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Clevert DA, Gürtler VM, Meimarakis G, D'Anastasi M, Weidenhagen R, Reiser MF, Becker CR. Classification of endoleaks in the follow-up after EVAR using the time-to-peak of the contrast agent in CEUS examinations. Clin Hemorheol Microcirc 2014; 55:183-91. [PMID: 23455839 DOI: 10.3233/ch-131701] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the feasibility of the classification of endoleaks following endovascular aortic aneurysm repair using the time-to-peak of the contrast agent in CEUS examinations. MATERIAL AND METHODS In this retrospective study, a cohort of 171 patients with a total of 489 CEUS follow-up examinations after EVAR were included. In 254 of the 489 examinations, an endoleak was seen and the time-to-peak was measured in seconds. Existence of an endoleak was confirmed by CT as the gold standard. RESULTS We evaluated 254 CEUS video sequences showing an endoleak out of a total of 489 examinations. Kruskal-Wallis test revealed with p = 0.001 differences between the single endoleak types based on the time to peak. Correction after Bonferroni showed significant differences between type Ia compared to Ib and to IIa over inferior mesenteric artery (IMA) and IIa over lumbar artery (LA). There are also disparities between type Ib and type IIa IMA and type III, furthermore between type IIa IMA compared to IIa LA and type III as well as type IIa LA matched to type III. CONCLUSION CEUS is an important method for the follow-up after EVAR. The time-to-peak does not seem to be a useful additional feature in classifying endoleaks, although there are differences between the time-to-peak of the single endoleak types and it is possible to make an order of the different endoleak types referring to the mean values.
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Affiliation(s)
- D A Clevert
- Department for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich-Grosshadern, Munich, Germany
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Abstract
Since its introduction a few years ago, multidetector row CT (MDCT) has become a widely used diagnostic procedure and has been proven to be a valuable tool for various indications. A major issue using this new modality is the inherent risk of applying increased radiation exposure, when compared to single-slice CT or other imaging modalities.However, MDCT offers some valuable options to save radiation exposure, such as choosing optimized exposure parameters or its superior dose efficiency in comparison to single-slice CT. Multi-phasic examinations should be restricted to indications where definitely necessary. Modern scanners offer intelligent tools for further reduction of radiation dose, such as ECG- or bodyshape-based realtime dose modulation. A new field of applications is the low-dose CT for early detection of diseases. While acquiring thin slices with high spatial resolution, the dose can be reduced to similar values as in conventional radiography, especially when examining under high-contrast conditions. Using all these various options available, radiation exposure can sometimes even be lower than using a conventional single-slice helical CT.
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Affiliation(s)
- P Herzog
- Institut für Klinische Radiologie, Klinikum der Universität München-Grosshadern, Germany.
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Wintersperger BJ, Helmberger TK, Herzog P, Jakobs TF, Waggershauser T, Becker CR, Reiser MF. Hochaufgelöste abdominelle Übersichtsangiographie mit einem 16-Detektorzeilen-CT-System Erste Erfahrungen. Radiologe 2014; 42:722-7. [PMID: 12244473 DOI: 10.1007/s00117-002-0801-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Purpose of this study was the implementation of a new abdominal CT angiography protocol on a 16 detector-row CT scanner and the comparison to selective catheter angiography. METHODS 76 patients with various vascular disorders underwent abdominal CT angiography on a recently developed 16 detector-row CT scanner using submillimeter slice collimation (16 x 0.75 mm). Results were compared with mesenteric and/or hepatic angiography in 17 patients performed during tumor embolization. Opacification was provided using individually tailored contrast application with a test bolus setting. To evaluate the contrast injection protocol density measurements within the vessel lumen were performed. RESULTS Diagnostic image quality was achieved in all patients with angiographic comparison (n = 17). Within the hepatic and mesenteric vasculature up to 4th generation vessels could be identified. Compared to selective angiography CT angiography provided equivalent morphologic information up to the detectable vessel generation. With the applied contrast application regimen there were no significant differences in vessel enhancement along the abdominal aorta and iliac arteries. CONCLUSION 16 detector-row CT enables whole abdominal angiographic studies with submillimeter resolution in a single breath-hold. The improved spatial resolution enables for high quality 3D visualization. Compared to invasive angiography, 16 detector-row CT reveals equivalent morphologic information.
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Affiliation(s)
- B J Wintersperger
- Institut für Klinische Radiologie, Klinikum der Universität München-Grosshadern, Germany.
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Jakobs TF, Becker CR, Wintersperger BJ, Herzog P, Ohnesorge B, Flohr T, Knez A, Reiser MF. CT-Angiographie der Koronararterien mit einem 16-Mehrzeilen-Spiral-CT Einfluss der räumlichen Auflösung auf die Bildqualität. Radiologe 2014; 42:733-8. [PMID: 12244475 DOI: 10.1007/s00117-002-0787-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate image quality of coronary CT angiography with retrospectively ECG-gated 16 multi-slice spiral CT (MSCT), reconstructed with 0.75 mm slice thickness for optimal spatial resolution and with 1.3 mm slice thickness, to produce spatial resolution comparable to a 4-MSCT. MATERIALS AND METHODS Ten patients underwent coronary CT angiography with a 16-MSCT (Siemens Sensation 16, Forchheim, Germany) with 0.75 mm detector collimation. Raw helical CT data were retrospectively reconstructed using two different settings. Setting A: B20f smooth kernel, axial MPR with 1.3 mm slice thickness and 0.7 mm increment. Setting B: B35f "HeartView" medium-smooth kernel, 0.75 mm slice thickness, 0.5 mm increment. In the axial slices two regions of interest (ROIs) were placed in the area of the aortic root (AR) and more caudal in the area of the left ventricle (LV). Image noise was determined by the standard deviation of the CT numbers.Two readers determined visibility of coronary arteries by standardized maximum intensity projections (MIP) post-processing in left, right anterior and left anterior oblique projection plane from setting A and B. Each projection was rated on a five point rating scale concerning plaque delineation. Points determined for each data set were summed up and used for comparison. RESULTS No significant difference between the CT-numbers was found for setting A and B (A: 283.0 in AR/295.9 in LV and B: 282,9 in AR/297.2 in LV; p >0.2). However, the image noise was significantly different for setting A and B (A: 4.46 in AR/1.67 in LV and B: 8.16 in AR/7.38 in LV; p <0.01). Better delineation of the coronary arteries and atherosclerotic lesions could be achieved from MIP projections in setting B compared to setting A. CONCLUSION Higher image noise is present in coronary 16-MSCT with thin-slice reconstruction compared to simulated 4-MSCT. However the MIP-reconstructions benefit most from the higher spatial resolution.
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Affiliation(s)
- T F Jakobs
- Institut für Klinische Radiologie, Klinikum der Universität München, Grosshadern, Germany
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Abstract
Assessment of atherosclerotic plaque burden may help to further stratify asymptomatic subjects with an intermediate cardiac event risk according to their conventional risk factors. Coronary calcium screening is a simple and effective method to noninvasively assess the atherosclerotic plaque burden. Standardized quantification of the coronary calcium mass will allow the results of ongoing prospective cohort studies to be used for any computed tomography (CT) scanner, electron-beam CT, as well as multidetector-row CT. Coronary multidetector-row CT angiography may have the potential to visualize vulnerable plaques that are prone to rupture and cause acute coronary symptoms. However, neither the reliability of detection nor the strategies for intervention of vulnerable plaques with multidetector-row CT have to date been proven.
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Affiliation(s)
- Christoph R Becker
- Computed Tomography, Department of Clinical Radiology, University Hospital Grosshadern, 81377 Munich, Germany.
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Schramm N, Englhart E, Schlemmer M, Hittinger M, Übleis C, Becker CR, Reiser MF, Berger F. Tumor response and clinical outcome in metastatic gastrointestinal stromal tumors under sunitinib therapy: comparison of RECIST, Choi and volumetric criteria. Eur J Radiol 2013; 82:951-8. [PMID: 23518148 DOI: 10.1016/j.ejrad.2013.02.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 01/21/2013] [Accepted: 02/16/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE Purpose of the study was to compare radiological treatment response according to RECIST, Choi and volumetry in GIST-patients under 2nd-line-sunitinib-therapy and to correlate the results of treatment response assessment with disease-specific survival (DSS). PATIENTS AND METHODS 20 patients (mean: 60.7 years; 12 male/8 female) with histologically proven GIST underwent baseline-CT of the abdomen under imatinib and follow-up-CTs 3 months and 1 year after change to sunitinib. 68 target lesions (50 hepatic, 18 extrahepatic) were investigated. Therapy response (partial response (PR), stable disease (SD), progressive disease (PD)) was evaluated according to RECIST, Choi and volumetric criteria. Response according to the different assessment systems was compared and correlated to the DSS of the patients utilizing Kaplan-Meier statistics. RESULTS The mean DSS (in months) of the response groups 3 months after therapy change was: RECIST: PR (0/20); SD (17/20): 30.4 (months); PD (3/20) 11.6. Choi: PR (10/20) 28.6; SD (8/20) 28.1; PD (2/20) 13.5. Volumetry: PR (4/20) 29.6; SD (11/20) 29.7; PD (5/20) 17.2. Response groups after 1 year of sunitinib showed the following mean DSS: RECIST: PR (3/20) 33.6; SD (9/20) 29.7; PD (8/20) 20.3. Choi: PR (10/20) 21.5; SD (4/20) 42.9; PD (6/20) 23.9. Volumetry: PR (6/20) 27.3; SD (5/20) 38.5; PD (9/20) 19.3. CONCLUSION One year after modification of therapy, only partial response according to RECIST indicated favorable survival in patients with GIST. The value of alternate response assessment strategies like Choi criteria for prediction of survival in molecular therapy still has to be demonstrated.
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Affiliation(s)
- N Schramm
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany.
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Haneder S, Gutfleisch A, Meier C, Brade J, Hannak D, Schoenberg SO, Becker CR, Michaely HJ. Evaluation of a handheld creatinine measurement device for real-time determination of serum creatinine in radiology departments. World J Radiol 2012; 4:328-34. [PMID: 22900135 PMCID: PMC3419870 DOI: 10.4329/wjr.v4.i7.328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 07/05/2012] [Accepted: 07/12/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the feasibility/accuracy of a commercial handheld device in the context of increased demand for point-of-care serum creatinine (SCr) determination.
METHODS: In this institutional review board-approved, prospective study, 401 patients referred for contrast-enhanced computed tomography were included at two centres. Capillary (c)SCr was determined using two devices A+B and venous (v)SCr was determined in the centre’s laboratory. Method comparison statistics for both centres and for vSCr<>1.2 mg/dL, receiver operating characteristic analysis, negative predictive values (NPV), sensitivity and specificity were calculated pre-/post-curve offset correction with vSCr.
RESULTS: Pearson’s coefficients for cSCr vs vSCr were: centre 1-A:0.93/B:0.92; centre 2-A:0.85/B:0.82 (all P < 0.0001). Overall correlation was better for vSCr > 1.2 mg/dL. The area under the receiver operating characteristic curves showed a high accuracy for cSCr, but the device underestimated SCr, which was confirmed by Bland-Altman plot. Addition of the offset correction factor to the original data from centre 1 resulted in an improvement in sensitivity for detecting patients at risk (> 1.2 mg/dL), whilst maintaining acceptable specificity and improving NPV.
CONCLUSION: This study showed the feasibility of SCr determination using the evaluated handheld device in a routine clinical setting. The device showed high sensitivity and high NPV, but may significantly underestimate SCr without offset correction to local laboratories.
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Sommer WH, Becker CR, Haack M, Rubin GD, Weidenhagen R, Schwarz F, Nikolaou K, Reiser MF, Johnson TR, Clevert DA. Time-resolved CT Angiography for the Detection and Classification of Endoleaks. Radiology 2012; 263:917-26. [DOI: 10.1148/radiol.12111217] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dorenkamp M, Bonaventura K, Sohns C, Becker CR, Leber AW. Direct costs and cost-effectiveness of dual-source computed tomography and invasive coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Heart 2011; 98:460-7. [PMID: 21846767 DOI: 10.1136/heartjnl-2011-300149] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS The study aims to determine the direct costs and comparative cost-effectiveness of latest-generation dual-source computed tomography (DSCT) and invasive coronary angiography for diagnosing coronary artery disease (CAD) in patients suspected of having this disease. METHODS The study was based on a previously elaborated cohort with an intermediate pretest likelihood for CAD and on complementary clinical data. Cost calculations were based on a detailed analysis of direct costs, and generally accepted accounting principles were applied. Based on Bayes' theorem, a mathematical model was used to compare the cost-effectiveness of both diagnostic approaches. Total costs included direct costs, induced costs and costs of complications. Effectiveness was defined as the ability of a diagnostic test to accurately identify a patient with CAD. RESULTS Direct costs amounted to €98.60 for DSCT and to €317.75 for invasive coronary angiography. Analysis of model calculations indicated that cost-effectiveness grew hyperbolically with increasing prevalence of CAD. Given the prevalence of CAD in the study cohort (24%), DSCT was found to be more cost-effective than invasive coronary angiography (€970 vs €1354 for one patient correctly diagnosed as having CAD). At a disease prevalence of 49%, DSCT and invasive angiography were equally effective with costs of €633. Above a threshold value of disease prevalence of 55%, proceeding directly to invasive coronary angiography was more cost-effective than DSCT. CONCLUSIONS With proper patient selection and consideration of disease prevalence, DSCT coronary angiography is cost-effective for diagnosing CAD in patients with an intermediate pretest likelihood for it. However, the range of eligible patients may be smaller than previously reported.
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Affiliation(s)
- Marc Dorenkamp
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13553 Berlin, Germany.
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Bamberg F, Sommer WH, Hoffmann V, Achenbach S, Nikolaou K, Conen D, Reiser MF, Hoffmann U, Becker CR. Meta-Analysis and Systematic Review of the Long-Term Predictive Value of Assessment of Coronary Atherosclerosis by Contrast-Enhanced Coronary Computed Tomography Angiography. J Am Coll Cardiol 2011; 57:2426-36. [DOI: 10.1016/j.jacc.2010.12.043] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Revised: 12/02/2010] [Accepted: 12/04/2010] [Indexed: 01/27/2023]
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Bamberg F, Dierks A, Nikolaou K, Reiser MF, Becker CR, Johnson TRC. Metal artifact reduction by dual energy computed tomography using monoenergetic extrapolation. Eur Radiol 2011; 21:1424-9. [PMID: 21249370 DOI: 10.1007/s00330-011-2062-1] [Citation(s) in RCA: 390] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 11/19/2010] [Accepted: 12/01/2010] [Indexed: 02/06/2023]
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Bamberg F, Marcus R, Sommer W, Schwarz F, Nikolaou K, Becker CR, Reiser MF, Johnson TRC. Diagnostic image quality of a comprehensive high-pitch dual-spiral cardiothoracic CT protocol in patients with undifferentiated acute chest pain. Eur J Radiol 2010; 81:3697-702. [PMID: 21196093 DOI: 10.1016/j.ejrad.2010.11.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 11/19/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate diagnostic image quality of high-pitch dual source comprehensive cardiothoracic CT protocol in patients presenting with acute undifferentiated chest pain. MATERIALS AND METHODS Consecutive symptomatic subjects (n=51) with undifferentiated acute chest pain underwent ECG-synchronized high-pitch dual-spiral chest CT angiography (Definition Flash, Siemens Medical Solutions, 2 × 100 kVp or 2 × 120 kV if BMI>30, collimation: 128 × 0.6mm, pitch: 3.2). Independent investigators determined the image quality of each cardiac and pulmonary vessel segment, measured contrast-to-noise-ratio (CNR), and determined radiation exposure. In addition, the prevalence of CT findings (pulmonary embolism (PE), aortic dissection (AD) and significant coronary stenosis (≥ 50%)) was determined. Univariate and multivariate analysis were performed to determine the subpopulation with highest diagnostic quality. RESULTS Among 51 subjects (66% male, average age: 63 ± 15.8), the prevalence of positive CT findings was moderate (overall: 11.7%). Overall, image quality of the pulmonary, aortic and coronary vasculature was good (1.26 ± 0.43 and CNR: 2.52) with an average radiation dose of 3.82 mSv and 3.2% of segments rated non-evaluable. The image quality was lowest in the coronary arteries (p=0.02), depending on the heart rate (r=0.52, p<0.001). In subjects with a heart rate of ≤ 65 bpm (n=30) subjective image quality and CNR of the coronary arteries were higher (1.6 ± 0.5 vs. 2.1 ± 0.5, p=0.03 and 1.21 ± 0.3 vs. 1.02 ± 0.3, p=0.05) with only 1.5% segments classified as non-evaluable. CONCLUSION High-pitch dual-spiral comprehensive cardiothoracic CT provides low radiation exposure with excellent image quality at heart rates ≤ 65 bpm. In subjects with higher heart rates, image quality of the aortic and pulmonary vasculature remains excellent, while the assessment of the coronary arteries degrades substantially.
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Affiliation(s)
- Fabian Bamberg
- Department of Clinical Radiology, Ludwig-Maximilians University, Klinikum Grosshadern, Munich, Germany.
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Sommer WH, Hoffmann RT, Becker CR, Reiser MF, Clevert DA. Comparison of time-resolved CT-angiography, contrast-enhanced ultrasound and digital subtraction angiography in a patient with a small type II endoleak after endovascular aneurysm repair. Clin Hemorheol Microcirc 2010; 45:19-25. [PMID: 20571226 DOI: 10.3233/ch-2010-1283] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report discordant imaging findings of a small persistent type II endoleak in a 72-year-old man who had undergone endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm. Although the aneurysm was growing in size digital subtraction angiography could not detect an endoleak, but time-resolved CT-angiography and contrast enhanced ultrasound did detect a small type II endoleak.
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Affiliation(s)
- Wieland H Sommer
- Department of Clinical Radiology, University Hospitals-Grosshadern, Ludwig-Maximilians University, Munich, Germany.
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Thieme SF, Hoegl S, Nikolaou K, Fisahn J, Irlbeck M, Maxien D, Reiser MF, Becker CR, Johnson TRC. Pulmonary ventilation and perfusion imaging with dual-energy CT. Eur Radiol 2010; 20:2882-9. [PMID: 20571800 DOI: 10.1007/s00330-010-1866-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 05/13/2010] [Accepted: 05/21/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Sven F Thieme
- Department of Clinical Radiology, Ludwig Maximilians University, Klinikum Großhadern, Marchioninistr. 15, 81377, München, Germany.
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Bamberg F, Sommer WH, Schenzle JC, Becker CR, Nikolaou K, Reiser M, Johnson TR. Wertigkeit einer Systolischen Datenakquisition der Koronar-CT Angiographie in einem unselektionierten Patientenkollektiv. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sommer WH, Graser A, Becker CR, Clevert DA, Reiser MF, Nikolaou K, Johnson TR. Image Quality of Virtual Noncontrast Images Derived from Dual-energy CT Angiography after Endovascular Aneurysm Repair. J Vasc Interv Radiol 2010; 21:315-21. [DOI: 10.1016/j.jvir.2009.10.040] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 10/14/2009] [Accepted: 10/17/2009] [Indexed: 11/29/2022] Open
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Schmidt GP, Baur-Melnyk A, Haug A, Becker CR, Tiling R, Reiser M, Herrmann K. Ganzkörper-MRT bei 1.5 und 3 Tesla im Vergleich mit der FDG-PET-CT zur Rezidiverkennung bei Patienten mit kolorektalem Ca. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Graser A, Becker CR, Nikolaou K, Mang T. 3D CT-Kolonographie (CTK): Vergleich von diagnostischer Genauigkeit und Befundungszeit zwischen Standard-3D-Software und virtueller Dissektionstechnik. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Graser A, Schoepf UJ, Huda W, Reiser M, Becker CR. Strahlenexposition und Organdosen bei CT-Kolonographie in Niedrigdosistechnik. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sommer W, Schenzle JC, Becker CR, Neumaier K, Nikolaou K, Graser A, Reiser M, Johnson TR. Dosiseinsparung bei Triple-Rule-Out Protokollen durch hohe Pitch-Faktoren. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Helck A, Bamberg F, Sommer WH, Wessely M, Becker CR, Clevert DA, Reiser M, Nikolaou K. Darstellung der Nierengefäße mithilfe eines mulitphasischen CT-Angiographie-Protokolls – Möglichkeit der signifikanten Kontrastmittelreduktion. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bamberg F, Sommer WH, Schenzle JC, Becker CR, Nikolaou K, Reiser MF, Johnson TRC. Systolic acquisition of coronary dual-source computed tomography angiography: feasibility in an unselected patient population. Eur Radiol 2009; 20:1331-6. [DOI: 10.1007/s00330-009-1680-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 10/11/2009] [Accepted: 10/17/2009] [Indexed: 10/20/2022]
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Becker CR, Saam T. Evaluation of coronary atherosclerotic plaques. Cardiol Clin 2009; 27:611-7. [PMID: 19766918 DOI: 10.1016/j.ccl.2009.06.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In many patients, unheralded myocardial infarction associated with a mortality of approximately 20% is the first manifestation of coronary artery disease. Approximately 40% of the population is considered to have a moderate midterm risk of 10% to 20%. Any of the stratification schemes suffers from a lack of accuracy to correctly determine the risk, and uncertainty exists regarding how to treat individuals who have been identified to be at intermediate risk. Other tools providing information about the necessity to reassure or to treat these patients are warranted. Currently, the assessment of the atherosclerotic plaque burden by CT may be able provide valid information for this cohort. This article discusses the potential value and limitations of cardiac CT for evaluating coronary atherosclerotic plaque.
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Affiliation(s)
- Christoph R Becker
- Department of Clinical Radiology, Ludwig-Maximilians-University Munich, Grosshadern Clinics, 81377 Munich, Germany.
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Abstract
CT colonography (CTC) is also referred to as virtual colonoscopy and is being used with increasing frequency in radiological practice. While there are still no generally accepted, clear-cut indications for its use in mass colorectal cancer screening, there is evidence that this investigation is useful in patients in whom colonoscopy has not been successful or who have known stenotic lesions in the colon. Recent results of significant comparative studies of CTC and conventional colonoscopy will have some influence on the future place of CTC in screening for cancer of the bowel; they show the great potential of CT-aided bowel examination.
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Affiliation(s)
- A Graser
- Institut für Klinische Radiologie, Klinikum Grosshadern der LMU München, Marchioninistr. 15, 81377, München.
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Graser A, Johnson TRC, Hecht EM, Becker CR, Leidecker C, Staehler M, Stief CG, Hildebrandt H, Godoy MCB, Finn ME, Stepansky F, Reiser MF, Macari M. Dual-energy CT in patients suspected of having renal masses: can virtual nonenhanced images replace true nonenhanced images? Radiology 2009; 252:433-40. [PMID: 19487466 DOI: 10.1148/radiol.2522080557] [Citation(s) in RCA: 311] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To qualitatively and quantitatively compare virtual nonenhanced (VNE) data sets derived from dual-energy (DE) computed tomography (CT) with true nonenhanced (TNE) data sets in the same patients and to calculate potential radiation dose reductions for a dual-phase renal multidetector CT compared with a standard triple-phase protocol. MATERIALS AND METHODS This prospective study was approved by the institutional review board; all patients provided written informed consent. Seventy one men (age range, 30-88 years) and 39 women (age range, 22-87 years) underwent preoperative DE CT that included unenhanced, DE nephrographic, and delayed phases. DE CT parameters were 80 and 140 kV, 96 mAs (effective). Collimation was 14 x 1.2 mm. CT numbers were measured in renal parenchyma and tumor, liver, aorta, and psoas muscle. Image noise was measured on TNE and VNE images. Exclusion of relevant anatomy with the 26-cm field of view detector was quantified with a five-point scale (0 = none, 4 = >75%). Image quality and noise (1 = none, 5 = severe) and acceptability for VNE and TNE images were rated. Effective radiation doses for DE CT and TNE images were calculated. Differences were tested with a Student t test for paired samples. RESULTS Mean CT numbers (+/- standard deviation) on TNE and VNE images, respectively, for renal parenchyma were 30.8 HU +/- 4.0 and 31.6 HU +/- 7.1, P = .29; liver, 55.8 HU +/- 8.6 and 57.8 HU +/- 10.1, P = .11; aorta, 42.1 HU +/- 4.1 and 43.0 HU +/- 8.8, P = .16; psoas, 47.3 HU +/- 5.6 and 48.1 HU +/- 9.3 HU, P = .38. No exclusion of the contralateral kidney was seen in 50 patients, less than 25% was seen in 43, 25%-50% was seen in 13, and 50%-75% was seen in four. Mean image noise was 1.71 +/- 0.71 for VNE and 1.22 +/- 0.45 for TNE (P < .001); image quality was 1.70 HU +/- 0.72 for VNE and 1.15 HU +/- 0.36 for TNE (P < .0001). In all but three patients radiologists accepted VNE images as replacement for TNE images. Mean effective dose for DE CT scans of the abdomen was 5.21 mSv +/- 1.86 and that for nonenhanced scans was 4.97 mSv +/- 1.43. Mean dose reduction by omitting the TNE scan was 35.05%. CONCLUSION In patients with renal masses, DE CT can provide high-quality VNE data sets, which are a reasonable approximation of TNE data sets. Integration of DE scanning into a renal mass protocol will lower radiation exposure by 35%.
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Affiliation(s)
- Anno Graser
- Department of Clinical Radiology, University of Munich-Grosshadern Campus, Marchioninistr 15, 81377 Munich, Germany.
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Arnoldi E, Johnson TR, Rist C, Wintersperger BJ, Sommer WH, Becker A, Becker CR, Reiser MF, Nikolaou K. Adequate image quality with reduced radiation dose in prospectively triggered coronary CTA compared with retrospective techniques. Eur Radiol 2009; 19:2147-55. [PMID: 19415293 DOI: 10.1007/s00330-009-1411-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [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: 12/20/2008] [Revised: 02/18/2009] [Accepted: 03/06/2009] [Indexed: 11/26/2022]
Abstract
The goal of our study was to compare a prospective triggering (PT) CT technique with retrospectively gated (RG) CT techniques in coronary computed tomographic angiograms (CCTA) with respect to image quality and radiation dose. Sixty consecutive patients were enrolled. CCTAs using the RG technique were obtained with a dual-source 64-slice CT system in 40 patients, using ECG-triggered tube current modulation, with either a broad pulsing window at 30-80% of the RR interval (group RGb, 20 patients, heart rate > 70 bpm) or a small pulsing window at 70% (group RGs, 20 patients, heart rate < 70 bpm). The other 20 patients underwent CCTA using the PT technique on a 128-slice CT system (group PT, heart rate < 70 bpm). All images were evaluated by two observers for quality on a three-point scale, with 1 being excellent and 3 being insufficient. The effective radiation dose was calculated for each patient. The average image quality score was 1.5 +/- 0.6 for PT, 1.35 +/- 0.5 for RGs and 1.65 +/- 0.5 for RGb. The mean effective dose for RGb was 9 +/- 4 mSv, for RGs 7 +/- 3 mSv and for PT 3 +/- 1 mSv. This represents a 57% dose reduction for PT compared with RGs and a 67% dose reduction for PT compared with RGb. In conclusion, in selected patients CCTA with the PT technique offers adequate image quality with a significantly lower radiation dose compared with CCTA using RG techniques.
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Affiliation(s)
- Elisabeth Arnoldi
- Department of Clinical Radiology, University Hospitals Munich-Grosshadern Campus, Ludwig-Maximilians University, Marchioninistrasse 15, Munich 81377, Germany.
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Sommer WH, Johnson TR, Becker CR, Reiser MF, Nikolaou K. Die Wertigkeit der dynamischen CT-Angiographie in der Diagnostik der peripheren arteriellen Verschlusskrankheit. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Johnson TR, Morhard D, Fink C, Graser A, Reiser MF, Becker CR. Knochenentfernung aus CT-Angiographien mittels Dual Energy CT. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Graser A, Kolligs FT, Schäfer C, Reiser MF, Becker CR, Mang T. Vergleich der diagnostischen Genauigkeit verschiedener 3D-Visualisierungen in der CT-Kolonographie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Graser A, Staehler M, Nikolaou K, Reiser MF, Becker CR, Johnson TR. Dual Energy CT bei Patienten mit Nierentumoren: Histopathologische Korrelation, diagnostische Genauigkeit und Strahlenexposition. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schramm N, Schlemmer M, Englhart E, Nikolaou K, Becker CR, Reiser MF, Berger F. Dual-Energy CT zum Monitoring spezifischer molekularer Therapien bei Patienten mit fortgeschrittenem gastrointestinalem Stromatumor. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sommer WH, Clevert DA, Helck AD, Nikolaou K, Reiser MF, Johnson TR, Becker CR. Dynamische CT-Angiographie in der Diagnostik von Aortendissektionen und Endoleaks nach Stentversorgung von Aortenaneurysmen. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Helck A, Klotz E, Sommer WH, Reiser MF, Becker CR. Messung der glomerulären Filtrationsrate mithilfe der zeitaufgelösten Nieren-CT-Angiographie – gleichzeitige Erfassung von Funktion und Morphologie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Becker CR. Dual Source CT und Dual Energy. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rist C, Johnson TR, Kirchin MA, Wintersperger B, Becker CR, Vogt F, Reiser MF, Nikolaou K. Modifikation des herzchirurgischen Vorgehens vor geplanter Reoperation durch kardiale und thorakale Dual-Source Computertomographie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Johnson TRC, Thieme SF, Deutsch MA, Hinterseer M, Reiser MF, Becker CR, Nikolaou K. Images in cardiovascular medicine: unilateral pulmonary artery agenesis: noninvasive diagnosis with dual-source computed tomography. Circulation 2009; 119:1158-60. [PMID: 19255355 DOI: 10.1161/circulationaha.108.777698] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- T R C Johnson
- Institut für Klinische Radiologie der LMU München, Klinikum Grosshadern, Munich, Germany
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Schmidt GP, Baur-Melnyk A, Haug A, Utzschneider S, Becker CR, Tiling R, Reiser MF, Hermann KA. Whole-body MRI at 1.5 T and 3 T compared with FDG-PET-CT for the detection of tumour recurrence in patients with colorectal cancer. Eur Radiol 2009; 19:1366-78. [PMID: 19190917 DOI: 10.1007/s00330-008-1289-y] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [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: 08/02/2008] [Accepted: 12/09/2008] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to assess the diagnostic accuracy of whole-body MRI (WB-MRI) at 1.5 T or 3 T compared with FDG-PET-CT in the follow-up of patients suffering from colorectal cancer. In a retrospective study, 24 patients with a history of colorectal cancer and suspected tumour recurrence underwent FDG-PET-CT and WB-MRI with the use of parallel imaging (PAT) for follow-up. High resolution coronal T1w-TSE and STIR sequences at four body levels, HASTE imaging of the lungs, contrast-enhanced T1w- and T2w-TSE sequences of the liver, brain, abdomen and pelvis were performed, using WB-MRI at either 1.5 T (n = 14) or 3 T (n = 10). Presence of local recurrent tumour, lymph node involvement and distant metastatic disease was confirmed using radiological follow-up within at least 5 months as a standard of reference. Seventy seven malignant foci in 17 of 24 patients (71%) were detected with both WB-MRI and PET-CT. Both investigations concordantly revealed two local recurrent tumours. PET-CT detected significantly more lymph node metastases (sensitivity 93%, n = 27/29) than WB-MRI (sensitivity 63%, n = 18/29). PET-CT and WB-MRI achieved a similar sensitivity for the detection of organ metastases with 80% and 78%, respectively (37/46 and 36/46). WB-MRI detected brain metastases in one patient. One false-positive local tumour recurrence was indicated by PET-CT. Overall diagnostic accuracy for PET-CT was 91% (sensitivity 86%, specificity 96%) and 83% for WB-MRI (sensitivity 72%, specificity 93%), respectively. Examination time for WB-MRI at 1.5 T and 3 T was 52 min and 43 min, respectively; examination time for PET-CT was 103 min. Initial results suggest that differences in accuracy for local and distant metastases detection using FDG-PET-CT and WB-MRI for integrated screening of tumour recurrence in colorectal cancer depend on the location of the malignant focus. Our results show that nodal disease is better detected using PET-CT, whereas organ disease is depicted equally well by both investigations.
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Affiliation(s)
- G P Schmidt
- Department of Clinical Radiology, University Hospitals Grosshadern, Ludwig Maximilian University Munich, Marchioninistr. 15, 81377, Munich, Germany.
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Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, Nikolaou K, Lottes A, Geisbüsch S, Kramer H, Wagner AC, Diepolder H, Schirra J, Roth HJ, Seidel D, Göke B, Reiser MF, Kolligs FT. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut 2009; 58:241-8. [PMID: 18852257 DOI: 10.1136/gut.2008.156448] [Citation(s) in RCA: 290] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS This prospective trial was designed to compare the performance characteristics of five different screening tests in parallel for the detection of advanced colonic neoplasia: CT colonography (CTC), colonoscopy (OC), flexible sigmoidoscopy (FS), faecal immunochemical stool testing (FIT) and faecal occult blood testing (FOBT). METHODS Average risk adults provided stool specimens for FOBT and FIT, and underwent same-day low-dose 64-multidetector row CTC and OC using segmentally unblinded OC as the standard of reference. Sensitivities and specificities were calculated for each single test, and for combinations of FS and stool tests. CTC radiation exposure was measured, and patient comfort levels and preferences were assessed by questionnaire. RESULTS 221 adenomas were detected in 307 subjects who completed CTC (mean radiation dose, 4.5 mSv) and OC; 269 patients provided stool samples for both FOBT and FIT. Sensitivities of OC, CTC, FS, FIT and FOBT for advanced colonic neoplasia were 100% (95% CI 88.4% to 100%), 96.7% (82.8% to 99.9%), 83.3% (95% CI 65.3% to 94.4%), 32% (95% CI 14.9% to 53.5) and 20% (95% CI 6.8% to 40.7%), respectively. Combination of FS with FOBT or FIT led to no relevant increase in sensitivity. 12 of 45 advanced adenomas were smaller than 10 mm. 46% of patients preferred CTC and 37% preferred OC (p<0.001). CONCLUSIONS High-resolution and low-dose CTC is feasible for colorectal cancer screening and reaches sensitivities comparable with OC for polyps >5 mm. For patients who refuse full bowel preparation and OC or CTC, FS should be preferred over stool tests. However, in cases where stool tests are performed, FIT should be recommended rather than FOBT.
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Affiliation(s)
- A Graser
- Department of Clinical Radiology, University of Munich, Klinikum Grosshadern, Munich, Germany.
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Thieme SF, Becker CR, Hacker M, Nikolaou K, Reiser MF, Johnson TRC. Dual energy CT for the assessment of lung perfusion--correlation to scintigraphy. Eur J Radiol 2008; 68:369-74. [PMID: 18775618 DOI: 10.1016/j.ejrad.2008.07.031] [Citation(s) in RCA: 224] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 07/29/2008] [Indexed: 11/30/2022]
Abstract
Purpose of this study was to determine the diagnostic value of dual energy CT in the assessment of pulmonary perfusion with reference to pulmonary perfusion scintigraphy. Thirteen patients received both dual energy CT (DECT) angiography (Somatom Definition, Siemens) and ventilation/perfusion scintigraphy. Median time between scans was 3 days (range, 0-90). DECT perfusion maps were generated based on the spectral properties of iodine. Two blinded observes assessed DECT angiograms, perfusion maps and scintigrams for presence and location of perfusion defects. The results were compared by patient and by segment, and diagnostic accuracy of DECT perfusion imaging was calculated regarding scintigraphy as standard of reference. Diagnostic accuracy per patient showed 75% sensitivity, 80% specificity and a negative predictive value of 66%. Sensitivity per segment amounted to 83% with 99% specificity, with 93% negative predictive value. Peripheral parts of the lungs were not completely covered by the 80 kVp detector in 85% of patients. CTA identified corresponding emboli in 66% of patients with concordant perfusion defects in DECT and scintigraphy. Dual energy CT perfusion imaging is able to display pulmonary perfusion defects with good agreement to scintigraphic findings. DECT can provide a pulmonary CT angiogram, high-resolution morphology of the lung parenchyma and perfusion information in one single exam.
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Affiliation(s)
- Sven F Thieme
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich, Germany
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von Ziegler F, Leber AW, Becker A, Kaczmarek I, Schönermarck U, Raps C, Tittus J, Überfuhr P, Becker CR, Reiser M, Steinbeck G, Knez A. Detection of significant coronary artery stenosis with 64-slice computed tomography in heart transplant recipients: a comparative study with conventional coronary angiography. Int J Cardiovasc Imaging 2008; 25:91-100. [DOI: 10.1007/s10554-008-9343-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 07/05/2008] [Indexed: 01/12/2023]
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Haseke NS, Bader M, Johnson TRC, Graser A, Staehler M, Nikolaou K, Reiser MF, Becker CR, Stief CG. DUAL ENERGY CT CHARACTERIZATION OF URINARY CALCULI: INITIAL IN VITRO AND CLINICAL EXPERIENCE. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61725-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rist C, Johnson TR, Becker CR, Reiser MF, Nikolaou K. New applications for noninvasive cardiac imaging: dual-source computed tomography. ACTA ACUST UNITED AC 2008; 17 Suppl 6:F16-25. [DOI: 10.1007/s10406-007-0224-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Laymon CM, Sashin D, Carney JP, Ruszkiewicz J, Altenburger D, Becker CR, Lopresti BJ, Mason NS, Mountz JM, Price JC, Schavey R, Mathis CA. Evaluation of a commercial radiochromatography module as an arterial blood activity monitor. Phys Med Biol 2008; 53:339-51. [PMID: 18184990 DOI: 10.1088/0031-9155/53/2/003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Input functions required for positron emission tomography (PET) tracer kinetic modeling are often obtained from arterial blood. In some situations, using short-lived radiotracers, e.g. [(15)O]water, rapid sample handling is required. A method used at several facilities is to pump blood through a detector system at a constant rate. We investigate the suitability of a commercial radiochromatography module (IN/US Posi-RAM) for this new use. The Posi-RAM consists of two 2.5 cm (length) x 2.5 cm (diameter) cylindrical bismuth germanate (BGO) detectors that can operate in coincidence mode. Arterial blood is transported through the system via a length of tubing with flow rate controlled by a peristalsis pump. A custom-counting loop and support frame were designed for the Posi-RAM for PET studies. System sensitivity was determined to be 1.1 x 10(4) cps/(MBq ml(-1)). Dead time as a function of count-rate was found to be less than 1% for concentrations below 3.5 MBq ml(-1), a range encompassing all human-study values. In a human study, the performance of the device was found to be similar to that of the facility's current blood monitor (Siemens Fluid Monitor). We conclude that the Posi-RAM has the necessary sensitivity and count-rate capabilities to be used as a real-time blood activity monitor.
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Affiliation(s)
- C M Laymon
- University of Pittsburgh, Department of Radiology, Pittsburgh, PA 15213, USA.
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Graser A, Johnson TR, Staehler M, Reiser M, Stief C, Becker CR. Kann die Nativphase bei der Untersuchung von Patienten mit Nierentumoren durch die virtuellen Nativbilder eines Dual Energy-Scans ersetzt warden? ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Johnson TR, Graser A, Bader M, Stähler M, Haseke N, Stief CG, Reiser M, Becker CR. Dual Energy CT Typisierung von Nierensteinen in vitro und in vivo. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Graser A, Stieber P, Becker CR, Geisbüsch S, Schäfer C, Reiser M, Göke B, Kolligs FT. Prospektiver Vergleich von Koloskopie, CT-Kolonographie, Sigmoidoskopie und Tests auf okkultes Blut im Stuhl in der Detektion von Kolonadenomen bei asymptomatischen Personen. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rist C, Johnson TR, Mueller-Starck J, Becker A, Becker CR, Reiser M, Nikolaou K. Wertigkeit der kardialen Dual-Source Computertomographie bei Patienten mit chronischem Vorhofflimmern. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sommer WH, Johnson TR, Nikolaou K, Reiser M, Becker CR. Dual-Source Computertomographie in der Diagnostik fraglicher Endoleaks bei Patienten mit thorakalen oder abdominellen Aortenstents. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rist C, Becker CR, Kirchin MA, Johnson TR, Busch S, Bae KT, Leber AW, Reiser MF, Nikolaou K. Optimization of cardiac MSCT contrast injection protocols: dependency of the main bolus contrast density on test bolus parameters and patients' body weight. Acad Radiol 2008; 15:49-57. [PMID: 18078906 DOI: 10.1016/j.acra.2007.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 08/03/2007] [Accepted: 08/03/2007] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Our aim was to evaluate the correlation of test bolus (TB) curve parameters with main bolus (MB) contrast density for cardiac 16-slice computed tomography, and to correlate observed enhancement with patient body weight. MATERIALS AND METHODS Sixty patients with known or suspected coronary artery disease were included in a prospective double-blind study. Contrast material containing 300 mg iodine/mL (Iomeprol 300; Imeron 300, Bracco Imaging SpA, Milan, Italy) and 400 mg iodine/mL (Iomeprol 400; Imeron 400) was injected at a rate of 1 g of iodine/second. Contrast densities (Hounsfield units) of the MB were determined in the left cardiac system. The peak density (PD) of maximum attenuation and the area under the curve (AUC) of the TB curve were calculated for each patient. The dependency of MB contrast attenuation on these parameters and on patient body weight was evaluated. RESULTS Positive correlations (r = 0.52 and r = 0.56, respectively; P < .0001) were obtained between the PD and AUC of the TB curve with the mean density of the MB. Stronger correlations (r = 0.63 and r = 0.64, respectively; P < .0001) between PD and AUC of the TB curve and MB attenuation were found when patient body weight was included in the analysis. CONCLUSIONS Strong correlation of the PD and AUC of the TB curve with the mean density of the MB is observed when patient body weight is considered. Contrast injection protocols may be optimized, and variations of MB contrast density in the left ventricle and main coronary arteries reduced, by taking these TB parameters and the weight of the patient into account.
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Affiliation(s)
- Carsten Rist
- Department of Clinical Radiology, University Hospitals - Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany.
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Leber AW, von Ziegler F, Becker A, Becker CR, Reiser M, Steinbeck G, Knez A, Boekstegers P. Characteristics of coronary plaques before angiographic progression determined by Multi-Slice CT. Int J Cardiovasc Imaging 2007; 24:423-8. [DOI: 10.1007/s10554-007-9278-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Accepted: 10/15/2007] [Indexed: 01/28/2023]
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