26
|
Wielpütz MO, Eichinger M, Biederer J, Wege S, Stahl M, Sommerburg O, Mall MA, Kauczor HU, Puderbach M. Imaging of Cystic Fibrosis Lung Disease and Clinical Interpretation. ROFO-FORTSCHR RONTG 2016; 188:834-45. [PMID: 27074425 DOI: 10.1055/s-0042-104936] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
UNLABELLED Progressive lung disease in cystic fibrosis (CF) is the life-limiting factor of this autosomal recessive genetic disorder. Increasing implementation of CF newborn screening allows for a diagnosis even in pre-symptomatic stages. Improvements in therapy have led to a significant improvement in survival, the majority now being of adult age. Imaging provides detailed information on the regional distribution of CF lung disease, hence longitudinal imaging is recommended for disease monitoring in the clinical routine. Chest X-ray (CXR), computed tomography (CT) and magnetic resonance imaging (MRI) are now available as routine modalities, each with individual strengths and drawbacks, which need to be considered when choosing the optimal modality adapted to the clinical situation of the patient. CT stands out with the highest morphological detail and has often been a substitute for CXR for regular severity monitoring at specialized centers. Multidetector CT data can be post-processed with dedicated software for a detailed measurement of airway dimensions and bronchiectasis and potentially a more objective and precise grading of disease severity. However, changing to CT was inseparably accompanied by an increase in radiation exposure of CF patients, a young population with high sensitivity to ionizing radiation and lifetime accumulation of dose. MRI as a cross-sectional imaging modality free of ionizing radiation can depict morphological hallmarks of CF lung disease at lower spatial resolution but excels with comprehensive functional lung imaging, with time-resolved perfusion imaging currently being most valuable. KEY POINTS • Hallmarks are bronchiectasis, mucus plugging, air trapping, perfusion abnormalities, and emphysema.• Imaging is more sensitive to disease progression than lung function testing.• CT provides the highest morphological detail but is associated with radiation exposure.• MRI shows comparable sensitivity for morphology but excels with additional functional information.• MRI sensitively depicts reversible abnormalities such as mucus plugging and perfusion abnormalities. Citation Format: • Wielpütz MO, Eichinger M, Biederer J et al. Imaging of Cystic Fibrosis Lung Disease and Clinical Interpretation. Fortschr Röntgenstr 2016; 188: 834 - 845.
Collapse
|
27
|
Lorenz J, Bals R, Ewert R, Heussel CP, Kauczor HU, Randerath W, Steinkamp G, Watz H, Worth H. [Expert meeting obstructive airway disease measuring and evaluating in COPD]. Pneumologie 2015; 69:521-33. [PMID: 26335896 DOI: 10.1055/s-0034-1392787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This report gives an overview on the contributions presented in an expert meeting in February, 2015. They deal with the analysis and evaluation of the multiple dimensions of COPD. This complex disease not only interferes with pulmonary mechanics and gas exchange, but also with cardiopulmonary crosstalk and the ventilator pump. A bulk of inflammatory and microbial activity develops during the progression of disease. As a consequence, systemic effects on muscles, metabolism and psyche develop.The sections consider the value of multiple endpoints in clinical research. Quantifiable parameters of lung mechanics and gas exchange, of exercise tolerance and biomarkers improve the measurability of effects in interventions. However, do we really know in a biological sense what we are measuring? What conclusions can we draw in terms of prognosis?Vice versa, we have to look into the origin and meaning of integrative endpoints e.g. quality or life, dyspnoea and spontaneous physical activity. As a new dimension, the clinical significance of morphological findings in HRCT and MRT is analyzed.
Collapse
|
28
|
Hansen J, Wielpütz MO, Pahn G, Schlemmer HP, Kauczor HU, Stiller W. Quantitative dual-energy computed tomography (DECT) imaging: Evaluation of system performance regarding iodine quantification accuracy. Pneumologie 2015. [DOI: 10.1055/s-0035-1556644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
29
|
Weinheimer O, Heussel CP, Kauczor HU, Wielpütz MO. Simulation study about the accuracy of advanced airway geometry determination on MDCT using a computer-generated phantom. Pneumologie 2015. [DOI: 10.1055/s-0035-1556645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
30
|
Jobst B, Wielpütz MO, Triphan S, Anjorin A, Ley-Zaporozhan J, Kauczor HU, Biederer J, Ley S, Sedlaczek O. Morpho-functional Lung MRI in COPD: Short-term Test-retest Reliability. Pneumologie 2015. [DOI: 10.1055/s-0035-1556616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
31
|
Flechsig P, Zabeck H, Heußel CP, Kauczor HU, Haberkorn U, Giesel F. Sequential dynamic PET and dynamic MR imaging in N-staging of lung cancer patients. Pneumologie 2015. [DOI: 10.1055/s-0035-1556660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
32
|
Triphan S, Wielpütz M, Heussel CP, Biederer J, Kauczor HU, Jakob P, Jobst B. Echo-time dependence of observed lung T1 in COPD patients: preliminary results. Pneumologie 2015. [DOI: 10.1055/s-0035-1556615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
33
|
Renz M, Abels B, Quispe G, Wielpütz M, Kohlmann P, Puderbach M, Dinkel J, Eichinger M, Herth F, Hoffmann H, Kauczor HU, Heußel CP. Dynamic contrast-enhanced MRI Perfusion of the Lung – Feasibility and Accuracy in Patients with COPD, lung cancer and pulmonary embolism. Pneumologie 2015. [DOI: 10.1055/s-0035-1556618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
34
|
Sommer CM, Stampfl U, Kauczor HU, Pereira PL. [National S3 guidelines on hepatocellular carcinoma]. Radiologe 2015; 54:642-53. [PMID: 25047521 DOI: 10.1007/s00117-014-2656-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CLINICAL/METHODICAL ISSUE Evidence-based therapeutic and diagnostic algorithm for hepatocellular carcinoma. STANDARD RADIOLOGICAL METHODS Ultrasound, computed tomography, magnetic resonance imaging, image-guided percutaneous biopsy, percutaneous thermal ablation and transarterial chemoembolization. METHODICAL INNOVATIONS Diagnostic and therapy of hepatocellular carcinoma according to the official German interdisciplinary guidelines. PERFORMANCE The formulation of the German S3 guidelines on diagnosis and therapy of hepatocellular carcinoma was performed under special consideration of quality indicators and standardized quality improvement methods. ACHIEVEMENTS In 2013 the German S3 guidelines on diagnosis and therapy of hepatocellular carcinoma were published and clinically implemented as part of the nationwide guideline program in oncology of the Deutsche Krebsgesellschaft (German Cancer Society). PRACTICAL RECOMMENDATIONS The German S3 guidelines on diagnosis and therapy of hepatocellular carcinoma have to be considered as the national gold standard with the goal of optimization of patient care.
Collapse
|
35
|
Sedlaczek O, Wiedemann C, Gruellich C, Klingmüller U, Kauczor HU, Schlemmer HP. Alteration of MR-DWI/ADC before and 24h after induction of chemotherapy in patients with lung cancer. Cancer Imaging 2014. [PMCID: PMC4242758 DOI: 10.1186/1470-7330-14-s1-p34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
36
|
Demirel S, Chen D, Mei Y, Partovi S, von Tengg-Kobligk H, Dadrich M, Böckler D, Kauczor HU, Müller-Eschner M. Comparison of morphological and rheological conditions between conventional and eversion carotid endarterectomy using computational fluid dynamics – a pilot study. Vascular 2014; 23:474-82. [DOI: 10.1177/1708538114552836] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To compare postoperative morphological and rheological conditions after eversion carotid endarterectomy versus conventional carotid endarterectomy using computational fluid dynamics. Basic methods: Hemodynamic metrics (velocity, wall shear stress, time-averaged wall shear stress and temporal gradient wall shear stress) in the carotid arteries were simulated in one patient after conventional carotid endarterectomy and one patient after eversion carotid endarterectomy by computational fluid dynamics analysis based on patient specific data. Principal findings: Systolic peak of the eversion carotid endarterectomy model showed a gradually decreased pressure along the stream path, the conventional carotid endarterectomy model revealed high pressure (about 180 Pa) at the carotid bulb. Regions of low wall shear stress in the conventional carotid endarterectomy model were much larger than that in the eversion carotid endarterectomy model and with lower time-averaged wall shear stress values (conventional carotid endarterectomy: 0.03–5.46 Pa vs. eversion carotid endarterectomy: 0.12–5.22 Pa). Conclusions: Computational fluid dynamics after conventional carotid endarterectomy and eversion carotid endarterectomy disclosed differences in hemodynamic patterns. Larger studies are necessary to assess whether these differences are consistent and might explain different rates of restenosis in both techniques.
Collapse
|
37
|
Tedla M, Golatta M, Stieber A, Rauch G, Marmé F, Schulz S, Harcos A, Schott S, Domschke C, Kauczor HU, Schneeweiss A, Schuetz F, Sohn C, Sinn P, Heil J. Prädiktion einer pathologischen Komplettremission nach neoadjuvanter Chemotherapie bei Brustkrebs mithilfe bildgebender und pathologischer Befunde. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388423] [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] Open
|
38
|
Gockner TL, Zelzer S, Mokry T, Gnutzmann D, Bellemann N, Mogler C, Beierfuß A, Köllensperger E, Germann G, Radeleff BA, Stampfl U, Kauczor HU, Pereira PL, Sommer CM. Sphere-enhanced microwave ablation (sMWA) versus bland microwave ablation (bMWA): technical parameters, specific CT 3D rendering and histopathology. Cardiovasc Intervent Radiol 2014; 38:442-52. [PMID: 25167958 DOI: 10.1007/s00270-014-0964-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 06/30/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE This study was designed to compare technical parameters during ablation as well as CT 3D rendering and histopathology of the ablation zone between sphere-enhanced microwave ablation (sMWA) and bland microwave ablation (bMWA). METHODS In six sheep-livers, 18 microwave ablations were performed with identical system presets (power output: 80 W, ablation time: 120 s). In three sheep, transarterial embolisation (TAE) was performed immediately before microwave ablation using spheres (diameter: 40 ± 10 μm) (sMWA). In the other three sheep, microwave ablation was performed without spheres embolisation (bMWA). Contrast-enhanced CT, sacrifice, and liver harvest followed immediately after microwave ablation. Study goals included technical parameters during ablation (resulting power output, ablation time), geometry of the ablation zone applying specific CT 3D rendering with a software prototype (short axis of the ablation zone, volume of the largest aligned ablation sphere within the ablation zone), and histopathology (hematoxylin-eosin, Masson Goldner and TUNEL). RESULTS Resulting power output/ablation times were 78.7 ± 1.0 W/120 ± 0.0 s for bMWA and 78.4 ± 1.0 W/120 ± 0.0 s for sMWA (n.s., respectively). Short axis/volume were 23.7 ± 3.7 mm/7.0 ± 2.4 cm(3) for bMWA and 29.1 ± 3.4 mm/11.5 ± 3.9 cm(3) for sMWA (P < 0.01, respectively). Histopathology confirmed the signs of coagulation necrosis as well as early and irreversible cell death for bMWA and sMWA. For sMWA, spheres were detected within, at the rim, and outside of the ablation zone without conspicuous features. CONCLUSIONS Specific CT 3D rendering identifies a larger ablation zone for sMWA compared with bMWA. The histopathological signs and the detectable amount of cell death are comparable for both groups. When comparing sMWA with bMWA, TAE has no effect on the technical parameters during ablation.
Collapse
|
39
|
Kauczor HU. Radiologische Diagnose und Therapiestratifizierung der COPD. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373415] [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]
|
40
|
Weber MA, Sprengel SD, Omlor G, Lehner B, Kauczor HU, Rehnitz C. Radiofrequenzablation zur Therapie von Osteoidosteomen und Osteoblastomen in der Wirbelsäule – langfristige klinische Erfolgsraten und Techniken zur Protektion angrenzender Nervenwurzeln. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373596] [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]
|
41
|
Mokry T, Pahn G, Stiller W, Schemmer P, Stampfl U, Kauczor HU, Radeleff B, Sommer C. Dosis-reduzierte CT-Angiografie bei Leberlebendspendern mittels 64-Zeilen CT mit Stellar-Detektoren: Vergleich der Bildqualität bei „Filtered Back Projektion“- und iterativer Rekonstruktion. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372831] [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]
|
42
|
Gnutzmann D, Mechel J, Schmitz A, Bellemann N, Sommer CM, Gockner T, Mokry T, Kortes N, Stampfl U, Kauczor HU, Radeleff BA. Vergleich der Plasma- und Gewebekonzentrationskinetik von Irinotecan zweier unterchiedlicher mit Irinotecan beladener Partikel. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373006] [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]
|
43
|
Hansen J, Wielpütz MO, Pahn G, Kauczor HU, Stiller W. Quantitative Dual-Energy CT Bildgebung: Systemcharakterisierung im Hinblick auf die Genauigkeit der Jodquantifizierung. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372742] [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]
|
44
|
Schmitz A, Gnutzmann D, Bellemann N, Mokry T, Kortes N, Sommer C, Gotthard D, Weiss KH, Stampfl U, Kauczor HU, Radeleff B. Erste Erfahrungen mit der superselektiven TANDEM® TACE in Heidelberg. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373007] [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]
|
45
|
Hoegen P, Müller-Eschner M, Schalck S, Unterhinninghofen R, Geisbüsch P, Kauczor HU, Tengg-Kobligk HV. Endovaskuläre Therapie (TEVAR) bei Typ-B-Aortendissektionen: In vivo Konfiguration von Stentgrafts postinterventionell und im Follow-Up im Vergleich zu Herstellerangaben. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373026] [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]
|
46
|
Skornitzke S, Fritz F, Klauß M, Pahn G, Grenacher L, Kauczor HU, Stiller W. Untersuchung der Effektivität von rigiden und deformierenden Algorithmen zur Bewegungskorrektur für die CT-Perfusionsmessung für abdominelle Organe unter Einfluss der Atembewegung. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372741] [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]
|
47
|
Vollherbst D, Fritz S, Zelzer S, Wachter MF, Bellemann N, Gockner T, Mokry T, Gnutzmann D, Schmitz A, Aulmann S, Stampfl U, Pereira PL, Kauczor HU, Werner J, Radeleff BA, Sommer CM. Transarterielle Chemoembolisation (TACE) in Kombination mit irreversibler Elektroporation (IRE): Eine experimentelle Machbarkeitsstudie zur perkutanen Elektrochemotherapie in der Leber. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373476] [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]
|
48
|
Weber MA, Sprengel SD, Lehner B, Ewerbeck V, Kauczor HU, Rehnitz C. Radiofrequenzablation zur Therapie von Osteoblastomen – Langfristiger klinischer Erfolg und dezidierte Techniken der Ablation. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373598] [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]
|
49
|
Mayer JL, Lehners N, Egerer G, Kauczor HU, Heußel CP. CT-morphological characterization of respiratory syncytial virus (RSV) pneumonia in immune-compromised adults. ROFO-FORTSCHR RONTG 2014; 186:686-92. [PMID: 24557598 DOI: 10.1055/s-0033-1356353] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Characterization and follow-up evaluation of chest CT of RSV pneumonia in immune-compromised adults during a seasonal epidemic. MATERIALS AND METHODS Retrospective analysis of 132 chest CT examinations of 51 adult immune-compromised patients (29 m/22f, Ø58 years) with clinical signs of pneumonia and positive RSV test in winter 2011/2012. Two experienced chest radiologists evaluated the morphology (bronchial wall thickening, tree-in-bud, nodules, halo, ground-glass opacities, consolidations, pleural fluid) of the CT scans by consensus. RESULTS Pathological findings were in 86 % of the chest CT scans: Areas of ground-glass attenuation in 64 %, consolidations in 56 %, nodules in 55 % (Ø 8 mm in maximal diameter, with halo in 71 %), pleural fluid in 44 % (Ø 2 cm), tree-in-bud in 36 %, bronchial wall thickening in 27 % and more than one morphological finding in 72 %. There were no pathological CT findings in 14 % of patients with clinical symptoms of pneumonia because these patients did not undergo follow-up. Radiological progression was found in 45 % of patients and regression in 33 % in follow-up examinations. In 37 % an additional examination of the paranasal sinuses was performed and showed sinusitis in 63 % of cases. 90 % of the patients had sinusitis as well as pneumonia. In addition to RSV, a further pathogenic agent was found in bronchoalveolar lavage of five patients (Aspergillus spec., herpes simplex virus, Pseudomonas aeruginosa). CONCLUSION The most characteristic signs in chest CT scans were at the beginning of pneumonia with nodules and tree-in-bud often combined with bronchial wall thickening. The following CT scans showed characteristic but not pathognomonic chest CT findings of RSV pneumonia. These morphological findings should be recognized seasonally (winter) especially at the beginning of the case of pneumonia. RSV-associated additional sinusitis is probably common and should be noticed.
Collapse
|
50
|
Rengier F, Delles M, Jeong YJ, Tengg-Kobligk HV, Kauczor HU, Unterhinninghofen R, Ley S, Eichhorn J. Noninvasive 4D Pressure Difference Mapping Derived from 4D Flow MRI in Patients with Repaired Aortic Coarctation: Comparison with Young Healthy Volunteers. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|