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Guenzel K, Lukas Baumgaertner G, Padhani AR, Luckau J, Carsten Lock U, Ozimek T, Heinrich S, Schlegel J, Busch J, Magheli A, Struck J, Borgmann H, Penzkofer T, Hamm B, Hinz S, Alexander Hamm C. Diagnostic Utility of Artificial Intelligence-assisted Transperineal Biopsy Planning in Prostate Cancer Suspected Men: A Prospective Cohort Study. Eur Urol Focus 2024:S2405-4569(24)00059-2. [PMID: 38688825 DOI: 10.1016/j.euf.2024.04.007] [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: 01/30/2024] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND OBJECTIVE Accurate magnetic resonance imaging (MRI) reporting is essential for transperineal prostate biopsy (TPB) planning. Although approved computer-aided diagnosis (CAD) tools may assist urologists in this task, evidence of improved clinically significant prostate cancer (csPCa) detection is lacking. Therefore, we aimed to document the diagnostic utility of using Prostate Imaging Reporting and Data System (PI-RADS) and CAD for biopsy planning compared with PI-RADS alone. METHODS A total of 262 consecutive men scheduled for TPB at our referral centre were analysed. Reported PI-RADS lesions and an US Food and Drug Administration-cleared CAD tool were used for TPB planning. PI-RADS and CAD lesions were targeted on TPB, while four (interquartile range: 2-5) systematic biopsies were taken. The outcomes were the (1) proportion of csPCa (grade group ≥2) and (2) number of targeted lesions and false-positive rate. Performance was tested using free-response receiver operating characteristic curves and the exact Fisher-Yates test. KEY FINDINGS AND LIMITATIONS Overall, csPCa was detected in 56% (146/262) of men, with sensitivity of 92% and 97% (p = 0.007) for PI-RADS- and CAD-directed TPB, respectively. In 4% (10/262), csPCa was detected solely by CAD-directed biopsies; in 8% (22/262), additional csPCa lesions were detected. However, the number of targeted lesions increased by 54% (518 vs 336) and the false-positive rate doubled (0.66 vs 1.39; p = 0.009). Limitations include biopsies only for men at clinical/radiological suspicion and no multidisciplinary review of MRI before biopsy. CONCLUSIONS AND CLINICAL IMPLICATIONS The tested CAD tool for TPB planning improves csPCa detection at the cost of an increased number of lesions sampled and false positives. This may enable more personalised biopsy planning depending on urological and patient preferences. PATIENT SUMMARY The computer-aided diagnosis tool tested for transperineal prostate biopsy planning improves the detection of clinically significant prostate cancer at the cost of an increased number of lesions sampled and false positives. This may enable more personalised biopsy planning depending on urological and patient preferences.
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Affiliation(s)
- Karsten Guenzel
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany; Prostate-Diagnostic-Centre Berlin, PDZB, Berlin, Germany; Department of Urology, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.
| | | | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Middlesex, UK
| | - Johannes Luckau
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | | | - Tomasz Ozimek
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Stefan Heinrich
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Jakob Schlegel
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Jonas Busch
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Ahmed Magheli
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Julian Struck
- Department of Urology, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Hendrik Borgmann
- Department of Urology, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Hinz
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany; Department of Urology, Magdeburg University Medical Center, Otto von Guericke University, Magdeburg, Germany
| | - Charlie Alexander Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
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Lohmeier J, Radbruch H, Brenner W, Hamm B, Hansen B, Tietze A, Makowski MR. Detection of recurrent high-grade glioma using microstructure characteristics of distinct metabolic compartments in a multimodal and integrative 18F-FET PET/fast-DKI approach. Eur Radiol 2024; 34:2487-2499. [PMID: 37672058 PMCID: PMC10957712 DOI: 10.1007/s00330-023-10141-0] [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: 01/29/2023] [Revised: 06/25/2023] [Accepted: 07/06/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES Differentiation between high-grade glioma (HGG) and post-treatment-related effects (PTRE) is challenging, but advanced imaging techniques were shown to provide benefit. We aim to investigate microstructure characteristics of metabolic compartments identified from amino acid PET and to evaluate the diagnostic potential of this multimodal and integrative O-(2-18F-fluoroethyl)-L-tyrosine-(FET)-PET and fast diffusion kurtosis imaging (DKI) approach for the detection of recurrence and IDH genotyping. METHODS Fifty-nine participants with neuropathologically confirmed recurrent HGG (n = 39) or PTRE (n = 20) were investigated using static 18F-FET PET and a fast-DKI variant. PET and advanced diffusion metrics of metabolically defined (80-100% and 60-75% areas of 18F-FET uptake) compartments were assessed. Comparative analysis was performed using Mann-Whitney U tests with Holm-Šídák multiple-comparison test and Wilcoxon signed-rank test. Receiver operating characteristic (ROC) curves, regression, and Spearman's correlation analysis were used for statistical evaluations. RESULTS Compared to PTRE, recurrent HGG presented increased 18F-FET uptake and diffusivity (MD60), but lower (relative) mean kurtosis tensor (rMKT60) and fractional anisotropy (FA60) (respectively p < .05). Diffusion metrics determined from the metabolic periphery showed improved diagnostic performance - most pronounced for FA60 (AUC = 0.86, p < .001), which presented similar benefit to 18F-FET PET (AUC = 0.86, p < .001) and was negatively correlated with amino acid uptake (rs = - 0.46, p < .001). When PET and DKI metrics were evaluated in a multimodal biparametric approach, TBRmax + FA60 showed highest diagnostic accuracy (AUC = 0.93, p < .001), which improved the detection of relapse compared to PET alone (difference in AUC = 0.069, p = .04). FA60 and MD60 distinguished the IDH genotype in the post-treatment setting. CONCLUSION Detection of glioma recurrence benefits from a multimodal and integrative PET/DKI approach, which presented significant diagnostic advantage to the assessment based on PET alone. CLINICAL RELEVANCE STATEMENT A multimodal and integrative 18F-FET PET/fast-DKI approach for the non-invasive microstructural characterization of metabolic compartments provided improved diagnostic capability for differentiation between recurrent glioma and post-treatment-related changes, suggesting a role for the diagnostic workup of patients in post-treatment settings. KEY POINTS • Multimodal PET/MRI with integrative analysis of 18F-FET PET and fast-DKI presents clinical benefit for the assessment of CNS cancer, particularly for the detection of recurrent high-grade glioma. • Microstructure markers of the metabolic periphery yielded biologically pertinent estimates characterising the tumour microenvironment, and, thereby, presented improved diagnostic accuracy with similar accuracy to amino acid PET. • Combined 18F-FET PET/fast-DKI achieved the best diagnostic performance for detection of high-grade glioma relapse with significant benefit to the assessment based on PET alone.
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Affiliation(s)
- Johannes Lohmeier
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Helena Radbruch
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Brian Hansen
- Department of Clinical Medicine, Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Universitetsbyen 3, 8000, Aarhus C, Denmark
| | - Anna Tietze
- Institute of Neuroradiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Marcus R Makowski
- Department of Radiology, Technical University Munich, Ismaninger Str. 22, 81675, München, Germany
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Hamm CA, Baumgärtner GL, Padhani AR, Froböse KP, Dräger F, Beetz NL, Savic LJ, Posch H, Lenk J, Schallenberg S, Maxeiner A, Cash H, Günzel K, Hamm B, Asbach P, Penzkofer T. Reduction of false positives using zone-specific prostate-specific antigen density for prostate MRI-based biopsy decision strategies. Eur Radiol 2024:10.1007/s00330-024-10700-z. [PMID: 38538841 DOI: 10.1007/s00330-024-10700-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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVES To develop and test zone-specific prostate-specific antigen density (sPSAD) combined with PI-RADS to guide prostate biopsy decision strategies (BDS). METHODS This retrospective study included consecutive patients, who underwent prostate MRI and biopsy (01/2012-10/2018). The whole gland and transition zone (TZ) were segmented at MRI using a retrained deep learning system (DLS; nnU-Net) to calculate PSAD and sPSAD, respectively. Additionally, sPSAD and PI-RADS were combined in a BDS, and diagnostic performances to detect Grade Group ≥ 2 (GG ≥ 2) prostate cancer were compared. Patient-based cancer detection using sPSAD was assessed by bootstrapping with 1000 repetitions and reported as area under the curve (AUC). Clinical utility of the BDS was tested in the hold-out test set using decision curve analysis. Statistics included nonparametric DeLong test for AUCs and Fisher-Yates test for remaining performance metrics. RESULTS A total of 1604 patients aged 67 (interquartile range, 61-73) with 48% GG ≥ 2 prevalence (774/1604) were evaluated. By employing DLS-based prostate and TZ volumes (DICE coefficients of 0.89 (95% confidence interval, 0.80-0.97) and 0.84 (0.70-0.99)), GG ≥ 2 detection using PSAD was inferior to sPSAD (AUC, 0.71 (0.68-0.74)/0.73 (0.70-0.76); p < 0.001). Combining PI-RADS with sPSAD, GG ≥ 2 detection specificity doubled from 18% (10-20%) to 43% (30-44%; p < 0.001) with similar sensitivity (93% (89-96%)/97% (94-99%); p = 0.052), when biopsies were taken in PI-RADS 4-5 and 3 only if sPSAD was ≥ 0.42 ng/mL/cc as compared to all PI-RADS 3-5 cases. Additionally, using the sPSAD-based BDS, false positives were reduced by 25% (123 (104-142)/165 (146-185); p < 0.001). CONCLUSION Using sPSAD to guide biopsy decisions in PI-RADS 3 lesions can reduce false positives at MRI while maintaining high sensitivity for GG ≥ 2 cancers. CLINICAL RELEVANCE STATEMENT Transition zone-specific prostate-specific antigen density can improve the accuracy of prostate cancer detection compared to MRI assessments alone, by lowering false-positive cases without significantly missing men with ISUP GG ≥ 2 cancers. KEY POINTS • Prostate biopsy decision strategies using PI-RADS at MRI are limited by a substantial proportion of false positives, not yielding grade group ≥ 2 prostate cancer. • PI-RADS combined with transition zone (TZ)-specific prostate-specific antigen density (PSAD) decreased the number of unproductive biopsies by 25% compared to PI-RADS only. • TZ-specific PSAD also improved the specificity of MRI-directed biopsies by 9% compared to the whole gland PSAD, while showing identical sensitivity.
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Affiliation(s)
- Charlie A Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
- Berlin Institute of Health (BIH), Berlin, Germany.
| | - Georg L Baumgärtner
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
| | - Konrad P Froböse
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Franziska Dräger
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nick L Beetz
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Lynn J Savic
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Helena Posch
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Julian Lenk
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Simon Schallenberg
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Maxeiner
- Department of Urology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hannes Cash
- Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany
| | - Karsten Günzel
- Department of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Patrick Asbach
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
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Halskov S, Krenzien F, Segger L, Geisel D, Hamm B, Pelzer U, Ihlow J, Schöning W, Auer TA, Fehrenbach U. Intrahepatic Mass-Forming Cholangiocarcinoma: Is There Additional Prognostic Value in Using Gd-EOB Enhanced MRI? Cancers (Basel) 2024; 16:1314. [PMID: 38610992 PMCID: PMC11011032 DOI: 10.3390/cancers16071314] [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: 02/04/2024] [Revised: 03/12/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE To investigate the prognostic value of enhancement patterns of intrahepatic mass-forming cholangiocarcinomas (IMCCs) during the hepatobiliary phase (HBP) in gadoxetic acid (Gd-EOB)-enhanced MRI. METHODS We retrospectively identified 66 consecutive patients with histopathologically proven IMCCs (reference standard: resection) and preoperative Gd-EOB-enhanced MRI. Gd-EOB retention area was subjectively rated based on areas of intermediate signal intensity. Lesions were classified as either hypointense (0-25% retention area) or significantly-retaining (>25% retention area). Clinical, radiological, and prognostic features were compared between these groups. The primary endpoints were recurrence-free survival (RFS) and overall survival (OS) after primary surgical resection. RESULTS 73% (48/66) of lesions were rated as hypointense and 29% (19/66) as significantly-retaining. While the hypointense subgroup more frequently featured local and distant intrahepatic metastases (p = 0.039 and p = 0.022) and an infiltrative growth pattern (p = 0.005), RFS, OS, and clinical features did not differ significantly with estimated Gd-EOB retention area or quantitatively measured HBP enhancement ratios. Lymph node metastasis was an independent predictor of poor RFS (p = 0.001). CONCLUSIONS Gd-EOB-enhanced MRI revealed two subtypes of IMCC in the HBP: hypointense and signal-retaining. The hypointense subtype is associated with more frequent intrahepatic metastases and an infiltrative growth pattern, indicating potential tumor aggressiveness. However, this did not result in a significant difference in survival after the primary resection of IMCC.
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Affiliation(s)
- Sebastian Halskov
- Department of Radiology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Felix Krenzien
- Berlin Institute of Health, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
- Department of Surgery, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Laura Segger
- Department of Radiology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Uwe Pelzer
- Department of Hematology, Oncology and Cancer Immunology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jana Ihlow
- Berlin Institute of Health, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
- Institute of Pathology, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Wenzel Schöning
- Department of Surgery, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Timo Alexander Auer
- Department of Radiology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Berlin Institute of Health, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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Petersen A, Nagel SN, Hamm B, Elgeti T, Schaafs LA. The influence of left bundle branch block on myocardial T1 mapping. Sci Rep 2024; 14:5379. [PMID: 38438510 PMCID: PMC10912434 DOI: 10.1038/s41598-024-55821-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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/28/2024] [Indexed: 03/06/2024] Open
Abstract
Tissue characterisation using T1 mapping has become an established magnetic resonance imaging (MRI) technique to detect myocardial diseases. This retrospective study aimed to determine the influence of left bundle branch block (LBBB) on T1 mapping at 1.5 T. Datasets of 36 patients with LBBB and 27 healthy controls with T1 mapping (Modified Look-Locker inversion-recovery (MOLLI), 5(3)3 sampling) were included. T1 relaxation times were determined on mid-cavity short-axis images. R2 maps were generated as a pixel-wise indicator for the goodness of the fit of T1 maps. R2 values were significantly lower in patients with LBBB than in healthy controls (whole myocardium/septum, 0.997, IQR, 0.00 vs. 0.998, IQR, 0.00; p = 0.008/0.998, IQR, 0.00 vs. 0.999, IQR, 0.00; p = 0.027). Manual correction of semi-automated evaluation tended to improve R2 values but not significantly. Strain analysis was performed and the systolic dyssynchrony index (SDIglobal) was calculated as a measure for left ventricular dyssynchrony. While MRI is generally prone to artefacts, lower goodness of the fit in LBBB may be mainly attributable to asynchronous contraction. Therefore, careful checking of the source data and, if necessary, manual post-processing is important. New techniques might improve the goodness of the fit of T1 mapping by reducing sampling in the motion prone diastole of LBBB patients.
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Affiliation(s)
- Antonia Petersen
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Sebastian Niko Nagel
- Academic Department of Diagnostic and Interventional Radiology and Paediatric Radiology, Protestant Hospital of the Bethel Foundation, Bielefeld University, Medical School and University Medical Center East Westphalia-Lippe, Burgsteig 13, 33617, Bielefeld, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Thomas Elgeti
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Lars-Arne Schaafs
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
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Weidlich M, Hamm B, Schaafs LA, Elgeti T. Epicardial fat volume and its association with cardiac arrhythmias in CT coronary angiography. Pol J Radiol 2024; 89:e122-e127. [PMID: 38510546 PMCID: PMC10953510 DOI: 10.5114/pjr.2024.135797] [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: 11/22/2023] [Accepted: 02/01/2024] [Indexed: 03/22/2024] Open
Abstract
Purpose This retrospective study aimed to investigate the epicardial fat volume in cardiac computed tomography (CT), its relationship with cardiac arrhythmias, and its correlation with the coronary artery disease reporting and data system (CAD-RADS) score. Material and methods Ninety-six patients who underwent CT coronary angiography (CTCA) were included in this study. Patient data, including demographic information, clinical history, and imaging data were collected retrospectively. Epicardial fat volume was quantified using a standardised algorithm, the CAD-RADS scoring system was applied to assess the extent of coronary artery disease (CAD). Descriptive statistics, correlation analyses, and receiver operating characteristics methods were used. Results The study found a significant correlation between epicardial fat volume and CAD-RADS score (r2 = 0.31; p < 0.001), indicating the known influence of epicardial fat on CAD risk. Moreover, patients with higher epicardial fat volumes were more likely to experience cardiac tachyarrhythmia (p < 0.001). Receiver operating characteristic analysis established a threshold value of 123 cm3 for epicardial fat volume to predict tachyarrhythmia with 80% sensitivity (AUC = 0.69). Conclusions In this study a volume of at least 123 cm3 epicardial fat in native coronary calcium scans is associated with cardiac tachyarrhythmia. In these patients, careful selection of suitable imaging protocols is advised.
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Affiliation(s)
- Matthias Weidlich
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lars-Arne Schaafs
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Elgeti
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Münch F, Silivasan EIE, Spiesecke P, Göhler F, Galbavy Z, Eckardt KU, Hamm B, Fischer T, Lerchbaumer MH. Intra- and Interobserver Study Investigating the Adapted EFSUMB Bosniak Cyst Categorization Proposed for Contrast-Enhanced Ultrasound (CEUS) in 2020. Ultraschall Med 2024; 45:47-53. [PMID: 37072033 DOI: 10.1055/a-2048-6383] [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] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
BACKGROUND To investigate the inter- and intraobserver variability in comparison to an expert gold standard of the new and modified renal cyst Bosniak classification proposed for contrast-enhanced ultrasound findings (CEUS) by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) in 2020. MATERIALS AND METHODS 84 CEUS examinations for the evaluation of renal cysts were evaluated retrospectively by six readers with different levels of ultrasound expertise using the modified Bosniak classification proposed for CEUS. All cases were anonymized, and each case was rated twice in randomized order. The consensus reading of two experts served as the gold standard, to which all other readers were compared. Statistical analysis was performed using Cohen's weighted kappa tests, where appropriate. RESULTS Intraobserver variability showed substantial to almost perfect agreement (lowest kappa κ=0.74; highest kappa κ=0.94), with expert level observers achieving the best results. Comparison to the gold standard was almost perfect for experts (highest kappa κ=0.95) and lower for beginner and intermediate level readers still achieving mostly substantial agreement (lowest kappa κ=0.59). Confidence of rating was highest for Bosniak classes I and IV and lowest for classes IIF and III. CONCLUSION Categorization of cystic renal lesions based on the Bosniak classification proposed by the EFSUMB in 2020 showed very good reproducibility. While even less experienced observers achieved mostly substantial agreement, training remains a major factor for better diagnostic performance.
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Affiliation(s)
- Frederic Münch
- Department of Nephrology and Medical Intensive Care, Charite University Hospital Berlin, Berlin, Germany
| | | | - Paul Spiesecke
- Department of Radiology, Charite University Hospital Berlin, Berlin, Germany
| | - Friedemann Göhler
- Department of Radiology, Charite University Hospital Berlin, Berlin, Germany
| | - Zaza Galbavy
- Department of Emergency Medicine (CVK, CCM), Charite University Hospital Berlin, Berlin, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charite University Hospital Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charite University Hospital Berlin, Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charite University Hospital Berlin, Berlin, Germany
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Hamm B, Marti-Bonmati L, Sardanelli F. ESR Journals editors' joint statement on Guidelines for the Use of Large Language Models by Authors, Reviewers, and Editors. Insights Imaging 2024; 15:18. [PMID: 38267715 PMCID: PMC10808425 DOI: 10.1186/s13244-023-01600-9] [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: 01/26/2024] Open
Affiliation(s)
- Bernd Hamm
- European Society of Radiology (ESR), Vienna, Austria.
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Hamm B, Marti-Bonmati L, Sardanelli F. ESR Journals editors' joint statement on Guidelines for the Use of Large Language Models by Authors, Reviewers, and Editors. Eur Radiol Exp 2024; 8:7. [PMID: 38227105 DOI: 10.1186/s41747-023-00420-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Affiliation(s)
- Bernd Hamm
- European Society of Radiology (ESR), Vienna, Austria.
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Hamm B, Marti-Bonmati L, Sardanelli F. ESR Journals editors' joint statement on Guidelines for the Use of Large Language Models by Authors, Reviewers, and Editors. Eur Radiol 2024:10.1007/s00330-023-10511-8. [PMID: 38206406 DOI: 10.1007/s00330-023-10511-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Bernd Hamm
- European Society of Radiology (ESR), Vienna, Austria.
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Segger L, Lerchbaumer MH, Collettini F, Hamm B, Fleckenstein FN, Fehrenbach U, Gebauer B, Auer TA. Percutaneous Computed Tomography (CT) Fluoroscopy-Guided Biopsy of the Spleen Using Fibrin Glue as a Sealant. Diagnostics (Basel) 2024; 14:162. [PMID: 38248038 PMCID: PMC10814976 DOI: 10.3390/diagnostics14020162] [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: 11/28/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Some authors consider the risk of bleeding an absolute contraindication to percutaneous image-guided splenic puncture. While splenic punctures are mainly performed at specialized centers, no technique for the closure of the puncture tract has been broadly established. The aim of this study was to investigate the effectiveness and safety of a percutaneous image-guided biopsy of the spleen using fibrin glue to plug the tract. A total of 27 requests for splenic image-guided interventions were identified between 2010 and 2021 and considered for inclusion in our retrospective single-center study. Seven patients needed to be excluded, which left twenty patients who underwent a percutaneous computed tomography (CT) fluoroscopy-guided biopsy of a splenic lesion during this period. In all patients, a 17G coaxial needle with an 18G core biopsy needle was used. Diagnostic adequacy and accuracy were evaluated, and complications were classified using the CIRSE classification system for adverse events. Diagnostic adequacy was 100% (20/20), and a median of four samples were collected. Diagnostic accuracy was 80% (16/20). The four off-target samples included one inconclusive finding and three samples of regular spleen tissue. The overall complication rate was 5% (1/20). No mild (grade 1-2) or moderate (grade 3-4) complications occurred. One severe (grade 5-6) complication occurred. Although controversial and potentially high-risk, diagnostic percutaneous biopsies of the spleen appear to be relatively safe with the use of fibrin glue to seal the tract.
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Affiliation(s)
- Laura Segger
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
| | | | - Federico Collettini
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
| | - Florian Nima Fleckenstein
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
| | - Bernhard Gebauer
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
| | - Timo A. Auer
- Department of Radiology, Campus Virchow-Klinikum, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (F.C.); (B.H.); (F.N.F.); (U.F.); (B.G.); (T.A.A.)
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
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Hamm B. Navigating challenges and opportunities: a new era for European Radiology. Eur Radiol 2024; 34:3-5. [PMID: 38165431 DOI: 10.1007/s00330-023-10486-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Almutawakel S, Halleck F, Dürr M, Grittner U, Schrezenmeier E, Budde K, Althoff CE, Hamm B, Sack I, Fischer T, Marticorena Garcia SR. Shear Wave Elastography for Assessing Liver Stiffness in HCV-Infected Kidney Transplant Recipients after Direct-Acting Antiviral Treatment: A Comparative Study with Magnetic Resonance Elastography. J Clin Med 2023; 12:7547. [PMID: 38137615 PMCID: PMC10743898 DOI: 10.3390/jcm12247547] [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: 10/19/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Hepatitis C virus (HCV) infection can lead to hepatic fibrosis. The advent of direct-acting antivirals (DAAs) has substantially improved sustained virological response (SVR) rates. In this context, kidney transplant recipients (KTRs) are of particular interest due to their higher HCV infection rates and uncertain renal excretion and bioavailability of DAAs. We investigated liver stiffness after DAA treatment in 15 HCV-infected KTRs using ultrasound shear wave elastography (SWE) in comparison with magnetic resonance elastography (MRE). KTRs were treated with DAAs (daclatasvir and sofosbuvir) for three months and underwent SWE at baseline, end of therapy (EOT), and 3 (EOT+3) and 12 months (EOT+12) after EOT. Fourteen patients achieved SVR12. Shear wave speed (SWS)-as a surrogate parameter for tissue stiffness-was substantially lower at all three post-therapeutic timepoints compared with baseline (EOT: -0.42 m/s, p < 0.01; CI = -0.75--0.09, EOT+3: -0.43 m/s, p < 0.01; CI = -0.75--0.11, and EOT+12: -0.52 m/s, p < 0.001; CI = -0.84--0.19), suggesting liver regeneration after viral eradication and end of inflammation. Baseline SWS correlated positively with histopathological fibrosis scores (r = 0.48; CI = -0.11-0.85). Longitudinal results correlated moderately with APRI (r = 0.41; CI = 0.12-0.64) but not with FIB-4 scores (r = 0.12; CI = -0.19-0.41). Although higher on average, SWE-derived measurements correlated strongly with MRE (r = 0.64). In conclusion, SWE is suitable for non-invasive therapy monitoring in KTRs with HCV infection.
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Affiliation(s)
- Salma Almutawakel
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Fabian Halleck
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Michael Dürr
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Eva Schrezenmeier
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Klemens Budde
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian E. Althoff
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Bernd Hamm
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Ingolf Sack
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Thomas Fischer
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Stephan R. Marticorena Garcia
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
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Marth AA, Auer TA, Bertalan G, Gebert P, Kirchenberger T, Geisel D, Hamm B, Keller S. Advanced muscle imaging in adolescent elite rowers utilizing diffusion tensor imaging: Association of imaging findings with stroke typology. PLoS One 2023; 18:e0294693. [PMID: 38019893 PMCID: PMC10686450 DOI: 10.1371/journal.pone.0294693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Muscular overuse injuries are a common health issue in elite athletes. Changes in the muscular microenvironment can be depicted by Diffusion Tensor Imaging (DTI). We hypothesize that the biomechanics of different stroke typologies plays a role in muscle injury and tested our hypothesis by magnetic resonance imaging (MRI) examination of the lumbar spine muscles of adolescent rowers utilizing DTI. METHODS AND MATERIALS Twenty-two male elite rowers (12 sweep, 10 scull rowers) with a mean age of 15.8 ± 1.2 years underwent 3-Tesla MRI of the lumbar spine 6 hours after cessation of training. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated for the erector spinae and multifidus muscle. Student's t-test was used to test differences of DTI parameters between sweep and scull rowers and a Pearson correlation was utilized to correlate the parameters to training volume. RESULTS ADC values in the erector spinae and multifidus muscle were significantly higher (p = 0.039) and FA values significantly lower (p < 0.001) in sweep rowers compared to scull rowers. There was no significant association between DTI parameters and training volume (r ≤ -0.459, p ≥ 0.074). CONCLUSIONS Our DTI results show that lumbar spine muscle diffusivity is higher in sweep rowers than in scull rowers. Altered muscle diffusivity is suggestive of microscopic tissue disruption and might be attributable to biomechanical differences between stroke typologies.
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Affiliation(s)
- Adrian Alexander Marth
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timo Alexander Auer
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health at Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Gergely Bertalan
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Pimrapat Gebert
- Institute for Biometry, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timo Kirchenberger
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sarah Keller
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Lohmeier J, Radbruch H, Brenner W, Hamm B, Tietze A, Makowski MR. Predictive IDH Genotyping Based on the Evaluation of Spatial Metabolic Heterogeneity by Compartmental Uptake Characteristics in Preoperative Glioma Using 18F-FET PET. J Nucl Med 2023; 64:1683-1689. [PMID: 37652542 PMCID: PMC10626372 DOI: 10.2967/jnumed.123.265642] [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] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/13/2023] [Indexed: 09/02/2023] Open
Abstract
Molecular markers are of increasing importance for classifying, treating, and determining the prognosis for central nervous system tumors. Isocitrate dehydrogenase (IDH) is a critical regulator of glucose and amino acid metabolism. Our objective was to investigate metabolic reprogramming of glioma using compartmental uptake (CU) characteristics in O-(2-18F-fluoroethyl)-l-tyrosine (FET) PET and to evaluate its diagnostic potential for IDH genotyping. Methods: Between 2017 and 2022, patients with confirmed glioma were preoperatively investigated using static 18F-FET PET. Metabolic tumor volume (MTV), MTV for 60%-100% uptake (MTV60), and T2-weighted and contrast-enhancing lesion volumes were automatically segmented using U-Net neural architecture and isocontouring. Volume intersections were determined using the Dice coefficient. Uptake characteristics were determined for metabolically defined compartments (central [80%-100%] and peripheral [60%-75%] areas of 18F-FET uptake). CU ratio was defined as the fraction between the peripheral and central compartments. Mean target-to-background ratio was calculated. Comparisons were performed using parametric and nonparametric tests. Receiver-operating-characteristic curves, regression, and correlation were used for statistical analysis. Results: In total, 52 participants (male, 27, female, 25; mean age ± SD, 51 ± 16 y) were evaluated. MTV60 was greater and distinct from contrast-enhancing lesion volume (P = 0.046). IDH-mutated tumors presented a greater volumetric CU ratio and SUV CU ratio than IDH wild-type tumors (P < 0.05). Volumetric CU ratio determined IDH genotype with excellent diagnostic performance (area under the curve [AUC], 0.88; P < 0.001) at more than 5.49 (sensitivity, 86%, specificity, 90%), because IDH-mutated tumors presented a greater peripheral metabolic compartment than IDH wild-type tumors (P = 0.045). MTV60 and MTV were not suitable for IDH classification (P > 0.05). SUV CU ratio (AUC, 0.72; P = 0.005) and target-to-background ratio (AUC, 0.68; P = 0.016) achieved modest diagnostic performance-inferior to the volumetric CU ratio. Furthermore, the classification of loss of heterozygosity of chromosomes 1p and 19q (AUC, 0.75; P = 0.019), MGMT promoter methylation (AUC, 0.70; P = 0.011), and ATRX loss (AUC, 0.73; P = 0.004) by amino acid PET was evaluated. Conclusion: We proposed parametric 18F-FET PET as a noninvasive metabolic biomarker for the evaluation of CU characteristics, which differentiated IDH genotype with excellent diagnostic performance, establishing a critical association between spatial metabolic heterogeneity, mitochondrial tricarboxylic acid cycle, and genomic features with critical implications for clinical management and the diagnostic workup of patients with central nervous system cancer.
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Affiliation(s)
- Johannes Lohmeier
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany;
| | - Helena Radbruch
- Department of Neuropathology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Tietze
- Institute of Neuroradiology, Charité-Universitätsmedizin Berlin, Berlin, Germany; and
| | - Marcus R Makowski
- Department of Radiology, Technical University Munich, Munich, Germany
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Loch FN, Beyer K, Kreis ME, Kamphues C, Rayya W, Schineis C, Jahn J, Tronser M, Elsholtz FHJ, Hamm B, Reiter R. Diagnostic performance of Node Reporting and Data System (Node-RADS) for regional lymph node staging of gastric cancer by CT. Eur Radiol 2023:10.1007/s00330-023-10352-5. [PMID: 37921924 DOI: 10.1007/s00330-023-10352-5] [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: 03/24/2023] [Revised: 07/25/2023] [Accepted: 08/20/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVES Diagnostic performance of imaging for regional lymph node assessment in gastric cancer is still limited, and there is a lack of consensus on radiological evaluation. At the same time, there is an increasing demand for structured reporting using Reporting and Data Systems (RADS) to standardize oncological imaging. We aimed at investigating the diagnostic performance of Node-RADS compared to the use of various individual criteria for assessing regional lymph nodes in gastric cancer using histopathology as reference. METHODS In this retrospective single-center study, consecutive 91 patients (median age, 66 years, range 33-91 years, 54 men) with CT scans and histologically proven gastric adenocarcinoma were assessed using Node-RADS assigning scores from 1 to 5 for the likelihood of regional lymph node metastases. Additionally, different Node-RADS criteria as well as subcategories of altered border contour (lobulated, spiculated, indistinct) were assessed individually. Sensitivity, specificity, and Youden's index were calculated for Node-RADS scores, and all criteria investigated. Interreader agreement was calculated using Cohen's kappa. RESULTS Among all criteria, best performance was found for Node-RADS scores ≥ 3 and ≥ 4 with a sensitivity/specificity/Youden's index of 56.8%/90.7%/0.48 and 48.6%/98.1%/0.47, respectively, both with substantial interreader agreement (κ = 0.73 and 0.67, p < 0.01). Among individual criteria, the best performance was found for short-axis diameter of 10 mm with sensitivity/specificity/Youden's index of 56.8%/87.0%/0.44 (κ = 0.65, p < 0.01). CONCLUSION This study shows that structured reporting of combined size and configuration criteria of regional lymph nodes in gastric cancer slightly improves overall diagnostic performance compared to individual criteria including short-axis diameter alone. The results show an increase in specificity and unchanged sensitivity. CLINICAL RELEVANCE STATEMENT The results of this study suggest that Node-RADS may be a suitable tool for structured reporting of regional lymph nodes in gastric cancer. KEY POINTS • Assessment of lymph nodes in gastric cancer is still limited, and there is a lack of consensus on radiological evaluation. • Node-RADS in gastric cancer improves overall diagnostic performance compared to individual criteria including short-axis diameter. • Node-RADS may be a suitable tool for structured reporting of regional lymph nodes in gastric cancer.
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Affiliation(s)
- Florian N Loch
- Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Katharina Beyer
- Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Martin E Kreis
- Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Carsten Kamphues
- Department of Surgery, Parkklinik Weißensee, Schönstraße 80, 13086, Berlin, Germany
| | - Wael Rayya
- Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Christian Schineis
- Department of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Janosch Jahn
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Moritz Tronser
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Fabian H J Elsholtz
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Rolf Reiter
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
- BIH Charité Digital Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Charitéplatz 1, 10117, Berlin, Germany.
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Wakonig KM, Dommerich S, Fischer T, Arens P, Hamm B, Olze H, Lerchbaumer MH. The Diagnostic Performance of Multiparametric Ultrasound in the Qualitative Assessment of Inconclusive Cervical Lymph Nodes. Cancers (Basel) 2023; 15:5035. [PMID: 37894402 PMCID: PMC10605624 DOI: 10.3390/cancers15205035] [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: 09/01/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Enlarged cervical lymph nodes (CLNs) can result from infection or malignancies, and a definitive diagnosis requires histological examination. Ultrasound (US) remains the first-line imaging modality for detection, and new US techniques may improve characterization. The aim of our study was to investigate whether the qualitative assessment of multiparametric US (mpUS) can improve diagnostic performance in the differentiation of benign and malignant CLNs. METHODS 107 CLNs in 105 patients were examined by preoperative mpUS consisting of B-mode US, color-coded duplex sonography (CCDS), shear wave elastography (SWE) and contrast-enhanced US (CEUS). US images were evaluated in consensus by two experienced US operators. Histopathological examination was used as reference standard. RESULTS SWE and CEUS combined showed the highest overall diagnostic performance (91% sensitivity, 77% specificity, 87% positive predictive value (PPV), 83% negative predictive value (NPV), 90% accuracy, χ2 (1) = 51.485, p < 0.001) compared to B-mode US and CCDS (87% sensitivity, 44% specificity, 73% PPV, 65% NPV, 73% accuracy χ2 (1) = 12.415, p < 0.001). In terms of individual techniques, SWE had higher specificity than B-mode and CCDS (71% sensitivity, 90% specificity, 92% PPV, 64% NPV, 78% accuracy, χ2 (1) = 36.115, p < 0.001), while qualitative CEUS showed the best diagnostic performance of all investigated US techniques (93% sensitivity, 85% specificity, 91% PPV, 87% NPV, 90% accuracy, χ2 (1) = 13.219, p < 0.001). Perfusion patterns, homogeneity, presence of necrosis, and malignancy differed significantly between malignant and benign CLNs (p < 0.001). CONCLUSIONS SWE and CEUS can facilitate the differentiation of inconclusive CLNs when performed to supplement B-mode US and CCDS. MpUS may thus aid the decision between surgery and a watch-and-scan strategy in enlarged CLNs.
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Affiliation(s)
- Katharina Margherita Wakonig
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; (S.D.); (P.A.); (H.O.)
| | - Steffen Dommerich
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; (S.D.); (P.A.); (H.O.)
| | - Thomas Fischer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (T.F.); (B.H.); (M.H.L.)
| | - Philipp Arens
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; (S.D.); (P.A.); (H.O.)
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (T.F.); (B.H.); (M.H.L.)
| | - Heidi Olze
- Department of Otorhinolaryngology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; (S.D.); (P.A.); (H.O.)
| | - Markus Herbert Lerchbaumer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (T.F.); (B.H.); (M.H.L.)
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Auer TA, Halskov S, Fehrenbach U, Nevermann NF, Pelzer U, Mohr R, Hamm B, Schöning W, Horst D, Ihlow J, Geisel D. Gd-EOB MRI for HCC subtype differentiation in a western population according to the 5 th edition of the World Health Organization classification. Eur Radiol 2023; 33:6902-6915. [PMID: 37115216 PMCID: PMC10511376 DOI: 10.1007/s00330-023-09669-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/29/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES To investigate the value of gadoxetic acid (Gd-EOB)-enhanced magnetic resonance imaging (MRI) for noninvasive subtype differentiation of HCCs according to the 5th edition of the WHO Classification of Digestive System Tumors in a western population. METHODS This retrospective study included 262 resected lesions in 240 patients with preoperative Gd-EOB-enhanced MRI. Subtypes were assigned by two pathologists. Gd-EOB-enhanced MRI datasets were assessed by two radiologists for qualitative and quantitative imaging features, including imaging features defined in LI-RADS v2018 and area of hepatobiliary phase (HBP) iso- to hyperintensity. RESULTS The combination of non-rim arterial phase hyperenhancement with non-peripheral portal venous washout was more common in "not otherwise specified" (nos-ST) (88/168, 52%) than other subtypes, in particular macrotrabecular massive (mt-ST) (3/15, 20%), chromophobe (ch-ST) (1/8, 13%), and scirrhous subtypes (sc-ST) (2/9, 22%) (p = 0.035). Macrovascular invasion was associated with mt-ST (5/16, p = 0.033) and intralesional steatosis with steatohepatitic subtype (sh-ST) (28/32, p < 0.001). Predominant iso- to hyperintensity in the HBP was only present in nos-ST (16/174), sh-ST (3/33), and clear cell subtypes (cc-ST) (3/13) (p = 0.031). Associations were found for the following non-imaging parameters: age and sex, as patients with fibrolamellar subtype (fib-ST) were younger (median 44 years (19-66), p < 0.001) and female (4/5, p = 0.023); logarithm of alpha-fetoprotein (AFP) was elevated in the mt-ST (median 397 µg/l (74-5370), p < 0.001); type II diabetes mellitus was more frequent in the sh-ST (20/33, p = 0.027). CONCLUSIONS Gd-EOB-MRI reproduces findings reported in the literature for extracellular contrast-enhanced MRI and CT and may be a valuable tool for noninvasive HCC subtype differentiation. CLINICAL RELEVANCE STATEMENT Better characterization of the heterogeneous phenotypes of HCC according to the revised WHO classification potentially improves both diagnostic accuracy and the precision of therapeutic stratification for HCC. KEY POINTS • Previously reported imaging features of common subtypes in CT and MRI enhanced with extracellular contrast agents are reproducible with Gd-EOB-enhanced MRI. • While uncommon, predominant iso- to hyperintensity in the HBP was observed only in NOS, clear cell, and steatohepatitic subtypes. • Gd-EOB-enhanced MRI offers imaging features that are of value for HCC subtype differentiation according to the 5th edition of the WHO Classification of Digestive System Tumors.
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Affiliation(s)
- Timo A Auer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany.
| | - Sebastian Halskov
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Nora F Nevermann
- Department of Surgery - CVK/CCM, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Uwe Pelzer
- Department of Hematology, Oncology and Cancer Immunology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Raphael Mohr
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Wenzel Schöning
- Department of Surgery - CVK/CCM, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - David Horst
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jana Ihlow
- Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Kolck J, Auer TA, Walter-Rittel T, Hosse C, Elkilany A, Marth AA, Pelzer U, Mohr R, Krenzien F, Lurje G, Schöning W, Hamm B, Geisel D, Fehrenbach U. Prediction of regional lymph node metastasis in intrahepatic cholangiocarcinoma: it's not all about size. Abdom Radiol (NY) 2023; 48:3063-3071. [PMID: 37354262 PMCID: PMC10480242 DOI: 10.1007/s00261-023-03991-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES Lymph node metastases (LNM) are frequent in patients with intrahepatic cholangiocarcinoma (iCC) and worsen their prognosis even after surgery. Our aim was to investigate the predictive value of lymph node (LN) short axis, the most common discriminator for identifying LNM in tumor-imaging and to develop a predictive model for regional LNM in iCC taking computed tomography (CT) features of extranodal disease into account. MATERIALS AND METHODS We enrolled 102 patients with pathologically proven iCC who underwent CT prior to hepatic resection and hilar lymph node dissection (LND) from 2005 to 2021. Two blinded radiologists assessed various imaging characteristics and LN diameters, which were analyzed by bivariate and multivariate logistic regression to develop a prediction model for LNM. RESULTS Prevalence of LNM was high (42.4 %) and estimated survival was shorter in LN-positive patients (p = 0.07). An LN short axis diameter of ≥ 9 mm demonstrated the highest predictive power for LNM. Three additional, statistically significant imaging features, presence of intrahepatic metastasis (p = 0.003), hilar tumor infiltration (p = 0.003), and tumor growth along the liver capsule (p = 0.004), were integrated into a prediction model, which substantially outperformed use of LN axis alone in ROC analysis (AUC 0.856 vs 0.701). CONCLUSIONS LN diameter alone proved to be a relevant but unreliable imaging-marker for LNM prediction in iCC. Our proposed prognostic model, which additionally considers intrahepatic metastases and hilar and capsular infiltration, significantly improves discriminatory power. Hilar and capsular involvement might indicate direct tumor extension to lymphatic liver structures.
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Affiliation(s)
- Johannes Kolck
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Timo Alexander Auer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- BIH Biomedical Innovation Academy, Berlin Institute of Health at Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Thula Walter-Rittel
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Clarissa Hosse
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Aboelyazid Elkilany
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Uwe Pelzer
- Department of Hematology/Oncology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Raphael Mohr
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Krenzien
- BIH Biomedical Innovation Academy, Berlin Institute of Health at Charité -Universitätsmedizin Berlin, Berlin, Germany
- Department of Surgery CCM/CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Georg Lurje
- Department of Surgery CCM/CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Wenzel Schöning
- Department of Surgery CCM/CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Jensen LJ, Kim D, Elgeti T, Steffen IG, Schaafs LA, Hamm B, Nagel SN. The role of parametric feature maps to correct different volume of interest sizes: an in vivo liver MRI study. Eur Radiol Exp 2023; 7:48. [PMID: 37670193 PMCID: PMC10480134 DOI: 10.1186/s41747-023-00362-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/13/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Different volume of interest (VOI) sizes influence radiomic features. This study examined if translating images into feature maps before feature sampling could compensate for these effects in liver magnetic resonance imaging (MRI). METHODS T1- and T2-weighted sequences from three different scanners (two 3-T scanners, one 1.5-T scanner) of 66 patients with normal abdominal MRI were included retrospectively. Three differently sized VOIs (10, 20, and 30 mm in diameter) were drawn in the liver parenchyma (right lobe), excluding adjacent structures. Ninety-three features were extracted conventionally using PyRadiomics. All images were also converted to 93 parametric feature maps using a pretested software. Agreement between the three VOI sizes was assessed with overall concordance correlation coefficients (OCCCs), while OCCCs > 0.85 were rated reproducible. OCCCs were calculated twice: for the VOI sizes of 10, 20, and 30 mm and for those of 20 and 30 mm. RESULTS When extracted from original images, only 4 out of the 93 features were reproducible across all VOI sizes in T1- and T2-weighted images. When the smallest VOI was excluded, 5 features (T1-weighted) and 7 features (T2-weighted) were reproducible. Extraction from parametric maps increased the number of reproducible features to 9 (T1- and T2-weighted) across all VOIs. Excluding the 10-mm VOI, reproducibility improved to 16 (T1-weighted) and 55 features (T2-weighted). The stability of all other features also increased in feature maps. CONCLUSIONS Translating images into parametric maps before feature extraction improves reproducibility across different VOI sizes in normal liver MRI. RELEVANCE STATEMENT The size of the segmented VOI influences the feature quantity of radiomics, while software-based conversion of images into parametric feature maps before feature sampling improves reproducibility across different VOI sizes in MRI of normal liver tissue. KEY POINTS • Parametric feature maps can compensate for different VOI sizes. • The effect seems dependent on the VOI sizes and the MRI sequence. • Feature maps can visualize features throughout the entire image stack.
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Affiliation(s)
- Laura Jacqueline Jensen
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Damon Kim
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Thomas Elgeti
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Ingo Günter Steffen
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Lars-Arne Schaafs
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Bernd Hamm
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Sebastian Niko Nagel
- Charité-Universitätsmedizin Berlin, Department of Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
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Marth AA, Auer TA, Bertalan G, Gebert P, Kirchenberger T, Geisel D, Hamm B, Keller S. Low back pain in adolescent rowers: Association to muscle changes detected by magnetic resonance imaging. J Sports Sci 2023; 41:1558-1563. [PMID: 37979193 DOI: 10.1080/02640414.2023.2283289] [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] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023]
Abstract
Adult elite rowers are at risk of developing low back pain (LBP). However, LBP data on adolescent elite rowers is currently insufficient. Therefore, the aim of this study was to assess LBP prevalence, LBP intensity and training characteristics in male adolescent elite rowers and a healthy control group. Twenty rowers (mean age 15.8 ± 1.2 years) and a non-athletic control group matched by age and gender (n = 13) were prospectively enrolled and underwent LBP assessment with a validated questionnaire and magnetic resonance imaging (MRI) of the lumbar spine muscles, which included a T2-mapping sequence. From the quantitative image data, T2 relaxation times were calculated. The prevalence of LBP in the last 24 hours and 3 months in the rowing group was 55.0% and 85.0%, respectively, compared to 23.1% and 30.8% in the control group (p < 0.001). Rowers had significantly longer T2 relaxation times of the paraspinal muscles compared to controls (p ≤ 0.041). LBP intensity was associated with longer T2 relaxation times (p < 0.001). Adolescent rowers had a higher prevalence of LBP compared to an age-matched control group. The observed increase in T2 relaxation might be explained by muscle soreness due to strenuous exercise, which is correlated with short-term pain intensity.
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Affiliation(s)
- Adrian A Marth
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timo A Auer
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gergely Bertalan
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Pimrapat Gebert
- Institute for Biometry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Timo Kirchenberger
- Department of Sports Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sarah Keller
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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22
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Beetz NL, Dräger F, Hamm CA, Shnayien S, Rudolph MM, Froböse K, Elezkurtaj S, Haas M, Asbach P, Hamm B, Mahjoub S, Konietschke F, Wechsung M, Balzer F, Cash H, Hofbauer S, Penzkofer T. MRI-targeted biopsy cores from prostate index lesions: assessment and prediction of the number needed. Prostate Cancer Prostatic Dis 2023; 26:543-551. [PMID: 36209237 PMCID: PMC10449625 DOI: 10.1038/s41391-022-00599-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 05/20/2022] [Revised: 09/08/2022] [Accepted: 09/23/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is used to detect the prostate index lesion before targeted biopsy. However, the number of biopsy cores that should be obtained from the index lesion is unclear. The aim of this study is to analyze how many MRI-targeted biopsy cores are needed to establish the most relevant histopathologic diagnosis of the index lesion and to build a prediction model. METHODS We retrospectively included 451 patients who underwent 10-core systematic prostate biopsy and MRI-targeted biopsy with sampling of at least three cores from the index lesion. A total of 1587 biopsy cores were analyzed. The core sampling sequence was recorded, and the first biopsy core detecting the most relevant histopathologic diagnosis was identified. In a subgroup of 261 patients in whom exactly three MRI-targeted biopsy cores were obtained from the index lesion, we generated a prediction model. A nonparametric Bayes classifier was trained using the PI-RADS score, prostate-specific antigen (PSA) density, lesion size, zone, and location as covariates. RESULTS The most relevant histopathologic diagnosis of the index lesion was detected by the first biopsy core in 331 cases (73%), by the second in 66 cases (15%), and by the third in 39 cases (9%), by the fourth in 13 cases (3%), and by the fifth in two cases (<1%). The Bayes classifier correctly predicted which biopsy core yielded the most relevant histopathologic diagnosis in 79% of the subjects. PI-RADS score, PSA density, lesion size, zone, and location did not independently influence the prediction model. CONCLUSION The most relevant histopathologic diagnosis of the index lesion was made on the basis of three MRI-targeted biopsy cores in 97% of patients. Our classifier can help in predicting the first MRI-targeted biopsy core revealing the most relevant histopathologic diagnosis; however, at least three MRI-targeted biopsy cores should be obtained regardless of the preinterventionally assessed covariates.
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Affiliation(s)
- Nick Lasse Beetz
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin, Germany.
| | - Franziska Dräger
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Charlie Alexander Hamm
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Seyd Shnayien
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Madhuri Monique Rudolph
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Konrad Froböse
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sefer Elezkurtaj
- Department of Pathology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Haas
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Patrick Asbach
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Samy Mahjoub
- Department of Urology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Frank Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maximilian Wechsung
- Institute of Biometry and Clinical Epidemiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hannes Cash
- Department of Urology, University Hospital Magdeburg, Magdeburg, Sachsen-Anhalt, Germany
| | - Sebastian Hofbauer
- Department of Urology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charité University Hospital Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Berlin, Germany
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Marth AA, Auer TA, Walter-Rittel TC, Nevermann N, Krenzien F, Schmelzle M, Müller T, Kolck J, Wieners G, Geisel D, Gebauer B, Hamm B, Schöning W, Fehrenbach U. Gd-EOB-DTPA-MRCP to localize bile leakage after liver trauma and surgery: impact on treatment and outcome. Eur Radiol 2023; 33:5933-5942. [PMID: 37052657 PMCID: PMC10415430 DOI: 10.1007/s00330-023-09608-x] [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: 08/14/2022] [Revised: 02/20/2023] [Accepted: 03/19/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES Bile leakage (BL) is a challenging complication after hepatobiliary surgery and liver trauma. Gadolinium ethoxybenzyl (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiopancreatography (MRCP) is used to diagnose BL non-invasively. We assessed the value of Gd-EOB-DTPA-MRCP in the detection of postoperative and post-traumatic BL hypothesizing that exact identification of the leakage site is pivotal for treatment planning and outcome. METHODS We retrospectively enrolled 39 trauma and postoperative patients who underwent Gd-EOB-DTPA-MRCP for suspected BL. Three readers rated the presence of BL and leakage site (intraparenchymal, central, peripheral ± aberrant or disconnected ducts). Imaging findings were compared to subsequent interventional procedures and their complexity and outcome. RESULTS BL was detected in Gd-EOB-DTPA-MRCP in 25 of patients and was subsequently confirmed. Sites of BL differed significantly between postoperative (central [58%] and peripheral [42%]) and trauma patients (intraparenchymal [100%]; p < 0.001). Aberrant or disconnected ducts were diagnosed in 8%/26% of cases in the postoperative subgroup. Inter-rater agreement for the detection and localization of BL was almost perfect (Κ = 0.85 and 0.88; p < 0.001). Intraparenchymal BL required significantly less complex interventional procedures (p = 0.002), whereas hospitalization and mortality did not differ between the subgroups (p > 0.05). CONCLUSIONS Gd-EOB-DTPA-MRCP reliably detects and exactly locates BL in postoperative and trauma patients. Exact localization of biliary injuries enables specific treatment planning, as intraparenchymal leakages, which occur more frequently after trauma, require less complex interventions than central or peripheral leaks in the postoperative setting. As a result of specific treatment based on exact BL localization, there was no difference in the duration of hospitalization or mortality. CLINICAL RELEVANCE STATEMENT Gd-EOB-DTPA-MRCP is a reliable diagnostic tool for exactly localizing iatrogenic and post-traumatic biliary leakage. Its precise localization helps tailor local therapies for different injury patterns, resulting in comparable clinical outcomes despite varying treatments. KEY POINTS • Gd-EOB-DTPA-MRCP enables adequate detection and localization of bile leakages in both postoperative and post-traumatic patients. • The site of bile leakage significantly impacts the complexity of required additional interventions. • Intraparenchymal bile leakage is commonly seen in patients with a history of liver trauma and requires less complex interventions than postoperative central or peripheral bile leakages, while hospitalization and mortality are similar.
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Affiliation(s)
- Adrian A Marth
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Timo A Auer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thula C Walter-Rittel
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Nora Nevermann
- Department of Surgery | CCM | CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of General, Visceral and Transplant Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - Felix Krenzien
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Surgery | CCM | CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Moritz Schmelzle
- Department of Surgery | CCM | CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of General, Visceral and Transplant Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - Tobias Müller
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Kolck
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Gero Wieners
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernhard Gebauer
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Wenzel Schöning
- Department of Surgery | CCM | CVK, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Uli Fehrenbach
- Department of Radiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Jensen LJ, Loch FN, Kamphues C, Shahryari M, Marticorena Garcia SR, Siegmund B, Weidinger C, Kühl AA, Hamm B, Braun J, Sack I, Asbach P, Reiter R. Feasibility of in vivo magnetic resonance elastography of mesenteric adipose tissue in Crohn's disease. Quant Imaging Med Surg 2023; 13:4792-4805. [PMID: 37581033 PMCID: PMC10423387 DOI: 10.21037/qims-23-41] [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: 01/08/2023] [Accepted: 05/22/2023] [Indexed: 08/16/2023]
Abstract
Background Although there is growing evidence that functional involvement and structural changes of mesenteric adipose tissue (MAT) influence the course of Crohn's disease (CD), its viscoelastic properties remain elusive. Therefore, we aimed to investigate the viscoelastic properties of MAT in CD using magnetic resonance elastography (MRE), providing reference values for CD diagnosis. Methods In this prospective proof-of-concept study, 31 subjects (CD: n=11; healthy controls: n=20) were consecutively enrolled in a specialized care center for inflammatory bowel diseases (tertiary/quaternary care). Inclusion criteria for the CD patients were a clinically and endoscopically established diagnosis of CD based on the clinical record, absence of other concurrent bowel diseases, scheduled surgery for the following day, and age of at least 18 years. Diagnoses were confirmed by histological analysis of the resected bowel the day after MRE. Subjects were investigated using MRE at 1.5-T with frequencies of 40-70 Hz. To retrieve shear wave speed (SWS), volumes of interest (VOIs) in MAT were drawn adjacent to CD lesions (MATCD) and on the opposite side without adjacent bowel lesions in patients (MATCD_Opp) and controls (MATCTRL). The presented study is not registered in the clinical trial platform. Results A statistically significant decrease in mean SWS of 7% was found for MATCD_Opp vs. MATCTRL (0.76±0.05 vs. 0.82±0.04 m/s, P=0.012), whereas there was a nonsignificant trend with an 8% increase for MATCD vs. MATCD_Opp (0.82±0.07 vs. 0.76±0.05 m/s, P=0.098) and no difference for MATCD vs. MATCTRL. Preliminary area under the receiver operating characteristic curve (AUC) analysis showed diagnostic accuracy in detecting CD to be excellent for SWS of MATCD_Opp [AUC =0.82; 95% confidence interval (CI): 0.64-0.96] but poor for SWS of MATCD (AUC =0.52; 95% CI: 0.34-0.73). Conclusions This study demonstrates the feasibility of MRE of MAT and presents preliminary reference values for CD patients and healthy controls. Our results motivate further studies for the biophysical characterization of MAT in inflammatory bowel disease.
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Affiliation(s)
- Laura J. Jensen
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian N. Loch
- Department of Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Mehrgan Shahryari
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan R. Marticorena Garcia
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Britta Siegmund
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carl Weidinger
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anja A. Kühl
- iPATH.Berlin-Immunopathology for Experimental Models, Core Facility, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Braun
- Department of Medical Informatics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Patrick Asbach
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rolf Reiter
- Department of Radiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Berlin, Germany
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Molwitz I, Kemper C, Stahlmann K, Oechtering TH, Sieren MM, Afat S, Gerwing M, Bucher AM, Storz C, Langenbach MC, Reim M, Lotz J, Zagrosek-Regitz V, Can E, Köhler D, Yamamura J, Adam G, Hamm B, Keller S. Work expectations, their fulfillment, and exhaustion among radiologists of all career levels: what can be learned from the example of Germany. Eur Radiol 2023; 33:5664-5674. [PMID: 36897346 PMCID: PMC9999063 DOI: 10.1007/s00330-023-09510-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/31/2022] [Revised: 01/21/2023] [Accepted: 02/07/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES To evaluate work expectations of radiologists at different career levels, their fulfillment, prevalence of exhaustion, and exhaustion-associated factors. METHODS A standardized digital questionnaire was distributed internationally to radiologists of all career levels in the hospital and in ambulatory care via radiological societies and sent manually to 4500 radiologists of the largest German hospitals between December 2020 and April 2021. Statistics were based on age- and gender-adjusted regression analyses of respondents working in Germany (510 out of 594 total respondents). RESULTS The most frequent expectations were "joy at work" (97%) and a "good working atmosphere" (97%), which were considered fulfilled by at least 78%. The expectation of a "structured residency within the regular time interval" (79%) was more frequently judged fulfilled by senior physicians (83%, odds ratio (OR) 4.31 [95% confidence interval (95% CI) 1.95-9.52]), chief physicians (85%, 6.81 [95% CI 1.91-24.29]), and radiologists outside the hospital (88%, 7.59 [95% CI 2.40-24.03]) than by residents (68%). Exhaustion was most common among residents (physical exhaustion: 38%; emotional exhaustion: 36%), in-hospital specialists (29%; 38%), and senior physicians (30%; 29%). In contrast to paid extra hours, unpaid extra hours were associated with physical exhaustion (5-10 extra hours: OR 2.54 [95% CI 1.54-4.19]). Fewer opportunities to shape the work environment were related to a higher probability of physical (2.03 [95% CI 1.32-3.13]) and emotional (2.15 [95% CI 1.39-3.33]) exhaustion. CONCLUSIONS While most radiologists enjoy their work, residents wish for more training structure. Ensuring payment of extra hours and employee empowerment may help preventing burnout in high-risk groups. KEY POINTS • Most important work expectations of radiologists who work in Germany are "joy at work," a "good working atmosphere," "support for further qualification," and a "structured residency within the regular time interval," with the latter containing potential for improvement according to residents. • Physical and emotional exhaustion are common at all career levels except for chief physicians and for radiologists who work outside the hospital in ambulatory care. • Exhaustion as a major burnout criterion is associated with unpaid extra hours and reduced opportunities to shape the work environment.
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Affiliation(s)
- Isabel Molwitz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christoph Kemper
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Katharina Stahlmann
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thekla Helene Oechtering
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Malte Maria Sieren
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany
| | - Mirjam Gerwing
- Clinic of Radiology, Medical Faculty, University of Münster, Münster, Germany
| | - Andreas Michael Bucher
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt Am Main, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marcel C Langenbach
- Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Martin Reim
- Department of Radiology and Interventional Radiology, Tartu University Hospital, University of Tartu, Tartu, Estonia
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Vera Zagrosek-Regitz
- Institute for Gender in Medicine, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Cardiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Elif Can
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daniel Köhler
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- evidia Group, Berlin, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Hamm
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sarah Keller
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Kotlyarov M, Mews J, Ulas ST, Ziegeler K, Hamm B, Diekhoff T. Influence of contrast medium on tophus detection using dual-energy CT: phantom study and clinical illustration. Eur Radiol Exp 2023; 7:43. [PMID: 37486463 PMCID: PMC10366067 DOI: 10.1186/s41747-023-00348-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/25/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND To investigate the influence of iodinated contrast medium (ICM) on detection of monosodium urate (MSU) with dual-energy computed tomography (DECT) in two types of phantoms and demonstrate an example patient for clinical illustration. METHODS Approval is by the institutional review board, and written informed consent was obtained. A grid-like and a biophantom with 25 suspensions containing different concentrations of ICM (0 to 2%) and MSU (0 to 50%) were prepared and scanned with sequential single-source DECT using established methodology. Ascending orders of tube currents were applied at 80 kVp (16.5 to 220.0 mAs) and 135 kVp (2.75 to 19.25 mAs). Volume and mass measurements were performed using clinical gout software (dual-energy decomposition analysis). Numbers of true-positive and false-positive MSU detections were recorded and compared for different ICM concentrations. We demonstrate a patient with gouty arthritis for clinical illustration. RESULTS Effects of ICM on MSU detection varied with the amount of iodine. Lower ICM concentrations (0.25 and 0.50%) improved detection of small uric acid concentrations of 35 to 45% in comparison to scans without ICM. However, high ICM concentrations (1 and 2%) almost completely precluded MSU detection for all MSU concentrations investigated. In a patient with gouty arthritis, tophi in the wrist were only detected after intravenous ICM administration. CONCLUSIONS Exploring multimodal DECT for arthritis imaging, enhancement of ICM influences tophus detection. It can help in visualizing previously undetected MSU depositions but, with too strong enhancement, also obscure tophi. RELEVANCE STATEMENT Use of iodinated contrast media in dual-energy CT might help in visualizing previously undetected uric acid depositions but, with too strong enhancement, obscure gouty tophi. KEY POINTS • Iodine significantly influences the uric acid crystal detection in systematic phantom studies. • Lower iodine concentrations improved detection of low and medium uric acid concentrations. • High concentrations of iodine hampered detection of all uric acid concentrations.
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Affiliation(s)
- Maximilian Kotlyarov
- Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität Zu Berlin, Freie Universität Berlin, 10117, Berlin, Germany.
| | - Jürgen Mews
- Canon Medical Systems, Europe BV, Zoetermeer, Netherlands
| | - Sevtap Tugce Ulas
- Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität Zu Berlin, Freie Universität Berlin, 10117, Berlin, Germany
| | - Katharina Ziegeler
- Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität Zu Berlin, Freie Universität Berlin, 10117, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität Zu Berlin, Freie Universität Berlin, 10117, Berlin, Germany
| | - Torsten Diekhoff
- Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität Zu Berlin, Freie Universität Berlin, 10117, Berlin, Germany
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Bayerl C, Berg AK, Angermair S, Kim D, Hamm B, Beyer K, Schineis C. First successful treatment of Clostridium perfringens-associated emphysematous hepatitis: a case report. Front Med (Lausanne) 2023; 10:1164466. [PMID: 37265483 PMCID: PMC10229863 DOI: 10.3389/fmed.2023.1164466] [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: 02/12/2023] [Accepted: 04/18/2023] [Indexed: 06/03/2023] Open
Abstract
Emphysematous diseases of the abdomen are rare with an often inconspicuous presentation of symptoms and rapid lethal outcome if untreated. We report the first successfully treated case of Clostridium perfringens-associated emphysematous hepatitis. In the emergency room, a 79-year-old man presented with shortness of breath and deteriorated general condition since the morning of admission. Initial CT scans showed a small but rapidly expanding gas collection in liver segment 6. Emergency surgery with atypical liver resection was performed immediately. With early resection and prolonged administration of antibiotics in the presence of sepsis, the patient recovered successfully and was discharged 37 days after admission. As in our case, prompt diagnosis with early surgical treatment is crucial for the management of emphysematous hepatitis.
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Affiliation(s)
- Christian Bayerl
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Berlin, Germany
| | - Ann-Kathrin Berg
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Surgery, Berlin, Germany
| | - Stefan Angermair
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany
| | - Damon Kim
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Berlin, Germany
| | - Bernd Hamm
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Berlin, Germany
| | - Katharina Beyer
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Surgery, Berlin, Germany
| | - Christian Schineis
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Surgery, Berlin, Germany
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Bressem KK, Adams LC, Proft F, Hermann KGA, Diekhoff T, Spiller L, Niehues SM, Makowski MR, Hamm B, Protopopov M, Rios Rodriguez V, Haibel H, Rademacher J, Torgutalp M, Lambert RG, Baraliakos X, Maksymowych WP, Vahldiek JL, Poddubny D. Deep Learning Detects Changes Indicative of Axial Spondyloarthritis at MRI of Sacroiliac Joints. Radiology 2023; 307:e239007. [PMID: 37093751 DOI: 10.1148/radiol.239007] [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: 04/25/2023]
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Hamm CA, Baumgärtner GL, Biessmann F, Beetz NL, Hartenstein A, Savic LJ, Froböse K, Dräger F, Schallenberg S, Rudolph M, Baur ADJ, Hamm B, Haas M, Hofbauer S, Cash H, Penzkofer T. Interactive Explainable Deep Learning Model Informs Prostate Cancer Diagnosis at MRI. Radiology 2023; 307:e222276. [PMID: 37039688 DOI: 10.1148/radiol.222276] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Background Clinically significant prostate cancer (PCa) diagnosis at MRI requires accurate and efficient radiologic interpretation. Although artificial intelligence may assist in this task, lack of transparency has limited clinical translation. Purpose To develop an explainable artificial intelligence (XAI) model for clinically significant PCa diagnosis at biparametric MRI using Prostate Imaging Reporting and Data System (PI-RADS) features for classification justification. Materials and Methods This retrospective study included consecutive patients with histopathologic analysis-proven prostatic lesions who underwent biparametric MRI and biopsy between January 2012 and December 2017. After image annotation by two radiologists, a deep learning model was trained to detect the index lesion; classify PCa, clinically significant PCa (Gleason score ≥ 7), and benign lesions (eg, prostatitis); and justify classifications using PI-RADS features. Lesion- and patient-based performance were assessed using fivefold cross validation and areas under the receiver operating characteristic curve. Clinical feasibility was tested in a multireader study and by using the external PROSTATEx data set. Statistical evaluation of the multireader study included Mann-Whitney U and exact Fisher-Yates test. Results Overall, 1224 men (median age, 67 years; IQR, 62-73 years) had 3260 prostatic lesions (372 lesions with Gleason score of 6; 743 lesions with Gleason score of ≥ 7; 2145 benign lesions). XAI reliably detected clinically significant PCa in internal (area under the receiver operating characteristic curve, 0.89) and external test sets (area under the receiver operating characteristic curve, 0.87) with a sensitivity of 93% (95% CI: 87, 98) and an average of one false-positive finding per patient. Accuracy of the visual and textual explanations of XAI classifications was 80% (1080 of 1352), confirmed by experts. XAI-assisted readings improved the confidence (4.1 vs 3.4 on a five-point Likert scale; P = .007) of nonexperts in assessing PI-RADS 3 lesions, reducing reading time by 58 seconds (P = .009). Conclusion The explainable AI model reliably detected and classified clinically significant prostate cancer and improved the confidence and reading time of nonexperts while providing visual and textual explanations using well-established imaging features. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Chapiro in this issue.
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Affiliation(s)
- Charlie A Hamm
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Georg L Baumgärtner
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Felix Biessmann
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Nick L Beetz
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Alexander Hartenstein
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Lynn J Savic
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Konrad Froböse
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Franziska Dräger
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Simon Schallenberg
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Madhuri Rudolph
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Alexander D J Baur
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Bernd Hamm
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Matthias Haas
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Sebastian Hofbauer
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Hannes Cash
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
| | - Tobias Penzkofer
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany (C.A.H., G.L.B., N.L.B., A.H., L.J.S., K.F., F.D., M.R., A.D.J.B., B.H., M.H., S.H., T.P.); Berlin Institute of Health (BIH), Berlin, Germany (C.A.H., N.L.B., L.J.S., T.P.); Faculty VI-Informatics and Media, Berliner Hochschule für Technik (BHT), Einstein Center Digital Future, Berlin, Germany (G.L.B., F.B.); Bayer AG, Medical Affairs and Pharmacovigilance, Integrated Evidence Generation & Business Innovation, Berlin, Germany (A.H.); Institute of Pathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany (S.S.); and Department of Urology, Otto-von-Guericke-University Magdeburg, Germany and PROURO, Berlin, Germany (H.C.)
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30
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Segger L, Marth AA, Gosch V, Oppenheimer J, Lüken S, Bierbrauer A, Nilssen MS, Jahn M, Hamm B, Lerchbaumer M, Auer TA. Invest in the future: "Hands-on Radiology" summer school. Insights Imaging 2023; 14:53. [PMID: 36977861 PMCID: PMC10049897 DOI: 10.1186/s13244-023-01382-0] [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: 11/27/2022] [Accepted: 01/29/2023] [Indexed: 03/30/2023] Open
Abstract
PURPOSE The field of radiology is currently underestimated by undergraduate medical students. The "Hands-on Radiology" summer school was established to improve radiology knowledge and interest among undergraduates. The purpose of this questionnaire survey was to analyze whether a radiological hands-on course is an effective tool to reach and motivate undergraduate students. MATERIALS AND METHODS The three-day course held in August 2022 included lectures, quizzes, and small group hands-on workshops focusing on practical work with simulators. All participants (n = 30) were asked to rate their knowledge and motivation to specialize in radiology at the beginning of the summer school (day 1) and the end (day 3). The questionnaires included multiple choice questions, 10-point scale questions and open comment questions. The second questionnaire (day 3) included additional questions regarding the program (topic choice, length, etc.). RESULTS Out of 178 applicants, 30 students (16.8%) from 21 universities were selected to participate (50% female and 50% male students). All students completed both questionnaires. The overall rating was 9.47 on a 10-point scale. While the self-reported knowledge level increased from 6.47 (day 1) to 7.50 (day 3), almost all participants (96.7%, n = 29/30) mentioned an increased interest in the specialization of radiology after the event. Interestingly, most students (96.7%) preferred onsite teaching instead of online teaching and chose residents over board-certified radiologists as teachers. CONCLUSION Intensive three-day courses are valuable tools to strengthen interest in radiology and increase knowledge among medical students. Particularly, students who already have a tendency to specialize in radiology are further motivated.
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Affiliation(s)
- Laura Segger
- Department of Diagnostic and Interventional Radiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany.
| | - Adrian A Marth
- Department of Diagnostic and Interventional Radiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Vitus Gosch
- Department of Diagnostic and Interventional Radiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Jonas Oppenheimer
- Department of Radiology, Campus Benjamin-Franklin, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Sophia Lüken
- Department of Radiology, Campus Benjamin-Franklin, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Annika Bierbrauer
- Department of Radiology, Campus Benjamin-Franklin, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Martine S Nilssen
- Innlandet Hospital, Division Tynset, Sjukehusveien 9, 2500, Tynset, Norway
| | - Mona Jahn
- Central Institute of Radiology (ZIR), Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Bremserstr. 79, 67063, Ludwigshafen, Germany
| | - Bernd Hamm
- Department of Diagnostic and Interventional Radiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Markus Lerchbaumer
- Department of Radiology, Campus Mitte, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
| | - Timo A Auer
- Department of Diagnostic and Interventional Radiology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany
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31
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Petersen A, Nagel S, Hamm B, Taupitz M. Chest computed tomography findings typical of COVID-19 pneumonia in Germany as early as 30 December 2019: a case report. J Med Case Rep 2023; 17:117. [PMID: 36964561 PMCID: PMC10038364 DOI: 10.1186/s13256-023-03809-0] [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: 11/21/2021] [Accepted: 01/31/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND The first cases of coronavirus disease 2019 were officially confirmed in Germany and its European neighbors in late January 2020. In France and Italy, there is evidence that coronavirus disease 2019 was spreading as early as December 2019. CASE PRESENTATION We report on a 71-year-old male patient from Germany who was admitted to our hospital on 30 December 2019 with pneumonia of unclear etiology and chest computed tomography findings typical of COVID-19 pneumonia. CONCLUSION This case may indicate that coronavirus disease 2019 was already spreading in Germany as early as December 2019.
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Affiliation(s)
- Antonia Petersen
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Sebastian Nagel
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Matthias Taupitz
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
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32
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Gertler C, Jauert N, Freyhardt P, Valentova M, Aland SC, Walter-Rittel TC, Unterberg-Buchwald C, Placzek M, Ding-Reinelt V, Bekfani T, Doehner W, Hasenfuß G, Hamm B, Sandek A. Magnetic resonance imaging of organ iron before and after correction of iron deficiency in patients with heart failure. ESC Heart Fail 2023; 10:1847-1859. [PMID: 36907649 DOI: 10.1002/ehf2.14329] [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: 08/24/2022] [Revised: 11/29/2022] [Accepted: 02/06/2023] [Indexed: 03/14/2023] Open
Abstract
AIMS Intravenous iron therapy (IVIT) is known to improve functional status in chronic heart failure (CHF) patients. The exact mechanism is not completely understood. We correlated magnetic resonance imaging (MRI) patterns of T2* iron signal in various organs to systemic iron and exercise capacity (EC) in CHF before and after IVIT. METHODS AND RESULTS We prospectively analysed 24 patients with systolic CHF for T2* MRI pattern of the left ventricle (LV), small and large intestines, spleen, liver, skeletal muscle, and brain for iron. In 12 patients with iron deficiency (ID), we restored iron deficit by IVIT using ferric carboxymaltose. The effects after 3 months were analysed by spiroergometry and MRI. Patients with vs. without ID showed lower blood ferritin, haemoglobin (76 ± 63 vs. 196 ± 82 μg/L and 12.3 ± 1.1 vs. 14.2 ± 1.1 g/dL, all P < 0.002), and in trend a lower transferrin saturation (TSAT) (19.1 [13.1; 28.2] vs. 25.1 [21.3; 29.1] %, P = 0.05). Spleen and liver iron was lower as expressed by higher T2* value (71.8 [66.4; 93.1] vs. 36.9 [32.9; 51.7] ms, P < 0.002 and 33.5 ± 5.9 vs. 28.8 ± 3.9 ms, and P < 0.03). There was a strong trend for a lower cardiac septal iron content in ID (40.6 [33.0; 57.3] vs. 33.7 [31.3; 40.2] ms, P = 0.07). After IVIT, ferritin, TSAT, and haemoglobin increased (54 [30; 104] vs. 235 [185; 339] μg/L, 19.1 [13.1; 28.2] vs. 25.0 [21.0; 33.7] %, 12.3 ± 1.1 vs. 13.3 ± 1.3 g/L, all P < 0.04). Peak VO2 improved (18.2 ± 4.2 vs. 20.9 ± 3.8 mL/min/kg-1 , P = 0.05). Higher peak VO2 at anaerobic threshold was associated with higher blood ferritin, reflecting higher metabolic exercise capacity after therapy (r = 0.9, P = 0.0009). Increase in EC was associated with haemoglobin increase (r = 0.7, P = 0.034). LV iron increased by 25.4% (48.5 [36.2; 64.8] vs. 36.2 [32.9; 41.9] ms, P < 0.04). Spleen and liver iron increased by 46.4 and 18.2%, respectively (71.8 [66.4; 93.1] vs. 38.5 [22.4; 76.9] ms, P < 0.04 and 33.5 ± 5.9 vs. 27.4 ± 8.6 ms, P < 0.007). Iron in skeletal muscle, brain, intestine, and bone marrow remained unchanged (29.6 [28.6; 31.2] vs. 30.4 [29.7; 30.7] ms, P = 0.7, 81.0 ± 6.3 vs. 82.9 ± 9.9 ms, P = 0.6, 34.3 ± 21.4 vs. 25.3 ± 14.1 ms, P = 0.2, 9.4 [7.5; 21.8] vs. 10.3 [6.7; 15.7] ms, P = 0.5 and 9.8 ± 1.5 vs. 13.7 ± 8.9 ms, P = 0.1). CONCLUSIONS CHF patients with ID showed lower spleen, liver, and in trend lower cardiac septal iron. After IVIT, iron signal of the left ventricle as well as spleen and liver increased. Improvement in EC was associated with increase in haemoglobin after IVIT. In ID, liver, spleen, and brain but not heart iron were associated with markers of systemic ID.
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Affiliation(s)
- Christoph Gertler
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany
| | - Nadja Jauert
- BIH Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Freyhardt
- Department of Diagnostic and Interventional Radiology, Helios Hospital Krefeld, Krefeld, Germany.,School of Medicine, Faculty of Health, University Witten-Herdecke, Witten, Germany
| | - Miroslava Valentova
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany
| | - Sven Christopher Aland
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany
| | | | - Christina Unterberg-Buchwald
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany.,Institute for Diagnostic and Interventional Radiology, University of Göttingen Medical Center, Göttingen, Germany
| | - Marius Placzek
- Department of Medical Statistics, University of Göttingen, Göttingen, Germany
| | | | - Tarek Bekfani
- Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Magdeburg, Otto von Guericke-University, Magdeburg, Germany
| | - Wolfram Doehner
- BIH Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anja Sandek
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany
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Shnayien S, Beetz NL, Bressem KK, Hamm B, Niehues SM. Comparison of a High-Pitch Non-ECG-Gated and a Prospective ECG-Gated Protocol for Preprocedural Computed Tomography Imaging Before TAVI/TAVR. ROFO-FORTSCHR RONTG 2023; 195:139-147. [PMID: 36063835 DOI: 10.1055/a-1898-6504] [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: 02/04/2023]
Abstract
PURPOSE Preprocedural computed tomography (CT) imaging before transcatheter aortic valve implantation/replacement (TAVI/TAVR) requires high diagnostic accuracy without motion artifacts. The aim of this retrospective study is to compare the image quality of a high-pitch non-electrocardiography (ECG)-gated CT protocol used in patients with atrial tachyarrhythmias with a prospectively ECG-gated CT protocol used in patients with sinus rhythm. MATERIALS AND METHODS We retrospectively included 108 patients who underwent preprocedural CT imaging before TAVI/TAVR. 52 patients with sinus rhythm were imaged using a prospectively ECG-gated protocol (Group A), and 56 patients with atrial tachyarrhythmias were imaged using the high-pitch non-ECG-gated protocol (Group B). Image quality was rated subjectively by two experienced radiologists and assessed by objective parameters including radiation dose, image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) at the levels of the aortic root and abdominal aorta. RESULTS Subjective image quality was equally good with both CT protocols, and interrater agreement was substantial in both groups but tended to be higher in Group B at the level of the aortic root (Group A: κw = 0.644, Group B: κw = 0.741). With the high-pitch non-ECG-gated CT protocol, image noise was significantly increased (p = 0.001), whereas the SNR, CNR, and radiation dose were significantly decreased (p = 0.002, p = 0.003, and p < 0.001, respectively) at the level of the aortic root compared to the prospectively ECG-gated CT protocol. CONCLUSION The high-pitch non-ECG-gated protocol yields images with similar subjective image quality compared with the prospectively ECG-gated CT protocol and allows motion-free assessment of the aortic root for accurate TAVI/TAVR planning. The high-pitch non-ECG-gated protocol may be used as an alternative for preprocedural CT imaging in patients with atrial tachyarrhythmias. KEY POINTS · In patients with atrial tachyarrhythmias, a high-pitch non-ECG-gated CT protocol achieves similar subjective image quality compared to a prospective ECG-gated CT protocol.. · At the level of the aortic root, image noise is significantly increased, whereas SNR and CNR are significantly decreased using the high-pitch non-ECG-gated protocol.. · Radiation dose is reduced by 55 % using the high-pitch non-ECG-gated protocol.. CITATION FORMAT · Shnayien S, Beetz N, Bressem KK et al. Comparison of a High-Pitch Non-ECG-Gated and a Prospective ECG-Gated Protocol for Preprocedural Computed Tomography Imaging Before TAVI/TAVR. Fortschr Röntgenstr 2023; 195: 139 - 147.
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Affiliation(s)
- Seyd Shnayien
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Nick Lasse Beetz
- Department of Radiology, Charite University Hospital Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Bernd Hamm
- Department of Radiology, Charite University Hospital Berlin, Germany
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Abstract
BACKGROUND Computed tomography is a standard imaging procedure for the detection of liver lesions, such as metastases, which can often be small and poorly contrasted, and therefore hard to detect. Advances in image reconstruction have shown promise in reducing image noise and improving low-contrast detectability. PURPOSE To examine a novel, specialized, model-based iterative reconstruction (MBIR) technique for improved low-contrast liver lesion detection. MATERIAL AND METHODS Patient images with reported poorly contrasted focal liver lesions were retrospectively reconstructed with the low-contrast attenuating algorithm (FIRST-LCD) from primary raw data. Liver-to-lesion contrast, signal-to-noise, and contrast-to-noise ratios for background and liver noise for each lesion were compared for all three FIRST-LCD presets with the established hybrid iterative reconstruction method (AIDR-3D). An additional visual conspicuity score was given by two experienced radiologists for each lesion. RESULTS A total of 82 lesions in 57 examinations were included in the analysis. All three FIRST-LCD algorithms provided statistically significant increases in liver-to-lesion contrast, with FIRSTMILD showing the largest increase (40.47 HU in AIDR-3D; 45.84 HU in FIRSTMILD; P < 0.001). Substantial improvement was shown in contrast-to-noise metrics. Visual analysis of the lesions shows decreased lesion visibility with all FIRST methods in comparison to AIDR-3D, with FIRSTSTR showing the closest results (P < 0.001). CONCLUSION Objective image metrics show promise for MBIR methods in improving the detectability of low-contrast liver lesions; however, subjective image quality may be perceived as inferior. Further improvements are necessary to enhance image quality and lesion detection.
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Affiliation(s)
- Jonas Oppenheimer
- Department of Radiology, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany ,Jonas Oppenheimer, Charité – Universitätsmedizin Berlin, Clinic for Radiology Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Keno Kyrill Bressem
- Department of Radiology, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany ,Berlin Institute of Health at Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Henry Jürgen Elsholtz
- Department of Radiology, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefan Markus Niehues
- Department of Radiology, Charité, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Lerchbaumer MH, Aviram G, Ebner M, Ritter CO, Steimke L, Rozenbaum Z, Adam SZ, Granot Y, Hasenfuß G, Lotz J, Hamm B, Konstantinides SV, Lankeit M. Optimized definition of right ventricular dysfunction on computed tomography for risk stratification of pulmonary embolism. Eur J Radiol 2022; 157:110554. [PMID: 36308850 DOI: 10.1016/j.ejrad.2022.110554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES There is an ongoing discussion on the optimal right to left (RV/LV) diameter ratio threshold and the best definition of RV dysfunction on computed tomography pulmonary angiography (CTPA) for risk assessment of pulmonary embolism (PE). METHODS On routine diagnostic CTPA, volumetric and diameter measurements (axial and reconstructed views) of the ventricles and reflux of contrast medium into the inferior vena cava (IVC) and hepatic veins were assessed in consecutive PE patients enrolled in a prospective single-center registry. In-hospital adverse outcome was defined as PE-related death, cardiopulmonary resuscitation, mechanical ventilation or catecholamine administration. RESULTS Of 609 patients (median age, 69 [IQR, 56-77] years; 47 % male) included in the analysis, 68 patients (11.2 %) had an adverse outcome and 35 (5.7 %) died. While neither a RV/LV volume ratio ≥1.0 nor RV/LV diameter ratios ≥1.0 were able to predict an adverse outcome, higher thresholds increased specificity. Further, neither volumetric measurements nor reconstruction of images provided superior prognostic information compared to RV/LV ratios measured in axial planes. The combination of an axial RV/LV diameter ratio ≥1.5 with substantial reflux of contrast medium was present in 134 patients (22 %) and associated with the best prognostic performance to predict an adverse outcome in unselected (OR 3.7 [95 % CI, 2.0-6.6]) and normotensive (OR 2.8 [95 % CI, 1.1-6.7]) patients. CONCLUSION A new definition of RV dysfunction (axial RV/LV diameter ratio ≥1.5 and substantial reflux of contrast medium to the IVC and hepatic veins) allows an optimized CTPA-based prediction of PE-related adverse outcome.
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Affiliation(s)
| | - Galit Aviram
- Department of Radiology, Tel Aviv Medical Centre, Tel Aviv, Israel(2)
| | - Matthias Ebner
- Department of Cardiology and Angiology, Campus Charité Mitte (CCM), Charité - University Medicine Berlin, Germany
| | - Christian O Ritter
- Institute for Diagnostic and Interventional Radiology, University Medical Center, Goettingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Goettingen, Germany
| | - Laura Steimke
- Clinic of Cardiology and Pneumology, University Medical Center, Goettingen, Germany
| | - Zach Rozenbaum
- Department of Cardiology, Tel Aviv Medical Centre, Tel Aviv, Israel(3)
| | - Sharon Z Adam
- Department of Radiology, Tel Aviv Medical Centre, Tel Aviv, Israel(2)
| | - Yoav Granot
- Department of Cardiology, Tel Aviv Medical Centre, Tel Aviv, Israel(3)
| | - Gerd Hasenfuß
- German Center for Cardiovascular Research (DZHK), Partner Site Goettingen, Germany; Clinic of Cardiology and Pneumology, University Medical Center, Goettingen, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center, Goettingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Goettingen, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - University Medicine Berlin, Germany
| | - Stavros V Konstantinides
- Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece; Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Germany
| | - Mareike Lankeit
- Clinic of Cardiology and Pneumology, University Medical Center, Goettingen, Germany; Department of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité - University Medicine Berlin, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Germany
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Elgeti T, Fröhlich M, Wismayer KK, Tzschätzsch H, Hamm B, Sack I, Schaafs LA. The effect of smoking on quantification of aortic stiffness by ultrasound time-harmonic elastography. Sci Rep 2022; 12:17759. [PMID: 36273020 PMCID: PMC9588008 DOI: 10.1038/s41598-022-22638-7] [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: 09/20/2022] [Accepted: 10/18/2022] [Indexed: 01/19/2023] Open
Abstract
Smoking is a significant cardiovascular risk factor that causes stiffening of the central arteries, especially the aorta. While vessel stiffness can be determined indirectly by measuring pulse wave velocity, elastography allows image-based determination of vessel stiffness while at the same time providing information on vascular morphology. This study compares abdominal aortic wall stiffness as measured by ultrasound time-harmonic elastography (THE) in fifteen smokers and fifteen age-matched non-smoking controls without a history of cardiovascular disease. Smokers had a significantly higher abdominal aortic wall stiffness with a mean shear wave speed of 2.66 m/s (95% confidence interval (CI) 2.59-2.72 m/s) compared to 2.40 m/s (95% CI 2.34-2.47 m/s) (p < 0.01) in the group of non-smokers. All other baseline characteristics including aortic diameter showed no significant differences. Inter-rater variability was excellent with an intraclass correlation coefficient of 0.99 (95% CI 0.98-0.99). Our results show that THE is sensitive to subclinical stiffening of the aorta in young and middle-aged smokers even before morphological changes occur and may therefore has the potential to serve as a screening tool for early aortic abnormalities and longitudinal risk factors for cardiovascular health.
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Affiliation(s)
- Thomas Elgeti
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Matthias Fröhlich
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neonatology, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Kim Kathrin Wismayer
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Heiko Tzschätzsch
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Bernd Hamm
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Ingolf Sack
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Lars-Arne Schaafs
- grid.6363.00000 0001 2218 4662Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Hindenburgdamm 30, 12203 Berlin, Germany
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Petersen A, Nagel SN, Hamm B, Elgeti T, Schaafs LA. Cardiac magnetic resonance imaging in patients with left bundle branch block: Patterns of dyssynchrony and implications for late gadolinium enhancement imaging. Front Cardiovasc Med 2022; 9:977414. [PMID: 36337885 PMCID: PMC9631472 DOI: 10.3389/fcvm.2022.977414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background Left bundle branch block (LBBB) is a ventricular conduction delay with high prevalence. Aim of our study is to identify possible recurring patterns of artefacts in late gadolinium enhancement (LGE) imaging in patients with LBBB who undergo cardiac magnetic resonance imaging (MRI) and to define parameters of mechanical dyssynchrony associated with artefacts in LGE images. Materials and methods Fifty-five patients with LBBB and 62 controls were retrospectively included. Inversion time (TI) scout and LGE images were reviewed for artefacts. Dyssynchrony was identified using cardiac MRI by determining left ventricular systolic dyssynchrony indices (global, septal segments, and free wall segments) derived from strain analysis and features of mechanical dyssynchrony (apical rocking and septal flash). Results Thirty-seven patients (67%) with LBBB exhibited inhomogeneous myocardial nulling in TI scout images. Among them 25 (68%) patients also showed recurring artefact patterns in the septum or free wall on LGE images and artefacts also persisted in 18 (72%) of those cases when utilising phase sensitive inversion recovery. Only the systolic dyssynchrony index of septal segments allowed differentiation of patient subgroups (artefact/no artefact) and healthy controls (given as median, median ± interquartile range); LBBB with artefact: 10.44% (0.44–20.44%); LBBB without artefact: 6.82% (-2.18–15.83%); controls: 4.38% (1.38–7.38%); p < 0.05 with an area under the curve of 0.863 (81% sensitivity, 89% specificity). Septal flash and apical rocking were more frequent in the LBBB with artefact group than in the LBBB without artefact group (70 and 62% versus 33 and 17%; p < 0.05). Conclusion Patients with LBBB show recurring artefact patterns in LGE imaging. Use of strain analysis and evaluation of mechanical dyssynchrony may predict the occurrence of such artefacts already during the examination and counteract misinterpretation.
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Gorodetski B, Becker PH, Baur ADJ, Hartenstein A, Rogasch JMM, Furth C, Amthauer H, Hamm B, Makowski M, Penzkofer T. Inferring FDG-PET-positivity of lymph node metastases in proven lung cancer from contrast-enhanced CT using radiomics and machine learning. Eur Radiol Exp 2022; 6:44. [PMID: 36104467 PMCID: PMC9474782 DOI: 10.1186/s41747-022-00296-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background We evaluated the role of radiomics applied to contrast-enhanced computed tomography (CT) in the detection of lymph node (LN) metastases in patients with known lung cancer compared to 18F-fluorodeoxyglucose positron emission tomography (PET)/CT as a reference. Methods This retrospective analysis included 381 patients with 1,799 lymph nodes (450 malignant, 1,349 negative). The data set was divided into a training and validation set. A radiomics analysis with 4 filters and 6 algorithms resulting in 24 different radiomics signatures and a bootstrap algorithm (Bagging) with 30 bootstrap iterations was performed. A decision curve analysis was applied to generate a net benefit to compare the radiomics signature to two expert radiologists as one-by-one and as a prescreening tool in combination with the respective radiologist and only the radiologists. Results All 24 modeling methods showed good and reliable discrimination for malignant/benign LNs (area under the curve 0.75−0.87). The decision curve analysis showed a net benefit for the least absolute shrinkage and selection operator (LASSO) classifier for the entire probability range and outperformed the expert radiologists except for the high probability range. Using the radiomics signature as a prescreening tool for the radiologists did not improve net benefit. Conclusions Radiomics showed good discrimination power irrespective of the modeling technique in detecting LN metastases in patients with known lung cancer. The LASSO classifier was a suitable diagnostic tool and even outperformed the expert radiologists, except for high probabilities. Radiomics failed to improve clinical benefit as a prescreening tool. Supplementary Information The online version contains supplementary material available at 10.1186/s41747-022-00296-8.
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Auer J, Braun J, Lenk J, Gollrad J, Ro SR, Hamm B, de Bucourt M. Tunneled hemodialysis catheter insertion: Above, within, or below the right atrium-Where is the tip? Acta Radiol Open 2022; 11:20584601221122421. [PMID: 36134126 PMCID: PMC9483979 DOI: 10.1177/20584601221122421] [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: 11/18/2021] [Accepted: 08/05/2022] [Indexed: 11/21/2022] Open
Abstract
Background One major challenge when inserting a tunneled, cuffed central venous catheter (CVC) for hemodialysis under fluoroscopy is to accurately place the catheter tip by assessing its position in relation to the cardiac silhouette to approximate the right atrium (RA). Purpose To investigate whether a weighted mean calculated from published results for two two-dimensional landmark reference distances may be useful in assessing CVC tip positions in relation to the RA. Material and Methods Central venous catheter tip positions attained under fluoroscopic imaging during insertion using the cardiac silhouette as approximation were retrospectively related to two reference distances (carina to cranial RA border and craniocaudal RA extent), which were used to group catheter tip locations above (1), within (2), or below (3) the RA (henceforth referred to as landmark technique approximation, LTA). The LTA-derived catheter tip locations were validated by correlation with postinterventional computed tomography (CT) datasets acquired shortly after implantation (if available). Results Based on LTA, 45 catheter tips (10.6%) were above, 179 (42.2%) within, and 200 (47.2%) below the RA. Postinterventional CT (n = 57; 13.4%) visualized 26.3% above, 66.7% within, and 7.0% below the RA. Conclusion The LTA reference distances appear to lead to a rather low categorization of the CVC tips, or the tips have been placed rather low in the study population. Validation using postinterventional CT indicated an underestimation of the RA in the LTA. Patient characteristics with a higher risk of false estimation through LTA have been defined.
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Affiliation(s)
- Jonas Auer
- Department of Radiology, Charité - University
Medicine, Berlin, Germany
- Jonas Auer, Department of Radiology,
Charité – University Medicine, Hindenburgdamm 30, Berlin 12203 Berlin.
| | - Joachim Braun
- Department of Radiology, Charité - University
Medicine, Berlin, Germany
| | - Julian Lenk
- Department of Radiology, Charité - University
Medicine, Berlin, Germany
| | - Johannes Gollrad
- Department of Radiation Oncology
and Radiotherapy, Charité - University
Medicine, Berlin, Germany
| | - Sa-Ra Ro
- Department of Radiology, Charité - University
Medicine, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - University
Medicine, Berlin, Germany
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Jensen LJ, Kim D, Elgeti T, Steffen IG, Schaafs LA, Hamm B, Nagel SN. Enhancing the stability of CT radiomics across different volume of interest sizes using parametric feature maps: a phantom study. Eur Radiol Exp 2022; 6:43. [PMID: 36104519 PMCID: PMC9474978 DOI: 10.1186/s41747-022-00297-7] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In radiomics studies, differences in the volume of interest (VOI) are often inevitable and may confound the extracted features. We aimed to correct this confounding effect of VOI variability by applying parametric maps with a fixed voxel size. METHODS Ten scans of a cup filled with sodium chloride solution were scanned using a multislice computed tomography (CT) unit. Sphere-shaped VOIs with different diameters (4, 8, or 16 mm) were drawn centrally into the phantom. A total of 93 features were extracted conventionally from the original images using PyRadiomics. Using a self-designed and pretested software tool, parametric maps for the same 93 features with a fixed voxel size of 4 mm3 were created. To retrieve the feature values from the maps, VOIs were copied from the original images to preserve the position. Differences in feature quantities between the VOI sizes were tested with the Mann-Whitney U-test and agreement with overall concordance correlation coefficients (OCCC). RESULTS Fifty-five conventionally extracted features were significantly different between the VOI sizes, and none of the features showed excellent agreement in terms of OCCCs. When read from the parametric maps, only 8 features showed significant differences, and 3 features showed an excellent OCCC (≥ 0.85). The OCCCs for 89 features substantially increased using the parametric maps. CONCLUSIONS This phantom study shows that converting CT images into parametric maps resolves the confounding effect of VOI variability and increases feature reproducibility across VOI sizes.
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Affiliation(s)
- Laura J Jensen
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Damon Kim
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Thomas Elgeti
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Ingo G Steffen
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Lars-Arne Schaafs
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Bernd Hamm
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Sebastian N Nagel
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
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Wurster TH, Landmesser U, Abdelwahed YS, Skurk C, Morguet A, Leistner DM, Fröhlich G, Haghikia A, Engel LC, Schuster A, Noutsias M, Schulze D, Hamm B, Furth C, Brenner W, Botnar RM, Bigalke B, Makowski MR. Simultaneous [18F]fluoride and gadobutrol enhanced coronary positron emission tomography/magnetic resonance imaging for in vivo plaque characterization. Eur Heart J Cardiovasc Imaging 2022; 23:1391-1398. [PMID: 35015852 DOI: 10.1093/ehjci/jeab276] [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: 07/18/2021] [Accepted: 12/13/2021] [Indexed: 01/25/2023] Open
Abstract
AIMS 18F-sodium fluoride ([18F]fluoride) and gadobutrol are promising probes for positron emission tomography (PET) and magnetic resonance imaging (MRI) characterizing coronary artery disease (CAD) activity. Unlike [18F]fluoride-PET/computed tomography (CT), the potential of PET/MR using [18F]fluoride and gadobutrol simultaneously, has so far not been evaluated. This study assessed feasibility and diagnostic potential of [18F]fluoride and gadobutrol enhanced dual-probe PET/MR in patients with CAD. METHODS AND RESULTS Twenty-one patients (age, 66.7 ± 6.7 years) with CAD scheduled for invasive coronary angiography (XCA) underwent simultaneous [18F]fluoride (mean activity/effective dose: 157.2 ± 29.7 MBq/3.77 ± 0.72 mSv) and gadobutrol enhanced PET/MR on an integrated PET/MRI (3 T) scanner. Optical coherence tomography (OCT) was used as reference. Target-to-background ratio (TBR, [18F]fluoride-PET) and contrast-to-noise ratio (CNR) values (MRI, gadobutrol) were calculated for each coronary segment. Previously suggested PET/CT-TBR thresholds for adverse coronary events were evaluated. High-risk plaques, i.e. calcified and non-calcified thin-cap fibroatheromas (TCFAs) were predominantly located in segments with a TBR >1.28 (P = 0.012). Plaques containing a lipid core on OCT, were more frequently detected in segments with a TBR >1.25 (P < 0.001). TBR values significantly correlated with maximum calcification thickness (P = 0.009), while fibrous cap thickness was significantly less in segments with a TBR >1.28 (P = 0.044). Above a TBR threshold of >1.28, CNR values significantly correlated with the presence of calcified TCFAs (P = 0.032). CONCLUSION Simultaneous [18F]fluoride and gadobutrol dual-probe PET/MRI is feasible in clinical practice and may facilitate the identification of high-risk patients. The combination of coronary MR-derived CNR values post gadobutrol and [18F]fluoride based TBR values may improve identification of high-risk plaque features.
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Affiliation(s)
- Thomas H Wurster
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- Berlin Institute of Health (BIH), Berlin 10117, Germany
| | - Ulf Landmesser
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- Berlin Institute of Health (BIH), Berlin 10117, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site Berlin, Berlin 12203, Germany
| | - Youssef S Abdelwahed
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- Berlin Institute of Health (BIH), Berlin 10117, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site Berlin, Berlin 12203, Germany
| | - Carsten Skurk
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site Berlin, Berlin 12203, Germany
| | - Andreas Morguet
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
| | - David M Leistner
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- Berlin Institute of Health (BIH), Berlin 10117, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site Berlin, Berlin 12203, Germany
| | - Georg Fröhlich
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site Berlin, Berlin 12203, Germany
| | - Arash Haghikia
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- Berlin Institute of Health (BIH), Berlin 10117, Germany
- DZHK (German Centre for Cardiovascular Research) Partner Site Berlin, Berlin 12203, Germany
| | - Leif Christopher Engel
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
- Berlin Institute of Health (BIH), Berlin 10117, Germany
- Department of Cardiology, Deutsches Herzzentrum München/German Heart Center Munich, Munich, Germany
| | - Andreas Schuster
- Department of Cardiology and Pulmonology, Georg-August-University, Göttingen, Germany
- Department of Cardiology and Pulmonology, German Centre for Cardiovascular Research (DZHK Partner Site), Göttingen, Germany
| | - Michel Noutsias
- Division of Cardiology, Angiology and Intensive Medical Care, Department of Internal Medicine III (KIM-III), Mid-German Heart Center, University Hospital Halle, Martin-Luther-University Halle, Halle, Germany
| | - Daniel Schulze
- Charité - Universitätsmedizin Berlin, Institute of biometrics and clinical epidemiology, Charitéplatz 1, 10117 Berlin
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Furth
- Berlin Institute of Health (BIH), Berlin 10117, Germany
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rene M Botnar
- King's College London, School of Biomedical Engineering and Imaging Sciences, London, UK
- Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Boris Bigalke
- Department of Cardiology, University Heart Center Berlin and Charité-Universitätsmedizin Berlin, Campus Benjamin-Franklin (CBF), Hindenburgdamm 30, Berlin D-12203, Germany
| | - Marcus R Makowski
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, München, Germany
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Lohmeier J, Silva RV, Tietze A, Taupitz M, Kaneko T, Prüss H, Paul F, Infante-Duarte C, Hamm B, Caravan P, Makowski MR. Fibrin-targeting molecular MRI in inflammatory CNS disorders. Eur J Nucl Med Mol Imaging 2022; 49:3692-3704. [PMID: 35507058 PMCID: PMC9399196 DOI: 10.1007/s00259-022-05807-8] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 04/16/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Fibrin deposition is a fundamental pathophysiological event in the inflammatory component of various CNS disorders, such as multiple sclerosis (MS) and Alzheimer's disease. Beyond its traditional role in coagulation, fibrin elicits immunoinflammatory changes with oxidative stress response and activation of CNS-resident/peripheral immune cells contributing to CNS injury. PURPOSE To investigate if CNS fibrin deposition can be determined using molecular MRI, and to assess its capacity as a non-invasive imaging biomarker that corresponds to inflammatory response and barrier impairment. MATERIALS AND METHODS Specificity and efficacy of a peptide-conjugated Gd-based molecular MRI probe (EP2104-R) to visualise and quantify CNS fibrin deposition were evaluated. Probe efficacy to specifically target CNS fibrin deposition in murine adoptive-transfer experimental autoimmune encephalomyelitis (EAE), a pre-clinical model for MS (n = 12), was assessed. Findings were validated using immunohistochemistry and laser ablation inductively coupled plasma mass spectrometry. Deposition of fibrin in neuroinflammatory conditions was investigated and its diagnostic capacity for disease staging and monitoring as well as quantification of immunoinflammatory response was determined. Results were compared using t-tests (two groups) or one-way ANOVA with multiple comparisons test. Linear regression was used to model the relationship between variables. RESULTS For the first time (to our knowledge), CNS fibrin deposition was visualised and quantified in vivo using molecular imaging. Signal enhancement was apparent in EAE lesions even 12-h after administration of EP2104-R due to targeted binding (M ± SD, 1.07 ± 0.10 (baseline) vs. 0.73 ± 0.09 (EP2104-R), p = .008), which could be inhibited with an MRI-silent analogue (M ± SD, 0.60 ± 0.14 (EP2104-R) vs. 0.96 ± 0.13 (EP2104-La), p = .006). CNS fibrin deposition corresponded to immunoinflammatory activity (R2 = 0.85, p < .001) and disability (R2 = 0.81, p < .001) in a model for MS, which suggests a clinical role for staging and monitoring. Additionally, EP2104-R showed substantially higher SNR (M ± SD, 6.6 ± 1 (EP2104-R) vs. 2.7 ± 0.4 (gadobutrol), p = .004) than clinically used contrast media, which increases sensitivity for lesion detection. CONCLUSIONS Molecular imaging of CNS fibrin deposition provides an imaging biomarker for inflammatory CNS pathology, which corresponds to pathophysiological ECM remodelling and disease activity, and yields high signal-to-noise ratio, which can improve diagnostic neuroimaging across several neurological diseases with variable degrees of barrier impairment.
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Affiliation(s)
- Johannes Lohmeier
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany.
| | - Rafaela V Silva
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Einstein Center for Neurosciences Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Anna Tietze
- Institute of Neuroradiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Matthias Taupitz
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Takaaki Kaneko
- Center for the Evolutionary Origins of Human Behavior, Kyoto University, Inuyama, Aichi, 484-8506, Japan
| | - Harald Prüss
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte (CCM) and German Center for Neurodegenerative Diseases (DZNE) Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Carmen Infante-Duarte
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
| | - Peter Caravan
- A. A. Martinos Center for Biomedical Imaging, Institute for Innovation in Imaging, Massachusetts General Hospital, Harvard Medical School, 149 Thirteenth Street, Suite 2301, Charlestown, MB, 02129, USA
| | - Marcus R Makowski
- Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Charité Mitte (CCM), Charitéplatz 1, 10117, Berlin, Germany
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany
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Schmidt M, Gebauer S, Bartholmes A, Kadioglu D, Kleesiek J, Hamm B, Vogl TJ, Penzkofer T, Bucher AM, Storf H. CODEX Meets RACOON - A Concept for Collaborative Documentation of Clinical and Radiological COVID-19 Data. Stud Health Technol Inform 2022; 296:58-65. [PMID: 36073489 DOI: 10.3233/shti220804] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Within the scope of the two NUM projects CODEX and RACOON we developed a preliminary technical concept for documenting clinical and radiological COVID-19 data in a collaborative approach and its preceding findings of a requirement analysis. At first, we provide an overview of NUM and its two projects CODEX and RACOON including the GECCO data set. Furthermore, we demonstrate the foundation for the increased collaboration of both projects, which was additionally supported by a survey conducted at University Hospital Frankfurt. Based on the survey results mint Lesion™, developed by Mint Medical and used at all project sites within RACOON, was selected as the "Electronic Data Capture" (EDC) system for CODEX. Moreover, to avoid duplicate entry of GECCO data into both EDC systems, an early effort was made to consider a collaborative and efficient technical approach to reduce the workload for the medical documentalists. As a first effort we present a preliminary technical concept representing the current and possible future data workflow of CODEX and RACOON. This concept includes a software component to synchronize GECCO data sets between the two EDC systems using the HL7 FHIR standard. Our first approach of a collaborative use of an EDC system and its medical documentalists could be beneficial in combination with the presented synchronization component for all participating project sites of CODEX and RACOON with regard to an overall reduced documentation workload.
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Affiliation(s)
- Marvin Schmidt
- Institute of Medical Informatics, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sebastian Gebauer
- Institute of Medical Informatics, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Annette Bartholmes
- Data Integration Center, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Dennis Kadioglu
- Institute of Medical Informatics, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
- Data Integration Center, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jens Kleesiek
- Institute for AI in Medicine (IKIM), University Hospital Essen, Essen, Germany
| | - Bernd Hamm
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Michael Bucher
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Holger Storf
- Institute of Medical Informatics, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
- Data Integration Center, University Hospital Frankfurt, Frankfurt am Main, Germany
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Bressem KK, Adams LC, Proft F, Hermann KGA, Diekhoff T, Spiller L, Niehues SM, Makowski MR, Hamm B, Protopopov M, Rios Rodriguez V, Haibel H, Rademacher J, Torgutalp M, Lambert RG, Baraliakos X, Maksymowych WP, Vahldiek JL, Poddubnyy D. Deep Learning Detects Changes Indicative of Axial Spondyloarthritis at MRI of Sacroiliac Joints. Radiology 2022; 305:655-665. [PMID: 35943339 DOI: 10.1148/radiol.212526] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background MRI is frequently used for early diagnosis of axial spondyloarthritis (axSpA). However, evaluation is time-consuming and requires profound expertise because noninflammatory degenerative changes can mimic axSpA, and early signs may therefore be missed. Deep neural networks could function as assistance for axSpA detection. Purpose To create a deep neural network to detect MRI changes in sacroiliac joints indicative of axSpA. Materials and Methods This retrospective multicenter study included MRI examinations of five cohorts of patients with clinical suspicion of axSpA collected at university and community hospitals between January 2006 and September 2020. Data from four cohorts were used as the training set, and data from one cohort as the external test set. Each MRI examination in the training and test sets was scored by six and seven raters, respectively, for inflammatory changes (bone marrow edema, enthesitis) and structural changes (erosions, sclerosis). A deep learning tool to detect changes indicative of axSpA was developed. First, a neural network to homogenize the images, then a classification network were trained. Performance was evaluated with use of area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. P < .05 was considered indicative of statistically significant difference. Results Overall, 593 patients (mean age, 37 years ± 11 [SD]; 302 women) were studied. Inflammatory and structural changes were found in 197 of 477 patients (41%) and 244 of 477 (51%), respectively, in the training set and 25 of 116 patients (22%) and 26 of 116 (22%) in the test set. The AUCs were 0.94 (95% CI: 0.84, 0.97) for all inflammatory changes, 0.88 (95% CI: 0.80, 0.95) for inflammatory changes fulfilling the Assessment of SpondyloArthritis international Society definition, and 0.89 (95% CI: 0.81, 0.96) for structural changes indicative of axSpA. Sensitivity and specificity on the external test set were 22 of 25 patients (88%) and 65 of 91 patients (71%), respectively, for inflammatory changes and 22 of 26 patients (85%) and 70 of 90 patients (78%) for structural changes. Conclusion Deep neural networks can detect inflammatory or structural changes to the sacroiliac joint indicative of axial spondyloarthritis at MRI. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Keno K Bressem
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Lisa C Adams
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Fabian Proft
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Kay Geert A Hermann
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Torsten Diekhoff
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Laura Spiller
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Stefan M Niehues
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Marcus R Makowski
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Bernd Hamm
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Mikhail Protopopov
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Valeria Rios Rodriguez
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Hildurn Haibel
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Judith Rademacher
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Murat Torgutalp
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Robert G Lambert
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Xenofon Baraliakos
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Walter P Maksymowych
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Janis L Vahldiek
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
| | - Denis Poddubnyy
- From the Institute for Radiology (K.K.B., L.C.A., K.G.A.H., T.D., S.M.N., B.H., J.L.V.) and Department of Gastroenterology, Infectious Diseases and Rheumatology (including Nutrition Medicine) (F.P., L.S., M.P., V.R.R., H.H., J.R., M.T., D.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany (K.K.B., L.C.A., J.R.); Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Technical University of Munich, Munich, Germany (M.R.M.); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.G.L., W.P.M.); Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Germany (X.B.); and Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany (D.P.)
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Nawabi J, Desser D, Morotti A, Mazzacane F, Böhmer FM, Elsayed S, Schlunk F, Sporns P, Hamm B, Fiehler J, Hanning U. Deep learning pipeline for automatic segmentation and volume measurement in intracerebral hemorrhage with differentiation of hemorrhage, intraventricular extension and perihematomal edema. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J Nawabi
- Charité Universitätsmedizin Berlin, Klinik für Radiologie und Kinderradiologie, Berlin
| | - D Desser
- Neuroradiologie, Charité, Berlin
| | - A Morotti
- Department of Clinical and Experimental Sciences, Neurology Unit, Brescia, Italien
| | - F Mazzacane
- ASST Valcamonica, Neurology Unit, Esine, Italien
| | | | - S Elsayed
- Neuroradiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - F Schlunk
- Neuroradiologie, Charité Berlin, Berlin
| | - P Sporns
- Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Schweiz
| | - B Hamm
- Radiologie, Charité Berlin, Berlin
| | - J Fiehler
- Neuroradiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - U Hanning
- Neuroradiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
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Beetz NL, Haas M, Baur A, Konietschke F, Roy A, Hamm CA, Rudolph MM, Shnayien S, Hamm B, Cash H, Asbach P, Penzkofer T. Inter-Reader Variability Using PI-RADS v2 Versus PI-RADS v2.1: Most New Disagreement Stems from Scores 1 and 2. ROFO-FORTSCHR RONTG 2022; 194:852-861. [PMID: 35545106 DOI: 10.1055/a-1752-1038] [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: 10/18/2022]
Abstract
PURPOSE To analyze possible differences in the inter-reader variability between PI-RADS version 2 (v2) and version 2.1 (v2.1) for the classification of prostate lesions using multiparametric MRI (mpMRI) of the prostate. METHODS In this retrospective and randomized study, 239 annotated and histopathologically correlated prostate lesions (104 positive and 135 negative for prostate cancer) were rated twice by three experienced uroradiologists using PI-RADS v2 and v2.1 with an interval of at least two months between readings. Results were tabulated across readers and reading timepoints and inter-reader variability was determined using Fleiss' kappa (κ). Thereafter, an additional analysis of the data was performed in which PI-RADS scores 1 and 2 were combined, as they have the same clinical consequences. RESULTS PI-PI-RADS v2.1 showed better inter-reader agreement in the peripheral zone (PZ), but poorer inter-reader agreement in the transition zone (TZ) (PZ: κ = 0.63 vs. κ = 0.58; TZ: κ = 0.47 vs. κ = 0.57). When PI-RADS scores 1 and 2 were combined, the use of PI-RADS v2.1 resulted in almost perfect inter-reader agreement in the PZ and substantial agreement in the TZ (PZ: κ = 0.81; TZ: κ = 0.80). CONCLUSION PI-RADS v2.1 improves inter-reader agreement in the PZ. New differences in inter-reader agreement were mainly the result of the assignment of PI-RADS v2.1 scores 1 and 2 to lesions in the TZ. Combining scores 1 and 2 improved inter-reader agreement both in the TZ and in the PZ, indicating that refined definitions may be warranted for these PI-RADS scores. KEY POINTS · PI-RADSv2.1 improves inter-reader agreement in the PZ but not in the TZ.. · New differences derived from PI-RADSv2.1 scores 1 and 2 in the TZ.. · Combined PI-RADSv2.1 scores of 1 and 2 yielded better inter-reader agreement.. · PI-RADSv2.1 appears to provide more precise description of lesions in the PZ.. · Improved inter-reader agreement in the PZ stresses the importance of appropriate lexicon description.. CITATION FORMAT · Beetz N, Haas M, Baur A et al. Inter-Reader Variability Using PI-RADS v2 Versus PI-RADS v2.1: Most New Disagreement Stems from Scores 1 and 2. Fortschr Röntgenstr 2022; 194: 852 - 861.
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Affiliation(s)
- Nick Lasse Beetz
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Matthias Haas
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Alexander Baur
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Frank Konietschke
- Department of Biometry and Clinical Epidemiology, Charite University Hospital Berlin, Germany
| | - Akash Roy
- Biostatistics and Bioinformatics, Duke University School of Medicine, DURHAM, United States
| | | | | | - Seyd Shnayien
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Hannes Cash
- Department of Urology, Charite University Hospital Berlin, Germany
| | - Patrick Asbach
- Department of Radiology, Charite University Hospital Berlin, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charite University Hospital Berlin, Germany
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Auer TA, Sofue K, Ueshima E, Rauer N, Yamaguchi T, Gebauer B, Hamm B, Murakami T, Althoff CE. Transarterial Chemoebolization in Hepatocellular Carcinoma: A Binational Japanese-German Study. J Hepatocell Carcinoma 2022; 9:695-705. [PMID: 35937908 PMCID: PMC9355341 DOI: 10.2147/jhc.s359705] [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: 02/16/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The purpose of this study was to investigate outcomes of transarterial chemoembolization (TACE) in treating hepatocellular carcinoma (HCC) comparing the different approaches used in Germany and Japan. Methods This binational IRB-approved retrospective dual-center study included a total of 94 HCC patients subdivided in a German and a Japanese cohort. For each patient, liver and tumor volumetry was performed using computed tomography (CT) and magnetic resonance imaging (MRI). Furthermore, a comprehensive risk profile, including body constitution and liver and kidney function was established. Primary endpoints were progression-free and overall survival (PFS/OS). Results PFS in the German cohort was 168 vs 224d in the Japanese cohort (p=0.640). When subdivided by BCLC stage, no significant differences were reported (p=0.160–0.429). OS was significantly longer in the Japanese cohort with 856 vs. 303d (p<0.001). OS for BCLC A was significantly longer in the Japanese cohort (1960 vs. 428d; p<0.001), while survival rates did not differ significantly in BCLC B (785 vs 330d; p=0.067) and C-stages (208 vs 302d; p=0.186). Older age (p=0.034), poorer liver/kidney function (p=0.025-0-035), and a higher liver/tumor ratio (p<0.001) were found to correlate with shorter survival. ECOG scores were significantly higher in the German cohort (p=0.002). Conclusion While OS is longer in TACE-treated patients in the Japanese cohort compared to the German cohort, the two approaches seem to be equally effective as PFS does not differ significantly. The different survival rates may be caused by the different clinical performance status of the selected collectives. In very early and early stage HCC, TACE in Japan seems to be an effective treatment option while in Germany for patients in those stages TACE remains a second-line option for patients not available for surgery or ablation.
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Affiliation(s)
- Timo A Auer
- Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
- Correspondence: Timo A Auer, Department of Radiology, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany, Tel +49-30-450-557001, Fax +49-30-450-557901, Email
| | - Keitaro Sofue
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Eisuke Ueshima
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nina Rauer
- Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Takeru Yamaguchi
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Bernhard Gebauer
- Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Takamichi Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Christian E Althoff
- Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany
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Kader A, Kaufmann JO, Mangarova DB, Moeckel J, Brangsch J, Adams LC, Zhao J, Reimann C, Saatz J, Traub H, Buchholz R, Karst U, Hamm B, Makowski MR. Iron Oxide Nanoparticles for Visualization of Prostate Cancer in MRI. Cancers (Basel) 2022; 14:cancers14122909. [PMID: 35740575 PMCID: PMC9221397 DOI: 10.3390/cancers14122909] [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] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/07/2022] [Accepted: 06/11/2022] [Indexed: 12/16/2022] Open
Abstract
Prostate cancer (PCa) is one of the most common cancers in men. For detection and diagnosis of PCa, non-invasive methods, including magnetic resonance imaging (MRI), can reduce the risk potential of surgical intervention. To explore the molecular characteristics of the tumor, we investigated the applicability of ferumoxytol in PCa in a xenograft mouse model in two different tumor volumes, 500 mm3 and 1000 mm3. Macrophages play a key role in tumor progression, and they are able to internalize iron-oxide particles, such as ferumoxytol. When evaluating T2*-weighted sequences on MRI, a significant decrease of signal intensity between pre- and post-contrast images for each tumor volume (n = 14; p < 0.001) was measured. We, furthermore, observed a higher signal loss for a tumor volume of 500 mm3 than for 1000 mm3. These findings were confirmed by histological examinations and laser ablation inductively coupled plasma-mass spectrometry. The 500 mm3 tumors had 1.5% iron content (n = 14; σ = 1.1), while the 1000 mm3 tumors contained only 0.4% iron (n = 14; σ = 0.2). In vivo MRI data demonstrated a correlation with the ex vivo data (R2 = 0.75). The results of elemental analysis by inductively coupled plasma-mass spectrometry correlated strongly with the MRI data (R2 = 0.83) (n = 4). Due to its long retention time in the blood, biodegradability, and low toxicity to patients, ferumoxytol has great potential as a contrast agent for visualization PCa.
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Affiliation(s)
- Avan Kader
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
- Department of Biology, Chemistry and Pharmacy, Institute of Biology, Freie Universität Berlin, Königin-Luise-Str. 1-3, 14195 Berlin, Germany
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Correspondence:
| | - Jan O. Kaufmann
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
- Division 1.5 Protein Analysis, Bundesanstalt für Materialforschung und-Prüfung (BAM), Richard-Willstätter-Str. 11, 12489 Berlin, Germany
- Department of Chemistry, Humboldt-Universität zu Berlin, Brook-Taylor-Str. 2, 12489 Berlin, Germany
| | - Dilyana B. Mangarova
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
- Department of Veterinary Medicine, Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, Building 12, 14163 Berlin, Germany
| | - Jana Moeckel
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
| | - Julia Brangsch
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
| | - Lisa C. Adams
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
| | - Jing Zhao
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
| | - Carolin Reimann
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
| | - Jessica Saatz
- Division 1.1 Inorganic Trace Analysis, Bundesanstalt für Materialforschung und-Prüfung (BAM), Richard-Willstätter-Str. 11, 12489 Berlin, Germany; (J.S.); (H.T.)
| | - Heike Traub
- Division 1.1 Inorganic Trace Analysis, Bundesanstalt für Materialforschung und-Prüfung (BAM), Richard-Willstätter-Str. 11, 12489 Berlin, Germany; (J.S.); (H.T.)
| | - Rebecca Buchholz
- Institute of Inorganic and Analytical Chemistry, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany; (R.B.); (U.K.)
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany; (R.B.); (U.K.)
| | - Bernd Hamm
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
| | - Marcus R. Makowski
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (J.O.K.); (D.B.M.); (J.M.); (J.B.); (L.C.A.); (J.Z.); (C.R.); (B.H.); (M.R.M.)
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- School of Biomedical Engineering and Imaging Sciences, King’s College London, St Thomas’ Hospital Westminster Bridge Road, London SE1 7EH, UK
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Lerchbaumer MH, Fischer T, Uluk D, Friedersdorff F, Hamm B, Spiesecke P. Diagnostic value of contrast-enhanced ultrasound (CEUS) in kidney allografts - 12 years of experience in a tertiary referral center. Clin Hemorheol Microcirc 2022; 82:75-83. [PMID: 35662110 DOI: 10.3233/ch-211357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND B-Mode and Doppler ultrasound are standard diagnostic techniques for early postoperative monitoring and long-term follow-up of kidney transplants. In certain cases, contrast-enhanced ultrasound (CEUS) is used to clarify unclear Doppler findings. OBJECTIVE To investigate the diagnostic performance of CEUS in the workup of renal allograft pathologies. METHODS A systematic search for CEUS examinations of renal transplants conducted in our department between 2008 and 2020 was performed using the following inclusion criteria: i) patient age ≥18 years and ii) confirmation of diagnosis by biopsy and histopathology, imaging follow-up by CEUS, contrast-enhanced computed tomography (ceCT), contrast-enhanced magnetic resonance imaging (ceMRI), or angiography, or intraoperative findings. Exclusion criteria were: i) CEUS performed in the setting of a study and ii) CEUS for other indications than dedicated renal transplant examination. Statistical analysis was performed separately for subgroups with different indications (focal vs non-focal). RESULTS Overall, 78 patients were included in the statistical analysis, which revealed high sensitivity (92.2%, 95% -confidence interval [CI] 81.5-96.9%) and high specificity (88.9%, 95% -CI 71.9-96.1%) of CEUS. CONCLUSIONS The high diagnostic performance demonstrated here and the superficial location of kidney allografts advocate the additional use of CEUS in the follow-up of renal transplant recipients.
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Affiliation(s)
- Markus Herbert Lerchbaumer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Memberof Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thomas Fischer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Memberof Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Deniz Uluk
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Germany
| | - Frank Friedersdorff
- Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Memberof Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Bernd Hamm
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Memberof Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Paul Spiesecke
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Memberof Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Kaufmann JO, Brangsch J, Kader A, Saatz J, Mangarova DB, Zacharias M, Kempf WE, Schwaar T, Ponader M, Adams LC, Möckel J, Botnar RM, Taupitz M, Mägdefessel L, Traub H, Hamm B, Weller MG, Makowski MR. ADAMTS4-specific MR probe to assess aortic aneurysms in vivo using synthetic peptide libraries. Nat Commun 2022; 13:2867. [PMID: 35606349 PMCID: PMC9126943 DOI: 10.1038/s41467-022-30464-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
The incidence of abdominal aortic aneurysms (AAAs) has substantially increased during the last 20 years and their rupture remains the third most common cause of sudden death in the cardiovascular field after myocardial infarction and stroke. The only established clinical parameter to assess AAAs is based on the aneurysm size. Novel biomarkers are needed to improve the assessment of the risk of rupture. ADAMTS4 (A Disintegrin And Metalloproteinase with ThromboSpondin motifs 4) is a strongly upregulated proteoglycan cleaving enzyme in the unstable course of AAAs. In the screening of a one-bead-one-compound library against ADAMTS4, a low-molecular-weight cyclic peptide is discovered with favorable properties for in vivo molecular magnetic resonance imaging applications. After identification and characterization, it's potential is evaluated in an AAA mouse model. The ADAMTS4-specific probe enables the in vivo imaging-based prediction of aneurysm expansion and rupture.
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Affiliation(s)
- Jan O Kaufmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Humboldt-Universität zu Berlin, Department of Chemistry, Brook-Taylor-Str. 2, 12489, Berlin, Germany
- Federal Institute for Materials Research and Testing (BAM), Division 1.5 Protein Analysis, Richard-Willstätter-Str. 11, 12489, Berlin, Germany
| | - Julia Brangsch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Freie Universität Berlin, Königsweg 67, Building 21, 14163, Berlin, Germany
| | - Avan Kader
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Institute of Biology, Freie Universität Berlin, Königin-Luise-Str. 1-3, 14195, Berlin, Germany
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Straße 22, 81675, Munich, Germany
| | - Jessica Saatz
- Federal Institute for Materials Research and Testing (BAM), Division 1.1 Inorganic Trace Analysis, Richard-Willstätter-Str. 11, 12489, Berlin, Germany
| | - Dilyana B Mangarova
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, Building 12, 14163, Berlin, Germany
| | - Martin Zacharias
- Center of Functional Protein Assemblies, Technische Universität München (TUM), Ernst-Otto-Fischer-Str. 9, 85748, Garching, Germany
| | - Wolfgang E Kempf
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technische Universität München (TUM), 81675, Munich, Germany
| | - Timm Schwaar
- Federal Institute for Materials Research and Testing (BAM), Division 1.0 SAFIA Technologies, Richard-Willstätter-Str. 11, 12489, Berlin, Germany
| | - Marco Ponader
- Federal Institute for Materials Research and Testing (BAM), Division 1.5 Protein Analysis, Richard-Willstätter-Str. 11, 12489, Berlin, Germany
| | - Lisa C Adams
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Jana Möckel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Rene M Botnar
- King's College London, School of Biomedical Engineering and Imaging Sciences, London, UK
- Wellcome Trust / EPSRC Centre for Medical Engineering, King's College London, London, UK
- BHF Centre of Excellence, King's College London, London, UK
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Institute in Intelligent Healthcare Engineering, Santiago de Chile, Campus San Joaquín - Avda.Vicuña Mackenna, 4860, Macul, Santiago, Chile
- St Thomas' Hospital Westminster Bridge Road, London, SE1 7EH, UK
- Denmark Hill Campus, 125 Coldharbour Lane, London, SE5 9NU, UK
| | - Matthias Taupitz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Lars Mägdefessel
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technische Universität München (TUM), 81675, Munich, Germany
| | - Heike Traub
- Federal Institute for Materials Research and Testing (BAM), Division 1.1 Inorganic Trace Analysis, Richard-Willstätter-Str. 11, 12489, Berlin, Germany
| | - Bernd Hamm
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Michael G Weller
- Federal Institute for Materials Research and Testing (BAM), Division 1.5 Protein Analysis, Richard-Willstätter-Str. 11, 12489, Berlin, Germany
| | - Marcus R Makowski
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
- Department of Radiology, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Straße 22, 81675, Munich, Germany.
- King's College London, School of Biomedical Engineering and Imaging Sciences, London, UK.
- St Thomas' Hospital Westminster Bridge Road, London, SE1 7EH, UK.
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