppler in the management of uterine leiomyoma by arterial embolization. Ultrasound Obstet Gynecol 2012; 40:452-458. [PMID: 22173924 DOI: 10.1002/uog.11074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To study Doppler changes in the uterine artery immediately following and 3 months after uterine artery embolization (UAE) and to test the feasibility of using uterine artery Doppler as a predictor of the predominant side of arterial supply to leiomyomas, amount of embolizing material needed and leiomyoma tumor volume at follow-up. METHODS The study included 38 patients undergoing UAE for leiomyomas. Uterine artery Doppler was performed transabdominally before, within 6 hours after and 3 months after UAE to determine the peak systolic (PSV) and end-diastolic (EDV) velocities and resistance index (RI). Leiomyoma volume was measured using contrast-enhanced magnetic resonance imaging (MRI) before and 3 months after UAE. The predominant side of arterial supply to the leiomyoma was determined on digital subtraction angiography using the uterine artery diameter and tumor blush after contrast injection. For correlations with leiomyoma volume, the average PSV, EDV and RI of both sides was used, while for prediction of the predominant side of supply and for correlation with the amount of embolizing material needed, separate measurements from each side were used. RESULTS Relative to the pre-embolization value, the uterine artery PSV and EDV were significantly reduced (P < 0.05) immediately following UAE, while the RI was significantly elevated (P < 0.05). For prediction of the predominant side of supply, the lowest RI showed the highest accuracy (81.6%). There was no significant correlation between the pre-embolization PSV, EDV or RI and the amount of embolizing material utilized. Immediately post-embolization EDV and RI values were statistically significantly correlated with the 3-month follow-up leiomyoma volume, with RI showing the strongest correlation (P = 0.0400 and 0.0002, rho = 0.34 and - 0.58, respectively). The leiomyoma volume was predicted to have reduced by 38-61% after 3 months if the immediate post-embolization average RI value was between 0.82 and 0.88. CONCLUSION Pre-interventional Doppler assessment can be used to predict the predominant side of supply to leiomyomas but not the amount of embolizing material needed. Immediate post-interventional Doppler assessment can predict the leiomyoma volume after UAE.
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Affiliation(s)
- N N N Naguib
- Radiology Department, Frankfurt University Hospital, Frankfurt, Germany.
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Eichler K, Zangos S, Mack MG, Hammerstingl R, Gruber-Rouh T, Gallus C, Vogl TJ. First human study in treatment of unresectable liver metastases from colorectal cancer with irinotecan-loaded beads (DEBIRI). Int J Oncol 2012; 41:1213-20. [PMID: 22842404 PMCID: PMC3583653 DOI: 10.3892/ijo.2012.1572] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 05/29/2012] [Indexed: 12/27/2022] Open
Abstract
The objective of this pilot clinical study was to assess the safety, technical feasibility, pharmacokinetic (PK) profile and tumour response of DC Bead™ with irinotecan (DEBIRI™) delivered by intra-arterial embolisation for the treatment of metastatic colorectal cancer. Eleven patients with unresectable liver metastases from CRC, tumour burden <30% of liver volume, adequate haematological, liver and renal function, performance status of <2 were included in this study. Patients received up to 4 sessions of TACE with DEBIRI at 3-week intervals. Feasibility of the procedure, safety and tumour response were assessed after each cycle. PK was measured after the first cycle. Patients were followed up to 24 weeks. Only mild to moderate adverse events were observed. DEBIRI is a technically feasibile procedure; no technical complications were observed. Average Cmax for irinotecan and SN-38 was 194 ng/ml and 16.7 ng/ml, respectively, with average t½ of 4.6 h and 12.4 h following administration of DEBIRI. Best overall response during the study showed disease control in 9 patients (2 patients with partial response and 7 with stable disease, overall response rate of 18%). Our study shows that transarterial chemoembolisation with irinotecan-loaded DC beads (DEBIRI) is safe, technically feasible and effective with a good PK profile.
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Affiliation(s)
- K Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, D-60590 Frankfurt, Germany.
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Vogl TJ, Zangos S, Eichler K, Gruber-Rouh T, Hammerstingl RM, Trojan J, Weisser P. [Radiological diagnosis and intervention of cholangiocarcinomas (CC)]. ROFO-FORTSCHR RONTG 2012; 184:883-92. [PMID: 22711249 DOI: 10.1055/s-0032-1312842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
To present current data on diagnosis, indication and different therapy options in patients with cholangiocarcinoma (CC) based on an analysis of the current literature and clinical experience. The diagnostic routine includes laboratory investigations with parameters of cholestasis and also serum tumor markers CA19 - 9 and CEA. After ultrasound for clarifying a tumor and/or dilated bile ducts, contrast-enhanced magnetic resonance imaging (MRI) should be performed with magnetic resonance cholangiography (MRCP). The accuracy (positive predictive value) for diagnosing a CC is 37-84% (depending on the location) for ultrasound, 79-94% for computed tomography (CT), and 95% for MRI and MRCP. An endoscopic retrograde cholangiography (ERCP) can then be planned, especially if biliary drainage or cytological or histological specimen sampling is intended. A curative approach can be achieved by surgical resection, rarely by liver transplantation. However, many patients are not eligible for surgery. In addition to systemic chemotherapy, locoregional therapies such as transarterial chemoembolization (TACE), hepatic arterial infusion (HAI)--also known as chemoperfusion--, drug eluting beads-therapy (DEB) as well as thermoablative procedures, such as laser-induced thermotherapy (LITT), microwave ablation (MWA) and radiofrequency ablation (RFA) can be provided with a palliative intention.
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Affiliation(s)
- T J Vogl
- Institut für Diagnostische und Interventionelle Radiologie, J.-W.-Goethe-Universität Frankfurt, Frankfurt.
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Nour-Eldin Mohammed N, Abdelmonem Hassan Ahmed O, Gruber-Rouh T, Lehnert T, Naguib N, Vogl TJ. Pulmonale Blutungen als Komplikation der Radiofrequenz Ablation, von mildem Hämoptysis bis zum lebensbedrohlichen Bild. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vogl TJ, Naguib N, Gruber-Rouh T, Koitka K, Lehnert T, Nour-Eldin Mohammed N. Mikrowellenablation (MWA) bei pulmonalen Metastasen: Klinische Wertigkeit. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Naguib N, Nour-Eldin Mohammed N, Lehnert T, Gruber-Rouh T, Zangos S, Vogl TJ. Uterine Artery Embolization: Correlation between the Pre-embolization Leiomyoma Volume and the Duration of Post-Embolization Pain, Recovery and Return to Normal Life. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gruber-Rouh T, Naguib N, Beeres M, Eichler K, Zangos S, Schell B, Nour-Eldin Mohammed N, Lehnert T, Bodelle B, Vogl TJ. Die transarterielle Chemoembolisation (TACE) als minimal-invasive lokoregionale Behandlungsmaßnahme bei irresektablen Lebermetastasen eines kolorektalen Karzinoms. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nour-Eldin Mohammed N, Abdelmonem Hassan Ahmed O, Naguib N, Gruber-Rouh T, Naguib N, Vogl TJ. MRT- Befunde und Änderung des Volumens von suprarenalen Neuroblastomen im Verlauf (wait and see) der Therapie. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nour-Eldin MN, Abdelmonem Hassan Ahmed O, Auerbach K, Naguib N, Gruber-Rouh T, Vogl TJ. MRT- Befunde und Änderung des Volumens von suprarenalen Neuroblastomen im Verlauf (wait and see) der Therapie. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279331] [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: 10/18/2022]
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Gruber-Rouh T, Zangos S, Lehnert T, Naguib N, Nour-Eldin MN, Vogl TJ. Repetitive transarterielle Chemoembolisation (TACE) der Lebermetastasen eines Ovarialkarzinoms: lokales Tumoransprechen und Überlebensdaten. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279198] [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: 10/18/2022]
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Nour-Eldin MN, Naguib N, Auerbach K, Gruber-Rouh T, Vogl TJ. Ergebnisse eines algorithmischen Ansatzes zur Handhabung des Pneumothorax Komplikationen bei Thermoablation von pulmonalen Neoplasien. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279417] [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: 10/18/2022]
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Gruber-Rouh T, Bodelle B, Lee C, Naguib N, Nour-Eldin MN, Vogl TJ. Transarterielle Chemoembolisation (TACE) der Lebermetastasen eines malignen Melanoms: lokales Tumoransprechen und Überlebensdaten. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279197] [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: 10/18/2022]
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Naguib N, Nour-Eldin MN, Lehnert T, Gruber-Rouh T, Jost A, Vogl TJ. Intraarterielle kontrastmittelverstärkte C-Arm CT: Kontrastmittelanreicherungsmuster verschiedener Typen fokaler maligner Leberläsionen und das „double-ring“ Zeichen. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279470] [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: 10/18/2022]
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Bodelle B, Zangos S, Hübner F, Gruber-Rouh T, Eichler K, Mack MG, Schell B, Beeres M, Vogl TJ. MR-gesteuerte transgluteale Biopsie der Prostata bei Patienten mit Verdacht auf ein Prostatakarzinom. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279117] [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: 10/18/2022]
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Nour-Eldin MN, Auerbach K, Naguib N, Gruber-Rouh T, Vogl TJ. Pulmonale Blutungen als Komplikation der Radiofrequenz Ablation, von mildem Hämoptysis bis zum lebensbedrohlichen Bild. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279422] [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: 10/18/2022]
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Vogl TJ, Mack MG, Eichler K, Zangos S, Naguib NN, Gruber-Rouh T. [Chemoperfusion and embolization in the treatment of liver metastases]. ROFO-FORTSCHR RONTG 2010; 183:12-23. [PMID: 21113865 DOI: 10.1055/s-0029-1245880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Presentation of techniques and procedures for regional chemotherapy in the treatment of unresectable liver metastases from different primary tumors as a modality of interdisciplinary therapy management. Such transarterial therapy methods include hepatic arterial infusion (HAI), transarterial chemoembolization (TACE), chemoembolization with cytostatic-loaded microspheres (DEBs), transarterial embolization (TAE) and selective internal radiation therapy (SIRT). Regional chemotherapy procedures in the treatment of liver metastases represent a minimally invasive treatment option that can be successfully combined with surgical resection and/or radiofrequency (RFA), laser-induced thermotherapy (LITT), microwave ablation (MWA). These procedures allow optimization of the local control rate with strictly intrahepatic processes and lead to increased survival rates without any quality of life restriction.
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Affiliation(s)
- T J Vogl
- Institut für Diagnostische und Interventionelle Radiologie, J.-W.-Goethe-Universität Frankfurt.
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Naguib N, Nour-Eldin NA, Gruber-Rouh T, Lehnert T, Vogl T. Nachweis Maligner Fokaler Leberläsionen: Vergleich von kontrastverstärkter MRT und intraarteriell kontrastverstärkter C-Arm-CT. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252884] [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: 10/19/2022]
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Gruber-Rouh T, Zangos S, Naguib N, Vogl T. Transarterielle chemoembolisation (TACE) der Lebermetastasen des Ovarialkarzinoms: lokales Tumoransprechen und Überlebensdaten. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252663] [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: 10/19/2022]
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