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Bauer J, Raum HN, Kugel H, Müther M, Mannil M, Heindel W. 2-Hydroxyglutarate as an MR spectroscopic predictor of an IDH mutation in gliomas. ROFO-FORTSCHR RONTG 2024. [PMID: 38648790 DOI: 10.1055/a-2285-4923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The mutated enzyme isocitrate dehydrogenase (IDH) 1 and 2 has been detected in various tumor entities such as gliomas and can convert α-ketoglutarate into the oncometabolite 2-hydroxyglutarate (2-HG). This neuro-oncologically significant metabolic product can be detected by MR spectroscopy and is therefore suitable for noninvasive glioma classification and therapy monitoring.This paper provides an up-to-date overview of the methodology and relevance of 1H-MR spectroscopy (MRS) in the oncological primary and follow-up diagnosis of gliomas. The possibilities and limitations of this MR spectroscopic examination are evaluated on the basis of the available literature.By detecting 2-HG, MRS can in principle offer a noninvasive alternative to immunohistological analysis thus avoiding surgical intervention in some cases. However, in addition to an adapted and optimized examination protocol, the individual measurement conditions in the examination region are of decisive importance. Due to the inherently small signal of 2-HG, unfavorable measurement conditions can influence the reliability of detection. · MR spectroscopy enables the non-invasive detection of 2-hydroxyglutarate.. · The measurement of this metabolite allows the detection of an IDH mutation in gliomas.. · The choice of MR examination method is particularly important.. · Detection reliability is influenced by glioma size, necrotic tissue and the existing measurement conditions.. · Bauer J, Raum HN, Kugel H et al. 2-Hydroxyglutarate as an MR spectroscopic predictor of an IDH mutation in gliomas. Fortschr Röntgenstr 2024; DOI 10.1055/a-2285-4923.
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Affiliation(s)
- Jochen Bauer
- Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Heiner N Raum
- Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Harald Kugel
- Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Michael Müther
- Department of Neurosurgery, University of Münster and University Hospital Münster, Münster, Germany
| | - Manoj Mannil
- Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany
- Institute for Diagnostic and Interventional Radiology, Caritas Hospital Bad Mergentheim, Bad Mergentheim, Germany
| | - Walter Heindel
- Clinic for Radiology, University of Münster and University Hospital Münster, Münster, Germany
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Roll W, Masthoff M, Köhler M, Rahbar K, Stegger L, Ventura D, Morgül H, Trebicka J, Schäfers M, Heindel W, Wildgruber M, Schindler P. Radiomics-Based Prediction Model for Outcome of Radioembolization in Metastatic Colorectal Cancer. Cardiovasc Intervent Radiol 2024; 47:462-471. [PMID: 38416178 DOI: 10.1007/s00270-024-03680-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE To evaluate the benefit of a contrast-enhanced computed tomography (CT) radiomics-based model for predicting response and survival in patients with colorectal liver metastases treated with transarterial Yttrium-90 radioembolization (TARE). MATERIALS AND METHODS Fifty-one patients who underwent TARE were included in this single-center retrospective study. Response to treatment was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) at 3-month follow-up. Patients were stratified as responders (complete/partial response and stable disease, n = 24) or non-responders (progressive disease, n = 27). Radiomic features (RF) were extracted from pre-TARE CT after segmentation of the liver tumor volume. A model was built based on a radiomic signature consisting of reliable RFs that allowed classification of response using multivariate logistic regression. Patients were assigned to high- or low-risk groups for disease progression after TARE according to a cutoff defined in the model. Kaplan-Meier analysis was performed to analyze survival between high- and low-risk groups. RESULTS Two independent RF [Energy, Maximal Correlation Coefficient (MCC)], reflecting tumor heterogeneity, discriminated well between responders and non-responders. In particular, patients with higher magnitude of voxel values in an image (Energy), and texture complexity (MCC), were more likely to fail TARE. For predicting treatment response, the area under the receiver operating characteristic curve of the radiomics-based model was 0.75 (95% CI 0.48-1). The high-risk group had a shorter overall survival than the low-risk group (3.4 vs. 6.4 months, p < 0.001). CONCLUSION Our CT radiomics model may predict the response and survival outcome by quantifying tumor heterogeneity in patients treated with TARE for colorectal liver metastases.
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Affiliation(s)
- Wolfgang Roll
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Max Masthoff
- Clinic for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Michael Köhler
- Clinic for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Kambiz Rahbar
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Lars Stegger
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - David Ventura
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Haluk Morgül
- Department for General, Visceral and Transplantation Surgery, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Jonel Trebicka
- Department of Gastroenterology and Hepatology, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Walter Heindel
- Clinic for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany
| | - Moritz Wildgruber
- Clinic for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
- Department of Radiology, University Hospital LMU, Munich, Munich, Germany
| | - Philipp Schindler
- Clinic for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
- West German Cancer Centre (WTZ), Münster Site, Münster, Germany.
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Borgers T, Enneking V, Klug M, Garbe J, Meinert H, Wulle M, König P, Zwiky E, Herrmann R, Selle J, Dohm K, Kraus A, Grotegerd D, Repple J, Opel N, Leehr EJ, Gruber M, Goltermann J, Meinert S, Bauer J, Heindel W, Kavakbasi E, Baune BT, Dannlowski U, Redlich R. Long-term effects of electroconvulsive therapy on brain structure in major depression. Psychol Med 2024; 54:940-950. [PMID: 37681274 DOI: 10.1017/s0033291723002647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) studies on major depressive disorder (MDD) have predominantly found short-term electroconvulsive therapy (ECT)-related gray matter volume (GMV) increases, but research on the long-term stability of such changes is missing. Our aim was to investigate long-term GMV changes over a 2-year period after ECT administration and their associations with clinical outcome. METHODS In this nonrandomized longitudinal study, patients with MDD undergoing ECT (n = 17) are assessed three times by structural MRI: Before ECT (t0), after ECT (t1) and 2 years later (t2). A healthy (n = 21) and MDD non-ECT (n = 33) control group are also measured three times within an equivalent time interval. A 3(group) × 3(time) ANOVA on whole-brain level and correlation analyses with clinical outcome variables is performed. RESULTS Analyses yield a significant group × time interaction (pFWE < 0.001) resulting from significant volume increases from t0 to t1 and decreases from t1 to t2 in the ECT group, e.g., in limbic areas. There are no effects of time in both control groups. Volume increases from t0 to t1 correlate with immediate and delayed symptom increase, while volume decreases from t1 to t2 correlate with long-term depressive outcome (all p ⩽ 0.049). CONCLUSIONS Volume increases induced by ECT appear to be a transient phenomenon as volume strongly decreased 2 years after ECT. Short-term volume increases are associated with less symptom improvement suggesting that the antidepressant effect of ECT is not due to volume changes. Larger volume decreases are associated with poorer long-term outcome highlighting the interplay between disease progression and structural changes.
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Affiliation(s)
- Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Jasper Garbe
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Hannah Meinert
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Marius Wulle
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Philine König
- Department of Psychology, University of Halle, Emil-Abderhalden-Straße 26, 06108 Halle, Germany
| | - Esther Zwiky
- Department of Psychology, University of Halle, Emil-Abderhalden-Straße 26, 06108 Halle, Germany
| | - Rebekka Herrmann
- Department of Psychology, University of Halle, Emil-Abderhalden-Straße 26, 06108 Halle, Germany
| | - Janine Selle
- Department of Psychology, University of Halle, Emil-Abderhalden-Straße 26, 06108 Halle, Germany
- Deutsches Zentrum für Psychische Gesundheit, German Center of Mental Health, Site Halle, MLU Halle, Halle, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Anna Kraus
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Strasse 10, 60528 Frankfurt am Main, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Philosophenweg 3, 07743 Jena, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Campus 1, Building A16, 48149 Münster, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Campus 1, Building A16, 48149 Münster, Germany
| | - Erhan Kavakbasi
- Department of Psychiatry, University Hospital Münster, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University Hospital Münster, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
- Department of Psychiatry, University of Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9a, 48149 Münster, Germany
- Department of Psychology, University of Halle, Emil-Abderhalden-Straße 26, 06108 Halle, Germany
- Deutsches Zentrum für Psychische Gesundheit, German Center of Mental Health, Site Halle, MLU Halle, Halle, Germany
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Winter NR, Blanke J, Leenings R, Ernsting J, Fisch L, Sarink K, Barkhau C, Emden D, Thiel K, Flinkenflügel K, Winter A, Goltermann J, Meinert S, Dohm K, Repple J, Gruber M, Leehr EJ, Opel N, Grotegerd D, Redlich R, Nitsch R, Bauer J, Heindel W, Gross J, Risse B, Andlauer TFM, Forstner AJ, Nöthen MM, Rietschel M, Hofmann SG, Pfarr JK, Teutenberg L, Usemann P, Thomas-Odenthal F, Wroblewski A, Brosch K, Stein F, Jansen A, Jamalabadi H, Alexander N, Straube B, Nenadić I, Kircher T, Dannlowski U, Hahn T. A Systematic Evaluation of Machine Learning-Based Biomarkers for Major Depressive Disorder. JAMA Psychiatry 2024; 81:386-395. [PMID: 38198165 PMCID: PMC10782379 DOI: 10.1001/jamapsychiatry.2023.5083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/05/2023] [Indexed: 01/11/2024]
Abstract
Importance Biological psychiatry aims to understand mental disorders in terms of altered neurobiological pathways. However, for one of the most prevalent and disabling mental disorders, major depressive disorder (MDD), no informative biomarkers have been identified. Objective To evaluate whether machine learning (ML) can identify a multivariate biomarker for MDD. Design, Setting, and Participants This study used data from the Marburg-Münster Affective Disorders Cohort Study, a case-control clinical neuroimaging study. Patients with acute or lifetime MDD and healthy controls aged 18 to 65 years were recruited from primary care and the general population in Münster and Marburg, Germany, from September 11, 2014, to September 26, 2018. The Münster Neuroimaging Cohort (MNC) was used as an independent partial replication sample. Data were analyzed from April 2022 to June 2023. Exposure Patients with MDD and healthy controls. Main Outcome and Measure Diagnostic classification accuracy was quantified on an individual level using an extensive ML-based multivariate approach across a comprehensive range of neuroimaging modalities, including structural and functional magnetic resonance imaging and diffusion tensor imaging as well as a polygenic risk score for depression. Results Of 1801 included participants, 1162 (64.5%) were female, and the mean (SD) age was 36.1 (13.1) years. There were a total of 856 patients with MDD (47.5%) and 945 healthy controls (52.5%). The MNC replication sample included 1198 individuals (362 with MDD [30.1%] and 836 healthy controls [69.9%]). Training and testing a total of 4 million ML models, mean (SD) accuracies for diagnostic classification ranged between 48.1% (3.6%) and 62.0% (4.8%). Integrating neuroimaging modalities and stratifying individuals based on age, sex, treatment, or remission status does not enhance model performance. Findings were replicated within study sites and also observed in structural magnetic resonance imaging within MNC. Under simulated conditions of perfect reliability, performance did not significantly improve. Analyzing model errors suggests that symptom severity could be a potential focus for identifying MDD subgroups. Conclusion and Relevance Despite the improved predictive capability of multivariate compared with univariate neuroimaging markers, no informative individual-level MDD biomarker-even under extensive ML optimization in a large sample of diagnosed patients-could be identified.
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Affiliation(s)
- Nils R. Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Julian Blanke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - Jan Ernsting
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany
- Institute for Geoinformatics, University of Münster, Münster, Germany
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kelvin Sarink
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Carlotta Barkhau
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Daniel Emden
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kira Flinkenflügel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Elisabeth J. Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health, Jena, Germany
- German Center for Mental Health (DZPG), Jena, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health, Jena, Germany
- Department of Psychology, University of Halle, Halle, Germany
- German Center for Mental Health (DZPG), Halle, Germany
| | - Robert Nitsch
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Jochen Bauer
- Clinic for Radiology, University of Münster, University Hospital Münster, Münster, Germany
| | - Walter Heindel
- Clinic for Radiology, University of Münster, University Hospital Münster, Münster, Germany
| | - Joachim Gross
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | - Benjamin Risse
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
- Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany
- Institute for Geoinformatics, University of Münster, Münster, Germany
| | - Till F. M. Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas J. Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology, Central Institute of Mental Health, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefan G. Hofmann
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Lea Teutenberg
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
- Core Facility Brain Imaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Münster, Münster, Germany
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5
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Sporns PB, Kemmling A, Meyer L, Krogias C, Puetz V, Thierfelder KM, Duering M, Lukas C, Kaiser D, Langner S, Brehm A, Rotkopf LT, Kunz WG, Beuker C, Heindel W, Fiehler J, Schramm P, Wiendl H, Minnerup H, Psychogios MN, Minnerup J. Computed tomography hypoperfusion-hypodensity mismatch vs. automated perfusion mismatch to identify stroke patients eligible for thrombolysis. Front Neurol 2023; 14:1320620. [PMID: 38225983 PMCID: PMC10788186 DOI: 10.3389/fneur.2023.1320620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/04/2023] [Indexed: 01/17/2024] Open
Abstract
Background and purpose Automated perfusion imaging can detect stroke patients with unknown time of symptom onset who are eligible for thrombolysis. However, the availability of this technique is limited. We, therefore, established the novel concept of computed tomography (CT) hypoperfusion-hypodensity mismatch, i.e., an ischemic core lesion visible on cerebral perfusion CT without visible hypodensity in the corresponding native cerebral CT. We compared both methods regarding their accuracy in identifying patients suitable for thrombolysis. Methods In a retrospective analysis of the MissPerfeCT observational cohort study, patients were classified as suitable or not for thrombolysis based on established time window and imaging criteria. We calculated predictive values for hypoperfusion-hypodensity mismatch and automated perfusion imaging to compare accuracy in the identification of patients suitable for thrombolysis. Results Of 247 patients, 219 (88.7%) were eligible for thrombolysis and 28 (11.3%) were not eligible for thrombolysis. Of 197 patients who were within 4.5 h of symptom onset, 190 (96.4%) were identified by hypoperfusion-hypodensity mismatch and 88 (44.7%) by automated perfusion mismatch (p < 0.001). Of 22 patients who were beyond 4.5 h of symptom onset but were eligible for thrombolysis, 5 patients (22.7%) were identified by hypoperfusion-hypodensity mismatch. Predictive values for the hypoperfusion-hypodensity mismatch vs. automated perfusion mismatch were as follows: sensitivity, 89.0% vs. 50.2%; specificity, 71.4% vs. 100.0%; positive predictive value, 96.1% vs. 100.0%; and negative predictive value, 45.5% vs. 20.4%. Conclusion The novel method of hypoperfusion-hypodensity mismatch can identify patients suitable for thrombolysis with higher sensitivity and lower specificity than established techniques. Using this simple method might therefore increase the proportion of patients treated with thrombolysis without the use of special automated software.The MissPerfeCT study is a retrospective observational multicenter cohort study and is registered with clinicaltrials.gov (NCT04277728).
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Affiliation(s)
- Peter B. Sporns
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Radiology, Westfaelische Wilhelms-University of Münster and University Hospital of Münster, Münster, Germany
| | - André Kemmling
- Department of Radiology, Westfaelische Wilhelms-University of Münster and University Hospital of Münster, Münster, Germany
- Department of Neuroradiology, Westpfalz-Klinikum, Kaiserslautern, Germany
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Lennart Meyer
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Christos Krogias
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
| | - Volker Puetz
- Department of Neurology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Kolja M. Thierfelder
- Department of Radiology and Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany
| | - Marco Duering
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany
| | - Carsten Lukas
- Department of Neuroradiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
| | - Daniel Kaiser
- Department of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Sönke Langner
- Department of Radiology and Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany
| | - Alex Brehm
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Lukas T. Rotkopf
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Wolfgang G. Kunz
- Department of Radiology, University Hospital, LMU Munich, Germany
| | - Carolin Beuker
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Walter Heindel
- Department of Radiology, Westfaelische Wilhelms-University of Münster and University Hospital of Münster, Münster, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Schramm
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Heike Minnerup
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Marios Nikos Psychogios
- Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Jens Minnerup
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
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Gerwing M, Schindler P, Katou S, Köhler M, Stamm AC, Schmidt VF, Heindel W, Struecker B, Morgul H, Pascher A, Wildgruber M, Masthoff M. Multi-organ Radiomics-Based Prediction of Future Remnant Liver Hypertrophy Following Portal Vein Embolization. Ann Surg Oncol 2023; 30:7976-7985. [PMID: 37670120 PMCID: PMC10625940 DOI: 10.1245/s10434-023-14241-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Portal vein embolization (PVE) is used to induce remnant liver hypertrophy prior to major hepatectomy. The purpose of this study was to evaluate the predictive value of baseline computed tomography (CT) data for future remnant liver (FRL) hypertrophy after PVE. METHODS In this retrospective study, all consecutive patients undergoing right-sided PVE with or without hepatic vein embolization between 2018 and 2021 were included. CT volumetry was performed before and after PVE to assess standardized FRL volume (sFRLV). Radiomic features were extracted from baseline CT after segmenting liver (without tumor), spleen and bone marrow. For selecting features that allow classification of response (hypertrophy ≥ 1.33), a stepwise dimension reduction was performed. Logistic regression models were fitted and selected features were tested for their predictive value. Decision curve analysis was performed on the test dataset. RESULTS A total of 53 patients with liver tumor were included in this study. sFRLV increased significantly after PVE, with a mean hypertrophy of FRL of 1.5 ± 0.3-fold. sFRLV hypertrophy ≥ 1.33 was reached in 35 (66%) patients. Three independent radiomic features, i.e. liver-, spleen- and bone marrow-associated, differentiated well between responders and non-responders. A logistic regression model revealed the highest accuracy (area under the curve 0.875) for the prediction of response, with sensitivity of 1.0 and specificity of 0.5. Decision curve analysis revealed a positive net benefit when applying the model. CONCLUSIONS This proof-of-concept study provides first evidence of a potential predictive value of baseline multi-organ radiomics CT data for FRL hypertrophy after PVE.
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Affiliation(s)
- Mirjam Gerwing
- Clinic for Radiology, University Hospital Münster, Münster, Germany.
| | | | - Shadi Katou
- Department for General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Michael Köhler
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | | | | | - Walter Heindel
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | - Benjamin Struecker
- Department for General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Haluk Morgul
- Department for General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Andreas Pascher
- Department for General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany
| | - Moritz Wildgruber
- Clinic for Radiology, University Hospital Münster, Münster, Germany
- Department for Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Max Masthoff
- Clinic for Radiology, University Hospital Münster, Münster, Germany
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7
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Weigel S, Heindel W, Decker T, Weyer-Elberich V, Kerschke L, Gerß J, Hense HW. Digital Breast Tomosynthesis versus Digital Mammography for Detection of Early-Stage Cancers Stratified by Grade: A TOSYMA Subanalysis. Radiology 2023; 309:e231533. [PMID: 38051184 DOI: 10.1148/radiol.231533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Background Breast cancer screening with digital breast tomosynthesis (DBT) plus synthesized mammography (SM) increases invasive tumor detection compared with digital mammography (DM). However, it is not known how the prognostic characteristics of the cancers detected with the two screening approaches differ. Purpose To compare invasive breast cancers detected with DBT plus SM (test arm) versus DM (control arm) screening with regard to tumor stage, histologic grade, patient age, and breast density. Materials and Methods This exploratory subanalysis of the Tomosynthesis plus Synthesized Mammography (TOSYMA) study, which is a multicenter randomized controlled trial embedded in the German mammography screening program, recruited women aged 50-70 years from July 2018 to December 2020. It compared invasive cancer detection rates (iCDRs), rate differences, and odds ratios (ORs) between the arms stratified by Union for International Cancer Control (UICC) stage (I vs II-IV), histologic grade (1 vs 2 or 3), age group (50-59 vs 60-70 years), and Breast Imaging Reporting and Data System categories of breast density (A or B vs C or D). Results In total, 49 462 (median age, 57 years [IQR, 53-62 years]) and 49 669 (median age, 57 years [IQR, 53-62 years]) participants were allocated to DBT plus SM and DM screening, respectively. The iCDR of stage I tumors with DBT plus SM was 51.6 per 10 000 women (255 of 49 462) and with DM it was 30.0 per 10 000 women (149 of 49 669). DBT plus SM depicted more stage I tumors with grade 2 or 3 (166 of 49 462, 33.7 per 10 000 women) than DM (106 of 49 669, 21.3 per 10 000 women; rate difference, +12.3 per 10 000 women [95% CI: 0.3, 24.9]; OR, 1.6 [95% CI: 0.9, 2.7]). DBT plus SM achieved the highest iCDR of stage I tumors with grade 2 or 3 among women aged 60-70 years with dense breasts (41 of 7364, 55.4 per 10 000 women; rate difference, +21.6 per 10 000 women [95% CI: -21.1, 64.3]; OR, 1.6 [95% CI: 0.6, 4.5]). Conclusion DBT plus SM screening appears to lead to higher detection of early-stage invasive breast cancers of grade 2 or 3 than DM screening, with the highest rate among women aged 60-70 years with dense breasts. Clinical trial registration no. NCT03377036 © RSNA, 2023 See also the editorial by Ha and Chang in this issue.
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Affiliation(s)
- Stefanie Weigel
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Walter Heindel
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Thomas Decker
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Veronika Weyer-Elberich
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Laura Kerschke
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Joachim Gerß
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Hans-Werner Hense
- From the Clinic for Radiology and Reference Center for Mammography Münster (S.W., W.H., T.D.), Institute of Biostatistics and Clinical Research (V.W.E., L.K., J.G.), and Institute of Epidemiology and Social Medicine (H.W.H.), University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
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8
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Gerwing M, Hoffmann E, Geyer C, Helfen A, Maus B, Schinner R, Wachsmuth L, Heindel W, Eisenblaetter M, Faber C, Wildgruber M. Intratumoral heterogeneity after targeted therapy in murine cancer models with differing degrees of malignancy. Transl Oncol 2023; 37:101773. [PMID: 37666208 PMCID: PMC10483060 DOI: 10.1016/j.tranon.2023.101773] [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: 06/30/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Conventional morphologic and volumetric assessment of treatment response is not suitable for adequately assessing responses to targeted cancer therapy. The aim of this study was to evaluate changes in tumor composition after targeted therapy in murine models of breast cancer with differing degrees of malignancy via non-invasive magnetic resonance imaging (MRI). MATERIALS AND METHODS Mice bearing highly malignant 4T1 tumors or low malignant 67NR tumors were treated with either a combination of two immune checkpoint inhibitors (ICI, anti-PD1 and anti-CTLA-4) or the multi-tyrosine kinase inhibitor sorafenib, following experiments with macrophage-depleting clodronate-loaded liposomes and vessel-stabilizing angiopoietin-1. Mice were imaged on a 9.4 T small animal MRI system with a multiparametric (mp) protocol, comprising T1 and T2 mapping and diffusion-weighted imaging. Tumors were analyzed ex vivo with histology. RESULTS AND DISCUSSIONS All treatments led to an increase in non-viable areas, but therapy-induced intratumoral changes differed between the two tumor models and the different targeted treatments. While ICI treatment led to intratumoral hemorrhage, sorafenib treatment mainly induced intratumoral necrosis. Treated 4T1 tumors showed increasing and extensive areas of necrosis, in comparison to 67NR tumors with only small, but also increasing, necrotic areas. After either of the applied treatments, intratumoral heterogeneity, was increased in both tumor models, and confirmed ex vivo by histology. Apparent diffusion coefficient with subsequent histogram analysis proved to be the most sensitive MRI sequence. In conclusion, mp MRI enables to assess dedicated therapy-related intratumoral changes and may serve as a biomarker for treatment response assessment.
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Affiliation(s)
- M Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany.
| | - E Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany
| | - C Geyer
- Clinic of Radiology, University of Münster, Münster, Germany
| | - A Helfen
- Clinic of Radiology, University of Münster, Münster, Germany
| | - B Maus
- Clinic of Radiology, University of Münster, Münster, Germany
| | - R Schinner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - L Wachsmuth
- Clinic of Radiology, University of Münster, Münster, Germany
| | - W Heindel
- Clinic of Radiology, University of Münster, Münster, Germany
| | - M Eisenblaetter
- Department of Diagnostic and Interventional Radiology, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - C Faber
- Clinic of Radiology, University of Münster, Münster, Germany
| | - M Wildgruber
- Clinic of Radiology, University of Münster, Münster, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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Hoffmann E, Schache D, Höltke C, Soltwisch J, Niland S, Krähling T, Bergander K, Grewer M, Geyer C, Groeneweg L, Eble JA, Vogl T, Roth J, Heindel W, Maus B, Helfen A, Faber C, Wildgruber M, Gerwing M, Hoerr V. Multiparametric chemical exchange saturation transfer MRI detects metabolic changes in breast cancer following immunotherapy. J Transl Med 2023; 21:577. [PMID: 37641066 PMCID: PMC10463706 DOI: 10.1186/s12967-023-04451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/19/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND With metabolic alterations of the tumor microenvironment (TME) contributing to cancer progression, metastatic spread and response to targeted therapies, non-invasive and repetitive imaging of tumor metabolism is of major importance. The purpose of this study was to investigate whether multiparametric chemical exchange saturation transfer magnetic resonance imaging (CEST-MRI) allows to detect differences in the metabolic profiles of the TME in murine breast cancer models with divergent degrees of malignancy and to assess their response to immunotherapy. METHODS Tumor characteristics of highly malignant 4T1 and low malignant 67NR murine breast cancer models were investigated, and their changes during tumor progression and immune checkpoint inhibitor (ICI) treatment were evaluated. For simultaneous analysis of different metabolites, multiparametric CEST-MRI with calculation of asymmetric magnetization transfer ratio (MTRasym) at 1.2 to 2.0 ppm for glucose-weighted, 2.0 ppm for creatine-weighted and 3.2 to 3.6 ppm for amide proton transfer- (APT-) weighted CEST contrast was conducted. Ex vivo validation of MRI results was achieved by 1H nuclear magnetic resonance spectroscopy, matrix-assisted laser desorption/ionization mass spectrometry imaging with laser postionization and immunohistochemistry. RESULTS During tumor progression, the two tumor models showed divergent trends for all examined CEST contrasts: While glucose- and APT-weighted CEST contrast decreased and creatine-weighted CEST contrast increased over time in the 4T1 model, 67NR tumors exhibited increased glucose- and APT-weighted CEST contrast during disease progression, accompanied by decreased creatine-weighted CEST contrast. Already three days after treatment initiation, CEST contrasts captured response to ICI therapy in both tumor models. CONCLUSION Multiparametric CEST-MRI enables non-invasive assessment of metabolic signatures of the TME, allowing both for estimation of the degree of tumor malignancy and for assessment of early response to immune checkpoint inhibition.
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Affiliation(s)
- Emily Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany.
| | - Daniel Schache
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Carsten Höltke
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Jens Soltwisch
- Institute of Hygiene, University of Münster, Münster, Germany
| | - Stephan Niland
- Institute of Physiological Chemistry and Pathobiochemistry, University of Münster, Münster, Germany
| | - Tobias Krähling
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Klaus Bergander
- Institute of Organic Chemistry, University of Münster, Münster, Germany
| | - Martin Grewer
- Clinic of Radiology, University of Münster, Münster, Germany
| | | | - Linda Groeneweg
- Institute of Immunology, University of Münster, Münster, Germany
| | - Johannes A Eble
- Institute of Physiological Chemistry and Pathobiochemistry, University of Münster, Münster, Germany
| | - Thomas Vogl
- Institute of Immunology, University of Münster, Münster, Germany
| | - Johannes Roth
- Institute of Immunology, University of Münster, Münster, Germany
| | - Walter Heindel
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Bastian Maus
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Anne Helfen
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Cornelius Faber
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Moritz Wildgruber
- Clinic of Radiology, University of Münster, Münster, Germany
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Mirjam Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Verena Hoerr
- Clinic of Radiology, University of Münster, Münster, Germany
- Heart Center Bonn, Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany
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10
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Musigmann M, Nacul NG, Kasap DN, Heindel W, Mannil M. Use Test of Automated Machine Learning in Cancer Diagnostics. Diagnostics (Basel) 2023; 13:2315. [PMID: 37510059 PMCID: PMC10378334 DOI: 10.3390/diagnostics13142315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Our aim is to investigate the added value of automated machine learning (AutoML) for potential future applications in cancer diagnostics. Using two important diagnostic questions, the non-invasive determination of IDH mutation status and ATRX status, we analyze whether it is possible to use AutoML to develop models that are comparable in performance to conventional machine learning models (ML) developed by experts. For this purpose, we develop AutoML models using different feature preselection methods and compare the results with previously developed conventional ML models. The cohort used for our study comprises T2-weighted MRI images of 124 patients with histologically confirmed gliomas. Using AutoML, we were able to develop sophisticated models in a very short time with only a few lines of computer code. In predicting IDH mutation status, we obtained a mean AUC of 0.7400 and a mean AUPRC of 0.8582. ATRX mutation status was predicted with very similar discriminatory power, with a mean AUC of 0.7810 and a mean AUPRC of 0.8511. In both cases, AutoML was even able to achieve a discriminatory power slightly above that of the respective conventionally developed models in a very short computing time, thus making such methods accessible to non-experts in the near future.
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Affiliation(s)
- Manfred Musigmann
- University Clinic for Radiology, University Hospital Muenster, WWU Muenster, Albert-Schweitzer-Campus 1, DE-48149 Muenster, Germany
| | - Nabila Gala Nacul
- University Clinic for Radiology, University Hospital Muenster, WWU Muenster, Albert-Schweitzer-Campus 1, DE-48149 Muenster, Germany
| | - Dilek N Kasap
- University Clinic for Radiology, University Hospital Muenster, WWU Muenster, Albert-Schweitzer-Campus 1, DE-48149 Muenster, Germany
| | - Walter Heindel
- University Clinic for Radiology, University Hospital Muenster, WWU Muenster, Albert-Schweitzer-Campus 1, DE-48149 Muenster, Germany
| | - Manoj Mannil
- University Clinic for Radiology, University Hospital Muenster, WWU Muenster, Albert-Schweitzer-Campus 1, DE-48149 Muenster, Germany
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11
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Goltermann J, Winter NR, Meinert S, Sindermann L, Lemke H, Leehr EJ, Grotegerd D, Winter A, Thiel K, Waltemate L, Breuer F, Repple J, Gruber M, Richter M, Teckentrup V, Kroemer NB, Brosch K, Meller T, Pfarr JK, Ringwald KG, Stein F, Heindel W, Jansen A, Kircher T, Nenadić I, Dannlowski U, Opel N, Hahn T. Resting-state functional connectivity patterns associated with childhood maltreatment in a large bicentric cohort of adults with and without major depression. Psychol Med 2023; 53:4720-4731. [PMID: 35754405 PMCID: PMC10388325 DOI: 10.1017/s0033291722001623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/11/2022] [Accepted: 05/13/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood maltreatment (CM) represents a potent risk factor for major depressive disorder (MDD), including poorer treatment response. Altered resting-state connectivity in the fronto-limbic system has been reported in maltreated individuals. However, previous results in smaller samples differ largely regarding localization and direction of effects. METHODS We included healthy and depressed samples [n = 624 participants with MDD; n = 701 healthy control (HC) participants] that underwent resting-state functional MRI measurements and provided retrospective self-reports of maltreatment using the Childhood Trauma Questionnaire. A-priori defined regions of interest [ROI; amygdala, hippocampus, anterior cingulate cortex (ACC)] were used to calculate seed-to-voxel connectivities. RESULTS No significant associations between maltreatment and resting-state connectivity of any ROI were found across MDD and HC participants and no interaction effect with diagnosis became significant. Investigating MDD patients only yielded maltreatment-associated increased connectivity between the amygdala and dorsolateral frontal areas [pFDR < 0.001; η2partial = 0.050; 95%-CI (0.023-0.085)]. This effect was robust across various sensitivity analyses and was associated with concurrent and previous symptom severity. Particularly strong amygdala-frontal associations with maltreatment were observed in acutely depressed individuals [n = 264; pFDR < 0.001; η2partial = 0.091; 95%-CI (0.038-0.166)). Weaker evidence - not surviving correction for multiple ROI analyses - was found for altered supracallosal ACC connectivity in HC individuals associated with maltreatment. CONCLUSIONS The majority of previous resting-state connectivity correlates of CM could not be replicated in this large-scale study. The strongest evidence was found for clinically relevant maltreatment associations with altered adult amygdala-dorsolateral frontal connectivity in depression. Future studies should explore the relevance of this pathway for a maltreated subgroup of MDD patients.
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Affiliation(s)
- Janik Goltermann
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Nils Ralf Winter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Susanne Meinert
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
- University of Münster, Institute for Translational Neuroscience, Münster, Germany
| | - Lisa Sindermann
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Hannah Lemke
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Elisabeth J. Leehr
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Dominik Grotegerd
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Alexandra Winter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Katharina Thiel
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Lena Waltemate
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Fabian Breuer
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Jonathan Repple
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Marius Gruber
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Maike Richter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Vanessa Teckentrup
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Department of Psychiatry & Psychotherapy, University of Bonn, Bonn, Germany
| | - Katharina Brosch
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | | | | | - Frederike Stein
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Walter Heindel
- University of Münster, Department of Clinical Radiology, Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Nils Opel
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
- University of Münster, Interdisciplinary Centre for Clinical Research (IZKF), Münster, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Tim Hahn
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
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12
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Nacul Mora NG, Akkurt BH, Kasap D, Blömer D, Heindel W, Mannil M, Musigmann M. Comparison of MRI Sequences to Predict ATRX Status Using Radiomics-Based Machine Learning. Diagnostics (Basel) 2023; 13:2216. [PMID: 37443610 DOI: 10.3390/diagnostics13132216] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
ATRX is an important molecular marker according to the 2021 WHO classification of adult-type diffuse glioma. We aim to predict the ATRX mutation status non-invasively using radiomics-based machine learning models on MRI and to determine which MRI sequence is best suited for this purpose. In this retrospective study, we used MRI images of patients with histologically confirmed glioma, including the sequences T1w without and with the administration of contrast agent, T2w, and the FLAIR. Radiomics features were extracted from the corresponding MRI images by hand-delineated regions of interest. Data partitioning into training data and independent test data was repeated 100 times to avoid random effects. Feature preselection and subsequent model development were performed using Lasso regression. The T2w sequence was found to be the most suitable and the FLAIR sequence the least suitable for predicting ATRX mutations using radiomics-based machine learning models. For the T2w sequence, our seven-feature model developed with Lasso regression achieved a mean AUC of 0.831, a mean accuracy of 0.746, a mean sensitivity of 0.772, and a mean specificity of 0.697. In conclusion, for the prediction of ATRX mutation using radiomics-based machine learning models, the T2w sequence is the most suitable among the commonly used MRI sequences.
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Affiliation(s)
- Nabila Gala Nacul Mora
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Burak Han Akkurt
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Dilek Kasap
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - David Blömer
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Walter Heindel
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Manoj Mannil
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
| | - Manfred Musigmann
- Clinic for Radiology, University of Münster and University Hospital Münster Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany
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13
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Hoffmann E, Gerwing M, Krähling T, Hansen U, Kronenberg K, Masthoff M, Geyer C, Höltke C, Wachsmuth L, Schinner R, Hoerr V, Heindel W, Karst U, Eisenblätter M, Maus B, Helfen A, Faber C, Wildgruber M. Vascular response patterns to targeted therapies in murine breast cancer models with divergent degrees of malignancy. Breast Cancer Res 2023; 25:56. [PMID: 37221619 DOI: 10.1186/s13058-023-01658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Response assessment of targeted cancer therapies is becoming increasingly challenging, as it is not adequately assessable with conventional morphological and volumetric analyses of tumor lesions. The tumor microenvironment is particularly constituted by tumor vasculature which is altered by various targeted therapies. The aim of this study was to noninvasively assess changes in tumor perfusion and vessel permeability after targeted therapy in murine models of breast cancer with divergent degrees of malignancy. METHODS Low malignant 67NR or highly malignant 4T1 tumor-bearing mice were treated with either the multi-kinase inhibitor sorafenib or immune checkpoint inhibitors (ICI, combination of anti-PD1 and anti-CTLA4). Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with i.v. injection of albumin-binding gadofosveset was conducted on a 9.4 T small animal MRI. Ex vivo validation of MRI results was achieved by transmission electron microscopy, immunohistochemistry and laser ablation-inductively coupled plasma-mass spectrometry. RESULTS Therapy-induced changes in tumor vasculature differed between low and highly malignant tumors. Sorafenib treatment led to decreased tumor perfusion and endothelial permeability in low malignant 67NR tumors. In contrast, highly malignant 4T1 tumors demonstrated characteristics of a transient window of vascular normalization with an increase in tumor perfusion and permeability early after therapy initiation, followed by decreased perfusion and permeability parameters. In the low malignant 67NR model, ICI treatment also mediated vessel-stabilizing effects with decreased tumor perfusion and permeability, while ICI-treated 4T1 tumors exhibited increasing tumor perfusion with excessive vascular leakage. CONCLUSION DCE-MRI enables noninvasive assessment of early changes in tumor vasculature after targeted therapies, revealing different response patterns between tumors with divergent degrees of malignancy. DCE-derived tumor perfusion and permeability parameters may serve as vascular biomarkers that allow for repetitive examination of response to antiangiogenic treatment or immunotherapy.
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Grants
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
- 446302350, 194468054, 431460824 Deutsche Forschungsgemeinschaft
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Affiliation(s)
- Emily Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany.
| | - Mirjam Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Tobias Krähling
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Uwe Hansen
- Institute for Musculoskeletal Medicine, University of Münster, Münster, Germany
| | - Katharina Kronenberg
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Max Masthoff
- Clinic of Radiology, University of Münster, Münster, Germany
| | | | - Carsten Höltke
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Lydia Wachsmuth
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Regina Schinner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Verena Hoerr
- Clinic of Radiology, University of Münster, Münster, Germany
- Heart Center Bonn, Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany
| | - Walter Heindel
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Michel Eisenblätter
- Clinic of Radiology, University of Münster, Münster, Germany
- Department of Diagnostic and Interventional Radiology, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - Bastian Maus
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Anne Helfen
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Cornelius Faber
- Clinic of Radiology, University of Münster, Münster, Germany
| | - Moritz Wildgruber
- Clinic of Radiology, University of Münster, Münster, Germany
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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14
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Förster K, Grotegerd D, Dohm K, Lemke H, Enneking V, Meinert S, Redlich R, Heindel W, Bauer J, Kugel H, Suslow T, Ohrmann P, Carballedo A, O'Keane V, Fagan A, Doolin K, McCarthy H, Kanske P, Frodl T, Dannlowski U. Association of hospitalization with structural brain alterations in patients with affective disorders over nine years. Transl Psychiatry 2023; 13:170. [PMID: 37202406 DOI: 10.1038/s41398-023-02452-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
Repeated hospitalizations are a characteristic of severe disease courses in patients with affective disorders (PAD). To elucidate how a hospitalization during a nine-year follow-up in PAD affects brain structure, a longitudinal case-control study (mean [SD] follow-up period 8.98 [2.20] years) was conducted using structural neuroimaging. We investigated PAD (N = 38) and healthy controls (N = 37) at two sites (University of Münster, Germany, Trinity College Dublin, Ireland). PAD were divided into two groups based on the experience of in-patient psychiatric treatment during follow-up. Since the Dublin-patients were outpatients at baseline, the re-hospitalization analysis was limited to the Münster site (N = 52). Voxel-based morphometry was employed to examine hippocampus, insula, dorsolateral prefrontal cortex and whole-brain gray matter in two models: (1) group (patients/controls)×time (baseline/follow-up) interaction; (2) group (hospitalized patients/not-hospitalized patients/controls)×time interaction. Patients lost significantly more whole-brain gray matter volume of superior temporal gyrus and temporal pole compared to HC (pFWE = 0.008). Patients hospitalized during follow-up lost significantly more insular volume than healthy controls (pFWE = 0.025) and more volume in their hippocampus compared to not-hospitalized patients (pFWE = 0.023), while patients without re-hospitalization did not differ from controls. These effects of hospitalization remained stable in a smaller sample excluding patients with bipolar disorder. PAD show gray matter volume decline in temporo-limbic regions over nine years. A hospitalization during follow-up comes with intensified gray matter volume decline in the insula and hippocampus. Since hospitalizations are a correlate of severity, this finding corroborates and extends the hypothesis that a severe course of disease has detrimental long-term effects on temporo-limbic brain structure in PAD.
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Affiliation(s)
- Katharina Förster
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychology, University of Halle, Halle, Germany
| | - Walter Heindel
- Department of Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Jochen Bauer
- Department of Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Harald Kugel
- Department of Radiology, University of Münster and University Hospital Münster, Münster, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | | | - Angela Carballedo
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Veronica O'Keane
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Andrew Fagan
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Kelly Doolin
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Hazel McCarthy
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Thomas Frodl
- Department of Psychiatry & Trinity College Institute of Neuroscience, University Dublin, Dublin, Ireland
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, RWTH University Aachen, Aachen, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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15
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Backhaus P, Burg MC, Asmus I, Pixberg M, Büther F, Breyholz HJ, Yeh R, Weigel SB, Stichling P, Heindel W, Bobe S, Barth P, Tio J, Schäfers M. Initial Results of 68Ga-FAPI-46 PET/MRI to Assess Response to Neoadjuvant Chemotherapy in Breast Cancer. J Nucl Med 2023; 64:717-723. [PMID: 36396458 PMCID: PMC10152127 DOI: 10.2967/jnumed.122.264871] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
Improving imaging-based response after neoadjuvant chemotherapy (NAC) in breast cancer assessment could obviate histologic confirmation of pathologic complete response (pCR) and facilitate deescalation of chemotherapy or surgery. Fibroblast activation protein inhibitor (FAPI) PET/MRI is a promising novel molecular imaging agent for the tumor microenvironment with intense uptake in breast cancer. We assessed the diagnostic performance of follow-up breast 68Ga-FAPI-46 (68Ga-FAPI) PET/MRI in classifying the response status of local breast cancer and lymph node metastases after completion of NAC and validated this approach immunohistochemically. Methods: In women who completed NAC for invasive breast cancer, follow-up 68Ga-FAPI PET/MRI and corresponding fibroblast activation protein (FAP) immunostainings were retrospectively analyzed. Metrics of 68Ga-FAPI uptake and FAP immunoreactivity in women with or without pCR were compared using the Mann-Whitney U test. Diagnostic performance to detect remnant invasive cancer was calculated for tracer uptake metrics using receiver-operating-characteristic curves and for masked readers' visual assessment categories of PET/MRI and MRI alone. Results: Thirteen women (mean age ± SD, 47 ± 9 y) were evaluated. Seven of the 13 achieved pCR in the breast and 6 in the axilla. FAP immunoreactivity was significantly associated with response status. The 68Ga-FAPI PET/MRI mean breast tumor-to-background ratio was 0.9 (range, 0.6-1.2) for pCR and 2.1 (range, 1.4-3.1) for no pCR (P = 0.001). Integrated PET/MRI could classify breast response correctly in all 13 women based on readers' visual assessment or tumor-to-background ratio. Evaluation of MRI alone resulted in at least 2 false-positives. For lymph nodes, PET/MRI readers had at least 2 false-negative classifications, whereas MRI alone resulted in 2 false-negatives and 1 false-positive. Conclusion: To our knowledge, this was the first analysis of 68Ga-FAPI PET/MRI for response assessment after NAC for breast cancer. The diagnostic performance of PET/MRI in a small study sample trended toward a gain over MRI alone, clearly supporting future prospective studies.
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Affiliation(s)
| | - Matthias C. Burg
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | - Inga Asmus
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Michaela Pixberg
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Florian Büther
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
| | - Hans-Jörg Breyholz
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Randy Yeh
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | | | | | - Walter Heindel
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | - Stefanie Bobe
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
- Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany; and
| | - Peter Barth
- Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany; and
| | - Joke Tio
- Department of Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
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16
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Ventura D, Schindler P, Masthoff M, Görlich D, Dittmann M, Heindel W, Schäfers M, Lenz G, Wardelmann E, Mohr M, Kies P, Bleckmann A, Roll W, Evers G. Radiomics of Tumor Heterogeneity in 18F-FDG-PET-CT for Predicting Response to Immune Checkpoint Inhibition in Therapy-Naïve Patients with Advanced Non-Small-Cell Lung Cancer. Cancers (Basel) 2023; 15:cancers15082297. [PMID: 37190228 DOI: 10.3390/cancers15082297] [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: 02/10/2023] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
We aimed to evaluate the predictive and prognostic value of baseline 18F-FDG-PET-CT (PET-CT) radiomic features (RFs) for immune checkpoint-inhibitor (CKI)-based first-line therapy in advanced non-small-cell lung cancer (NSCLC) patients. In this retrospective study 44 patients were included. Patients were treated with either CKI-monotherapy or combined CKI-based immunotherapy-chemotherapy as first-line treatment. Treatment response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST). After a median follow-up of 6.4 months patients were stratified into "responder" (n = 33) and "non-responder" (n = 11). RFs were extracted from baseline PET and CT data after segmenting PET-positive tumor volume of all lesions. A Radiomics-based model was developed based on a Radiomics signature consisting of reliable RFs that allow classification of response and overall progression using multivariate logistic regression. These RF were additionally tested for their prognostic value in all patients by applying a model-derived threshold. Two independent PET-based RFs differentiated well between responders and non-responders. For predicting response, the area under the curve (AUC) was 0.69 for "PET-Skewness" and 0.75 predicting overall progression for "PET-Median". In terms of progression-free survival analysis, patients with a lower value of PET-Skewness (threshold < 0.2014; hazard ratio (HR) 0.17, 95% CI 0.06-0.46; p < 0.001) and higher value of PET-Median (threshold > 0.5233; HR 0.23, 95% CI 0.11-0.49; p < 0.001) had a significantly lower probability of disease progression or death. Our Radiomics-based model might be able to predict response in advanced NSCLC patients treated with CKI-based first-line therapy.
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Affiliation(s)
- David Ventura
- Department of Nuclear Medicine, University Hospital Muenster, 48149 Muenster, Germany
- West German Cancer Center (WTZ), 48149 Muenster, Germany
| | - Philipp Schindler
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Clinic for Radiology, University and University Hospital Muenster, 48149 Muenster, Germany
| | - Max Masthoff
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Clinic for Radiology, University and University Hospital Muenster, 48149 Muenster, Germany
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany
| | - Matthias Dittmann
- Department of Nuclear Medicine, University Hospital Muenster, 48149 Muenster, Germany
- West German Cancer Center (WTZ), 48149 Muenster, Germany
| | - Walter Heindel
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Clinic for Radiology, University and University Hospital Muenster, 48149 Muenster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Muenster, 48149 Muenster, Germany
- West German Cancer Center (WTZ), 48149 Muenster, Germany
| | - Georg Lenz
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Department of Medicine A-Hematology, Oncology, Hemostaseology and Pneumology, University Hospital Muenster, 48149 Muenster, Germany
| | - Eva Wardelmann
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Gerhard-Domagk-Institute of Pathology, University Hospital Muenster, 48149 Muenster, Germany
| | - Michael Mohr
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Department of Medicine A-Hematology, Oncology, Hemostaseology and Pneumology, University Hospital Muenster, 48149 Muenster, Germany
| | - Peter Kies
- Department of Nuclear Medicine, University Hospital Muenster, 48149 Muenster, Germany
- West German Cancer Center (WTZ), 48149 Muenster, Germany
| | - Annalen Bleckmann
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Department of Medicine A-Hematology, Oncology, Hemostaseology and Pneumology, University Hospital Muenster, 48149 Muenster, Germany
| | - Wolfgang Roll
- Department of Nuclear Medicine, University Hospital Muenster, 48149 Muenster, Germany
- West German Cancer Center (WTZ), 48149 Muenster, Germany
| | - Georg Evers
- West German Cancer Center (WTZ), 48149 Muenster, Germany
- Department of Medicine A-Hematology, Oncology, Hemostaseology and Pneumology, University Hospital Muenster, 48149 Muenster, Germany
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17
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Blanken MAJT, Oudega ML, Hoogendoorn AW, Sonnenberg CS, Rhebergen D, Klumpers UMH, Van Diermen L, Birkenhager T, Schrijvers D, Redlich R, Dannlowski U, Heindel W, Coenjaerts M, Nordanskog P, Oltedal L, Kessler U, Frid LM, Takamiya A, Kishimoto T, Jorgensen MB, Jorgensen A, Bolwig T, Emsell L, Sienaert P, Bouckaert F, Abbott CC, Péran P, Arbus C, Yrondi A, Kiebs M, Philipsen A, van Waarde JA, Prinsen E, van Verseveld M, Van Wingen G, Ten Doesschate F, Camprodon JA, Kritzer M, Barbour T, Argyelan M, Cardoner N, Urretavizcaya M, Soriano-Mas C, Narr KL, Espinoza RT, Prudic J, Rowny S, van Eijndhoven P, Tendolkar I, Dols A. Sex-specifics of ECT outcome. J Affect Disord 2023; 326:243-248. [PMID: 36632848 DOI: 10.1016/j.jad.2022.12.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Electroconvulsive therapy (ECT) is the most effective treatment for patients with severe major depressive disorder (MDD). Given the known sex differences in MDD, improved knowledge may provide more sex-specific recommendations in clinical guidelines and improve outcome. In the present study we examine sex differences in ECT outcome and its predictors. METHODS Clinical data from 20 independent sites participating in the Global ECT-MRI Research Collaboration (GEMRIC) were obtained for analysis, totaling 500 patients with MDD (58.6 % women) with a mean age of 54.8 years. Severity of depression before and after ECT was assessed with validated depression scales. Remission was defined as a HAM-D score of 7 points or below after ECT. Variables associated with remission were selected based on literature (i.e. depression severity at baseline, age, duration of index episode, and presence of psychotic symptoms). RESULTS Remission rates of ECT were independent of sex, 48.0 % in women and 45.7 % in men (X2(1) = 0.2, p = 0.70). In the logistic regression analyses, a shorter index duration was identified as a sex-specific predictor for ECT outcome in women (X2(1) = 7.05, p = 0.01). The corresponding predictive margins did show overlapping confidence intervals for men and women. CONCLUSION The evidence provided by our study suggests that ECT as a biological treatment for MDD is equally effective in women and men. A shorter duration of index episode was an additional sex- specific predictor for remission in women. Future research should establish whether the confidence intervals for the corresponding predictive margins are overlapping, as we find, or not.
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Affiliation(s)
- M A J T Blanken
- Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands.
| | - M L Oudega
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands
| | - A W Hoogendoorn
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands
| | - C S Sonnenberg
- Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; GGZ Parnassia NH, Specialized Mental Health Care, Castricum, the Netherlands
| | - D Rhebergen
- Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands; GGZ Centraal, Specialized Mental Health Care, Amersfoort, the Netherlands
| | - U M H Klumpers
- GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands; Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Psychiatry, Amsterdam Public Health (Research Institute), Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands
| | - L Van Diermen
- Psychiatric Center Bethanië, Andreas Vesaliuslaan 39, 2980 Zoersel, Belgium; Department of Biomedical Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp. Universiteitsplein 1, 2610 Antwerp, Belgium; University Psychiatric Center (UPC) Duffel, Stationsstraat 22c, 2570 Duffel, Belgium
| | - T Birkenhager
- Department of Biomedical Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp. Universiteitsplein 1, 2610 Antwerp, Belgium; Erasmus MC, Rotterdam, the Netherlands
| | - D Schrijvers
- Department of Biomedical Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp. Universiteitsplein 1, 2610 Antwerp, Belgium; University Psychiatric Center (UPC) Duffel, Stationsstraat 22c, 2570 Duffel, Belgium
| | - R Redlich
- Department of Psychology, University of Halle, Germany; Institute for Translational Psychiatry, University of Münster Germany, Germany
| | - U Dannlowski
- Institute for Translational Psychiatry, University of Münster Germany, Germany
| | - W Heindel
- Department of Radiology, University of Münster Germany, Germany
| | - M Coenjaerts
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - P Nordanskog
- Center for Social and Affective Neuroscience (CSAN), Department of Biomedical and Clinical Sciences, Linköping University, Department of Psychiatry, Linköping University Hospital, Sweden
| | - L Oltedal
- Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - U Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - L M Frid
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - A Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan; Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - T Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| | - M B Jorgensen
- Psychiatric Centre Copenhagen and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - A Jorgensen
- Psychiatric Centre Copenhagen and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - T Bolwig
- Psychiatric Centre Copenhagen and Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - L Emsell
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - P Sienaert
- Academic Center for ECT and Neuromodulation (AcCENT), University Psychiatric Center (UPC) - KU Leuven, Kortenberg, Belgium
| | - F Bouckaert
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Belgium
| | - C C Abbott
- University of New Mexico Department of Psychiatry, 87131, United States of America
| | - P Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - C Arbus
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU Toulouse, Hospital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - A Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU Toulouse, Hospital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - M Kiebs
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; Section of Medical Psychology, University of Bonn, Bonn, Germany; School of Medicine & Health Sciences University Hospital Oldenburg at the Karl-Jaspers Clinic, Germany
| | - A Philipsen
- Section of Medical Psychology, University of Bonn, Bonn, Germany
| | | | | | | | - G Van Wingen
- Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - F Ten Doesschate
- Rijnstate Arnhem, the Netherlands; Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands
| | - J A Camprodon
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - M Kritzer
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
| | - T Barbour
- Massachusetts General Hospital, United States of America
| | - M Argyelan
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States of America
| | - N Cardoner
- Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - M Urretavizcaya
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, Universitat de Barcelona-UB, Barcelona, Spain
| | - C Soriano-Mas
- CIBERSAM, Carlos III Health Institute, Madrid, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Barcelona, Spain; Department of Social Psychology and Quantitative Psychology, Universitat de Barcelona-UB, Barcelona, Spain
| | - K L Narr
- Department of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States of America
| | - R T Espinoza
- Department of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, United States of America
| | - J Prudic
- Columbia University Irving Medical Center, United States of America
| | - S Rowny
- Columbia University Irving Medical Center, United States of America
| | | | - I Tendolkar
- Radboud University, Nijmegen, the Netherlands
| | - A Dols
- Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Amsterdam UMC, location Vumc, Amsterdam, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
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18
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Hahn T, Winter NR, Ernsting J, Gruber M, Mauritz MJ, Fisch L, Leenings R, Sarink K, Blanke J, Holstein V, Emden D, Beisemann M, Opel N, Grotegerd D, Meinert S, Heindel W, Witt S, Rietschel M, Nöthen MM, Forstner AJ, Kircher T, Nenadic I, Jansen A, Müller-Myhsok B, Andlauer TFM, Walter M, van den Heuvel MP, Jamalabadi H, Dannlowski U, Repple J. Genetic, individual, and familial risk correlates of brain network controllability in major depressive disorder. Mol Psychiatry 2023; 28:1057-1063. [PMID: 36639510 PMCID: PMC10005934 DOI: 10.1038/s41380-022-01936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023]
Abstract
Many therapeutic interventions in psychiatry can be viewed as attempts to influence the brain's large-scale, dynamic network state transitions. Building on connectome-based graph analysis and control theory, Network Control Theory is emerging as a powerful tool to quantify network controllability-i.e., the influence of one brain region over others regarding dynamic network state transitions. If and how network controllability is related to mental health remains elusive. Here, from Diffusion Tensor Imaging data, we inferred structural connectivity and inferred calculated network controllability parameters to investigate their association with genetic and familial risk in patients diagnosed with major depressive disorder (MDD, n = 692) and healthy controls (n = 820). First, we establish that controllability measures differ between healthy controls and MDD patients while not varying with current symptom severity or remission status. Second, we show that controllability in MDD patients is associated with polygenic scores for MDD and psychiatric cross-disorder risk. Finally, we provide evidence that controllability varies with familial risk of MDD and bipolar disorder as well as with body mass index. In summary, we show that network controllability is related to genetic, individual, and familial risk in MDD patients. We discuss how these insights into individual variation of network controllability may inform mechanistic models of treatment response prediction and personalized intervention-design in mental health.
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Affiliation(s)
- Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jan Ernsting
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marco J Mauritz
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Faculty of Mathematics and Computer Science, University of Münster, Münster, Germany
| | - Kelvin Sarink
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Julian Blanke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Vincent Holstein
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Daniel Emden
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marie Beisemann
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Interdisciplinary Centre for Clinical Research IZKF, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Walter Heindel
- Institute of Clinical Radiology, University of Münster, Münster, Germany
| | - Stephanie Witt
- Department of Genetic Epidemiology, Central Institute of Mental Health, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology, Central Institute of Mental Health, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Phillips University Marburg, Marburg, Germany
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Phillips University Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Phillips University Marburg, Marburg, Germany.,Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | | | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Martijn P van den Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Child Psychiatry, Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, Phillips University Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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19
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Weigel S, Heindel W, Hense HW, Decker T, Gerß J, Kerschke L. Breast Density and Breast Cancer Screening with Digital Breast Tomosynthesis: A TOSYMA Trial Subanalysis. Radiology 2023; 306:e221006. [PMID: 36194110 DOI: 10.1148/radiol.221006] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Digital breast tomosynthesis (DBT) plus synthesized mammography (SM) reduces the diagnostic pitfalls of tissue superimposition, which is a limitation of digital mammography (DM). Purpose To compare the invasive breast cancer detection rate (iCDR) of DBT plus SM versus DM screening for different breast density categories. Materials and Methods An exploratory subanalysis of the TOmosynthesis plus SYnthesized MAmmography (TOSYMA) study, a randomized, controlled, multicenter, parallel-group trial recruited within the German mammography screening program from July 2018 to December 2020. Women aged 50-69 years were randomly assigned (1:1) to DBT plus SM or DM screening examination. Breast density categories A-D were visually assessed according to the Breast Imaging Reporting and Data System Atlas. Exploratory analyses were performed of the iCDR in both study arms and stratified by breast density, and odds ratios and 95% CIs were determined. Results A total of 49 762 women allocated to DBT plus SM and 49 796 allocated to DM (median age, 57 years [IQR, 53-62 years]) were included. In the DM arm, the iCDR was 3.6 per 1000 screening examinations in category A (almost entirely fatty) (16 of 4475 screenings), 4.3 in category B (102 of 23 534 screenings), 6.1 in category C (116 of 19 051 screenings), and 2.3 in category D (extremely dense breasts) (six of 2629 screenings). The iCDR in the DBT plus SM arm was 2.7 per 1000 screening examinations in category A (12 of 4439 screenings), 6.9 in category B (154 of 22 328 screenings), 8.3 in category C (156 of 18 772 screenings), and 8.1 in category D (32 of 3940 screenings). The odds ratio for DM versus DBT plus SM in category D was 3.8 (95% CI: 1.5, 11.1). The invasive cancers detected with DBT plus SM were most often grade 2 tumors; in category C, it was 58% (91 of 156 invasive cancers), and in category D, it was 47% (15 of 32 invasive cancers). Conclusion The TOmosynthesis plus SYnthesized MAmmography trial revealed higher invasive cancer detection rates with digital breast tomosynthesis plus synthesized mammography than digital mammography in dense breasts, relatively and absolutely most marked among women with extremely dense breasts. ClinicalTrials.gov registration no.: NCT03377036 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Lee and Moy in this issue.
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Affiliation(s)
- Stefanie Weigel
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
| | - Walter Heindel
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
| | - Hans-Werner Hense
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
| | - Thomas Decker
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
| | - Joachim Gerß
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
| | - Laura Kerschke
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
| | -
- From the Clinic for Radiology and Reference Center for Mammography Münster, University of Münster and University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany (S.W., W.H., T.D.); Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany (H.W.H.); and Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany (J.G., L.K.)
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20
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Hahn T, Jamalabadi H, Nozari E, Winter NR, Ernsting J, Gruber M, Mauritz MJ, Grumbach P, Fisch L, Leenings R, Sarink K, Blanke J, Vennekate LK, Emden D, Opel N, Grotegerd D, Enneking V, Meinert S, Borgers T, Klug M, Leehr EJ, Dohm K, Heindel W, Gross J, Dannlowski U, Redlich R, Repple J. Towards a network control theory of electroconvulsive therapy response. PNAS Nexus 2023; 2:pgad032. [PMID: 36874281 PMCID: PMC9982063 DOI: 10.1093/pnasnexus/pgad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/09/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023]
Abstract
Electroconvulsive Therapy (ECT) is arguably the most effective intervention for treatment-resistant depression. While large interindividual variability exists, a theory capable of explaining individual response to ECT remains elusive. To address this, we posit a quantitative, mechanistic framework of ECT response based on Network Control Theory (NCT). Then, we empirically test our approach and employ it to predict ECT treatment response. To this end, we derive a formal association between Postictal Suppression Index (PSI)-an ECT seizure quality index-and whole-brain modal and average controllability, NCT metrics based on white-matter brain network architecture, respectively. Exploiting the known association of ECT response and PSI, we then hypothesized an association between our controllability metrics and ECT response mediated by PSI. We formally tested this conjecture in N = 50 depressive patients undergoing ECT. We show that whole-brain controllability metrics based on pre-ECT structural connectome data predict ECT response in accordance with our hypotheses. In addition, we show the expected mediation effects via PSI. Importantly, our theoretically motivated metrics are at least on par with extensive machine learning models based on pre-ECT connectome data. In summary, we derived and tested a control-theoretic framework capable of predicting ECT response based on individual brain network architecture. It makes testable, quantitative predictions regarding individual therapeutic response, which are corroborated by strong empirical evidence. Our work might constitute a starting point for a comprehensive, quantitative theory of personalized ECT interventions rooted in control theory.
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Affiliation(s)
- Tim Hahn
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
| | - Erfan Nozari
- Department of Mechanical Engineering, University of California, 92521 Riverside, USA
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Jan Ernsting
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany.,Faculty of Mathematics and Computer Science, University of Münster, 48149 Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Marco J Mauritz
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Pascal Grumbach
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany.,Faculty of Mathematics and Computer Science, University of Münster, 48149 Münster, Germany
| | - Kelvin Sarink
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Julian Blanke
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Leon Kleine Vennekate
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Daniel Emden
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany.,Institute for Translational Neuroscience, University of Münster, 48149 Münster, Germany
| | - Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Walter Heindel
- Institute of Clinical Radiology, University of Münster, 48149 Münster, Germany
| | - Joachim Gross
- Institute for Biomagnetism and Biosignalanalysis, University Hospital Münster, 48149 Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany.,Department of Psychology, University of Halle, 06099 Halle (Saale), Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, 48149 Münster, Germany
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21
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Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M. A magnetic resonance imaging based radiomics model to predict mitosis cycles in intracranial meningioma. Sci Rep 2023; 13:969. [PMID: 36653482 PMCID: PMC9849352 DOI: 10.1038/s41598-023-28089-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the 3D Slicer software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
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Affiliation(s)
- Hermann Krähling
- University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Manfred Musigmann
- University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Burak Han Akkurt
- University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | | | | | - Dylan J H A Henssen
- Department of Medical Imaging, Radboud University Medical Center, Radboud University, 6500HB, Nijmegen, The Netherlands
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Walter Heindel
- University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Benjamin Brokinkel
- Department of Neurosurgery, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Manoj Mannil
- University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
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22
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Weigel S, Brehl AK, Heindel W, Kerschke L. Artificial Intelligence for Indication of Invasive Assessment of Calcifications in Mammography Screening. ROFO-FORTSCHR RONTG 2023; 195:38-46. [PMID: 36587613 DOI: 10.1055/a-1967-1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Lesion-related evaluation of the diagnostic performance of an individual artificial intelligence (AI) system to assess mamographically detected and histologically proven calcifications. MATERIALS AND METHODS This retrospective study included 634 women of one screening unit (July 2012 - June 2018) who completed the invasive assessment of calcifications. For each leasion, the AI-system calculated a score between 0 and 98. Lesions scored > 0 were classified as AI-positive. The performance of the system was evaluated based on its positive predictive value of invasive assessment (PPV3), the false-negative rate and the true-negative rate. RESULTS The PPV3 increased across the categories (readers: 4a: 21.2 %, 4b: 57.7 %, 5: 100 %, overall 30.3 %; AI: 4a: 20.8 %, 4b: 57.8 %, 5: 100 %, overall: 30.7 %). The AI system yielded a false-negative rate of 7.2 % (95 %-CI: 4.3 %: 11.4 %) and a true-negative rate of 9.1 % (95 %-CI: 6.6 %; 11.9 %). These rates were highest in category 4a, 12.5 % and 10.4 % retrospectively. The lowest median AI score was observed for benign lesions (61, interquartile range (IQR): 45-74). Invasive cancers yielded the highest median AI score (81, IQR: 64-86). Median AI scores for ductal carcinoma in situ were: 74 (IQR: 63-84) for low grade, 70 (IQR: 52-79) for intermediate grade and 74 (IQR: 66-83) for high grade. CONCLUSION At the lowest threshold, the AI system yielded calcification-related PPV3 values that increased across categories, similar as seen in human evaluation. The strongest loss in AI-based breast cancer detection was observed for invasively assessed calcifications with the lowest suspicion of malignancy, yet with a comparable decrease in the false-positive rate. An AI-score based stratification of malignant lesions could not be determined. KEY POINTS · The AI-based PPV3 for calcifications is comparable to human assessment.. · AI showed a lower detection performance of screen-positive and screen-negative lesions in category 4a.. · Histological subgroups could not be discriminated by AI scores.. CITATION FORMAT · Weigel S, Brehl AK, Heindel W et al. Artificial Intelligence for Indication of Invasive Assessment of Calcifications in Mammography Screening. Fortschr Röntgenstr 2023; 195: 38 - 46.
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Affiliation(s)
- Stefanie Weigel
- Clinic for Radiology and Reference Center for Mammography, University Hospital and University of Münster, Münster, Germany
| | | | - Walter Heindel
- Clinic for Radiology and Reference Center for Mammography, University Hospital and University of Münster, Münster, Germany
| | - Laura Kerschke
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
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23
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Gerwing M, Hoffmann E, Kronenberg K, Hansen U, Masthoff M, Helfen A, Geyer C, Wachsmuth L, Höltke C, Maus B, Hoerr V, Krähling T, Hiddeßen L, Heindel W, Karst U, Kimm MA, Schinner R, Eisenblätter M, Faber C, Wildgruber M. Multiparametric MRI enables for differentiation of different degrees of malignancy in two murine models of breast cancer. Front Oncol 2022; 12:1000036. [PMID: 36408159 PMCID: PMC9667047 DOI: 10.3389/fonc.2022.1000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
Abstract
Objective The objective of this study was to non-invasively differentiate the degree of malignancy in two murine breast cancer models based on identification of distinct tissue characteristics in a metastatic and non-metastatic tumor model using a multiparametric Magnetic Resonance Imaging (MRI) approach. Methods The highly metastatic 4T1 breast cancer model was compared to the non-metastatic 67NR model. Imaging was conducted on a 9.4 T small animal MRI. The protocol was used to characterize tumors regarding their structural composition, including heterogeneity, intratumoral edema and hemorrhage, as well as endothelial permeability using apparent diffusion coefficient (ADC), T1/T2 mapping and dynamic contrast-enhanced (DCE) imaging. Mice were assessed on either day three, six or nine, with an i.v. injection of the albumin-binding contrast agent gadofosveset. Ex vivo validation of the results was performed with laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS), histology, immunhistochemistry and electron microscopy. Results Significant differences in tumor composition were observed over time and between 4T1 and 67NR tumors. 4T1 tumors showed distorted blood vessels with a thin endothelial layer, resulting in a slower increase in signal intensity after injection of the contrast agent. Higher permeability was further reflected in higher Ktrans values, with consecutive retention of gadolinium in the tumor interstitium visible in MRI. 67NR tumors exhibited blood vessels with a thicker and more intact endothelial layer, resulting in higher peak enhancement, as well as higher maximum slope and area under the curve, but also a visible wash-out of the contrast agent and thus lower Ktrans values. A decreasing accumulation of gadolinium during tumor progression was also visible in both models in LA-ICP-MS. Tissue composition of 4T1 tumors was more heterogeneous, with intratumoral hemorrhage and necrosis and corresponding higher T1 and T2 relaxation times, while 67NR tumors mainly consisted of densely packed tumor cells. Histogram analysis of ADC showed higher values of mean ADC, histogram kurtosis, range and the 90th percentile (p90), as markers for the heterogenous structural composition of 4T1 tumors. Principal component analysis (PCA) discriminated well between the two tumor models. Conclusions Multiparametric MRI as presented in this study enables for the estimation of malignant potential in the two studied tumor models via the assessment of certain tumor features over time.
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Affiliation(s)
- Mirjam Gerwing
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
- *Correspondence: Mirjam Gerwing,
| | - Emily Hoffmann
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Katharina Kronenberg
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Uwe Hansen
- Institute for Musculoskeletal Medicine, University of Münster, Münster, Germany
| | - Max Masthoff
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Anne Helfen
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Christiane Geyer
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Lydia Wachsmuth
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Carsten Höltke
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Bastian Maus
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Verena Hoerr
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
- Heart Center Bonn, Department of Internal Medicine II, University of Bonn, Bonn, Germany
| | - Tobias Krähling
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Lena Hiddeßen
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Walter Heindel
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany
| | - Melanie A. Kimm
- Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Regina Schinner
- Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Michel Eisenblätter
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
- Department of Diagnostic and Interventional Radiology, University of Freiburg, Freiburg, Germany
| | - Cornelius Faber
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
| | - Moritz Wildgruber
- Clinic of Radiology, University of Münster, Münster, Germany
- Translational Research Imaging Center, University of Münster, Münster, Germany
- Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
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24
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Sporns PB, Höhne M, Meyer L, Krogias C, Puetz V, Thierfelder KM, Duering M, Kaiser D, Langner S, Brehm A, Rotkopf LT, Kunz WG, Fiehler J, Heindel W, Schramm P, Wiendl H, Minnerup H, Psychogios MN, Kemmling A, Minnerup J. Simplified Assessment of Lesion Water Uptake for Identification of Patients within 4.5 Hours of Stroke
Onset: An Analysis of the MissPerfeCT Study. J Stroke 2022; 24:390-395. [PMID: 36221942 PMCID: PMC9561216 DOI: 10.5853/jos.2022.00220] [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: 01/17/2022] [Accepted: 04/01/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Purpose Many patients with stroke cannot receive intravenous thrombolysis because the time of symptom onset is unknown. We tested whether a simple method of computed tomography (CT)-based quantification of water uptake in the ischemic tissue can identify patients with stroke onset within 4.5 hours. Methods This retrospective analysis of the MissPerfeCT study (August 2009 to November 2017) includes consecutive patients with known onset of symptoms from seven tertiary stroke centers. We developed a simplified algorithm based on region of interest (ROI) measurements to quantify water uptake of the ischemic lesion and thereby quantify time of symptom onset within and beyond 4.5 hours. Perfusion CT was used to identify ischemic brain tissue, and its density was measured in non-contrast CT and related to the density of the corresponding area of the contralateral hemisphere to quantify lesion water uptake. Results Of 263 patients, 204 (77.6%) had CT within 4.5 hours. Water uptake was significantly lower in patients with stroke onset within (6.7%; 95% confidence interval [CI], 6.0% to 7.4%) compared to beyond 4.5 hours (12.7%; 95% CI, 10.7% to 14.7%). The area under the curve for distinguishing these patient groups according to percentage water uptake was 0.744 with an optimal cut-off value of 9.5%. According to this cut-off the positive predictive value was 88.8%, sensitivity was 73.5%, specificity 67.8%, negative predictive value was 42.6%. Conclusions Ischemic stroke patients with unknown time of symptom onset can be identified as being within a timeframe of 4.5 hours using a ROI-based method to assess water uptake on admission non-contrast head CT.
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Affiliation(s)
- Peter B. Sporns
- Department of Neuroradiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Correspondence: Peter B. Sporns Department of Neuroradiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland Tel: 41-61-328-6370 Fax: 41-61-328-6371 E-mail:
| | - Marco Höhne
- Department of Radiology, University Hospital of Münster, Westfaelische Wilhelms-University of Münster, Münster, Germany
| | - Lennart Meyer
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Christos Krogias
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany
| | - Volker Puetz
- Department of Neurology, University Hospital Carl Gustav Carus, Dresden, Germany
- Neurovascular Center Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Kolja M. Thierfelder
- Department of Radiology and Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany
| | - Marco Duering
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Daniel Kaiser
- Neurovascular Center Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
- Institute of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Sönke Langner
- Department of Radiology and Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany
| | - Alex Brehm
- Department of Neuroradiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Lukas T. Rotkopf
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Wolfgang G. Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walter Heindel
- Department of Radiology, University Hospital of Münster, Westfaelische Wilhelms-University of Münster, Münster, Germany
| | - Peter Schramm
- Department of Neuroradiology, University Medical Center Schleswig-Holstein, Lübeck, Germany
| | - Heinz Wiendl
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Heike Minnerup
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Marios Nikos Psychogios
- Department of Neuroradiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - André Kemmling
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Marburg, Marburg University, Marburg, Germany
| | - Jens Minnerup
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
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25
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Noto B, Roll W, Zinken L, Rischen R, Kerschke L, Evers G, Heindel W, Schäfers M, Büther F. Respiratory motion correction in F-18-FDG PET/CT impacts lymph node assessment in lung cancer patients. EJNMMI Res 2022; 12:61. [PMID: 36107357 PMCID: PMC9478021 DOI: 10.1186/s13550-022-00926-7] [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] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUNDS Elastic motion correction in PET has been shown to increase image quality and quantitative measurements of PET datasets affected by respiratory motion. However, little is known on the impact of respiratory motion correction on clinical image evaluation in oncologic PET. This study evaluated the impact of motion correction on expert readers' lymph node assessment of lung cancer patients. METHODS Forty-three patients undergoing F-18-FDG PET/CT for the staging of suspected lung cancer were included. Three different PET reconstructions were investigated: non-motion-corrected ("static"), belt gating-based motion-corrected ("BG-MC") and data-driven gating-based motion-corrected ("DDG-MC"). Assessment was conducted independently by two nuclear medicine specialists blinded to the reconstruction method on a six-point scale [Formula: see text] ranging from "certainly negative" (1) to "certainly positive" (6). Differences in [Formula: see text] between reconstruction methods, accounting for variation caused by readers, were assessed by nonparametric regression analysis of longitudinal data. From [Formula: see text], a dichotomous score for N1, N2, and N3 ("negative," "positive") and a subjective certainty score were derived. SUV and metabolic tumor volumes (MTV) were compared between reconstruction methods. RESULTS BG-MC resulted in higher scores for N1 compared to static (p = 0.001), whereas DDG-MC resulted in higher scores for N2 compared to static (p = 0.016). Motion correction resulted in the migration of N1 from tumor free to metastatic on the dichotomized score, consensually for both readers, in 3/43 cases and in 2 cases for N2. SUV was significantly higher for motion-corrected PET, while MTV was significantly lower (all p < 0.003). No significant differences in the certainty scores were noted. CONCLUSIONS PET motion correction resulted in significantly higher lymph node assessment scores of expert readers. Significant effects on quantitative PET parameters were seen; however, subjective reader certainty was not improved.
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Affiliation(s)
- Benjamin Noto
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Wolfgang Roll
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Laura Zinken
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Robert Rischen
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Laura Kerschke
- grid.5949.10000 0001 2172 9288Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Georg Evers
- grid.16149.3b0000 0004 0551 4246Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Münster, Münster, Germany
| | - Walter Heindel
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Michael Schäfers
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Florian Büther
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany
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26
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Winter NR, Leenings R, Ernsting J, Sarink K, Fisch L, Emden D, Blanke J, Goltermann J, Opel N, Barkhau C, Meinert S, Dohm K, Repple J, Mauritz M, Gruber M, Leehr EJ, Grotegerd D, Redlich R, Jansen A, Nenadic I, Nöthen MM, Forstner A, Rietschel M, Groß J, Bauer J, Heindel W, Andlauer T, Eickhoff SB, Kircher T, Dannlowski U, Hahn T. Quantifying Deviations of Brain Structure and Function in Major Depressive Disorder Across Neuroimaging Modalities. JAMA Psychiatry 2022; 79:879-888. [PMID: 35895072 PMCID: PMC9330277 DOI: 10.1001/jamapsychiatry.2022.1780] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Identifying neurobiological differences between patients with major depressive disorder (MDD) and healthy individuals has been a mainstay of clinical neuroscience for decades. However, recent meta-analyses have raised concerns regarding the replicability and clinical relevance of brain alterations in depression. OBJECTIVE To quantify the upper bounds of univariate effect sizes, estimated predictive utility, and distributional dissimilarity of healthy individuals and those with depression across structural magnetic resonance imaging (MRI), diffusion-tensor imaging, and functional task-based as well as resting-state MRI, and to compare results with an MDD polygenic risk score (PRS) and environmental variables. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional, case-control clinical neuroimaging study. Data were part of the Marburg-Münster Affective Disorders Cohort Study. Patients with depression and healthy controls were recruited from primary care and the general population in Münster and Marburg, Germany. Study recruitment was performed from September 11, 2014, to September 26, 2018. The sample comprised patients with acute and chronic MDD as well as healthy controls in the age range of 18 to 65 years. Data were analyzed from October 29, 2020, to April 7, 2022. MAIN OUTCOMES AND MEASURES Primary analyses included univariate partial effect size (η2), classification accuracy, and distributional overlapping coefficient for healthy individuals and those with depression across neuroimaging modalities, controlling for age, sex, and additional modality-specific confounding variables. Secondary analyses included patient subgroups for acute or chronic depressive status. RESULTS A total of 1809 individuals (861 patients [47.6%] and 948 controls [52.4%]) were included in the analysis (mean [SD] age, 35.6 [13.2] years; 1165 female patients [64.4%]). The upper bound of the effect sizes of the single univariate measures displaying the largest group difference ranged from partial η2 of 0.004 to 0.017, and distributions overlapped between 87% and 95%, with classification accuracies ranging between 54% and 56% across neuroimaging modalities. This pattern remained virtually unchanged when considering either only patients with acute or chronic depression. Differences were comparable with those found for PRS but substantially smaller than for environmental variables. CONCLUSIONS AND RELEVANCE Results of this case-control study suggest that even for maximum univariate biological differences, deviations between patients with MDD and healthy controls were remarkably small, single-participant prediction was not possible, and similarity between study groups dominated. Biological psychiatry should facilitate meaningful outcome measures or predictive approaches to increase the potential for a personalization of the clinical practice.
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Affiliation(s)
- Nils R. Winter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Ramona Leenings
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,University of Münster, Department of Mathematics and Computer Science, Münster, Germany
| | - Jan Ernsting
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,University of Münster, Department of Mathematics and Computer Science, Münster, Germany
| | - Kelvin Sarink
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Lukas Fisch
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Daniel Emden
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Julian Blanke
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Janik Goltermann
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Nils Opel
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Carlotta Barkhau
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Susanne Meinert
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,University of Münster, Institute for Translational Neuroscience, Münster, Germany
| | - Katharina Dohm
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Jonathan Repple
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Marco Mauritz
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Marius Gruber
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Elisabeth J. Leehr
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Dominik Grotegerd
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Ronny Redlich
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,Institute of Psychology, University of Halle, Halle, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Andreas Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany,Centre for Human Genetics, University of Marburg, Marburg, Germany,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Joachim Groß
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Till Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Simon B. Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine (INM-7), Research Centre Jülich, Jülich, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Udo Dannlowski
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Tim Hahn
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
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27
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Lemke H, Klute H, Skupski J, Thiel K, Waltemate L, Winter A, Breuer F, Meinert S, Klug M, Enneking V, Winter NR, Grotegerd D, Leehr EJ, Repple J, Dohm K, Opel N, Stein F, Meller T, Brosch K, Ringwald KG, Pfarr JK, Thomas-Odenthal F, Hahn T, Krug A, Jansen A, Heindel W, Nenadić I, Kircher T, Dannlowski U. Brain structural correlates of recurrence following the first episode in patients with major depressive disorder. Transl Psychiatry 2022; 12:349. [PMID: 36030219 PMCID: PMC9420111 DOI: 10.1038/s41398-022-02113-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022] Open
Abstract
Former prospective studies showed that the occurrence of relapse in Major Depressive Disorder (MDD) is associated with volume loss in the insula, hippocampus and dorsolateral prefrontal cortex (DLPFC). However, these studies were confounded by the patient's lifetime disease history, as the number of previous episodes predict future recurrence. In order to analyze neural correlates of recurrence irrespective of prior disease course, this study prospectively examined changes in brain structure in patients with first-episode depression (FED) over 2 years. N = 63 FED patients and n = 63 healthy controls (HC) underwent structural magnetic resonance imaging at baseline and after 2 years. According to their disease course during the follow-up interval, patients were grouped into n = 21 FED patients with recurrence (FEDrec) during follow-up and n = 42 FED patients with stable remission (FEDrem). Gray matter volume changes were analysed using group by time interaction analyses of covariance for the DLPFC, hippocampus and insula. Significant group by time interactions in the DLPFC and insula emerged. Pairwise comparisons showed that FEDrec had greater volume decline in the DLPFC and insula from baseline to follow-up compared with FEDrem and HC. No group by time interactions in the hippocampus were found. Cross-sectional analyses at baseline and follow-up revealed no differences between groups. This longitudinal study provides evidence for neural alterations in the DLPFC and insula related to a detrimental course in MDD. These effects of recurrence are already detectable at initial stages of MDD and seem to occur without any prior disease history, emphasizing the importance of early interventions preventing depressive recurrence.
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Affiliation(s)
- Hannah Lemke
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Klute
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jennifer Skupski
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Thiel
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Fabian Breuer
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Melissa Klug
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils R. Winter
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J. Leehr
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Frederike Stein
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tina Meller
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Kai G. Ringwald
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Julia-Katharina Pfarr
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Florian Thomas-Odenthal
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tim Hahn
- grid.5949.10000 0001 2172 9288Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Axel Krug
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Andreas Jansen
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Walter Heindel
- grid.5949.10000 0001 2172 9288University Clinic for Radiology, University of Münster, Münster, Germany
| | - Igor Nenadić
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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Patel Y, Shin J, Abé C, Agartz I, Alloza C, Alnæs D, Ambrogi S, Antonucci LA, Arango C, Arolt V, Auzias G, Ayesa-Arriola R, Banaj N, Banaschewski T, Bandeira C, Başgöze Z, Cupertino RB, Bau CHD, Bauer J, Baumeister S, Bernardoni F, Bertolino A, Bonnin CDM, Brandeis D, Brem S, Bruggemann J, Bülow R, Bustillo JR, Calderoni S, Calvo R, Canales-Rodríguez EJ, Cannon DM, Carmona S, Carr VJ, Catts SV, Chenji S, Chew QH, Coghill D, Connolly CG, Conzelmann A, Craven AR, Crespo-Facorro B, Cullen K, Dahl A, Dannlowski U, Davey CG, Deruelle C, Díaz-Caneja CM, Dohm K, Ehrlich S, Epstein J, Erwin-Grabner T, Eyler LT, Fedor J, Fitzgerald J, Foran W, Ford JM, Fortea L, Fuentes-Claramonte P, Fullerton J, Furlong L, Gallagher L, Gao B, Gao S, Goikolea JM, Gotlib I, Goya-Maldonado R, Grabe HJ, Green M, Grevet EH, Groenewold NA, Grotegerd D, Gruber O, Haavik J, Hahn T, Harrison BJ, Heindel W, Henskens F, Heslenfeld DJ, Hilland E, Hoekstra PJ, Hohmann S, Holz N, Howells FM, Ipser JC, Jahanshad N, Jakobi B, Jansen A, Janssen J, Jonassen R, Kaiser A, Kaleda V, Karantonis J, King JA, Kircher T, Kochunov P, Koopowitz SM, Landén M, Landrø NI, Lawrie S, Lebedeva I, Luna B, Lundervold AJ, MacMaster FP, Maglanoc LA, Mathalon DH, McDonald C, McIntosh A, Meinert S, Michie PT, Mitchell P, Moreno-Alcázar A, Mowry B, Muratori F, Nabulsi L, Nenadić I, O'Gorman Tuura R, Oosterlaan J, Overs B, Pantelis C, Parellada M, Pariente JC, Pauli P, Pergola G, Piarulli FM, Picon F, Piras F, Pomarol-Clotet E, Pretus C, Quidé Y, Radua J, Ramos-Quiroga JA, Rasser PE, Reif A, Retico A, Roberts G, Rossell S, Rovaris DL, Rubia K, Sacchet M, Salavert J, Salvador R, Sarró S, Sawa A, Schall U, Scott R, Selvaggi P, Silk T, Sim K, Skoch A, Spalletta G, Spaniel F, Stein DJ, Steinsträter O, Stolicyn A, Takayanagi Y, Tamm L, Tavares M, Teumer A, Thiel K, Thomopoulos SI, Tomecek D, Tomyshev AS, Tordesillas-Gutiérrez D, Tosetti M, Uhlmann A, Van Rheenen T, Vazquez-Bourgón J, Vernooij MW, Vieta E, Vilarroya O, Weickert C, Weickert T, Westlye LT, Whalley H, Willinger D, Winter A, Wittfeld K, Yang TT, Yoncheva Y, Zijlmans JL, Hoogman M, Franke B, van Rooij D, Buitelaar J, Ching CRK, Andreassen OA, Pozzi E, Veltman D, Schmaal L, van Erp TGM, Turner J, Castellanos FX, Pausova Z, Thompson P, Paus T. Virtual Ontogeny of Cortical Growth Preceding Mental Illness. Biol Psychiatry 2022; 92:299-313. [PMID: 35489875 PMCID: PMC11080987 DOI: 10.1016/j.biopsych.2022.02.959] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/02/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Morphology of the human cerebral cortex differs across psychiatric disorders, with neurobiology and developmental origins mostly undetermined. Deviations in the tangential growth of the cerebral cortex during pre/perinatal periods may be reflected in individual variations in cortical surface area later in life. METHODS Interregional profiles of group differences in surface area between cases and controls were generated using T1-weighted magnetic resonance imaging from 27,359 individuals including those with attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, schizophrenia, and high general psychopathology (through the Child Behavior Checklist). Similarity of interregional profiles of group differences in surface area and prenatal cell-specific gene expression was assessed. RESULTS Across the 11 cortical regions, group differences in cortical area for attention-deficit/hyperactivity disorder, schizophrenia, and Child Behavior Checklist were dominant in multimodal association cortices. The same interregional profiles were also associated with interregional profiles of (prenatal) gene expression specific to proliferative cells, namely radial glia and intermediate progenitor cells (greater expression, larger difference), as well as differentiated cells, namely excitatory neurons and endothelial and mural cells (greater expression, smaller difference). Finally, these cell types were implicated in known pre/perinatal risk factors for psychosis. Genes coexpressed with radial glia were enriched with genes implicated in congenital abnormalities, birth weight, hypoxia, and starvation. Genes coexpressed with endothelial and mural genes were enriched with genes associated with maternal hypertension and preterm birth. CONCLUSIONS Our findings support a neurodevelopmental model of vulnerability to mental illness whereby prenatal risk factors acting through cell-specific processes lead to deviations from typical brain development during pregnancy.
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Affiliation(s)
- Yash Patel
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Jean Shin
- The Hospital for Sick Children and Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Christoph Abé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Dag Alnæs
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Linda A Antonucci
- Departments of Education Science, Psychology, Communication Science, University of Bari Aldo Moro, Bari, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Guillaume Auzias
- National Centre for Scientific Research, Aix-Marseille University, Marseille, France
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marques de Valdecilla University Hospital, Instituto de Investigación Valdecilla, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cibele Bandeira
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Zeynep Başgöze
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jochen Bauer
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Alessandro Bertolino
- Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Caterina Del Mar Bonnin
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zürich, Zurich, Switzerland
| | | | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Juan R Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, New Mexico
| | - Sara Calderoni
- Department of Developmental Neuroscience, Scientific Institute for Research, Hospitalization and Healthcare Stella Maris Foundation, Pisa, Italy
| | - Rosa Calvo
- Institute of Neuroscience, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, Barcelona, Spain
| | | | - Dara M Cannon
- Clinical Neuroimaging Lab, Center for Neuroimaging, Cognition and Genomics, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Susanna Carmona
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Stanley V Catts
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Sneha Chenji
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Qian Hui Chew
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - David Coghill
- Department of Paediatrics, Department of Psychiatry, University of Melbourne, Parkville, Australia; Department of Psychiatry, Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Colm G Connolly
- Department of Biomedical Sciences, Florida State University, Tallahassee, Florida
| | - Annette Conzelmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Virgen del Rocio University Hospital, Universidad de Sevilla, Instituto de Biomedicina de Sevilla, CIBERSAM, Sevilla, Spain
| | - Kathryn Cullen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Andreas Dahl
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Christopher G Davey
- Department of Psychiatry, Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Christine Deruelle
- National Centre for Scientific Research, Aix-Marseille University, Marseille, France
| | | | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Jeffery Epstein
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Tracy Erwin-Grabner
- Laboratory of Systems Neuroscience and Imaging in Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Jennifer Fedor
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacqueline Fitzgerald
- Trinity Institute of Neuroscience, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - William Foran
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Judith M Ford
- San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | | | - Lisa Furlong
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Louise Gallagher
- Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Bingchen Gao
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California
| | - Si Gao
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jose M Goikolea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Ian Gotlib
- Department of Psychology, Stanford University, Stanford, California
| | - Roberto Goya-Maldonado
- Laboratory of Systems Neuroscience and Imaging in Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | | | - Eugenio H Grevet
- Department of Psychiatry, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Nynke A Groenewold
- Department of Psychiatry & Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Frans Henskens
- School of Medicine & Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Dirk J Heslenfeld
- Experimental and Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eva Hilland
- Norwegian Centre for Mental Disorders Research NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nathalie Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Fleur M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jonathan C Ipser
- Department of Psychiatry & Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Neda Jahanshad
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, California
| | - Babette Jakobi
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andreas Jansen
- Core Facility Brain imaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Rune Jonassen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - James Karantonis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Joseph A King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Tilo Kircher
- Department of Psychiatry, Marburg University, Marburg, Germany
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sheri-Michelle Koopowitz
- Department of Psychiatry & Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Mikael Landén
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | | | - Stephen Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Frank P MacMaster
- Departments of Psychiatry and Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Luigi A Maglanoc
- Department for Data Capture and Collections Management, University Center for Information Technology, University of Oslo, Oslo, Norway
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California
| | - Colm McDonald
- Galway Neuroscience Centre, Center for Neuroimaging, Cognition and Genomics, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Andrew McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Patricia T Michie
- School of Psychology, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Ana Moreno-Alcázar
- FIDMAG Germanes Hospitalàries Research Foundation, Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Bryan Mowry
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Filippo Muratori
- Department of Developmental Neuroscience, Scientific Institute for Research, Hospitalization and Healthcare Stella Maris Foundation, Pisa, Italy
| | - Leila Nabulsi
- Clinical Neuroimaging Lab, Center for Neuroimaging, Cognition and Genomics, Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | | | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton South, Victoria, Australia
| | - Mara Parellada
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Jose C Pariente
- Magnetic Resonance Imaging core facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Giulio Pergola
- Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Maria Piarulli
- Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Felipe Picon
- Graduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | | | - Clara Pretus
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paul E Rasser
- Priority Centre for Brain & Mental Health Research, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt am Main, Germany
| | | | | | - Susan Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia
| | - Diego Luiz Rovaris
- Department of Physiology and Biophysics, Instituto de Ciencias Biomédicas Universidade de São Paulo, São Paulo, Brazil
| | - Katya Rubia
- Child & Adolescent Psychiatry, King's College London, London, United Kingdom
| | - Matthew Sacchet
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Josep Salavert
- FIDMAG Germanes Hospitalàries Research Foundation, Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | | | | | - Akira Sawa
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ulrich Schall
- Priority Centre for Brain & Mental Health Research, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Rodney Scott
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Pierluigi Selvaggi
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Tim Silk
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
| | - Antonin Skoch
- National Institute of Mental Health, Klecany, Czech Republic
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic
| | - Dan J Stein
- Department of Psychiatry & Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Olaf Steinsträter
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Aleks Stolicyn
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Leanne Tamm
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Maria Tavares
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Sophia I Thomopoulos
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, California
| | - David Tomecek
- National Institute of Mental Health, Klecany, Czech Republic
| | | | - Diana Tordesillas-Gutiérrez
- Department of Radiology, University Hospital Marqués de Valdecilla, Instituto de Investigación Valdecilla, Santander, Spain
| | - Michela Tosetti
- Laboratory of Medical Physics and Magnetic Resonance, Scientific Institute for Research, Hospitalization and Healthcare Stella Maris Foundation, Pisa, Italy
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Tamsyn Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Javier Vazquez-Bourgón
- Department of Psychiatry, Marques de Valdecilla University Hospital, Instituto de Investigación Valdecilla, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eduard Vieta
- Institute of Neuroscience, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, Barcelona, Spain
| | - Oscar Vilarroya
- Department of Psychiatry, Autonomous University of Barcelona, Cerdanyola del Valles, Spain
| | - Cynthia Weickert
- Department of Neuroscience and Physiology, University of New South Wales, Sydney, Australia
| | | | - Lars T Westlye
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Heather Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - David Willinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zürich, Zurich, Switzerland
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Germany
| | - Tony T Yang
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California San Francisco, San Francisco, California
| | | | - Jendé L Zijlmans
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martine Hoogman
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christopher R K Ching
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, California
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Elena Pozzi
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Dick Veltman
- Department of Psychiatry, Amsterdam UMC, VUMC, Amsterdam, The Netherlands
| | - Lianne Schmaal
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California
| | | | | | - Zdenka Pausova
- The Hospital for Sick Children and Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Paul Thompson
- Imaging Genetics Center, USC Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, California
| | - Tomas Paus
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montréal, Montreal, Quebec, Canada.
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Musigmann M, Akkurt BH, Krähling H, Nacul NG, Remonda L, Sartoretti T, Henssen D, Brokinkel B, Stummer W, Heindel W, Mannil M. Testing the applicability and performance of Auto ML for potential applications in diagnostic neuroradiology. Sci Rep 2022; 12:13648. [PMID: 35953588 PMCID: PMC9366823 DOI: 10.1038/s41598-022-18028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
To investigate the applicability and performance of automated machine learning (AutoML) for potential applications in diagnostic neuroradiology. In the medical sector, there is a rapidly growing demand for machine learning methods, but only a limited number of corresponding experts. The comparatively simple handling of AutoML should enable even non-experts to develop adequate machine learning models with manageable effort. We aim to investigate the feasibility as well as the advantages and disadvantages of developing AutoML models compared to developing conventional machine learning models. We discuss the results in relation to a concrete example of a medical prediction application. In this retrospective IRB-approved study, a cohort of 107 patients who underwent gross total meningioma resection and a second cohort of 31 patients who underwent subtotal resection were included. Image segmentation of the contrast enhancing parts of the tumor was performed semi-automatically using the open-source software platform 3D Slicer. A total of 107 radiomic features were extracted by hand-delineated regions of interest from the pre-treatment MRI images of each patient. Within the AutoML approach, 20 different machine learning algorithms were trained and tested simultaneously. For comparison, a neural network and different conventional machine learning algorithms were trained and tested. With respect to the exemplary medical prediction application used in this study to evaluate the performance of Auto ML, namely the pre-treatment prediction of the achievable resection status of meningioma, AutoML achieved remarkable performance nearly equivalent to that of a feed-forward neural network with a single hidden layer. However, in the clinical case study considered here, logistic regression outperformed the AutoML algorithm. Using independent test data, we observed the following classification results (AutoML/neural network/logistic regression): mean area under the curve = 0.849/0.879/0.900, mean accuracy = 0.821/0.839/0.881, mean kappa = 0.465/0.491/0.644, mean sensitivity = 0.578/0.577/0.692 and mean specificity = 0.891/0.914/0.936. The results obtained with AutoML are therefore very promising. However, the AutoML models in our study did not yet show the corresponding performance of the best models obtained with conventional machine learning methods. While AutoML may facilitate and simplify the task of training and testing machine learning algorithms as applied in the field of neuroradiology and medical imaging, a considerable amount of expert knowledge may still be needed to develop models with the highest possible discriminatory power for diagnostic neuroradiology.
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Affiliation(s)
- Manfred Musigmann
- University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Burak Han Akkurt
- University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Hermann Krähling
- University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Nabila Gala Nacul
- University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Luca Remonda
- Institute of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland.,Faculty of Medicine, University of Bern, Bern, Switzerland
| | | | - Dylan Henssen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Benjamin Brokinkel
- Department of Neurosurgery, Westfälische Wilhelms-University Muenster and University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Walter Stummer
- Department of Neurosurgery, Westfälische Wilhelms-University Muenster and University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Walter Heindel
- University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Manoj Mannil
- University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
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30
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Ottow C, Schmidt S, Schulz R, Sottmann L, Heindel W, Krähling T, Pfeiffer H, Vieth V, Schmeling A. Forensische Altersdiagnostik mittels Niederfeld-Magnetresonanztomographie. Rechtsmedizin (Berl) 2022. [DOI: 10.1007/s00194-022-00588-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Zusammenfassung
Hintergrund
Ein rechtlich zulässiges medizinisches Altersfeststellungsverfahren mit möglichst schonenden und zuverlässigen Methoden bei unbegleiteten und fraglich minderjährigen Ausländern ist erforderlich, um den tatsächlich Minderjährigen den für sie gesetzlich vorgesehenen besonderen Schutz zukommen zu lassen.
Ziel der Arbeit
Studiendesign und erste Ergebnisse einer Studie zur forensischen Altersdiagnostik mittels Niederfeld-Magnetresonanztomographie werden vorgestellt.
Material und Methoden
Geplant ist die prospektive Untersuchung von 650 Studienteilnehmenden, gleichmäßig verteilt innerhalb der Altersgruppe 12 bis 24 Jahre zu je 25 Personen je Geschlecht. Es sollen Entwicklungsstadien von distalem Radius, distaler Ulna, distalem Femur und proximaler Tibia mithilfe eines 0,31-Tesla(T)-Niederfeld-MRT-Scanners erfasst und mittels Anwendung der Vieth-Klassifikation ausgewertet werden.
Ergebnisse
Nach Auswertung der Untersuchungen der bisher 487 untersuchten Studienteilnehmenden ist ersichtlich, dass die gewählten Sequenzen die für die Vieth-Klassifikation relevanten Charakteristika der Ossifikation der untersuchten Epiphysen erfassen. Die Untersuchungen erweisen sich überdies als einfach in der Durchführung.
Schlussfolgerung
Untersuchungen zur forensischen Altersschätzung am Lebenden unter Anwendung der Vieth-Klassifikation sind mit Niederfeld-MRT-Scannern bei einer Feldstärke von 0,31 T durchführbar. Es bleibt zu klären, ob die mit einem 0,31-T-Niederfeld-MRT-Scanner nachweisbaren Ossifikationsmerkmale am Handgelenk und am Knie einen zweifelsfreien Volljährigkeitsnachweis erlauben.
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Bobe C, Böhmer FM, Al-Itaibi R, Helfen A, Heindel W. Fehlender Uterus? – Lageanomalie im Rahmen eines
Mayer-Rokitansky-Küster-Hauser-Syndroms. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1756616] [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)
- C Bobe
- Klinik für Radiologie, Universitätsklinik
Münster, Münster
| | - F M Böhmer
- Klinik für Radiologie, Universitätsklinikum
Münster, Münster
| | - R Al-Itaibi
- Klinik für Radiologie, Universitätsklinik
Münster, Münster
| | - A Helfen
- Klinik für Radiologie, Universitätsklinikum
Münster, Münster
| | - W Heindel
- Klinik für Radiologie, Universitätsklinikum
Münster, Münster
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Mammadov O, Akkurt BH, Musigmann M, Ari AP, Blömer DA, Kasap DN, Henssen DJ, Nacul NG, Sartoretti E, Sartoretti T, Backhaus P, Thomas C, Stummer W, Heindel W, Mannil M. Radiomics for pseudoprogression prediction in high grade gliomas: added value of MR contrast agent. Heliyon 2022; 8:e10023. [PMID: 35965975 PMCID: PMC9364026 DOI: 10.1016/j.heliyon.2022.e10023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/04/2022] [Accepted: 07/18/2022] [Indexed: 10/31/2022] Open
Abstract
Objective Material & methods Results Conclusion Radiomics allows for prediction of pseudoprogression in high-grade gliomas. Use of contrast media boosts the performance of the Radiomics prediction model.
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33
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Krichbaum J, Heindel W, Stracke P. Die juguläre Variante des Eagle Syndroms. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1756575] [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: 11/07/2022]
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Heindel W, Weigel S, Hense HW. Surrogate endpoints in breast cancer screening trials – Authors' reply. Lancet Oncol 2022; 23:e361. [DOI: 10.1016/s1470-2045(22)00396-5] [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] [Received: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 10/16/2022]
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35
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Burg CM, Backhaus P, Tio J, Neri D, Cazzamalli S, Heindel W, Schäfers M. Erste Erfahrungen mit dem neuen Liganden 68Ga-OncoFAP zur Darstellung des Fibroblasten-Aktivierungs-Protein (FAP) im Brustkrebs-Staging mittels PET-MRT. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749847] [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)
- C M Burg
- Universitätsklinikum Münster, Klinik für Radiologie, Münster
| | - P Backhaus
- Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster
| | - J Tio
- Universitätsklinikum Münster, Klinik für Frauenheilkunde und Geburtshilfe, Bereich Senologie, Münster
| | - D Neri
- Department Chemie und angewandte Biowissenschaften, ETH Zürich und Philogen SpA, Zürich, Schweiz und Siena, Italien
| | | | - W Heindel
- Universitätsklinikum Münster, Klinik für Radiologie, Münster
| | - M Schäfers
- Universitätsklinikum Münster, Klinik für Nuklearmedizin, Münster
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36
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Auf der Springe K, Stamm CA, Schiborr M, Heindel W. Leber- Milz- und Knochenmarkbefall als seltene Manifestationen einer
Bartonella henselae-Infektion. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1756610] [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)
- K Auf der Springe
- Universitätsklinikum Münster, Inst. f. klinische
Radiologie -Klinik f. Nuklearm., Münster
| | - C A Stamm
- Institut für Klinische Radiologie, Universitätsklinikum
Münster, Münster
| | - M Schiborr
- Klinik für Radiologie, Universitätsklinikum
Münster, Münster
| | - W Heindel
- Klinik für Radiologie, Universitätsklinikum
Münster, Münster
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37
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Lemke H, Romankiewicz L, Förster K, Meinert S, Waltemate L, Fingas SM, Grotegerd D, Redlich R, Dohm K, Leehr EJ, Thiel K, Enneking V, Brosch K, Meller T, Ringwald K, Schmitt S, Stein F, Steinsträter O, Bauer J, Heindel W, Jansen A, Krug A, Nenadic I, Kircher T, Dannlowski U. Association of disease course and brain structural alterations in major depressive disorder. Depress Anxiety 2022; 39:441-451. [PMID: 35485921 DOI: 10.1002/da.23260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/22/2021] [Accepted: 04/16/2022] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The investigation of disease course-associated brain structural alterations in Major Depressive Disorder (MDD) have resulted in heterogeneous findings, possibly due to low reliability of single clinical variables used for defining disease course. The present study employed a principal component analysis (PCA) on multiple clinical variables to investigate effects of cumulative lifetime illness burden on brain structure in a large and heterogeneous sample of MDD patients. METHODS Gray matter volumes (GMV) was estimated in n = 681 MDD patients (mean age: 35.87 years; SD = 12.89; 66.6% female) using voxel-based-morphometry. Five clinical variables were included in a PCA to obtain components reflecting disease course to associate resulting components with GMVs. RESULTS The PCA yielded two main components: Hospitalization reflected by patients' frequency and duration of inpatient treatment and Duration of Illness reflected by the frequency and duration of depressive episodes. Hospitalization revealed negative associations with bilateral dorsolateral prefrontal cortex (DLPFC) and left insula volumes. Duration of Illness showed significant negative associations with left hippocampus and right DLPFC volumes. Results in the DLPFC and hippocampus remained significant after additional control for depressive symptom severity, psychopharmacotherapy, psychiatric comorbidities, and remission status. CONCLUSION This study shows that a more severe and chronic lifetime disease course in MDD is associated with reduced volume in brain regions relevant for executive and cognitive functions and emotion regulation in a large sample of patients representing the broad heterogeneity of MDD disease course. These findings were only partly influenced by other clinical characteristics (e.g., remission status, psychopharmacological treatment).
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Affiliation(s)
- Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lina Romankiewicz
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Förster
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Stella M Fingas
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.,Department of Psychology, University of Halle, Halle, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Brosch
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Kai Ringwald
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | | | | | - Walter Heindel
- University Clinic for Radiology, University of Münster, Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry, University of Marburg, Marburg, Germany.,Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Igor Nenadic
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
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38
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Brouwer RM, Klein M, Grasby KL, Schnack HG, Jahanshad N, Teeuw J, Thomopoulos SI, Sprooten E, Franz CE, Gogtay N, Kremen WS, Panizzon MS, Olde Loohuis LM, Whelan CD, Aghajani M, Alloza C, Alnæs D, Artiges E, Ayesa-Arriola R, Barker GJ, Bastin ME, Blok E, Bøen E, Breukelaar IA, Bright JK, Buimer EEL, Bülow R, Cannon DM, Ciufolini S, Crossley NA, Damatac CG, Dazzan P, de Mol CL, de Zwarte SMC, Desrivières S, Díaz-Caneja CM, Doan NT, Dohm K, Fröhner JH, Goltermann J, Grigis A, Grotegerd D, Han LKM, Harris MA, Hartman CA, Heany SJ, Heindel W, Heslenfeld DJ, Hohmann S, Ittermann B, Jansen PR, Janssen J, Jia T, Jiang J, Jockwitz C, Karali T, Keeser D, Koevoets MGJC, Lenroot RK, Malchow B, Mandl RCW, Medel V, Meinert S, Morgan CA, Mühleisen TW, Nabulsi L, Opel N, de la Foz VOG, Overs BJ, Paillère Martinot ML, Redlich R, Marques TR, Repple J, Roberts G, Roshchupkin GV, Setiaman N, Shumskaya E, Stein F, Sudre G, Takahashi S, Thalamuthu A, Tordesillas-Gutiérrez D, van der Lugt A, van Haren NEM, Wardlaw JM, Wen W, Westeneng HJ, Wittfeld K, Zhu AH, Zugman A, Armstrong NJ, Bonfiglio G, Bralten J, Dalvie S, Davies G, Di Forti M, Ding L, Donohoe G, Forstner AJ, Gonzalez-Peñas J, Guimaraes JPOFT, Homuth G, Hottenga JJ, Knol MJ, Kwok JBJ, Le Hellard S, Mather KA, Milaneschi Y, Morris DW, Nöthen MM, Papiol S, Rietschel M, Santoro ML, Steen VM, Stein JL, Streit F, Tankard RM, Teumer A, van 't Ent D, van der Meer D, van Eijk KR, Vassos E, Vázquez-Bourgon J, Witt SH, Adams HHH, Agartz I, Ames D, Amunts K, Andreassen OA, Arango C, Banaschewski T, Baune BT, Belangero SI, Bokde ALW, Boomsma DI, Bressan RA, Brodaty H, Buitelaar JK, Cahn W, Caspers S, Cichon S, Crespo-Facorro B, Cox SR, Dannlowski U, Elvsåshagen T, Espeseth T, Falkai PG, Fisher SE, Flor H, Fullerton JM, Garavan H, Gowland PA, Grabe HJ, Hahn T, Heinz A, Hillegers M, Hoare J, Hoekstra PJ, Ikram MA, Jackowski AP, Jansen A, Jönsson EG, Kahn RS, Kircher T, Korgaonkar MS, Krug A, Lemaitre H, Malt UF, Martinot JL, McDonald C, Mitchell PB, Muetzel RL, Murray RM, Nees F, Nenadić I, Oosterlaan J, Ophoff RA, Pan PM, Penninx BWJH, Poustka L, Sachdev PS, Salum GA, Schofield PR, Schumann G, Shaw P, Sim K, Smolka MN, Stein DJ, Trollor JN, van den Berg LH, Veldink JH, Walter H, Westlye LT, Whelan R, White T, Wright MJ, Medland SE, Franke B, Thompson PM, Hulshoff Pol HE. Genetic variants associated with longitudinal changes in brain structure across the lifespan. Nat Neurosci 2022; 25:421-432. [PMID: 35383335 PMCID: PMC10040206 DOI: 10.1038/s41593-022-01042-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 02/28/2022] [Indexed: 02/08/2023]
Abstract
Human brain structure changes throughout the lifespan. Altered brain growth or rates of decline are implicated in a vast range of psychiatric, developmental and neurodegenerative diseases. In this study, we identified common genetic variants that affect rates of brain growth or atrophy in what is, to our knowledge, the first genome-wide association meta-analysis of changes in brain morphology across the lifespan. Longitudinal magnetic resonance imaging data from 15,640 individuals were used to compute rates of change for 15 brain structures. The most robustly identified genes GPR139, DACH1 and APOE are associated with metabolic processes. We demonstrate global genetic overlap with depression, schizophrenia, cognitive functioning, insomnia, height, body mass index and smoking. Gene set findings implicate both early brain development and neurodegenerative processes in the rates of brain changes. Identifying variants involved in structural brain changes may help to determine biological pathways underlying optimal and dysfunctional brain development and aging.
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Affiliation(s)
- Rachel M Brouwer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU Amsterdam, Amsterdam, The Netherlands.
| | - Marieke Klein
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Katrina L Grasby
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Hugo G Schnack
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, The Netherlands
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Jalmar Teeuw
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carol E Franz
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Nitin Gogtay
- American Psychiatric Association, Washington, DC, USA
| | - William S Kremen
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
- VA San Diego Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Matthew S Panizzon
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Loes M Olde Loohuis
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Moji Aghajani
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden University, Leiden, The Netherlands
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Dag Alnæs
- NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Eric Artiges
- INSERM U1299 Trajectoires Développementales en Psychiatrie, Ecole Normale Supérieure Paris-Saclay, Université Paris Saclay, Université Paris Cité, CNRS UMR 9010; Centre Borelli, Gif-sur-Yvette, France
| | - Rosa Ayesa-Arriola
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital (HUMV), School of Medicine, University of Cantabria, Santander, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Santander, Spain
- Universidad de Cantabria, Santander, Spain
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mark E Bastin
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging, University of Edinburgh, Edinburgh, UK
| | - Elisabet Blok
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erlend Bøen
- Psychosomatic and CL Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Isabella A Breukelaar
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
| | - Joanna K Bright
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Elizabeth E L Buimer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Dara M Cannon
- Centre for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Simone Ciufolini
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nicolas A Crossley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Christienne G Damatac
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Casper L de Mol
- Department of Neurology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sonja M C de Zwarte
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Sylvane Desrivières
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | | | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Juliane H Fröhner
- Section of Systems Neuroscience, Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Antoine Grigis
- Université Paris-Saclay, CEA, Neurospin, Gif-sur-Yvette, France
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Laura K M Han
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Mathew A Harris
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Sarah J Heany
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Walter Heindel
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | - Dirk J Heslenfeld
- Departments of Experimental and Clinical Psychology, Amsterdam, The Netherlands
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Philip R Jansen
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU Amsterdam, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Human Genetics, VUmc, Amsterdam UMC, Amsterdam, The Netherlands
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Tianye Jia
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Science and Technology for Brain-Inspired Intelligence and MoE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, SGDP Centre, King's College London, London, UK
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Christiane Jockwitz
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Temmuz Karali
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
- Munich Center for Neurosciences (MCN) - Brain & Mind, Planegg-Martinsried, Germany
| | - Martijn G J C Koevoets
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- School of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, NM, USA
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - René C W Mandl
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Vicente Medel
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Catherine A Morgan
- School of Psychology and Centre for Brain Research, University of Auckland, Auckland, New Zealand
- Brain Research New Zealand - Rangahau Roro Aotearoa, Auckland, New Zealand
| | - Thomas W Mühleisen
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Cécile and Oskar Vogt Institute for Brain Research, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Leila Nabulsi
- Centre for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Víctor Ortiz-García de la Foz
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital (HUMV), School of Medicine, University of Cantabria, Santander, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Santander, Spain
- Neuroimaging Unit, Technological Facilities, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
| | | | - Marie-Laure Paillère Martinot
- INSERM U1299 Trajectoires Développementales en Psychiatrie, Ecole Normale Supérieure Paris-Saclay, Université Paris Saclay, Université Paris Cité, CNRS UMR 9010; Centre Borelli, Gif-sur-Yvette, France
- APHP, Sorbonne Université, Pitie-Salpetriere Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychology, University of Halle, Halle, Germany
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), Imperial College London, London, UK
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Gennady V Roshchupkin
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nikita Setiaman
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elena Shumskaya
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Gustavo Sudre
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Shun Takahashi
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, IDIVAL, Marqués de Valdecilla University Hospital, Santander, Spain
- Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander, Spain
| | - Aad van der Lugt
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Joanna M Wardlaw
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences and UK Dementia Research Institute Centre, University of Edinburgh, Edinburgh, UK
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Henk-Jan Westeneng
- Department of Neurology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Alyssa H Zhu
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Andre Zugman
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
| | | | - Gaia Bonfiglio
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU Amsterdam, Amsterdam, The Netherlands
| | - Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Shareefa Dalvie
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Gail Davies
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Linda Ding
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition and Genomics (NICOG), School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | - Andreas J Forstner
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Centre for Human Genetics, Philipps-University Marburg, Marburg, Germany
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Javier Gonzalez-Peñas
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Joao P O F T Guimaraes
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maria J Knol
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John B J Kwok
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Stephanie Le Hellard
- NORMENT Centre of Excellence, Department of Clinical Science, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Karen A Mather
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Derek W Morris
- Centre for Neuroimaging, Cognition and Genomics (NICOG), School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Sergi Papiol
- CIBERSAM, Biomedical Research Network on Mental Health Area, Santander, Spain
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital LMU, Munich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marcos L Santoro
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
- Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Vidar M Steen
- NORMENT Centre of Excellence, Department of Clinical Science, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Jason L Stein
- Department of Genetics & UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fabian Streit
- Department of Genetic Epidemiology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Rick M Tankard
- Mathematics and Statistics, Curtin University, Perth, WA, Australia
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Dennis van 't Ent
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Dennis van der Meer
- NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Kristel R van Eijk
- Department of Neurology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Trust, London, UK
| | - Javier Vázquez-Bourgon
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital (HUMV), School of Medicine, University of Cantabria, Santander, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Santander, Spain
- Universidad de Cantabria, Santander, Spain
| | - Stephanie H Witt
- Department of Genetic Epidemiology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Hieab H H Adams
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
| | - Ingrid Agartz
- NORMENT Centre, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - David Ames
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, VIC, Australia
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Cécile and Oskar Vogt Institute for Brain Research, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ole A Andreassen
- NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Melbourne, Melbourne VIC, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Sintia I Belangero
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
- Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Arun L W Bokde
- Discipline of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Rodrigo A Bressan
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
- Instituto Ame Sua Mente, São Paulo, Brazil
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Altrecht Science, Altrecht Mental Health Institute, Utrecht, The Netherlands
| | - Svenja Caspers
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Institute for Anatomy I, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Sven Cichon
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Benedicto Crespo-Facorro
- CIBERSAM, Biomedical Research Network on Mental Health Area, Santander, Spain
- Department of Psychiatry, Virgen del Rocio University Hospital, School of Medicine, University of Seville, IBIS, Seville, Spain
| | - Simon R Cox
- Lothian Birth Cohorts group, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Torbjørn Elvsåshagen
- NORMENT Centre, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thomas Espeseth
- Department of Psychology, University of Oslo, Oslo, Norway
- Bjørknes College, Oslo, Norway
| | - Peter G Falkai
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Simon E Fisher
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Penny A Gowland
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Hans J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | | | - Manon Hillegers
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Faculty of Health, Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry & Accare Child Study Center, Groningen, The Netherlands
| | - Mohammad A Ikram
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andrea P Jackowski
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
| | - Erik G Jönsson
- NORMENT Centre, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Rene S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- VISN 2 Mental Illness Research, Education & Clinical Center (MIRECC), James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, USA
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Herve Lemaitre
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, CNRS UMR 5293, Université de Bordeaux, Centre Broca Nouvelle-Aquitaine, Bordeaux, France
| | - Ulrik F Malt
- Unit for Psychosomatic Medicine and C-L Psychiatry, University of Oslo, Oslo, Norway
| | - Jean-Luc Martinot
- INSERM U1299 Trajectoires Développementales en Psychiatrie, Ecole Normale Supérieure Paris-Saclay, Université Paris Saclay, Université Paris Cité, CNRS UMR 9010; Centre Borelli, Gif-sur-Yvette, France
| | - Colm McDonald
- Centre for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Department of Pediatrics, Amsterdam Reproduction & Development, Amsterdam, The Netherlands
- Vrije Universiteit, Clinical Neuropsychology Section, Amsterdam, The Netherlands
| | - Roel A Ophoff
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands
| | - Pedro M Pan
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry, University Medical Center Goettingen, Göttingen, Germany
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW, Australia
| | - Giovanni A Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), CNPq, São Paulo, Brazil
- Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Gunter Schumann
- Center for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology for Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
- PONS Centre, Department of Psychiatry and Clinical Neuroscience, CCM, Charite University Medicine, Berlin, Germany
| | - Philip Shaw
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Julian N Trollor
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW, Australia
| | - Leonard H van den Berg
- Department of Neurology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jan H Veldink
- Department of Neurology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Henrik Walter
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute for Health, Berlin, Germany
| | - Lars T Westlye
- NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Hilleke E Hulshoff Pol
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands.
- Department of Psychology, Utrecht University, Utrecht, The Netherlands.
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39
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Abé C, Ching CRK, Liberg B, Lebedev AV, Agartz I, Akudjedu TN, Alda M, Alnæs D, Alonso-Lana S, Benedetti F, Berk M, Bøen E, Bonnin CDM, Breuer F, Brosch K, Brouwer RM, Canales-Rodríguez EJ, Cannon DM, Chye Y, Dahl A, Dandash O, Dannlowski U, Dohm K, Elvsåshagen T, Fisch L, Fullerton JM, Goikolea JM, Grotegerd D, Haatveit B, Hahn T, Hajek T, Heindel W, Ingvar M, Sim K, Kircher TTJ, Lenroot RK, Malt UF, McDonald C, McWhinney SR, Melle I, Meller T, Melloni EMT, Mitchell PB, Nabulsi L, Nenadić I, Opel N, Overs BJ, Panicalli F, Pfarr JK, Poletti S, Pomarol-Clotet E, Radua J, Repple J, Ringwald KG, Roberts G, Rodriguez-Cano E, Salvador R, Sarink K, Sarró S, Schmitt S, Stein F, Suo C, Thomopoulos SI, Tronchin G, Vieta E, Westlye LT, White AG, Yatham LN, Zak N, Thompson PM, Andreassen OA, Landén M. Longitudinal Structural Brain Changes in Bipolar Disorder: A Multicenter Neuroimaging Study of 1232 Individuals by the ENIGMA Bipolar Disorder Working Group. Biol Psychiatry 2022; 91:582-592. [PMID: 34809987 DOI: 10.1016/j.biopsych.2021.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/24/2021] [Accepted: 09/10/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with cortical and subcortical structural brain abnormalities. It is unclear whether such alterations progressively change over time, and how this is related to the number of mood episodes. To address this question, we analyzed a large and diverse international sample with longitudinal magnetic resonance imaging (MRI) and clinical data to examine structural brain changes over time in BD. METHODS Longitudinal structural MRI and clinical data from the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) BD Working Group, including 307 patients with BD and 925 healthy control subjects, were collected from 14 sites worldwide. Male and female participants, aged 40 ± 17 years, underwent MRI at 2 time points. Cortical thickness, surface area, and subcortical volumes were estimated using FreeSurfer. Annualized change rates for each imaging phenotype were compared between patients with BD and healthy control subjects. Within patients, we related brain change rates to the number of mood episodes between time points and tested for effects of demographic and clinical variables. RESULTS Compared with healthy control subjects, patients with BD showed faster enlargement of ventricular volumes and slower thinning of the fusiform and parahippocampal cortex (0.18 <d < 0.22). More (hypo)manic episodes were associated with faster cortical thinning, primarily in the prefrontal cortex. CONCLUSIONS In the hitherto largest longitudinal MRI study on BD, we did not detect accelerated cortical thinning but noted faster ventricular enlargements in BD. However, abnormal frontocortical thinning was observed in association with frequent manic episodes. Our study yields insights into disease progression in BD and highlights the importance of mania prevention in BD treatment.
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Affiliation(s)
- Christoph Abé
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden.
| | - Christopher R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California
| | - Benny Liberg
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Alexander V Lebedev
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Theophilus N Akudjedu
- Institute of Medical Imaging and Visualisation, Bournemouth University, Bournemouth, United Kingdom; Centre for Neuroimaging and Cognitive Genomics, Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia; National Institute of Mental Health, Klecany, Czech Republic
| | - Dag Alnæs
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Bjørknes College, Oslo, Norway
| | - Silvia Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Michael Berk
- Orygen, the National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, the University of Melbourne, Melbourne, Victoria, Australia; Department of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Deakin University, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Erlend Bøen
- Unit of Psychosomatic and CL Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Caterina Del Mar Bonnin
- Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clínic, Institute of Neurosciences, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Fabian Breuer
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Rachel M Brouwer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Erick J Canales-Rodríguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Signal Processing Laboratory, École polytechnique fédérale de Lausanne, Lausanne, Switzerland
| | - Dara M Cannon
- Centre for Neuroimaging and Cognitive Genomics, Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Yann Chye
- Turner Institute for Brain and Mental Health, School of Psychological Science and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Andreas Dahl
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Orwa Dandash
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Torbjørn Elvsåshagen
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Neurology, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Janice M Fullerton
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Jose M Goikolea
- Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clínic, Institute of Neurosciences, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Beathe Haatveit
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Tim Hahn
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia; National Institute of Mental Health, Klecany, Czech Republic; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia; National Institute of Mental Health, Klecany, Czech Republic; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Walter Heindel
- Clinic for Radiology, University of Münster, Münster, Germany
| | - Martin Ingvar
- Department of Clinical Neuroscience, Osher Center, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Department of Neuroradiology, Stockholm, Sweden
| | - Kang Sim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; West Region, Institute of Mental Health, Singapore, Singapore; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tilo T J Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | | | - Ulrik F Malt
- Department of Neurology, Oslo University Hospital, Oslo, Norway; Department of Psychiatry and Addiction, Section for C-L Psychiatry and Psychosomatics, Oslo University Hospital, Oslo, Norway
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics, Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Sean R McWhinney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Elisa M T Melloni
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Leila Nabulsi
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California; Centre for Neuroimaging and Cognitive Genomics, Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Bronwyn J Overs
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Francesco Panicalli
- Hospital general de Granollers, Barcelona, Spain; Benito Menni CASM, Barcelona, Spain
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Joaquim Radua
- Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Early Psychosis: Interventions and Clinical-detection lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Kai G Ringwald
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Elena Rodriguez-Cano
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Benito Menni CASM, Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Kelvin Sarink
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; West Region, Institute of Mental Health, Singapore, Singapore; Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Simon Schmitt
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany; Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig, University of Giessen, Giessen, Germany
| | - Chao Suo
- Turner Institute for Brain and Mental Health, School of Psychological Science and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California
| | - Giulia Tronchin
- Centre for Neuroimaging and Cognitive Genomics, Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine, Nursing, and Health Sciences, National University of Ireland, Galway, Ireland
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clínic, Institute of Neurosciences, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Adam G White
- Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathalia Zak
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California
| | - Ole A Andreassen
- KG Jebsen Centre for Neurodevelopmental Disorders, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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40
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Stein F, Buckenmayer E, Brosch K, Meller T, Schmitt S, Ringwald KG, Pfarr JK, Steinsträter O, Enneking V, Grotegerd D, Heindel W, Meinert S, Leehr EJ, Lemke H, Thiel K, Waltemate L, Winter A, Hahn T, Dannlowski U, Jansen A, Nenadić I, Krug A, Kircher T. Dimensions of Formal Thought Disorder and Their Relation to Gray- and White Matter Brain Structure in Affective and Psychotic Disorders. Schizophr Bull 2022; 48:902-911. [PMID: 35064667 PMCID: PMC9212109 DOI: 10.1093/schbul/sbac002] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Factorial dimensions and neurobiological underpinnings of formal thought disorders (FTD) have been extensively investigated in schizophrenia spectrum disorders (SSD). However, FTD are also highly prevalent in other disorders. Still, there is a lack of knowledge about transdiagnostic, structural brain correlates of FTD. In N = 1071 patients suffering from DSM-IV major depressive disorder, bipolar disorder, or SSD, we calculated a psychopathological factor model of FTD based on the SAPS and SANS scales. We tested the association of FTD dimensions with 3 T MRI measured gray matter volume (GMV) and white matter fractional anisotropy (FA) using regression and interaction models in SPM12. We performed post hoc confirmatory analyses in diagnostically equally distributed, age- and sex-matched sub-samples to test whether results were driven by diagnostic categories. Cross-validation (explorative and confirmatory) factor analyses revealed three psychopathological FTD factors: disorganization, emptiness, and incoherence. Disorganization was negatively correlated with a GMV cluster comprising parts of the middle occipital and angular gyri and positively with FA in the right posterior cingulum bundle and inferior longitudinal fascicle. Emptiness was negatively associated with left hippocampus and thalamus GMV. Incoherence was negatively associated with FA in bilateral anterior thalamic radiation, and positively with the hippocampal part of the right cingulum bundle. None of the gray or white matter associations interacted with diagnosis. Our results provide a refined mapping of cross-disorder FTD phenotype dimensions. For the first time, we demonstrated that their neuroanatomical signatures are associated with language-related gray and white matter structures independent of diagnosis.
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Affiliation(s)
- Frederike Stein
- To whom correspondence should be addressed; Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany; tel: +49-6421-58 63831, fax: +49-6421-58 65197, e-mail:
| | - Elena Buckenmayer
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany,Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kai Gustav Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Julia Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Olaf Steinsträter
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany,Core-Facility Brainimaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Walter Heindel
- Department of Radiology, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany,Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany,Core-Facility Brainimaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry und Psychotherapy, University of Bonn, Bonn, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
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Sporns PB, Kemmling A, Minnerup H, Meyer L, Krogias C, Puetz V, Thierfelder K, Duering M, Kaiser D, Langner S, Massoth C, Brehm A, Rotkopf L, Kunz WG, Karch A, Fiehler J, Heindel W, Schramm P, Royl G, Wiendl H, Psychogios M, Minnerup J. CT Hypoperfusion-Hypodensity Mismatch to Identify Patients With Acute Ischemic Stroke Within 4.5 Hours of Symptom Onset. Neurology 2021; 97:e2088-e2095. [PMID: 34649883 DOI: 10.1212/wnl.0000000000012891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/15/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To test the hypothesis that CT hypoperfusion-hypodensity mismatch identifies patients with ischemic stroke within 4.5 hours of symptom onset. METHODS We therefore performed the Retrospective Multicenter Hypoperfusion-Hypodensity Mismatch for The identification of Patients With Stroke Within 4.5 Hours study of patients with acute ischemic stroke and known time of symptom onset. The predictive values of hypoperfusion-hypodensity mismatch for the identification of patients with symptom onset within 4.5 hours were the main outcome measure. RESULTS Of 666 patients, 548 (82.3%) had multimodal CT within 4.5 hours and 118 (17.7%) beyond 4.5 hours. Hypoperfusion-hypodensity mismatch was visible in 516 (94.2%) patients with symptom onset within and in 30 (25.4%) patients beyond 4.5 hours. CT hypoperfusion-hypodensity mismatch identified patients within 4.5 hours of stroke onset with 94.2% (95% confidence interval [CI] 91.9%-95.8%) sensitivity, 74.6% (95% CI 66.0%-81.6%) specificity, 94.5% (95% CI 92.3%-96.1%) positive predictive value, and 73.3% (95% CI 64.8%-80.4%) negative predictive value. Interobserver agreement for hypoperfusion-hypodensity mismatch was substantial (κ = 0.61, 95% CI 0.53-0.69). DISCUSSION Patients with acute ischemic stroke with absence of a hypodensity on native CT (NCCT) within the hypoperfused core lesion on perfusion CT (hypoperfusion-hypodensity mismatch) are likely to be within the time window of thrombolysis. Applying this method may guide the decision to use thrombolysis in patients with unknown time of stroke onset. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov Identifier: NCT04277728. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that CT hypoperfusion-hypodensity mismatch identifies patients with stroke within 4.5 hours of onset.
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Affiliation(s)
- Peter B Sporns
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - André Kemmling
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Heike Minnerup
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Lennart Meyer
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Christos Krogias
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Volker Puetz
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Kolja Thierfelder
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Marco Duering
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Daniel Kaiser
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Soenke Langner
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Christina Massoth
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Alex Brehm
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Lukas Rotkopf
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Wolfgang G Kunz
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - André Karch
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Jens Fiehler
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Walter Heindel
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Peter Schramm
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Georg Royl
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Heinz Wiendl
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Marios Psychogios
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany
| | - Jens Minnerup
- From the Department of Neuroradiology (P.B.S., A.B., M.P.), Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland; Department of Diagnostic and Interventional Neuroradiology (P.B.S., J.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Radiology (P.B.S., W.H.), University Hospital Muenster; Department of Neuroradiology (A. Kemmling), University Hospital Marburg; Department of Neuroradiology (A. Kemmling, P.S.), University Medical Center Schleswig-Holstein, Luebeck; Institute of Epidemiology and Social Medicine (H.M., A. Karch), University of Muenster; Department of Neurology with Institute of Translational Neurology (L.M., H.W., J.M.), University Hospital Muenster; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University Bochum; Department of Neurology (V.P.), University Hospital Carl Gustav Carus, Dresden; Department of Radiology and Institute of Diagnostic and Interventional Radiology (K.T., S.L.), University Medical Center Rostock; Institute for Stroke and Dementia Research (ISD) (M.D.), University Hospital, LMU Munich, Germany; Medical Image Analysis Center (MIAC AG) and Department of Biomedical Engineering (M.D.), University of Basel, Switzerland; Department of Neuroradiology (D.K.), University Hospital Carl Gustav Carus, Dresden; Department of Anesthesiology (C.M.), Intensive Care and Pain Medicine, University Hospital Muenster; Department of Radiology (L.R.), German Cancer Research Center, Heidelberg; Department of Radiology (W.G.K.), University Hospital, LMU Munich; and Department of Neurology (G.R.), Center of Brain, Behaviour and Metabolism, University of Luebeck, Germany.
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Masthoff M, Freppon FN, Zondler L, Wilken E, Wachsmuth L, Niemann S, Schwarz C, Fredrich I, Havlas A, Block H, Gerwing M, Helfen A, Heindel W, Zarbock A, Wildgruber M, Faber C. Resolving immune cells with patrolling behaviour by magnetic resonance time-lapse single cell tracking. EBioMedicine 2021; 73:103670. [PMID: 34742131 PMCID: PMC8581510 DOI: 10.1016/j.ebiom.2021.103670] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/10/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Immune cells show distinct motion patterns that change upon inflammatory stimuli. Monocytes patrol the vasculature to screen for pathogens, thereby exerting an early task of innate immunity. Here, we aimed to non-invasively analyse single patrolling monocyte behaviour upon inflammatory stimuli. METHODS We used time-lapse Magnetic Resonance Imaging (MRI) of the murine brain to dynamically track single patrolling monocytes within the circulation distant to the actual site of inflammation in different inflammatory conditions, ranging from a subcutaneous pellet model to severe peritonitis and bacteraemia. FINDINGS Single patrolling immune cells with a velocity of <1 µm/s could be detected and followed dynamically using time-lapse MRI. We show, that due to local and systemic stimuli the slowly patrolling behaviour of monocytes is altered systemically and differs with type, duration and strength of the underlying stimulus. INTERPRETATION Using time-lapse MRI, it is now possible to investigate the behaviour of single circulating monocytes over the course of the systemic immune response. Monocyte patrolling behaviour is altered systemically even before the onset of clinical symptoms distant to and depending on the underlying inflammatory stimulus. FUNDING This study was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - CRC 1009 - 194468054 to AZ, CF and - CRC 1450 - 431460824 to MM, SN, HB, AZ, CF, the Joachim Herz Foundation (Add-on Fellowship for Interdisciplinary Life Sciences to MM), the Interdisciplinary Centre for Clinical Research (IZKF, core unit PIX) and the Medical Faculty of the University of Muenster (MEDK fellowship to FF and IF).
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Affiliation(s)
- Max Masthoff
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany.
| | - Felix Noah Freppon
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Lisa Zondler
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - Enrica Wilken
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Lydia Wachsmuth
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Silke Niemann
- Institute of Medical Microbiology, University Hospital of Muenster, Muenster, Germany
| | - Christian Schwarz
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Ina Fredrich
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Asli Havlas
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Helena Block
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - Mirjam Gerwing
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Anne Helfen
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Walter Heindel
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
| | - Alexander Zarbock
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany
| | - Moritz Wildgruber
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Cornelius Faber
- Clinic for Radiology, Translational Research Imaging Centre, University Hospital Muenster, Muenster, Germany
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Backhaus P, Burg MC, Roll W, Büther F, Breyholz HJ, Weigel S, Heindel W, Pixberg M, Barth P, Tio J, Schäfers M. Simultaneous FAPI PET/MRI Targeting the Fibroblast-Activation Protein for Breast Cancer. Radiology 2021; 302:39-47. [PMID: 34636633 DOI: 10.1148/radiol.2021204677] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background Integrated PET/MRI is a promising modality for breast assessment. The most frequently used tracer, fluorine 18 (18F) fluorodeoxyglucose (FDG), is applied for whole-body staging in advanced breast cancer but has limited accuracy in evaluating primary breast lesions. The fibroblast-activation protein (FAP) is abundantly expressed in invasive breast cancer. FAP-directed PET tracers have recently become available, but results in primary breast tumors remain lacking. Purpose To evaluate the use of FAP inhibitor (FAPI) breast PET/MRI in assessing breast lesions and of FAPI whole-body scanning for lymph node (LN) and distant staging using the ligand gallium 68 (68Ga)-FAPI-46. Materials and Methods In women with histologically confirmed invasive breast cancer, all primary 68Ga-FAPI-46 breast and whole-body PET/MRI and PET/CT examinations conducted at the authors' center between October 2019 and December 2020 were retrospectively analyzed. MRI lesion characteristics and standardized uptake values (SUVs) were quantified with dedicated software. Mann-Whitney U tests were used to compare tumor SUVs across different tumor types. The Pearson correlation coefficient was calculated between SUV and measures of MRI morphologic characteristics. Results Nineteen women (mean age, 49 years ± 9 [standard deviation]) were evaluated-18 to complement initial staging and one for restaging after therapy for distant metastases. Strong tracer accumulation was observed in all 18 untreated primary breast malignancies (mean maximum SUV [SUVmax] = 13.9 [range, 7.9-29.9]; median lesion diameter = 26 mm [range, 9-155 mm]), resulting in clear tumor delineation across different gradings, receptors, and histologic types. All preoperatively verified LN metastases in 13 women showed strong tracer accumulation (mean SUVmax= 12.2 [range, 3.3-22.4]; mean diameter = 21 mm [range, 14-35 mm]). Tracer uptake established or supported extra-axillary LN involvement in seven women and affected therapy decisions in three women. Conclusion This retrospective analysis indicates use of 68Ga fibroblast-activation protein inhibitor tracers for breast cancer diagnosis and staging. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Mankoff and Sellmyer in this issue.
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Affiliation(s)
- Philipp Backhaus
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Matthias C Burg
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Wolfgang Roll
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Florian Büther
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Hans-Jörg Breyholz
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Stefanie Weigel
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Walter Heindel
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Michaela Pixberg
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Peter Barth
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Joke Tio
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
| | - Michael Schäfers
- From the Department of Nuclear Medicine (P. Backhaus, W.R., F.B., H.J.B., M.P., M.S.), Clinic for Radiology (M.C.B., S.W., W.H.), and Department of Gynecology and Obstetrics (J.T.), University Hospital Münster, Albert-Schweitzer-Campus 1 A1, 48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Münster, Germany (P. Backhaus, F.B., M.S.); and Gerhard-Domagk Institute for Pathology, University of Münster, Münster, Germany (P. Barth)
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Bock K, Hecht G, Heindel W, Heywang-Köbrunner S, Siegmann-Luz K. Das Mammografie-Screening: Sollte es abgeschafft werden? Geburtshilfe Frauenheilkd 2021. [DOI: 10.1055/a-1372-7531] [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: 10/20/2022] Open
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Kerschke L, Weigel S, Rodriguez-Ruiz A, Karssemeijer N, Heindel W. Using deep learning to assist readers during the arbitration process: a lesion-based retrospective evaluation of breast cancer screening performance. Eur Radiol 2021; 32:842-852. [PMID: 34383147 PMCID: PMC8794989 DOI: 10.1007/s00330-021-08217-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/04/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Objectives To evaluate if artificial intelligence (AI) can discriminate recalled benign from recalled malignant mammographic screening abnormalities to improve screening performance. Methods A total of 2257 full-field digital mammography screening examinations, obtained 2011–2013, of women aged 50–69 years which were recalled for further assessment of 295 malignant out of 305 truly malignant lesions and 2289 benign lesions after independent double-reading with arbitration, were included in this retrospective study. A deep learning AI system was used to obtain a score (0–95) for each recalled lesion, representing the likelihood of breast cancer. The sensitivity on the lesion level and the proportion of women without false-positive ratings (non-FPR) resulting under AI were estimated as a function of the classification cutoff and compared to that of human readers. Results Using a cutoff of 1, AI decreased the proportion of women with false-positives from 89.9 to 62.0%, non-FPR 11.1% vs. 38.0% (difference 26.9%, 95% confidence interval 25.1–28.8%; p < .001), preventing 30.1% of reader-induced false-positive recalls, while reducing sensitivity from 96.7 to 91.1% (5.6%, 3.1–8.0%) as compared to human reading. The positive predictive value of recall (PPV-1) increased from 12.8 to 16.5% (3.7%, 3.5–4.0%). In women with mass-related lesions (n = 900), the non-FPR was 14.2% for humans vs. 36.7% for AI (22.4%, 19.8–25.3%) at a sensitivity of 98.5% vs. 97.1% (1.5%, 0–3.5%). Conclusion The application of AI during consensus conference might especially help readers to reduce false-positive recalls of masses at the expense of a small sensitivity reduction. Prospective studies are needed to further evaluate the screening benefit of AI in practice. Key Points • Integrating the use of artificial intelligence in the arbitration process reduces benign recalls and increases the positive predictive value of recall at the expense of some sensitivity loss. • Application of the artificial intelligence system to aid the decision to recall a woman seems particularly beneficial for masses, where the system reaches comparable sensitivity to that of the readers, but with considerably reduced false-positives. • About one-fourth of all recalled malignant lesions are not automatically marked by the system such that their evaluation (AI score) must be retrieved manually by the reader. A thorough reading of screening mammograms by readers to identify suspicious lesions therefore remains mandatory.
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Affiliation(s)
- Laura Kerschke
- Institute of Biostatistics and Clinical Research, IBKF, University of Muenster, Schmeddingstrasse 56, 48149, Muenster, Germany.
| | - Stefanie Weigel
- Clinic for Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | | | - Nico Karssemeijer
- ScreenPoint Medical BV, Toernooiveld 300, 6525, EC, Nijmegen, The Netherlands
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525, Nijmegen, GA, The Netherlands
| | - Walter Heindel
- Clinic for Radiology and Reference Center for Mammography Muenster, University of Muenster and University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
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Förster K, Danzer L, Redlich R, Opel N, Grotegerd D, Leehr EJ, Dohm K, Enneking V, Meinert S, Goltermann J, Lemke H, Waltemate L, Thiel K, Behnert K, Brosch K, Stein F, Meller T, Ringwald K, Schmitt S, Steinsträter O, Jansen A, Krug A, Nenadic I, Kircher T, Hahn T, Kugel H, Heindel W, Repple J, Dannlowski U. Social support and hippocampal volume are negatively associated in adults with previous experience of childhood maltreatment. J Psychiatry Neurosci 2021; 46:E328-E336. [PMID: 33904668 PMCID: PMC8327979 DOI: 10.1503/jpn.200162] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Childhood maltreatment has been associated with reduced hippocampal volume in healthy individuals, whereas social support, a protective factor, has been positively associated with hippocampal volumes. In this study, we investigated how social support is associated with hippocampal volume in healthy people with previous experience of childhood maltreatment. METHODS We separated a sample of 446 healthy participants into 2 groups using the Childhood Trauma Questionnaire: 265 people without maltreatment and 181 people with maltreatment. We measured perceived social support using a short version of the Social Support Questionnaire. We examined hippocampal volume using automated segmentation (Freesurfer). We conducted a social support × group analysis of covariance on hippocampal volumes controlling for age, sex, total intracranial volume, site and verbal intelligence. RESULTS Our analysis revealed significantly lower left hippocampal volume in people with maltreatment (left F1,432 = 5.686, p = 0.018; right F1,433 = 3.371, p = 0.07), but no main effect of social support emerged. However, we did find a significant social support × group interaction for left hippocampal volume (left F1,432 = 5.712, p = 0.017; right F1,433 = 3.480, p = 0.06). In people without maltreatment, we observed a trend toward a positive association between social support and hippocampal volume. In contrast, social support was negatively associated with hippocampal volume in people with maltreatment. LIMITATIONS Because of the correlative nature of our study, we could not infer causal relationships between social support, maltreatment and hippocampal volume. CONCLUSION Our results point to a complex dynamic between environmental risk, protective factors and brain structure - in line with previous evidence - suggesting a detrimental effect of maltreatment on hippocampal development.
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Affiliation(s)
- Katharina Förster
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Lorenz Danzer
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Ronny Redlich
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Nils Opel
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Dominik Grotegerd
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Elisabeth J Leehr
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Katharina Dohm
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Verena Enneking
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Susanne Meinert
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Janik Goltermann
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Hannah Lemke
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Lena Waltemate
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Katharina Thiel
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Katja Behnert
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Katharina Brosch
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Frederike Stein
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Tina Meller
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Kai Ringwald
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Simon Schmitt
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Olaf Steinsträter
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Andreas Jansen
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Axel Krug
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Igor Nenadic
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Tilo Kircher
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Tim Hahn
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Harald Kugel
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Walter Heindel
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Jonathan Repple
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
| | - Udo Dannlowski
- From the Department of Psychiatry, University of Münster, Münster, Germany (Förster, Danzer, Redlich, Opel, Grotegerd, Leehr, Dohm, Enneking, Meinert, Goltermann, Lemke, Waltemate, Thiel, Behnert, Hahn, Repple, Dannlowski); the Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, TU Dresden, Dresden, Germany (Förster); the Department of Clinical Psychology, University of Halle, Halle, Germany (Redlich); the Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany (Brosch, Stein, Meller, Ringwald, Schmitt, Steinsträter, Jansen, Krug, Nenadic, Kircher); the Core-Unit Brain Imaging, Faculty of Medicine, University of Marburg, Marburg, Germany (Jansen); the Department of Psychiatry, University of Bonn, Bonn, Germany (Krug); and the University Clinic for Clinical Radiology, University of Münster, Münster, Germany (Kugel, Heindel)
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47
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Schliemann C, Hemmerle T, Berdel AF, Angenendt L, Kerkhoff A, Hering JP, Heindel W, Hartmann W, Wardelmann E, Chawla SP, de Braud F, Lenz G, Neri D, Kessler T, Berdel WE. Dose escalation and expansion phase I studies with the tumour-targeting antibody-tumour necrosis factor fusion protein L19TNF plus doxorubicin in patients with advanced tumours, including sarcomas. Eur J Cancer 2021; 150:143-154. [PMID: 33901793 DOI: 10.1016/j.ejca.2021.03.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND L19TNF is a recombinant fusion protein composed of a human antibody fragment and human tumour necrosis factor. L19TNF targets the EDB domain of oncofetal fibronectin highly expressed in tumour vasculature and induces tumour remission in mouse tumours. We summarise two phase I trials testing a combination of L19TNF with doxorubicin in patients with solid tumours, particularly soft tissue sarcomas (STS). PATIENTS AND METHODS The first study, an open-label, dose-escalation and expansion phase I study of L19TNF plus doxorubicin, enrolled 27 patients. Three cohorts (10.4-17 μg/kg L19TNF) of patients received L19TNF intravenously at days 1, 3, and 5 and doxorubicin (75 mg/m2, then 60 mg/m2) on day 1 every 3 weeks. The expansion cohort enrolled patients with STS. The second study tried to re-escalate the doxorubicin dose to 75 mg/m2 with 13 μg/kg L19TNF. Among primary objectives was the establishment of a recommended dose (RD). RESULTS The combination was safely applicable. Dose-limiting toxicity occurred either at 17 μg/kg L19TNF or at 75 mg/m2 doxorubicin. RD is 13 μg/kg L19TNF plus 60 mg/m2 doxorubicin. In 15 STS patients of the extension cohort evaluable for efficacy, antitumour activity was observed with complete remission in 1, partial remission in 1 and minor tumour shrinkage in 7 patients. The median overall survival for this heavily pretreated cohort was 14.9 months. CONCLUSION L19TNF can be safely applied in combination with doxorubicin and induces encouraging tumour remissions in patients with soft tissue sarcomas.
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Affiliation(s)
- Christoph Schliemann
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany.
| | | | - Andrew F Berdel
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany
| | - Linus Angenendt
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany
| | - Andrea Kerkhoff
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany
| | - Jan P Hering
- Institute for Clinical Radiology, University Hospital Muenster, Albert Schweitzer Campus 1, Muenster, 48149, Germany
| | - Walter Heindel
- Institute for Clinical Radiology, University Hospital Muenster, Albert Schweitzer Campus 1, Muenster, 48149, Germany
| | - Wolfgang Hartmann
- Gerhard-Domagk-Institute for Pathology, University Hospital of Muenster, Albert Schweitzer Campus 1, Muenster, 48149, Germany
| | - Eva Wardelmann
- Gerhard-Domagk-Institute for Pathology, University Hospital of Muenster, Albert Schweitzer Campus 1, Muenster, 48149, Germany
| | - Sant P Chawla
- Sarcoma Oncology Center, 2811 Wilshire Blvd, Santa Monica, CA, 90403, USA
| | - Filippo de Braud
- Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian 1, Milano MI, 20133, Italy
| | - Georg Lenz
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany
| | | | - Torsten Kessler
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany
| | - Wolfgang E Berdel
- Department of Medicine A, Hematology, Oncology, University Hospital Muenster, Albert Schweitzer Campus 1, 48149 Muenster, Germany.
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48
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Heindel W, Bock K, Hecht G, Heywang-Köbrunner S, Kääb-Sanyal V, Siegmann-Luz K, Weigel S. [Systematic and quality-assured early diagnosis of sporadic breast cancer : Update on screening effects and scientific studies]. Radiologe 2021; 61:126-136. [PMID: 33492420 PMCID: PMC7851039 DOI: 10.1007/s00117-020-00803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/05/2022]
Abstract
BACKGROUND A quality-assured mammography screening programme has been available since 2009, nationwide, to all women in Germany between the ages of 50 and 69. The programme is based on the European Guidelines. In this review article the authors summarize the current status of scientific assessments of this national early detection programme for breast cancer and provide an outlook regarding ongoing studies on effectiveness tests and further development. RESULTS We expect a decline in mortality rates relating to breast cancer as a result of successfully bringing diagnoses forward and a decrease in advanced breast cancer after a repeated screening. The extent will be shown in the current ZEBra study on mortality evaluation. CONCLUSION Potential for a further increase in the effectiveness of the systematic early detection of breast cancer can be identified in four areas: (1) More women should take advantage of the early detection opportunities offered by the medical insurance funds; so far, on average, only about 50% of the women between 50 and 69 who are entitled to a screening examination actually take part in the programme. (2) Entitlement to take part in the programme should be extended to women over 70. (3) The further development of digital mammography towards digital breast tomosynthesis promises to reduce the number of false positive recalls while at the same time increasing sensitivity. (4) There should be scientific studies relating to an extension of screening strategies for the small number of women in the entitlement range who have extremly dense breasts.
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Affiliation(s)
- Walter Heindel
- Klinik für Radiologie und Referenzzentrum Mammographie Münster, Universität Münster (WWU) und Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.
| | - Karin Bock
- Referenzzentrum Mammographie Südwest, Bahnhofstraße 7, 35037, Marburg, Deutschland
| | - Gerold Hecht
- Referenzzentrum Mammographie Nord, Heiligengeiststraße 28, 26121, Oldenburg, Deutschland
| | | | - Vanessa Kääb-Sanyal
- Geschäftsstelle der Kooperationsgemeinschaft Mammographie, Goethestraße 85, 10623, Berlin, Deutschland
| | - Katja Siegmann-Luz
- Referenzzentrum Mammographie Berlin, Straße des 17. Juni 106-108, 10623, Berlin, Deutschland
| | - Stefanie Weigel
- Klinik für Radiologie und Referenzzentrum Mammographie Münster, Universität Münster (WWU) und Universitätsklinikum Münster (UKM), Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland
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49
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Masthoff M, Katou S, Köhler M, Schindler P, Heindel W, Wilms C, Schmidt HH, Pascher A, Struecker B, Wildgruber M, Morgul H. Portal and hepatic vein embolization prior to major hepatectomy. Z Gastroenterol 2021; 59:35-42. [PMID: 33429448 DOI: 10.1055/a-1330-9450] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To analyze safety and effectiveness of simultaneous portal and hepatic vein embolization (PHVE) or sequential hepatic vein embolization (HVE) compared to portal vein embolization (PVE) for future remnant liver (FRL) hypertrophy prior to major hepatic surgery. METHODS Patients undergoing PVE, PHVE or HVE at our tertiary care center between 2018 and 2020 were retrospectively included. FRLV, standardized FRLV (sFRLV) and sFRLV growth rate per day were assessed via volumetry, as well as laboratory parameters. RESULTS 36 patients (f = 15, m = 21; median 64.5 y) were included, 16 patients received PHVE and 20 patients PVE, of which 4 received sequential HVE. Significant increase of FRLV was achieved with both PVE and PHVE compared to baseline (p < 0.0001). sFRLV growth rate did not significantly differ following PHVE (2.2 ± 1.2 %/d) or PVE (2.2 ± 1.7 %/d, p = 0.94). Left portal vein thrombosis (LPVT) was observed after PHVE in 6 patients and in 1 patient after PVE. Sequential HVE showed a considerably high growth rate of 1.42 ± 0.45 %/d after PVE. CONCLUSION PHVE effectively induces FRL hypertrophy but yields comparable sFRLV to PVE. Sequential HVE further induces hypertrophy after insufficient growth due to PVE. Considering a potentially higher rate of LPVT after PHVE, PVE might be preferred in patients with moderate baseline sFRLV, with optional sequential HVE in non-sufficient responders.
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Affiliation(s)
- Max Masthoff
- Clinic of Radiology, University Hospital Muenster, Muenster, Germany
| | - Shadi Katou
- Department for General, Visceral and Transplantation Surgery, University Hospital Muenster, Muenster, Germany
| | - Michael Köhler
- Clinic of Radiology, University Hospital Muenster, Muenster, Germany
| | - Philipp Schindler
- Clinic of Radiology, University Hospital Muenster, Muenster, Germany
| | - Walter Heindel
- Clinic of Radiology, University Hospital Muenster, Muenster, Germany
| | - Christian Wilms
- Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - Hartmut H Schmidt
- Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany
| | - Andreas Pascher
- Department for General, Visceral and Transplantation Surgery, University Hospital Muenster, Muenster, Germany
| | - Benjamin Struecker
- Department for General, Visceral and Transplantation Surgery, University Hospital Muenster, Muenster, Germany
| | - Moritz Wildgruber
- Clinic of Radiology, University Hospital Muenster, Muenster, Germany.,Department of Radiology, University Hospital Ludwig-Maximilians-Universität, Munich, Germany
| | - Haluk Morgul
- Department for General, Visceral and Transplantation Surgery, University Hospital Muenster, Muenster, Germany
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50
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Sporns PB, Sträter R, Minnerup J, Wiendl H, Hanning U, Chapot R, Henkes H, Henkes E, Grams A, Dorn F, Nikoubashman O, Wiesmann M, Bier G, Weber A, Broocks G, Fiehler J, Brehm A, Psychogios M, Kaiser D, Yilmaz U, Morotti A, Marik W, Nolz R, Jensen-Kondering U, Schmitz B, Schob S, Beuing O, Götz F, Trenkler J, Turowski B, Möhlenbruch M, Wendl C, Schramm P, Musolino P, Lee S, Schlamann M, Radbruch A, Rübsamen N, Karch A, Heindel W, Wildgruber M, Kemmling A. Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke: The Save ChildS Study. JAMA Neurol 2020; 77:25-34. [PMID: 31609380 DOI: 10.1001/jamaneurol.2019.3403] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Randomized clinical trials have shown the efficacy of thrombectomy of large intracranial vessel occlusions in adults; however, any association of therapy with clinical outcomes in children is unknown. Objective To evaluate the use of endovascular recanalization in pediatric patients with arterial ischemic stroke. Design, Setting, and Participants This retrospective, multicenter cohort study, conducted from January 1, 2000, to December 31, 2018, analyzed the databases from 27 stroke centers in Europe and the United States. Included were all pediatric patients (<18 years) with ischemic stroke who underwent endovascular recanalization. Median follow-up time was 16 months. Exposures Endovascular recanalization. Main Outcomes and Measures The decrease of the Pediatric National Institutes of Health Stroke Scale (PedNIHSS) score from admission to day 7 was the primary outcome (score range: 0 [no deficit] to 34 [maximum deficit]). Secondary clinical outcomes included the modified Rankin scale (mRS) (score range: 0 [no deficit] to 6 [death]) at 6 and 24 months and rate of complications. Results Seventy-three children from 27 participating stroke centers were included. Median age was 11.3 years (interquartile range [IQR], 7.0-15.0); 37 patients (51%) were boys, and 36 patients (49%) were girls. Sixty-three children (86%) received treatment for anterior circulation occlusion and 10 patients (14%) received treatment for posterior circulation occlusion; 16 patients (22%) received concomitant intravenous thrombolysis. Neurologic outcome improved from a median PedNIHSS score of 14.0 (IQR, 9.2-20.0) at admission to 4.0 (IQR, 2.0-7.3) at day 7. Median mRS score was 1.0 (IQR, 0-1.6) at 6 months and 1.0 (IQR, 0-1.0) at 24 months. One patient (1%) developed a postinterventional bleeding complication and 4 patients (5%) developed transient peri-interventional vasospasm. The proportion of symptomatic intracerebral hemorrhage events in the HERMES meta-analysis of trials with adults was 2.79 (95% CI, 0.42-6.66) and in Save ChildS was 1.37 (95% CI, 0.03-7.40). Conclusions and Relevance The results of this study suggest that the safety profile of thrombectomy in childhood stroke does not differ from the safety profile in randomized clinical trials for adults; most of the treated children had favorable neurologic outcomes. This study may support clinicians' practice of off-label thrombectomy in childhood stroke in the absence of high-level evidence.
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Affiliation(s)
- Peter B Sporns
- Institute of Clinical Radiology, University Hospital of Muenster, Muenster, Germany
| | - Ronald Sträter
- Department of Pediatrics, University Hospital of Muenster, Muenster, Germany
| | - Jens Minnerup
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
| | - Heinz Wiendl
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
| | - Uta Hanning
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - René Chapot
- Department of Neuroradiology, Alfried-Krupp Hospital, Essen, Germany
| | - Hans Henkes
- Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany
| | - Elina Henkes
- Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany
| | - Astrid Grams
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Franziska Dorn
- Department for Diagnostic and Interventional Neuroradiology, University of Munich, Campus Grosshadern, Munich, Germany
| | | | - Martin Wiesmann
- Department of Neuroradiology, Aachen University, Aachen, Germany
| | - Georg Bier
- Institute of Clinical Radiology, University Hospital of Muenster, Muenster, Germany.,Diagnostic and Interventional Neuroradiology, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Anushe Weber
- Department of Radiology and Neuroradiology, Bochum, Germany
| | - Gabriel Broocks
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alex Brehm
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany
| | - Marios Psychogios
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany
| | - Daniel Kaiser
- Department of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Umut Yilmaz
- Department of Neuroradiology, Saarland University Hospital, Homburg, Germany
| | - Andrea Morotti
- Department of Neurology and Neurorehabilitation, Mondino Foundation, Pavia, Italy
| | - Wolfgang Marik
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Richard Nolz
- Division of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ulf Jensen-Kondering
- Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Bernd Schmitz
- Section of Neuroradiology, University of Ulm, Guenzburg, Germany
| | - Stefan Schob
- Department for Neuroradiology, University Hospital Leipzig, Leipzig, Germany
| | - Oliver Beuing
- Department of Neuroradiology, University Hospital of Magdeburg, Magdeburg, Germany
| | - Friedrich Götz
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Johannes Trenkler
- Department of Neuroradiology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - Bernd Turowski
- Institute of Neuroradiology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Markus Möhlenbruch
- Department of Neuroradiology at Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Wendl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Peter Schramm
- Department of Neuroradiology, University Hospital of Luebeck, Luebeck, Germany
| | - Patricia Musolino
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sarah Lee
- Division of Child Neurology, Department of Neurology, Stanford University, Stanford, California
| | - Marc Schlamann
- Department of Neuroradiology, University Hospital of Cologne, Cologne, Germany
| | - Alexander Radbruch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Nicole Rübsamen
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Walter Heindel
- Institute of Clinical Radiology, University Hospital of Muenster, Muenster, Germany
| | - Moritz Wildgruber
- Institute of Clinical Radiology, University Hospital of Muenster, Muenster, Germany
| | - André Kemmling
- Department of Neurology, University Hospital of Muenster, Muenster, Germany
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