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Pöhler GH, Klimeš F, Winther H, Wacker F, Ringe KI. Evaluation of tissue shrinkage after CT-guided microwave ablation in patients with liver malignancies using Jacobian determinant. Int J Hyperthermia 2022; 39:1371-1378. [PMID: 36266247 DOI: 10.1080/02656736.2022.2134593] [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: 10/24/2022] Open
Abstract
PURPOSE To assess short-term tissue shrinkage in patients with liver malignancies undergoing computed tomography (CT)-guided microwave ablation (MWA) using Jacobian determinant (JD). MATERIALS AND METHODS Twenty-nine patients with 29 hepatic malignancies (primary n = 24; metastases n = 5; median tumor diameter 18 mm) referred to CT-guided MWA (single position; 10 min, 100 W) were included in this retrospective IRB-approved study, after exclusion of five patients. Following segmentation of livers and tumors on pre-interventional images, segmentations were registered on post-interventional images. JD mapping was applied to quantify voxelwise tissue volume changes after MWA. Percentual volume changes were evaluated in the ablated tumor, a 5-cm tumor perimeter and in the whole liver and compared in different clinical conditions (tumor entity: primary vs. secondary; tumor location: subcapsular vs. non-subcapsular; tumor volume: >/<6 ml: cirrhosis: yes vs. no; prior chemotherapy: yes vs. no using Shapiro-Wilk, χ2 and Wilcoxon rank sum tests, respectively (with p < 0.05 deemed significant). RESULTS Tissue volume change was 0.6% in the ablated tumor, 1.6% in the 5-cm perimeter and 0.3% in the whole liver. Shrinkage in the ablated tumor was pronounced in non-subcapsular located tumors, whereas tissue expansion was noted in subcapsular tumors (median -3.5 vs. 1.1%; p = 0.0195). Shrinkage in the whole liver was higher in tumor volumes >6ml, compared with smaller tumors, in which tissue expansion was noted (median -1.0 vs. 2.5%; p = 0.002). Other clinical conditions had no significant influence on the extent of tissue shrinkage (p > 0.05). CONCLUSION 3D Jacobian analysis shows that hepatic tissue deformation following MWA is most pronounced in a 5-cm area surrounding the treated tumor. Tumor location and tumor volume may have an impact on the extent of tissue shrinkage which may affect estimation of the safety margin.
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Affiliation(s)
- Gesa H Pöhler
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Filip Klimeš
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Hinrich Winther
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
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2
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Behrendt L, Smith LJ, Voskrebenzev A, Klimeš F, Kaireit TF, Pöhler GH, Kern AL, Gonzalez CC, Dittrich AM, Marshall H, Schütz K, Hughes PJC, Ciet P, Tiddens HAWM, Wild JM, Vogel-Claussen J. A dual center and dual vendor comparison study of automated perfusion-weighted phase-resolved functional lung magnetic resonance imaging with dynamic contrast-enhanced magnetic resonance imaging in patients with cystic fibrosis. Pulm Circ 2022; 12:e12054. [PMID: 35514781 PMCID: PMC9063970 DOI: 10.1002/pul2.12054] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/17/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
For sensitive diagnosis and monitoring of pulmonary disease, ionizing radiation-free imaging methods are of great importance. A noncontrast and free-breathing proton magnetic resonance imaging (MRI) technique for assessment of pulmonary perfusion is phase-resolved functional lung (PREFUL) MRI. Since there is no validation of PREFUL MRI across different centers and scanners, the purpose of this study was to compare perfusion-weighted PREFUL MRI with the well-established dynamic contrast-enhanced (DCE) MRI across two centers on scanners from two different vendors. Sixteen patients with cystic fibrosis (CF) (Center 1: 10 patients; Center 2: 6 patients) underwent PREFUL and DCE MRI at 1.5T in the same imaging session. Normalized perfusion-weighted values and perfusion defect percentage (QDP) values were calculated for the whole lung and three central slices (dorsal, central, ventral of the carina). Obtained parameters were compared using Pearson correlation, Spearman correlation, Bland-Altman analysis, Wilcoxon signed-rank test, and Wilcoxon rank-sum test. Moderate-to-strong correlations between normalized perfusion-weighted PREFUL and DCE values were found (posterior slice: r = 0.69, p < 0.01). Spatial overlap of PREFUL and DCE QDP maps showed an agreement of 79.4% for the whole lung. Further, spatial overlap values of Center 1 were not significantly different to those of Center 2 for the three central slices (p > 0.07). The feasibility of PREFUL MRI across two different centers and two different vendors was shown in patients with CF and obtained results were in agreement with DCE MRI.
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Affiliation(s)
- Lea Behrendt
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Laurie J Smith
- Department of Infection, Immunity and Cardiovascular Disease, POLARIS, Imaging Sciences University of Sheffield Sheffield UK
| | - Andreas Voskrebenzev
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Filip Klimeš
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Till F Kaireit
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Gesa H Pöhler
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Agilo L Kern
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Cristian Crisosto Gonzalez
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
| | - Anna-Maria Dittrich
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany.,Department for Pediatric Pulmonology, Allergology and Neonatology Hannover Medical School Hannover Germany
| | - Helen Marshall
- Department of Infection, Immunity and Cardiovascular Disease, POLARIS, Imaging Sciences University of Sheffield Sheffield UK
| | - Katharina Schütz
- Department for Pediatric Pulmonology, Allergology and Neonatology Hannover Medical School Hannover Germany
| | - Paul J C Hughes
- Department of Infection, Immunity and Cardiovascular Disease, POLARIS, Imaging Sciences University of Sheffield Sheffield UK
| | - Pierluigi Ciet
- Department of Pediatric Pulmonology and Allergology Sophia Children's Hospital, Erasmus MC Rotterdam The Netherlands
| | - Harm A W M Tiddens
- Department of Pediatric Pulmonology and Allergology Sophia Children's Hospital, Erasmus MC Rotterdam The Netherlands.,Department of Radiology and Nuclear medicine Erasmus MC Rotterdam The Netherlands
| | - Jim M Wild
- Department of Infection, Immunity and Cardiovascular Disease, POLARIS, Imaging Sciences University of Sheffield Sheffield UK
| | - Jens Vogel-Claussen
- Department for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover Germany
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3
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Voskrebenzev A, Kaireit TF, Klimeš F, Pöhler GH, Behrendt L, Biller H, Berschneider K, Wacker F, Welte T, Hohlfeld JM, Vogel-Claussen J. PREFUL MRI Depicts Dual Bronchodilator Changes in COPD: A Retrospective Analysis of a Randomized Controlled Trial. Radiol Cardiothorac Imaging 2022; 4:e210147. [PMID: 35506142 PMCID: PMC9059092 DOI: 10.1148/ryct.210147] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Purpose To assess whether dynamic ventilation and perfusion (Q) biomarkers
derived by phase-resolved functional lung (PREFUL) MRI can measure
treatment response to 14-day therapy with indacaterol-glycopyrronium
(IND-GLY) and correlate to clinical outcomes including lung function,
symptoms, and cardiac function in patients with chronic obstructive
pulmonary disease (COPD), as determined by spirometry, body
plethysmography, cardiac MRI, and dyspnea score measurements. Materials and Methods The cardiac left ventricular function in COPD (CLAIM) study enrolled
patients aged 40 years or older with COPD, stable cardiovascular
function, and hyperinflation (residual volume > 135% predicted).
Dynamic MRI data of these patients were retrospectively analyzed using
the PREFUL technique to assess the effect of 14-day IND-GLY treatment
versus placebo on regional measurements of ventilation dynamics. After
manual segmentation of the lung parenchyma, flow-volume loops of each
voxel were correlated to an individualized reference flow-volume loop,
creating a two-dimensional flow-volume loop correlation map (FVL-CM) as
a measure of ventilation dynamics. Ventilation-perfusion match (VQM) was
evaluated in combination with perfusion and regional ventilation
(VQMRVent) and with perfusion and the FVL-CM measurement
(VQMCM). For image and statistical analysis, the lung
parenchyma was segmented as a region of interest by manually delineating
the lung boundary and excluding the large (central) vessels for each
section. Differences in ventilation, perfusion, and VQM between IND-GLY
and placebo were compared using analysis of variance, with study
treatment, patient, and period included as factors. Results Fifty patients (mean age, 64.3 years ± 7.65 [SD]; 35 men) were
included in this analysis. IND-GLY significantly increased mean
correlation as measured with FVL-CM versus that of placebo (least
squares [LS] means treatment difference: 0.05 [95% CI: 0.03, 0.07];
P < .0001). Compared with placebo, IND-GLY
increased mean Q (LS means treatment difference: 9.27 mL/min/100 mL [95%
CI: 0.05, 18.49]; P = .049) and improved both
VQMCM and VQMRVent (LS means treatment
difference: 0.06 [95% CI: 0.03, 0.08]; P < .0001
and 0.05 [95% CI: 0.02, 0.08]; P = .001,
respectively). Conclusion Regional ventilation dynamics and VQM measured by PREFUL MRI show
treatment response in COPD. Supplemental material is available for this
article. Clinical trial registration no. NTR6831 Keywords: MRI, COPD, Perfusion, Ventilation, Lung,
Pulmonary Published under a CC BY 4.0 license
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Affiliation(s)
- Andreas Voskrebenzev
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Till F Kaireit
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Filip Klimeš
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Gesa H Pöhler
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Lea Behrendt
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Heike Biller
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Korbinian Berschneider
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Tobias Welte
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Jens M Hohlfeld
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology (A.V., T.F.K., F.K., G.H.P., L.B., F.W., J.V.C.) and Department of Respiratory Medicine (T.W., J.M.H.), Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany; German Center for Lung Research (BREATH), Hannover, Germany (A.V., T.F.K., F.K., G.H.P., L.B., H.B., F.W., T.W., J.M.H., J.V.C.); Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany (H.B., J.M.H.); and Novartis Pharma, Clinical Research Respiratory, Nuremberg, Germany (K.B.)
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Sonnow L, Ziegler A, Pöhler GH, Kirschner MH, Richter M, Cetin M, Unal M, Kose O. Alterations in magnetic resonance imaging characteristics of bioabsorbable magnesium screws over time in humans: a retrospective single center study. Innov Surg Sci 2021; 6:105-113. [PMID: 35224178 PMCID: PMC8826160 DOI: 10.1515/iss-2021-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives This study aimed to examine the alterations in magnetic resonance imaging (MRI) characteristics of bioabsorbable magnesium (Mg) screws over time in a single center study in humans. Methods Seventeen patients who underwent medial malleolar (MM) fracture or osteotomy fixation using bioabsorbable Mg screws and had at least one postoperative MRI were included in this retrospective study. Six of them had more than one MRI in the postoperative period and were subject of the artifact reduction measurements. 1.5T or 3T MRI scans were acquired in different periods in each patient. The size and extent of the artifact were assessed independently by two experienced radiologists both quantitatively (distance measurement) and qualitatively (Likert scale). Results In the quantitative measurements of the six follow-up patients the screw’s signal loss artifact extent significantly decreased over the time, regardless of the MRI field strength (p<0.001). The mean artifact reduction was 0.06 mm (95% confidence interval [CI]: 0.05–0.07) for proton density weighted [PDw] and 0.04 mm (95% CI: 0.03–0.05) for T1 weighted (T1w) sequences per week. The qualitative assessments similarly showed significant artifact reduction in all MRI sequences. Different imaging findings, like bone marrow edema (BME), liquid collections, and gas formation were reported. The overall inter-reader agreement was high (κ=0.88, p<0.001). Conclusions The time-dependent artifact reduction of Mg screws in postoperative controls might indicate the expected self-degradation of the Mg implants. In addition, different MRI findings were reported, which are characteristic of Mg implants. Further MRI studies are required to get a better understanding of Mg imaging properties.
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Affiliation(s)
- Lena Sonnow
- Department of Diagnostic and Interventional Radiology , Hannover Medical School , Hannover , Germany
| | - Andreas Ziegler
- Medizincampus Davos , Davos , Switzerland
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal , Pietermaritzburg , South Africa
- Department of Cardiology , University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Gesa H. Pöhler
- Department of Diagnostic and Interventional Radiology , Hannover Medical School , Hannover , Germany
| | | | | | - Mustafa Cetin
- Department of Radiology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Melih Unal
- Department of Orthopedics and Traumatology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Ozkan Kose
- Department of Orthopedics and Traumatology , Antalya Education and Research Hospital , Antalya , Turkey
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Pöhler GH, Löffler F, Klimeš F, Behrendt L, Voskrebenzev A, González CC, Westhoff-Bleck M, Wacker F, Vogel-Claussen J. Validation of Phase-Resolved Functional Lung (PREFUL) Magnetic Resonance Imaging Pulse Wave Transit Time Compared to Echocardiography in Chronic Obstructive Pulmonary Disease. J Magn Reson Imaging 2021; 56:605-615. [PMID: 34870363 DOI: 10.1002/jmri.28016] [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: 10/03/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Phase-resolved functional lung (PREFUL) magnetic resonance imaging (MRI) pulmonary pulse wave transit time (pPTT) is a contrast agent free, vascular imaging biomarker, but has not been validated in chronic obstructive pulmonary disease (COPD). PURPOSE To validate PREFUL with echocardiographic pPTT as a reference standard and to compare arterial/venous pPTT mapping with spirometry and clinical parameters. STUDY TYPE Prospective. POPULATION Twenty-one patients (62% female) with COPD and 44 healthy participants (50% female). FIELD STRENGTH/SEQUENCE 1.5 T; 2D-spoiled gradient-echo sequence. ASSESSMENT Three coronal PREFUL MRI slices, echocardiography, and spirometry including forced expiratory volume in 1 second (FEV1, liter) and predicted defined as FEV1 in% divided by the population average FEV1%, were performed. Pulmonary pulse transit time from the main artery to the microvasculature (PREFUL pPTT), to the right upper lobe vein (PREFUL pPTTav , echo pPTTav ), from microvasculature to right upper lobe vein (PREFULvein ) and the ratio of PREFUL pPTT to PREFUL pPTTvein were calculated. Body mass index (BMI), Global Initiative for COPD (GOLD) stage 1-4, disease duration, and cigarette packs smoked per day multiplied by the smoked years (pack years) were computed. STATISTICAL TESTS Shapiro-Wilk-test, paired-two-sided-t-tests, Bland-Altman-analysis, coefficient of variation, Pearson ρ were applied, pPTT data were compared between 21 subjects from the 44 healthy subjects who were age- and sex-matched to the COPD cohort, P < 0.05 was considered statistically significant. RESULTS PREFUL pPTTav significantly correlated with echo pPTTav (ρ = 0.95) with 1.85 msec bias, 95% limits of agreement: 55.94 msec, -52.23 msec in all participants (P = 0.59). In the healthy participants, PREFUL and echo pPTTav significantly correlated with age (ρ = 0.81, ρ = 0.78), FEV1 (ρ = -0.47, ρ = -0.34) and BMI (ρ = 0.56, ρ = 0.51). In COPD patients, PREFUL pPTT significantly correlated with FEV1 predicted (ρ = -0.59), GOLD (ρ = 0.53), disease duration (ρ = 0.54), and pack years (ρ = 0.49). DATA CONCLUSION Arteriovenous PTT measured by PREFUL MRI corresponds precisely to echocardiography and appears to be feasible even in severe COPD. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Gesa H Pöhler
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Friederike Löffler
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Filip Klimeš
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Lea Behrendt
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Cristian Crisosto González
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | | | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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6
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Klimeš F, Voskrebenzev A, Gutberlet M, Obert AJ, Pöhler GH, Grimm R, Behrendt L, Crisosto C, Glandorf J, Moher Alsady T, Wacker F, Vogel-Claussen J. Repeatability of dynamic 3D phase-resolved functional lung (PREFUL) ventilation MR Imaging in patients with chronic obstructive pulmonary disease and healthy volunteers. J Magn Reson Imaging 2021; 54:618-629. [PMID: 33565215 DOI: 10.1002/jmri.27543] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 12/08/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A previous study has demonstrated the feasibility of 3D phase-resolved functional lung (PREFUL) MRI in healthy volunteers and patients with chronic pulmonary disease. Before clinical use, the repeatability of the ventilation parameters derived from 3D PREFUL MRI must be determined. PURPOSE To evaluate repeatability of 3D PREFUL and to compare with pulmonary functional lung testing (PFT). STUDY TYPE Prospective. POPULATION Fifty-three healthy subjects and 13 patients with chronic obstructive pulmonary disease (COPD). FIELD STRENGTH/SEQUENCE A prototype 3D stack-of-stars spoiled-gradient-echo sequence at 1.5 T. ASSESSMENT Study participants underwent repeated MRI examination (median time interval between scans COPD/healthy subjects [interquartile range]: 7/0 days [6-8/0-0 days]) and one PFT carried out at the time of the baseline MRI. For 3D PREFUL, regional ventilation (RVent) and flow-volume loops were computed and rated by cross-correlation (CC). Also, ventilation time-to-peak (VTTP) was computed. Ventilation defect percentage (VDP) maps were obtained for RVent and CC. STATISTICAL TESTS Repeatability of 3D PREFUL parameters was evaluated using Bland-Altman analysis, coefficient of variation (COV) and intraclass correlation coefficient (ICC). The relation between 3D PREFUL and PFT measures (forced expiratory volume in 1 second (FEV1 ) and forced vital capacity (FVC) was assessed using the Pearson correlation coefficient (r). RESULTS In healthy subjects and COPD patients, no significant bias (all P range: 0.09-0.77) and a moderate to good repeatability of RVent, VTTP, and VDPRVent were found (COV range: 0.1%-18.2%, ICC range: 0.51-0.88). For CC and VDPCC moderate repeatability was found (COV range: 0.6%-43.6%, ICC: 0.38-0.60). CC, VDPRVent , and VDPCC showed a good correlation with FEV1 (all |r| > 0.58, all P < 0.05) and FEV1 /FVC ratio (all |r| > 0.62, all P < 0.05). DATA CONCLUSION 3D PREFUL provided a good repeatability of RVent, VTTP, and VDPRVent and moderate repeatability of CC and VDPCC in healthy volunteers and COPD patients, and correlated well with FEV1 and FEV1 /FVC. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Filip Klimeš
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Andreas Voskrebenzev
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Marcel Gutberlet
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Arnd J Obert
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Gesa H Pöhler
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | | | - Lea Behrendt
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Cristian Crisosto
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Julian Glandorf
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Tawfik Moher Alsady
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
| | - Jens Vogel-Claussen
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Centre for Lung Research, Hanover, Germany
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7
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Ringe KI, Pöhler GH, Rabeh H, Wacker F. Electromagnetic Navigation System-Guided Microwave Ablation of Hepatic Tumors: A Matched Cohort Study. Cardiovasc Intervent Radiol 2021; 44:500-506. [PMID: 33409545 DOI: 10.1007/s00270-020-02761-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To assess the accuracy and applicability of an electromagnetic navigation system (EMNS) for CT-guided microwave ablation (MWA) of hepatic tumors in comparison with conventional CT-guidance. MATERIALS AND METHODS 34 patients (m = 20/f = 14, mean age 34 y) with 34 liver tumors (primary = 22, metastases = 14, mean size 20 mm) referred for CT-guided MWA were included in this IRB-approved study. Interventions were performed prospectively using an EMNS in 17 patients (navigation group), and results were compared to a matched historic cohort of 17 patients using conventional CT-guidance (control group, t-test, p < 0.05 deemed significant). Primary outcome measurement: accuracy of antenna placement (deviation). Secondary outcome measurements: setup time, number of control scans, duration and radiation exposure for antenna placement. RESULTS Ablations were performed using a single or a double-angulated approach. Application of the EMNS was feasible in 14 cases (82%). Mean total deviation of the antenna feed point in the navigation and control group was 2.4 mm (range 0.2-4.8 mm) and 3.9 mm (range 0.4-7.8 mm), p < 0.05. Mean setup time for the EMNS was 6.75 ± 3.9 min (range 3-12 min). Mean number of control scans in the navigation and control group was 3 ± 0.9 (range 1-4) and 6 ± 1.3 (range 4-8), p < 0.0001; mean time for antenna placement was 9 ± 7.3 min (range 1.4-25.9 min) and 11.45 ± 6.1 min (range 3.9-27.4 min), p = 0.3164. Radiation exposure was significantly less in the navigation group. CONCLUSION Our experience in a limited number of patients suggests that EMNS enables intuitive CT-guided MWA of liver tumors with higher accuracy when compared to ablations performed without navigation and with fewer control scans needed.
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Affiliation(s)
- K I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - G H Pöhler
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - H Rabeh
- IMACTIS, 20 Rue du Tour de l'Eau, Grenoble, 38400, Saint-Martin-d'Hères, France
| | - F Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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8
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Kaireit TF, Kern A, Voskrebenzev A, Pöhler GH, Klimes F, Behrendt L, Gutberlet M, Moher-Alsady T, Dittrich AM, Wacker F, Hohlfeld J, Vogel-Claussen J. Flow Volume Loop and Regional Ventilation Assessment Using Phase-Resolved Functional Lung (PREFUL) MRI: Comparison With 129 Xenon Ventilation MRI and Lung Function Testing. J Magn Reson Imaging 2020; 53:1092-1105. [PMID: 33247456 DOI: 10.1002/jmri.27452] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Regional flow volume loop ventilation-weighted noncontrast-enhanced proton lung MRI in free breathing has emerged as a novel technique for assessment of regional lung ventilation, but has yet not been validated with 129 Xenon MRI (129 Xe-MRI), a direct visualization of ventilation in healthy volunteers, cystic fibrosis (CF), and chronic obstructive pulmonary disease (COPD) patients. PURPOSE To compare regional ventilation and regional flow volume loops measured by noncontrast-enhanced ventilation-weighted phase-resolved functional lung MRI (PREFUL-MRI) with 129 Xe-MRI ventilation imaging and with lung function test parameters. STUDY TYPE Retrospective study. POPULATION Twenty patients with COPD, eight patients with CF, and six healthy volunteers. FIELD STRENGTH/SEQUENCE PREFUL and 129 Xe-MRI gradient echo sequences were acquired at 1.5T. ASSESSMENT Coronal slices of PREFUL-MRI (free breathing) and 129 Xe-MRI (single breath-hold) were acquired on the same day, matched by their ventrodorsal position and coregistered for evaluation. Ventilation defect percentage (VDP) was calculated based on regional ventilation (RV), regional flow volume loops (RFVL), or 129 Xe-MRI with two different threshold methods. A combined VDP was calculated for RV and RFVL. Additionally, lung function testing was performed (such as the forced expiratory volume in 1 second [FEV1 ]) was used. STATISTICAL TESTS The obtained parameters were compared using Wilcoxon tests, correlated using Spearman's correlation coefficient (r), and agreement between PREFUL and 129 Xe-MRI parameters was assessed using Bland-Altman analysis and Dice coefficients. RESULTS VDP measured by PREFUL and 129 Xe were significantly correlated with both thresholding techniques (r = 0.62-0.69, P < 0.05 for all) and with lung function test parameters. Combined RV and RFVL PREFUL defect maps correlated with lung function testing (eg, with FEV1 r = -0.87 P < 0.05), and showed better regional agreement to 129 Xe-MRI ventilation defects (Dice coefficient defect 0.413) with significantly higher VDP values (10.2 ± 27.3, P = 0.04) than either PREFUL defect map alone. DATA CONCLUSION Combined RV and RFVL PREFUL defect maps likely increase sensitivity to mild airway obstruction with increased VDP values compared to 129 Xe-MRI, and correlate strongly with lung function test parameters. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Till F Kaireit
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Agilo Kern
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Andreas Voskrebenzev
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Gesa H Pöhler
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Filip Klimes
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Lea Behrendt
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Marcel Gutberlet
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Tawfik Moher-Alsady
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Anna-Maria Dittrich
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany.,Department for Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
| | - Jens Hohlfeld
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany.,Clinic of Pneumology, Hannover Medical School, Hannover, Germany.,Fraunhofer Institute for T oxicology and Experimental Medicine, Hannover, Germany
| | - Jens Vogel-Claussen
- Department for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Lung Research Center (DZL), Hannover, Germany
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9
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Pöhler GH, Klimeš F, Behrendt L, Voskrebenzev A, Gonzalez CC, Wacker F, Hohlfeld JM, Vogel‐Claussen J. Repeatability of Phase‐Resolved Functional Lung (
PREFUL
)‐
MRI
Ventilation and Perfusion Parameters in Healthy Subjects and
COPD
Patients. J Magn Reson Imaging 2020; 53:915-927. [DOI: 10.1002/jmri.27385] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Gesa H. Pöhler
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Filip Klimeš
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Lea Behrendt
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Andreas Voskrebenzev
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Cristian Crisosto Gonzalez
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Jens M. Hohlfeld
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
- Department of Respiratory Medicine Hannover Medical School Hannover Germany
- Fraunhofer Institute of Toxicology and Experimental Medicine Hannover Germany
| | - Jens Vogel‐Claussen
- Institute for Diagnostic and Interventional Radiology Hannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL) Hannover Germany
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10
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Czerner CP, Schoenfeld C, Cebotari S, Renne J, Kaireit TF, Winther HB, Pöhler GH, Olsson KM, Hoeper MM, Wacker F, Vogel-Claussen J. Perioperative CTEPH patient monitoring with 2D phase-contrast MRI reflects clinical, cardiac and pulmonary perfusion changes after pulmonary endarterectomy. PLoS One 2020; 15:e0238171. [PMID: 32925924 PMCID: PMC7489536 DOI: 10.1371/journal.pone.0238171] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 08/11/2020] [Indexed: 11/18/2022] Open
Abstract
Magnetic resonance imaging (MRI) is an emerging tool for diagnosis and treatment monitoring of chronic thromboembolic pulmonary hypertension (CTEPH). The current study aims to identify central pulmonary arterial hemodynamic parameters that reflect clinical, cardiac and pulmonary changes after PEA. 31 CTEPH patients, who underwent PEA and received pre- and postoperative MRI, were analyzed retrospectively. Central pulmonary arterial blood flow, lung perfusion and right heart function data were derived from MRI. Mean pulmonary arterial pressure (mPAP) and 5-month follow-up six-minute walk-distance (6MWD) were assessed. After PEA, mPAP decreased significantly and patients achieved a higher 6MWD. Central pulmonary arterial blood flow velocities, pulmonary blood flow (PBF) and right ventricular function increased significantly. Two-dimensional (2D) phase-contrast (PC) MRI-derived average mean velocity, maximum mean velocity and deceleration volume changes after PEA correlated with changes of 6MWD and right heart ejection fraction (RVEF). Deceleration volume is a novel 2D PC MRI parameter showing further correlation with PBF changes. In conclusion, 2D PC MRI-derived main pulmonary hemodynamic changes reflect changes of RVEF, PBF and 5-month follow-up 6MWD and may be used for future CTEPH patient monitoring after PEA.
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Affiliation(s)
- Christoph P. Czerner
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Christian Schoenfeld
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Serghei Cebotari
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Julius Renne
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Till F. Kaireit
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Hinrich B. Winther
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Gesa H. Pöhler
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Karen M. Olsson
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
- Clinic for Pneumology, Hannover Medical School, Hannover, Germany
| | - Marius M. Hoeper
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
- Clinic for Pneumology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany
- * E-mail:
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11
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Vo Chieu VD, Wacker F, Rieder C, Pöhler GH, Schumann C, Ballhausen H, Ringe KI. Ablation zone geometry after CT-guided hepatic microwave ablation: evaluation of a semi-automatic software and comparison of two different ablation systems. Int J Hyperthermia 2020; 37:533-541. [PMID: 32468872 DOI: 10.1080/02656736.2020.1766704] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose: The aims of this study were to evaluate a semi-automatic segmentation software for assessment of ablation zone geometry in computed tomography (CT)-guided microwave ablation (MWA) of liver tumors and to compare two different MWA systems.Material and Methods: 27 patients with 40 hepatic tumors (primary liver tumor n = 20, metastases n = 20) referred for CT-guided MWA were included in this retrospective IRB-approved study. MWA was performed using two systems (system 1: 915 MHz; n = 20; system 2: 2.45 GHz; n = 20). Ablation zone segmentation and ellipticity index calculations were performed using SAFIR (Software Assistant for Interventional Radiology). To validate semi-automatic software calculations, results (2 perpendicular diameters, ellipticity index, volume) were compared with those of manual analysis (intraclass correlation, Pearson's correlation, Mann-Whitney U test; p < 0.05 deemed significant.Results: Manual measurements of mean maximum ablation zone diameters were 43 mm (system 1) and 34 mm (system 2), respectively. Correlations between manual and semi-automatic measurements were r = 0.72 and r = 0.66 (both p < 0.0001) for perpendicular diameters, and r = 0.98 (p < 0.001) for volume. Manual analysis demonstrated that ablation zones created with system 2 had a significantly lower ellipticity index compared to system 1 (mean 1.17 vs. 1.86, p < 0.0001). Results correlated significantly with semi-automatic software measurements (r = 0.71, p < 0.0001).Conclusion: Semi-automatic assessment of ablation zone geometry using SAFIR is feasible. Software-assisted evaluation of ablation zones may prove beneficial with complex ablation procedures, especially for less experienced operators. The 2.45 GHz MWA system generated a significantly more spherical ablation zone compared to the 915 MHz system. The choice of a specific MWA system significantly influences ablation zone geometry.
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Affiliation(s)
- Van Dai Vo Chieu
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Frank Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Christian Rieder
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Gesa H Pöhler
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | | | - Hanne Ballhausen
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
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12
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Pöhler GH, Klimes F, Voskrebenzev A, Behrendt L, Czerner C, Gutberlet M, Cebotari S, Ius F, Fegbeutel C, Schoenfeld C, Kaireit TF, Hauck EF, Olsson KM, Hoeper MM, Wacker F, Vogel‐Claussen J. Chronic Thromboembolic Pulmonary Hypertension Perioperative Monitoring Using Phase‐Resolved Functional Lung (PREFUL)‐MRI. J Magn Reson Imaging 2020; 52:610-619. [DOI: 10.1002/jmri.27097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 01/19/2023] Open
Affiliation(s)
- Gesa H. Pöhler
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Filip Klimes
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Andreas Voskrebenzev
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Lea Behrendt
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Christoph Czerner
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Marcel Gutberlet
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Serghei Cebotari
- Department of CardiothoracicTransplantation and Vascular Surgery, Hannover Medical School Hannover Germany
| | - Fabio Ius
- Department of CardiothoracicTransplantation and Vascular Surgery, Hannover Medical School Hannover Germany
| | - Christine Fegbeutel
- Department of CardiothoracicTransplantation and Vascular Surgery, Hannover Medical School Hannover Germany
| | - Christian Schoenfeld
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Till F. Kaireit
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Erik F. Hauck
- Department of NeurosurgeryDuke Hospital Durham North Carolina USA
| | - Karen M. Olsson
- Department of Respiratory MedicineHannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Marius M. Hoeper
- Department of Respiratory MedicineHannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Frank Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
| | - Jens Vogel‐Claussen
- Department of Diagnostic and Interventional Radiology, Hannover Medical School Hannover Germany
- German Centre for Lung Research, BREATH Hannover Germany
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13
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Behrendt L, Voskrebenzev A, Klimeš F, Gutberlet M, Winther HB, Kaireit TF, Alsady TM, Pöhler GH, Derlin T, Wacker F, Vogel‐Claussen J. Validation of Automated Perfusion‐Weighted Phase‐Resolved Functional Lung (PREFUL)‐MRI in Patients With Pulmonary Diseases. J Magn Reson Imaging 2019; 52:103-114. [DOI: 10.1002/jmri.27027] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/28/2019] [Accepted: 12/02/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Lea Behrendt
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Andreas Voskrebenzev
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Filip Klimeš
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Marcel Gutberlet
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Hinrich B. Winther
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
| | - Till F. Kaireit
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Tawfik Moher Alsady
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Gesa H. Pöhler
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Thorsten Derlin
- Department of Nuclear MedicineHannover Medical School Hannover Germany
| | - Frank Wacker
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
| | - Jens Vogel‐Claussen
- Department of Diagnostic and Interventional RadiologyHannover Medical School Hannover Germany
- Biomedical Research in Endstage and Obstructive Lung Disease (BREATH)Member of the German Center for Lung Research (DZL) Hannover Germany
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Pöhler GH, Ringe KI. [Computed tomography and/or magnetic resonance imaging of the liver : How, why, what for?]. Radiologe 2019; 59:804-811. [PMID: 31414150 DOI: 10.1007/s00117-019-00583-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
CLINICAL PROBLEM Colorectal metastases are the most common malignant liver lesions. Imaging of the liver in patients with colorectal carcinoma is performed for early detection of liver metastases (CRLM) at the time of initial tumor diagnosis, for monitoring and follow-up in order to exclude or diagnose metachronous metastases. STANDARD RADIOLOGICAL METHODS Radiological imaging includes primarily multislice computed tomography (CT) and magnetic resonance imaging (MRI), which play an important role regarding therapeutic management and assessment of prognosis. PERFORMANCE, ACHIEVEMENTS Contrast-enhanced CT is broadly available and allows for rapid image acquisition including the possibility for complete tumor staging. MRI, on the other hand, is characterized by very good soft tissue contrast and has-especially with the use of diffusion-weighted imaging and administration of liver-specific contrast agents-the highest sensitivity for detection of metastases smaller than 1 cm. PRACTICAL RECOMMENDATIONS The choice of imaging in daily routine is often dependent on availability and clinical question. Frequently, e.g. for assessment of resectability (extent of metastases, anatomic relation of lesions to critical structures), both modalities may be implemented in combination.
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Affiliation(s)
- G H Pöhler
- Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - K I Ringe
- Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
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