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Fink C, Haenssle HA. Non-invasive tools for the diagnosis of cutaneous melanoma. Skin Res Technol 2017; 23:261-271. [PMID: 27878858 DOI: 10.1111/srt.12350] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND While the excisional biopsy and histological examination of suspicious lesions remains the current gold standard for diagnosing cutaneous melanoma (CM), there is a demand for more objective and non-invasive examination methods that may support clinicians in their decision when to biopsy or not. METHODS This review is based on publications and guidelines retrieved by a selective search in PubMed and MEDLINE and focused on non-invasive diagnostic strategies for detecting melanoma. RESULTS Ten different non-invasive techniques were compared with regard to applicability, status of development, and resources necessary for introduction into clinical routine (dermoscopy, sequential digital dermoscopy, total body photography, computer-aided multispectral digital analysis, electrical impedance spectroscopy, Raman spectroscopy, reflectance confocal microscopy, multiphoton tomography, stepwise two-photon-laser spectroscopy, quantitative dynamic infrared imaging). In an effort to create a classification based on our analyses, we suggest to differentiate i) tools for screening of patients in daily clinical routine, ii) tools for examination of a restricted number of preselected lesions that produce an automated diagnostic score, iii) tools for examination of a restricted number of preselected lesions at specialized centers requiring extensive training, iv) devices at an experimental stage of development. CONCLUSION None of the discussed examination techniques is able to provide a definite and final diagnosis or to completely replace the histopathological examination. Up to date, the need for fully automated devices offering a complete skin cancer screening has not been satisfied.
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Fink C, Haenssle HA. [Singular skin-colored nodule on the trunk of an 18-month-old girl]. Hautarzt 2017; 68:674-676. [PMID: 28361251 DOI: 10.1007/s00105-017-3976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trojan M, Müller-Eschner M, Kotelis D, MD Partovi S, Karmonik C, Fink C, Tengg-Koblink H, Ruhparwar A, Böckler D, Kauczor H, Rengier F. Dynamische 3D-MR-Angiografie bei Patienten mit Aortendissektion als Risikofaktor für eine chronische Expansion. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tschandl P, Hofmann L, Fink C, Kittler H, Haenssle HA. Melanomas vs. nevi in high-risk patients under long-term monitoring with digital dermatoscopy: do melanomas and nevi already differ at baseline? J Eur Acad Dermatol Venereol 2017; 31:972-977. [PMID: 27896853 DOI: 10.1111/jdv.14065] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/10/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND What lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue. OBJECTIVE To compare the grade of atypia of melanomas and nevi of the same patient at baseline. METHODS Prospective observational study using 236 dermatoscopic baseline images (59 quartets from 59 patients, each including one melanoma detected during follow-up and three nevi). Dermatologists (n = 26) were asked to assess the 'grade of dermatoscopic atypia' on a numerical scale and to identify the melanomas. RESULTS On average, each dermatologist identified 24 of 59 melanomas (40%, range: 11-37). The number of correct picks was greater for dermatologists with moderate (mean: 28) or high (mean: 28) experience compared to beginners (mean 17; P < 0.001). In three of the 59 sets, none of the 26 dermatologists identified the melanoma. The mean grade of dermatoscopic atypia was 2.5 for nevi (95% CI: 2.4-2.6) and 3.0 for melanomas (95% CI: 2.9-3.1, P < 0.001). LIMITATIONS Rating dermatologists were informed that each quartet of images included one melanoma creating substantial deviation from a real-life situation. CONCLUSION A significant proportion of melanomas detected during follow-up cannot be differentiated from nevi at baseline. This necessitates the additional inclusion of less atypical lesions for monitoring.
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Fink C, Kallsen K, Bhandari A, Roeder T. Dysregulation of epithelial JAK/STAT-signaling leads to malformation of the fruit fly's airways. Pneumologie 2016. [DOI: 10.1055/s-0036-1584608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thiedmann M, Prange R, Bhandari A, Kallsen K, Fink C, Roeder T. Cigarette smoke exposure induces substantial changes in the airway epithelium of a Drosophila COPD model. Pneumologie 2016. [DOI: 10.1055/s-0036-1584642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bossen J, Uliczka K, Thiedmann M, Mai M, Fink C, Heine H, Roeder T. Ectopic activation of EGFR signaling in the airway epithelium of Drosophila induces lung cancer-like phenotypes. Pneumologie 2016. [DOI: 10.1055/s-0036-1584607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fink C, Uhlmann L, Enk A, Gholam P. Pain management in photodynamic therapy using a nitrous oxide/oxygen mixture: a prospective, within-patient, controlled clinical trial. J Eur Acad Dermatol Venereol 2016; 31:70-74. [PMID: 27393707 DOI: 10.1111/jdv.13788] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/25/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Photodynamic therapy is an effective treatment for actinic keratoses. Nevertheless, severe pain during the procedure is a serious adverse effect, which leads to interruption or even termination. Complete pain relief remains a difficult challenge. OBJECTIVE To evaluate the effect of a nitrous oxide/oxygen mixture on pain intensity during photodynamic therapy. METHODS This clinical trial has been designed as a prospective, single-centre, explorative, controlled, observational study. RESULTS We were able to detect a significant overall pain reduction of 55.2% after application of a nitrous oxide/oxygen mixture by means of an intra-individual comparison. Furthermore, the total number of therapy interruption significantly decreased by 82% after the inhalation analgesia. Additionally, treatment satisfaction ranged from 'extremely to very satisfied'. CONCLUSIONS This study shows that analgesia by means of a nitrous oxide/oxygen mixture is a very effective and well-tolerated method for achieving significant pain reduction during photodynamic therapy.
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Rengier F, Wörz S, Melzig C, Ley S, Fink C, Fink C, Rohr K, Grünig E, Kauczor H. Automatisierte 3D-MRT-Volumetrie der Pulmonalarterien: Prädiktion der pulmonalen Hypertonie und Auswerter-Übereinstimmung. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ruedl G, Helle K, Tecklenburg K, Schranz A, Fink C, Posch M, Burtscher M. [Impact of Self-Reported Fatigue on ACL Injuries in Alpine Skiing: A Sex Comparison]. SPORTVERLETZUNG-SPORTSCHADEN 2015; 29:226-30. [PMID: 26689190 DOI: 10.1055/s-0041-106948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In recreational alpine skiing, about one third of all injuries affect the knee joint, and the most common diagnosis in adult male and female skiers is a tear of the anterior cruciate ligament (ACL), which makes up 15 - 21 % of all injuries. General preventive recommendations to reduce the incidence of ski injuries include avoiding fatigue. However, it seems unclear to what extent ACL injuries in male and female recreational skiers are related to perceived fatigue. METHODS This study was conducted as a prospective questionnaire-based investigation in two Austrian ski injury clinics during the five winter seasons between 2009/2010 and 2013/2014. In total, 588 skiers (67.9 % females) with a mean age of 42.1 ± 10.9 years were interviewed about demographics, skiing ability, skiing behaviour, fitness, day and time of accident, skiing duration and perceived fatigue at the moment of accident. RESULTS ACL injured males reported a significantly higher skiing ability and fitness level as well as a more risky behaviour on ski slopes compared to females. About one third of males and females injured their ACL within the first day of the ski trip and about 57 % within the first two days, with no sex differences. However, a significantly higher number of female skiers sustained an ACL injury during the first hour of skiing (28 vs. 17 %) as well as during the first two hours of skiing compared to males (52 vs. 44 %). About 81 % of males and females felt no fatigue or just a trace of fatigue in their legs at the time of accident, with no sex differences. CONCLUSION Based on the findings of this study, fatigue does not seem to be a major risk factor for an ACL injury among male and female recreational skiers.
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Gholam P, Fink C, Bosselmann I, Enk A. Retrospective analysis evaluating the effect of a keratolytic and physical pretreatment with salicylic acid, urea and curettage on the efficacy and safety of photodynamic therapy of actinic keratoses with methylaminolaevulinate. J Eur Acad Dermatol Venereol 2015; 30:619-23. [DOI: 10.1111/jdv.13449] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/04/2015] [Indexed: 11/29/2022]
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Fink C, Happle R, Enk A, Haenssle H. Phacomatosis spilorosea: visual diagnosis and associated pathologies of a rare entity. J Eur Acad Dermatol Venereol 2015; 30:e69-e70. [DOI: 10.1111/jdv.13312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Adebahr S, Collette S, Shash E, Lambrecht M, Le Pechoux C, Faivre-Finn C, De Ruysscher D, Peulen H, Belderbos J, Dziadziuszko R, Fink C, Guckenberger M, Hurkmans C, Nestle U. Stereotactic body radiotherapy for central lung tumours: Author reply. Br J Radiol 2015; 88:20150532. [PMID: 26151618 PMCID: PMC4743584 DOI: 10.1259/bjr.20150532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/06/2015] [Indexed: 11/05/2022] Open
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Adebahr S, Collette S, Shash E, Lambrecht M, Le Pechoux C, Faivre-Finn C, De Ruysscher D, Peulen H, Belderbos J, Dziadziuszko R, Fink C, Guckenberger M, Hurkmans C, Nestle U. LungTech, an EORTC Phase II trial of stereotactic body radiotherapy for centrally located lung tumours: a clinical perspective. Br J Radiol 2015; 88:20150036. [PMID: 25873481 PMCID: PMC4628529 DOI: 10.1259/bjr.20150036] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/02/2015] [Accepted: 04/13/2015] [Indexed: 12/16/2022] Open
Abstract
Evidence supports stereotactic body radiotherapy (SBRT) as a curative treatment option for inoperable early stage non-small-cell lung cancer (NSCLC) resulting in high rates of tumour control and low risk of toxicity. However, promising results are mainly derived from SBRT of peripheral pulmonary lesions, whereas SBRT for the central tumours can lead to severe radiation sequelae owing to the spatial proximity to the serial organs at risk. Robust data on the tolerance of mediastinal structures to high-dose hypofractionated radiation are limited; furthermore, there are many open questions regarding the efficiency, safety and response assessment of SBRT in inoperable, centrally located early stage NSCLC, which are addressed in a prospective multicentre study [sponsored by the European Organization for Research and Treatment of Cancer (EORTC 22113-08113-LungTech)]. In this review, we summarize the current status regarding SBRT for centrally located early stage NSCLC that leads to the rationale of the LungTech trial. Outline and some essential features of the study with focus on a summary of current experiences in dose/fraction-toxicity coherences after SBRT to the mediastinal structures that lead to LungTech normal tissue constraints are provided.
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Kösters A, Rieder F, Wiesinger HP, Dorn U, Hofstaedter T, Fink C, Müller E, Seynnes OR. Alpine Skiing With total knee ArthroPlasty (ASWAP): effect on tendon properties. Scand J Med Sci Sports 2015; 25 Suppl 2:67-73. [PMID: 26083704 DOI: 10.1111/sms.12457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2015] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the effect of alpine skiing on patellar tendon properties in patients with total knee arthroplasty (TKA). Thirty-one adults (70.4 ± 4.7 years) with unilateral TKA were recruited 2.7 ± 0.9 years after surgery and assigned to an intervention (IG) or a control group (CG). The IG underwent a 12-week guided skiing program. Tendon stiffness, Young's modulus, and cross-sectional area (CSA) were measured before and after the intervention. In both groups, mean tendon CSA was 28% (P < 0.001) larger in the operated (OP) than in the non-operated (NOP) leg at baseline, without any difference in other tendon properties. After training, stiffness increased in the IG by 5.8% and 15.8%, respectively, in the OP and NOP legs. Likewise, mean CSA increased in the IG by 2.9% in the OP and 3.8% in the NOP leg, whereas no significant changes were found for the Young's modulus. None of the tendon parameters changed in the CG. Results indicate that patellar tendon structure and/or loading pattern are altered following TKA, but this tissue seems to retain its adaptation capacity. Further, alpine skiing appears to offer a suitable rehabilitation strategy for TKA patients.
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Kösters A, Pötzelsberger B, Dela F, Dorn U, Hofstaedter T, Fink C, Müller E. Alpine Skiing With total knee ArthroPlasty (ASWAP): study design and intervention. Scand J Med Sci Sports 2015; 25 Suppl 2:3-9. [DOI: 10.1111/sms.12459] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2015] [Indexed: 01/02/2023]
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Pötzelsberger B, Stöggl T, Scheiber P, Lindinger SJ, Seifert J, Fink C, Müller E. Alpine Skiing With total knee ArthroPlasty (ASWAP): symmetric loading during skiing. Scand J Med Sci Sports 2015; 25 Suppl 2:60-6. [DOI: 10.1111/sms.12476] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2015] [Indexed: 11/29/2022]
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Rieder F, Kösters A, Wiesinger HP, Dorn U, Hofstaedter T, Fink C, Seynnes OR, Müller E. Alpine Skiing With total knee ArthroPlasty (ASWAP): muscular adaptations. Scand J Med Sci Sports 2015; 25 Suppl 2:26-32. [DOI: 10.1111/sms.12451] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2015] [Indexed: 11/29/2022]
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Hofstaedter T, Fink C, Dorn U, Pötzelsberger B, Hepperger C, Gordon K, Müller E. Alpine Skiing With total knee ArthroPlasty (ASWAP): clinical and radiographic outcomes. Scand J Med Sci Sports 2015; 25 Suppl 2:10-5. [DOI: 10.1111/sms.12465] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 12/23/2022]
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Herbst E, Hoser C, Hildebrandt C, Raschner C, Hepperger C, Pointner H, Fink C. Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part II: clinical application of a new test battery. Knee Surg Sports Traumatol Arthrosc 2015; 23:1283-1291. [PMID: 25724802 PMCID: PMC4555207 DOI: 10.1007/s00167-015-3546-3] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 02/18/2015] [Indexed: 12/04/2022]
Abstract
PURPOSE The purpose of this study was to utilize a novel functional test system to facilitate determining the time of return to sports following ACL reconstruction. METHODS Sixty-nine patients with unilateral ACL reconstruction were included in this pilot study. All the patients performed a standardized test battery consisting of one- and two-legged stability tests, counter movement jumps, speedy jumps, plyometric jumps and a quick feed test. The first test was administered on average 170.7 ± 75.1 days post-operatively, and the retest was administered on average 239.1 ± 79.7 days post-operatively. The values of the subtests were compared with the normative data of healthy gender- and age-matched controls to determine the functional capacities of patients following ACL reconstruction. RESULTS After the first and second test, 15.9 and 17.4 % of the patients met the criteria for a "return to non-competitive sports". One patient fulfilled the criteria for a "return to competitive sports" after the second test battery. The most limiting factor was a poor LSI value of <90 % if the dominant leg was involved and <80 % if the non-dominant leg was involved. CONCLUSION This test battery demonstrates that, in terms of neuromuscular abilities, most patients, compared to healthy controls, are most likely not ready for a safe return to sports, even 8 months post-operatively. This should be considered in the future to determine when it is safe to return to sports and should avoid a premature return to competitive sports. LEVEL OF EVIDENCE III.
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Zaffagnini S, Fink C, Grassi A, Marcheggiani Muccioli G, Marcacci M. Meniskusimplantate. ARTHROSKOPIE 2015. [DOI: 10.1007/s00142-014-0837-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kallsen K, Fink C, Bhandari A, Kabesch M, Heine H, Roeder T. Deregulation of ORMDL3 expression induces stress responses and modulates repair pathways. Pneumologie 2014. [DOI: 10.1055/s-0034-1376771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fink C, Baumann P, Wente MN, Knebel P, Bruckner T, Ulrich A, Werner J, Büchler MW, Diener MK. Incisional hernia rate 3 years after midline laparotomy. Br J Surg 2013; 101:51-4. [PMID: 24281948 DOI: 10.1002/bjs.9364] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Incisional hernia is the most frequent long-term complication after visceral surgery, with an incidence of between 9 and 20 per cent 1 year after operation. Most controlled studies provide only short-term follow-up, and the actual incidence remains unclear. This study evaluated the incidence of incisional hernia up to 3 years after midline laparotomy in two prospective trials. METHODS Three-year follow-up data from the ISSAAC (prospective, multicentre, historically controlled) and INSECT (randomized, controlled, multicentre) trials focused on the rate of incisional hernia 1 and 3 years after surgery. Differences between the two groups were compared using t tests for continuous data and the χ2 test for categorical data. RESULTS Analysis of 775 patients included in the two trials suggested that the incisional hernia rate increased significantly from 12.6 per cent at 1 year to 22.4 per cent 3 years after surgery (P < 0.001), a relative increase of more than 60 per cent. CONCLUSION This follow-up of two trials demonstrated that 1 year of clinical follow-up for detection of incisional hernia is not sufficient; follow-up for at least 3 years should be mandatory in any study evaluating the rate of postoperative incisional hernia after midline laparotomy.
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Meyer M, Klein SA, Brix G, Fink C, Pilz L, Jafarov H, Hofmann WK, Schoenberg SO, Henzler T. Whole-body CT for lymphoma staging: feasibility of halving radiation dose and risk by iterative image reconstruction. Eur J Radiol 2013; 83:315-21. [PMID: 24355659 DOI: 10.1016/j.ejrad.2013.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/28/2013] [Accepted: 11/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Patients with lymphoma are at higher-risk of secondary malignancies mainly due to effects of cancer therapy as well as frequent radiological surveillance. We thus aimed to investigate the objective and subjective image quality as well as radiation exposure and risk of full-dose standard (FDS), full-dose iterative (FDI), and half-dose iterative (HDI) image reconstruction in patients with lymphoma. MATERIAL AND METHODS In 100 lymphoma patients, contrast-enhanced whole-body staging was performed on a dual-source CT. To acquire full-dose and half-dose CT data simultaneously, the total current-time product was equally distributed on both tubes operating at 120 kV. HDI reconstructions were calculated by using only data from one tube. Quantitative image quality was assessed by measuring image noise in different tissues of the neck, thorax, and abdomen. Overall diagnostic image quality was assessed using a 5-point Likert scale. Radiation doses and risks were estimated for a male and female reference person. RESULTS For all anatomical regions apart from the lungs image noise was significantly lower and the overall subjective image quality significantly better when using FDI and HDI instead of FDS reconstruction (p<0.05). For the half-dose protocol, the risk to develop a radiation-induced cancer was estimated to be less than 0.11/0.19% for an adult male/female. CONCLUSIONS Image quality of FDI and more importantly of HDI is superior to FDS reconstruction, thus enabling to halve radiation dose and risk to lymphoma patients.
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