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Jung F, Lamby P, Prantl L, Wiggermann P, Jung EM, Krüger-Genge A, Franke RP. Post-mortem distribution of Iodinated Contrast Media (ICM) (iodixanol versus iopromide) in the porcine kidney after multiple bolus injections in vivo into the supra-renal aorta1. Clin Hemorheol Microcirc 2023; 85:289-295. [PMID: 36502310 DOI: 10.3233/ch-229102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Iodinated contrast media (ICM) are widely used for diagnostic and interventional procedures in radiology and cardiology. Ideally, they should not interact with blood cells or vascular wall cells to avoid deteriorations of the blood circulation. However, it is well known that ICM can affect erythrocytes as well as endothelial cells which consequently might perturb especially the microcirculation. In former studies the influence of two ICM (iodixanol versus iopromide) on the vascular system, the development of blood stasis, on changes in renal resistive index (RRI) and vascular diameters, and on the post-mortem distribution of iodine as marker for ICM in the explanted kidneys was examined. The modus of ICM application into the supra-renal aorta followed the regime in interventional cardiology, so that 10 bolus injections were administered at steady intervals (iopromide 4,32 ml / iodixanol 5 ml) accompanied by infusion of 500 ml isotonic NaCl-solution.In the present study, the post-mortem X-ray analysis revealed that there were no differences in iodine content in the regions of the mid-cortex and the medullo-pelvic transition zone of the kidneys after application of both ICM. Remarkable differences, however, were found in the region of the capsule-near cortex, where the application of iopromide led to a significantly lower iodine content in the microcirculation. This is in good agreement with former studies, in which a maldistribution in this area, presumably due to a decrease in arteriolar inflow as a result of stasis/occlusion was shown.
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Affiliation(s)
- F Jung
- Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany
| | - P Lamby
- Department of Plastic and Hand Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L Prantl
- Department of Plastic and Hand Surgery, University Hospital Regensburg, Regensburg, Germany
| | - P Wiggermann
- Department of Radiology and Nuclear Medicine, Hospital Braunschweig, Braunschweig, Germany
| | - E M Jung
- Department of Radiology and Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany
| | - A Krüger-Genge
- Fraunhofer Institute for Applied Polymer Research (IAP), Potsdam-Golm, Germany
| | - R P Franke
- Department of Biomaterials, Central Institute for Biomedical Engineering, University of Ulm, Ulm, Germany
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Wiggermann P, Krüger-Genge A, Jung F. 38th Conference of the German Society for Clinical Microcirculation and Hemorheology (DGKMH). Clin Hemorheol Microcirc 2019; 73:1. [PMID: 31561330 DOI: 10.3233/ch-199200] [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: 11/15/2022]
Affiliation(s)
- P Wiggermann
- Klinikum Braunschweig, Röntgendiagnostik und Nuklearmedizin, Braunschweig, Germany
| | - A Krüger-Genge
- Fraunhofer Institut für Angewandte Polymerforschung (IAP), Potsdam-Golm, Germany
| | - F Jung
- Institut für Biotechnologie, Molekulare Zellbiologie, Brandenburgische Technische Universität Cottbus Senftenberg, Germany
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Niessen C, Beyer L, Haimerl M, Schicho A, Stroszczynski C, Wiggermann P, Jung E. Percutaneous irreversible electroporation of hepatocellular carcinoma: Contrast-enhanced ultrasound-findings during 1-year follow-up. Clin Hemorheol Microcirc 2019; 72:85-93. [DOI: 10.3233/ch-180449] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- C. Niessen
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L.P. Beyer
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - M. Haimerl
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - A. Schicho
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E.M. Jung
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
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Verloh N, Probst U, Utpatel K, Zeman F, Brennfleck F, Werner JM, Fellner C, Stroszczynski C, Evert M, Wiggermann P, Haimerl M. Influence of hepatic fibrosis and inflammation: Correlation between histopathological changes and Gd-EOB-DTPA-enhanced MR imaging. PLoS One 2019; 14:e0215752. [PMID: 31083680 PMCID: PMC6513096 DOI: 10.1371/journal.pone.0215752] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/08/2019] [Indexed: 02/07/2023] Open
Abstract
Objective To evaluate the influence of an active inflammatory process in the liver on Gd-EOB-DTPA-enhanced MR imaging in patients with different degrees of fibrosis/cirrhosis. Material and methods Overall, a number of 91 patients (61 men and 30 women; mean age 58 years) were included in this retrospective study. The inclusion criteria for this study were Gd-EOB-DTPA-enhanced MRI of the liver and histopathological evaluation of fibrotic and inflammatory changes. T1-weighted VIBE sequences of the liver with fat suppression were evaluated to determine the relative signal change (RE) between native and hepatobiliary phase (20min). In simple and multiple linear regression analyses, the influence of liver fibrosis/cirrhosis (Ishak score) and the histopathological degree of hepatitis (Modified Hepatic Activity Index, mHAI) on RE were evaluated. Results RE decreased significantly with increasing liver fibrosis/cirrhosis (p < 0.001) and inflammation (mHAI, p = 0.004). In particular, a correlation between RE and periportal or periseptal boundary zone hepatitis (moth feeding necrosis, mHAI A, p = 0.001) and portal inflammation (mHAI D, p < 0.001) was observed. In multiple linear regression analysis, both the degree of inflammation and the degree of fibrosis were significant predictors for RE (p < 0.01). Conclusion The results of this study suggest that the MR-based hepatic enhancement index RE is not only influenced by the degree of fibrosis, but also by the degree of inflammation.
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Affiliation(s)
- N. Verloh
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
- * E-mail:
| | - U. Probst
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - K. Utpatel
- Department of Pathology, University Regensburg, Regensburg, Germany
| | - F Zeman
- Center for Clinical Trials, University Hospital Regensburg, Regensburg, Germany
| | - F. Brennfleck
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - J. M. Werner
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - C. Fellner
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - M. Evert
- Department of Pathology, University Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology and Nuclear Medicine, Hospital Braunschweig, Braunschweig, Germany
| | - M. Haimerl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Wiesinger I, Beyer LP, Zausig N, Verloh N, Wiggermann P, Stroszczynski C, Jung EM. Evaluation of integrated color-coded perfusion analysis for contrast-enhanced ultrasound (CEUS) after percutaneous interventions for malignant liver lesions: First results. Clin Hemorheol Microcirc 2018; 69:59-67. [PMID: 29758936 DOI: 10.3233/ch-189131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 12/16/2022]
Abstract
BACKGROUND With the rising number of percutaneous ablation therapies in malignant liver lesions there is a need of reliable diagnostics after the intervention to differentiate between reactive changes and tumor. PURPOSE To assess the success of percutaneous ablation therapies for malignant liver lesions using CEUS with perfusion analysis. MATERIAL AND METHODS Retrospective analysis of perfusion analysis for 67 patients with 94 malignant liver lesions, treated with ablation therapies. The lesions were 70 hepatocellular carcinomas (HCC), 18 metastases, 4 cholangiocellular carcinomas (CCC), 2 lesions remained unclear. CEUS was performed after bolus injection of 1.6-2.4 ml of sulfur-hexafluoride microbubbles. The perfusion analysis was calculated using Peak, TTP, mTT and AUC with integrated software during the late arterial to early portal-venous phase for approximately 9 sec (5-15 sec). For the evaluation of the success after percutaneous treatment the perfusion results were compared to the follow-up control after 6 months with CT and MRI and CEUS. RESULTS Perfusion analyses after percutaneous treatment of malignant liver lesions showed highly significant perfusion differences when comparing the center to the surrounding tissue and the margins (p<0.0001) for Peak and also for AUC. 62 lesions were successfully treated, meaning there was no local recurrence after 6 months. In cases of residual tumor CEUS showed a nodular marginal enhancement, the corresponding perfusion analyses showed nodular red and yellow pseudo-color shades. CONCLUSIONS Using CEUS and perfusion analysis, a critical analysis of post-ablation defects in malignant liver lesions is possible. With the help of pseudo-colors, remaining tumor-vascularization can be detected.
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Affiliation(s)
- I Wiesinger
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L P Beyer
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - N Zausig
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - N Verloh
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P Wiggermann
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C Stroszczynski
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E M Jung
- Institute of Radiology, University Hospital Regensburg, Regensburg, Germany
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Wiesinger I, Jung W, Zausig N, Wohlgemuth WA, Pregler B, Wiggermann P, Stroszczynski C, Jung EM. Evaluation of dynamic effects of therapy-induced changes in microcirculation after percutaneous treatment of vascular malformations using contrast-enhanced ultrasound (CEUS) and time intensity curve (TIC) analyses. Clin Hemorheol Microcirc 2018; 69:45-57. [PMID: 29630543 DOI: 10.3233/ch-189118] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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
The aim of this follow-up study was to demonstrate the effect of percutaneous interventional treatment on local microcirculation of peripheral vascular malformations using CEUS and TIC analysis. MATERIAL AND METHODS Retrospective analysis of 197 patients (136 female; 61 male; 3-86 years) with 135 venous (VM), 39 arterio-venous (AVM), 8 lymphatic and 15 veno-lymphatic peripheral vascular malformations before and after the first percutaneous treatment.CEUS was performed after i.v. injection of 1-2.4 ml of sulfur hexafluoride microbubbles (SonoVue®) using a 6-9 MHz linear probe. Digitally stored cine loops (starting in the early arterial phase for 60 sec) were read by independent readers in consensus. Regions of interest (ROI) were defined in the center and at the margins of the malformation, as well as in the healthy surrounding tissue. TIC analyses with Time to Peak (TTP) and Area under the Curve (AUC) were calculated using integrated perfusion software. RESULTS After the treatment there was a significant decrease for median AUC in VM in the center from 297.8 (14.5-2167.6) rU down to 243.3 (0.1-1678.8) rU (p = 0.043) and in the surrounding tissue down to 107.7 (20.2-660.2) rU (p = 0.018). For the other malformations AUC decreased in the center and the margins as well. TTP rose, however these changes did not reach the level of significance. CONCLUSION Analyzing the capillary microcirculation TICs offer a possibility of monitoring therapy-induced capillary changes of vascular malformations.
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Affiliation(s)
- I Wiesinger
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - W Jung
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - N Zausig
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - W A Wohlgemuth
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - B Pregler
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - P Wiggermann
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - C Stroszczynski
- Institute of Radiology, University Medical Center Regensburg, Germany
| | - E M Jung
- Institute of Radiology, University Medical Center Regensburg, Germany
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Beyer LP, Lürken L, Verloh N, Haimerl M, Michalik K, Schaible J, Stroszczynski C, Wiggermann P. Stereotactically navigated percutaneous microwave ablation (MWA) compared to conventional MWA: a matched pair analysis. Int J Comput Assist Radiol Surg 2018; 13:1991-1997. [PMID: 29728899 DOI: 10.1007/s11548-018-1778-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 04/26/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To compare CT-navigated stereotactic microwave ablation (SMWA) to non-navigated conventional MWA (CMWA) for percutaneous ablation of liver malignancies. METHODS A matched pair analysis of 36 patients who underwent MWA of primary or secondary liver malignancies (10 hepatocellular carcinoma and 8 metastases) was conducted. A total of 18 patients undergoing SMWA were included in this prospective study. Patients were matched in terms of tumor size, liver segment and entity to retrospective CMWA procedures. The endpoints were procedure time, accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP). RESULTS The procedure durations were 23.9 min (SD 3.7) for CMWA and 21.8 min (SD 16.3) for SMWA (p = 0.22). The procedural accuracy for SMWA and CMWA was identical for both groups (3.7 mm). The total DLP was significantly lower for SMWA than for CMWA (2115 mGy cm (SD 276) vs. 3109 mGy cm (SD 1137), respectively; p < 0.01). Complete ablation without residual tumor was observed in 94% (17 of 18) of SMWA and in 83% (15 of 18) of CMWA patients (p = 0.31). No complications occurred. CONCLUSIONS SMWA is highly accurate and reduces the radiation dose without increasing the procedure time.
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Affiliation(s)
- L P Beyer
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany.
| | - L Lürken
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - N Verloh
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - M Haimerl
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - K Michalik
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - J Schaible
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - C Stroszczynski
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - P Wiggermann
- Department of Radiology, University Hospital Regensburg, 93053, Regensburg, Germany
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Pregler B, Beyer LP, Wiesinger I, Haimerl M, Stroszczynski C, Jung EM, Wiggermann P. Reduced microperfusion due to portal vein thrombosis: Impact on the outcome of percutaneous thermal tumor ablation. Clin Hemorheol Microcirc 2018; 67:383-388. [PMID: 28885205 DOI: 10.3233/ch-179218] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To determine the influence of pre-interventionally existing portal vein thrombosis on the ablation success of percutaneous tumor ablation of HCC. MATERIALS AND METHODS 15 patients with HCC and pre-existing portal vein thrombosis underwent thermal tumor ablation. We retrospectively analyzed the pre- and post-interventionally performed CT and MRI scans in terms of technical success as well as the complication rate. The portal vein thrombosis was classified into segmental, lobar and central thrombus. RESULTS In 13/15 cases (87%) complete ablation with no evidence of residual tumor tissue was seen 6 weeks after the procedure in contrast-enhanced MRI scans and contrast-enhanced ultrasound (CEUS). No major and 2 minor complications were observed after the ablation procedure. CONCLUSION Reduced perfusion due to pre-interventionally existing portal vein thrombosis has no significant impact on the ablation success or the complication rate.
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Affiliation(s)
- B Pregler
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L P Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - I Wiesinger
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - M Haimerl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Abstract
CLINICAL PROBLEM Prostate cancer is one of the most common malignant diseases in older men. As such, screening and early detection are of crucial importance. STANDARD TREATMENT The standard management of prostate cancer includes radical prostatectomy, radiation therapy, or hormonal therapy. These standard therapies yield excellent oncologic results, but also produce significant side effects. In cases of low-risk prostate cancer, these therapies might result in over-treatment; for this reason, active surveillance has been introduced. However, acceptance of this strategy varies between patients. TREATMENT INNOVATIONS Irreversible electroporation is a novel non-thermal ablation technique for soft tissues. The ablation mechanism of irreversible electroporation has some theoretical advantages in the treatment of prostate cancer. It allows image-guided focal treatment of malignant prostate tissue and a potential sparing of adjacent structures, thereby theoretically resulting in a marked reduction in treatment-related side effects compared with standard management. PRACTICAL RECOMMENDATIONS Although irreversible electroporation is a promising ablation technique, it should only be used in the context of clinical trials to treat prostate cancer due to the current lack of solid evidence for this new technology.
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Affiliation(s)
- P Wiggermann
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Deutschland.
| | - K Brünn
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - W Bäumler
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Deutschland
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Haimerl M, Beyer L, Wiggermann P. Abstract No. 688 Technical effectiveness of navigation-assisted percutaneous ablation of malignant liver tumors. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.733] [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: 10/17/2022] Open
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Wiggermann P, Aust D, Stroszczynski C, Kotzerke J, Zöphel K. Follow-up of FDG-PET/CT findings in retroperitoneal fibrosis associated with abdominal aortic aneurysm. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1621019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bruenn K, Beyer L, Haimerl M, Pregler B, Stroszczynski C, Jung E, Wiggermann P. Comparison of computed tomography (CT) and contrast-enhanced ultrasound (CEUS) for the quantitative evaluation of an ablation defect following radiofrequency ablation of malignant liver lesions. Clin Hemorheol Microcirc 2017; 67:445-451. [DOI: 10.3233/ch-179225] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- K. Bruenn
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - L. Beyer
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - M. Haimerl
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - B. Pregler
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - E.M. Jung
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology, University Medical Center Regensburg, Regensburg, Germany
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Beyer L, Pregler B, Verloh N, Brünn K, Haimerl M, Stroszczynski C, Jung E, Wiggermann P. Effect of irreversible electroporation of prostate cancer on microcirculation: Imaging findings in contrast-enhanced T1-weighted 3D MRI. Clin Hemorheol Microcirc 2017; 67:399-405. [DOI: 10.3233/ch-179220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- L.P. Beyer
- Department of Radiology, University Medical Center Regensburg, Germany
| | - B. Pregler
- Department of Radiology, University Medical Center Regensburg, Germany
| | - N. Verloh
- Department of Radiology, University Medical Center Regensburg, Germany
| | - K. Brünn
- Department of Radiology, University Medical Center Regensburg, Germany
| | - M. Haimerl
- Department of Radiology, University Medical Center Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Medical Center Regensburg, Germany
| | - E.M. Jung
- Department of Radiology, University Medical Center Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology, University Medical Center Regensburg, Germany
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Haimerl M, Brünn K, Poelsterl S, Beyer L, Wiesinger I, Stroszczynski C, Jung EM, Wiggermann P. Quantitative evaluation of real-time maximum liver capacity (LiMAx) and time intensity curve (TIC) analysis in CEUS-based microperfusion. Clin Hemorheol Microcirc 2017; 67:373-382. [DOI: 10.3233/ch-179217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- M. Haimerl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - K Brünn
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - S. Poelsterl
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L.P. Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - I. Wiesinger
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E.-M. Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Pregler B, Beyer LP, Teufel A, Niessen C, Stroszczynski C, Brodoefel H, Wiggermann P. Low Tube Voltage Liver MDCT with Sinogram-Affirmed Iterative Reconstructions for the Detection of Hepatocellular Carcinoma. Sci Rep 2017; 7:9460. [PMID: 28842662 PMCID: PMC5573356 DOI: 10.1038/s41598-017-10095-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/02/2017] [Indexed: 12/12/2022] Open
Abstract
Aim of this study was to compare low tube voltage computed tomography (80 kV) of the liver using iterative image reconstruction (SAFIRE) with standard computed tomography (120 kV) using filtered back-projection (FBP) for the detection of hepatocellular carcinoma (HCC). 46 patients (43 men) with 93 HCC confirmed by 3 T MRI with Gd-EOB-DPTA, in inconclusive cases combined with contrast-enhanced ultrasound, underwent dual-energy CT. The raw data of the 80 kV tube was reconstructed using the iterative reconstruction algorithm SAFIRE with two strengths (I3 and I5). The virtual 120 kV image data set was reconstructed using FBP. The CT images were reviewed to determine the lesion-to-liver contrast (LLC), the lesion contrast-to-noise ratio (CNR) and the sensitivity. The LLC (57.1/54.3 [I3/I5] vs. 34.9 [FBP]; p ≤ 0.01), CNR (3.67/4.45 [I3/I5] vs. 2.48 [FBP]; p < 0.01) and sensitivity (91.4%/88.2% [I3/I5] vs. 72.0% [FBP]; p ≤ 0.01) were significantly higher in the low-voltage protocol using SAFIRE. Therefore, low tube voltage CT using SAFIRE results in an increased lesion-to-liver contrast as well as an improved lesion contrast-to-noise ratio compared to FBP at 120 kV which results in a higher sensitivity for the detection of HCC.
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Affiliation(s)
- B Pregler
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany.
| | - L P Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - A Teufel
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - C Niessen
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - H Brodoefel
- Institute of Radiology, Hospital Ortenau Lahr-Ettenheim, Lahr, Germany
| | - P Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Beyer LP, Wiggermann P. Planning and guidance: New tools to enhance the human skills in interventional oncology. Diagn Interv Imaging 2017; 98:583-588. [PMID: 28818346 DOI: 10.1016/j.diii.2017.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/12/2017] [Indexed: 12/13/2022]
Abstract
Navigation systems have the potential to achieve a high accuracy for percutaneous ablation of tumors even for those in difficult locations. In the last years, successful research has been conducted to make navigation devices applicable to percutaneous tumor ablation with special planning software that now allows high accuracy even for deep-located small lesions close to critical structures. Because of the high number of available navigation systems, this review focuses on those with preexisting clinical studies.
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Affiliation(s)
- L P Beyer
- Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
| | - P Wiggermann
- Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
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17
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da Silva NPB, Beyer L, Hottenrott M, Hackl C, Schlitt H, Stroszczynski C, Wiggermann P, Jung E. Efficiency of contrast enhanced ultrasound for immediate assessment of ablation status after intraoperative radiofrequency ablation of hepatic malignancies. Clin Hemorheol Microcirc 2017; 66:357-368. [DOI: 10.3233/ch-179112] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | - L.P. Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - M.C. Hottenrott
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - C. Hackl
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - H.J. Schlitt
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E.M. Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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18
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Georgieva M, Beyer L, Goecze I, Stroszczynski C, Wiggermann P, Jung E. Contrast-enhanced ultrasound (CEUS) in an interdisciplinary intensive care unit (ICU): Diagnostic efficacy in the assessment of post-operative complications compared to contrast-enhanced computed tomography (CECT): First results. Clin Hemorheol Microcirc 2017; 66:277-282. [DOI: 10.3233/ch-179101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M. Georgieva
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany
| | - L. Beyer
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany
| | - I. Goecze
- Klinik und Poliklinik für Chirurgie, Universität Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany
| | - E.M. Jung
- Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Regensburg, Germany
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19
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Kamusella P, Scheer F, Lüdtke C, Wiggermann P, Wissgott C, Andresen R. Evaluation of radiation exposure to the examiner in the angiografy in routine clincal practice using a x-ray protictive glove. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600484] [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: 10/19/2022]
Affiliation(s)
| | - F Scheer
- Westküstenklinikum Heide, Institut für Diagnostisch und Interventionelle Radiologie/Neuroradiologie – Akademisches Lehrkrankenhaus der Universitäten Hamburg, Kiel und Lübeck, Heide
| | - C Lüdtke
- Klinikum Nordfriesland, Radiologisches Zentrum, Husum
| | - P Wiggermann
- Universitätsklinum Regensburg, Radiologie, Regensburg
| | - C Wissgott
- Westküstenklinikum Heide, Institut für Diagnostisch und Interventionelle Radiologie/Neuroradiologie – Akademisches Lehrkrankenhaus der Universitäten Hamburg, Kiel und Lübeck, Heide
| | - R Andresen
- Westküstenklinikum Heide, Institut für Diagnostisch und Interventionelle Radiologie/Neuroradiologie – Akademisches Lehrkrankenhaus der Universitäten Hamburg, Kiel und Lübeck, Heide
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20
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Haimerl M, Verloh N, Fellner C, Nickel D, Stroszczynski C, Wiggermann P. GD-EOB-DTPA-gestützte MRT zur Beurteilung der Leberfunktion: Vergleich zwischen Signalintensitätsindices und T1 Relaxometrie. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600208] [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: 10/19/2022]
Affiliation(s)
- M Haimerl
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - N Verloh
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - C Fellner
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - D Nickel
- Siemens AG, Healthcare GmbH, MR Applications Predevelopment, Erlangen
| | - C Stroszczynski
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - P Wiggermann
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
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21
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Wiesinger I, Zausig N, Lück C, Salzberger B, Beyer L, Wiggermann P, Stroszczynski C, Jung E. Perkutane Behandlung bei malignen Leberläsionen: Evaluation des Therapieerfolgs mittels CEUS und Perfusionssoftware. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600498] [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: 10/19/2022]
Affiliation(s)
| | - N Zausig
- Universitätsklinikum Regensburg, Regensburg
| | - C Lück
- Universitätsklinikum Regensburg, Regensburg
| | | | - L Beyer
- Universitätsklinikum Regensburg, Regensburg
| | | | | | - E Jung
- Universitätsklinikum Regensburg, Regensburg
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22
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Schicho A, Hellerbrand C, Wohlgemuth W, Stroszczynski C, Wiggermann P, Pereira P. Einfluss der Embolisate auf den Anstieg der proangiogenen VEGF-Level im Serum nach TACE. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600422] [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: 10/19/2022]
Affiliation(s)
- A Schicho
- Universitätsklinikum Regensburg, Radiologie, Regensburg
| | - C Hellerbrand
- Friedrich-Alexander-Universität Erlangen, Biochemie (Emil-Fischer-Zentrum)
| | - W Wohlgemuth
- Universitätsklinikum Regensburg, Radiologie, Regensburg
| | | | - P Wiggermann
- Universitätsklinikum Regensburg, Radiologie, Regensburg
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23
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Goessmann H, Dendl L, Pregler B, Wiggermann P, Scherer M, Opitz S, Niessen C, Fellner C, Stroszczynski C, Schreyer A. Natives Fast-MRI mit DWI zur radiologischen Evaluation einer Appendicitis. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600206] [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: 10/19/2022]
Affiliation(s)
- H Goessmann
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - L Dendl
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - B Pregler
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - P Wiggermann
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - M Scherer
- Universitaetsklinikum Regensburg, Klinik und Polyklinik für Chirugie, Regensburg
| | - S Opitz
- Universitaetsklinikum Regensburg, Klinik und Polyklinik für Chirugie, Regensburg
| | - C Niessen
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - C Fellner
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - C Stroszczynski
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
| | - A Schreyer
- Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg
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24
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Haimerl M, Utpatel K, Verloh N, Fellner C, Stroszczynski C, Wiggermann P. T1 mapping in der Gd-EOB-DTPA-gestützten MRT zur Detektion und Graduierung von Leberfibrose. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600479] [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: 10/19/2022]
Affiliation(s)
- M Haimerl
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - K Utpatel
- Universität Regensburg, Institut für Pathologie, Regensburg
| | - N Verloh
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - C Fellner
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - C Stroszczynski
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
| | - P Wiggermann
- Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg
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25
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Niessen C, Thumann S, Beyer L, Pregler B, Kramer J, Lang S, Teufel A, Jung EM, Stroszczynski C, Wiggermann P. Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors. Sci Rep 2017; 7:43687. [PMID: 28266600 PMCID: PMC5339813 DOI: 10.1038/srep43687] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/30/2017] [Indexed: 12/18/2022] Open
Abstract
Aim of this retrospective analysis was to evaluate the survival times after percutaneous irreversible electroporation (IRE) in inoperable liver tumors not amenable to thermal ablation. 71 patients (14 females, 57 males, median age 63.5 ± 10.8 years) with 103 liver tumors were treated in 83 interventions using IRE (NanoKnife® system). The median tumor short-axis diameter was 1.9 cm (minimum 0.4 cm, maximum 4.5 cm). 35 patients had primary liver tumors and 36 patients had liver metastases. The Kaplan-Meier method was employed to calculate the survival rates, and the different groups were compared using multivariate log-rank and Wilcoxon tests. The overall median survival time was 26.3 months; the median survival of patients with primary land secondary liver cancer did not significantly differ (26.8 vs. 19.9 months; p = 0.41). Patients with a tumor diameter >3 cm (p < 0.001) or more than 2 lesions (p < 0.005) died significantly earlier than patients with smaller or fewer tumors. Patients with hepatocellular carcinoma and Child-Pugh class B or C cirrhosis died significantly earlier than patients with Child-Pugh class A (p < 0.05). Patients with very early stage HCC survived significantly longer than patients with early stage HCC with a median survival of 22.3 vs. 13.7 months (p < 0.05).
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Affiliation(s)
- C. Niessen
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - S. Thumann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L. Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - B. Pregler
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - J. Kramer
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - S. Lang
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A. Teufel
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - E. M. Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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26
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Beyer L, Pregler B, Nießen C, Michalik K, Haimerl M, Stroszczynski C, Jung E, Wiggermann P. Percutaneous irreversible electroporation (IRE) of prostate cancer: Contrast-enhanced ultrasound (CEUS) findings during follow up. Clin Hemorheol Microcirc 2017; 64:501-506. [DOI: 10.3233/ch-168125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Pregler B, Beyer L, Wiesinger I, Nießen C, Jung E, Stroszczynski C, Wiggermann P. Microwave ablation of large HCC lesions: Added value of CEUS examinations for ablation success control. Clin Hemorheol Microcirc 2017; 64:483-490. [DOI: 10.3233/ch-168113] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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28
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Haimerl M, Poelsterl S, Beyer L, Wiesinger I, Nießen C, Stroszczynski C, Wiggermann P, Jung EM. Chronic liver disease: Quantitative MRI vs CEUS-based microperfusion. Clin Hemorheol Microcirc 2017; 64:435-446. [DOI: 10.3233/ch-168112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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29
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Beyer LP, Pregler B, Michalik K, Niessen C, Dollinger M, Müller M, Schlitt HJ, Stroszczynski C, Wiggermann P. Evaluation of a robotic system for irreversible electroporation (IRE) of malignant liver tumors: initial results. Int J Comput Assist Radiol Surg 2016; 12:803-809. [PMID: 27653615 DOI: 10.1007/s11548-016-1485-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 09/01/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Comparison of conventional CT-guided manual irreversible electroporation (IRE) of malignant liver tumors and a robot-assisted approach regarding procedural accuracy, intervention time, dose, complications, and treatment success. METHODS A retrospective single-center analysis of 40 cases of irreversible electroporation of malignant liver tumors in 35 patients (6 females, 29 males, average age 60.3 years). Nineteen of these ablation procedures were performed manually and 21 with robotic assistance. A follow-up (ultrasound, CT, and MRI) was performed after 6 weeks in all patients. RESULTS The time from the planning CT scan to the start of the ablation as well as the dose-length product were significantly lower under robotic assistance (63.5 vs. 87.4 min, [Formula: see text]; 2132 vs. 4714 mGy cm, [Formula: see text]). The procedural accuracy, measured as the deviation of the IRE probes with respect to a defined reference probe, was significantly higher using robotic guidance (2.2 vs. 3.1 mm, [Formula: see text]). There were no complications. There was one incomplete ablation in the manual group. CONCLUSION Robotic assistance for IRE of liver tumors allows for faster procedure times with higher accuracy while reducing radiation dose as compared to the manual placement of IRE probes.
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Affiliation(s)
- L P Beyer
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
| | - B Pregler
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany
| | - K Michalik
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany
| | - C Niessen
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany
| | - M Dollinger
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, University Medical Center Regensburg, Regensburg, Germany
| | - H J Schlitt
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - C Stroszczynski
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany
| | - P Wiggermann
- Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany
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Scheer F, Spunar P, Wiggermann P, Wissgott C, Andresen R. Mesenteric Panniculitis (MP) in CT – A Predictor of Malignancy? ROFO-FORTSCHR RONTG 2016; 188:926-32. [DOI: 10.1055/s-0042-110100] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- F. Scheer
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | | | - P. Wiggermann
- Department of Radiology, University Hospital Regensburg, Germany
| | - C. Wissgott
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - R. Andresen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
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Niessen C, Jung EM, Beyer L, Pregler B, Dollinger M, Haimerl M, Scheer F, Stroszczynski C, Wiggermann P. Percutaneous irreversible electroporation (IRE) of prostate cancer: Contrast-enhanced ultrasound (CEUS) findings. Clin Hemorheol Microcirc 2016; 61:135-41. [PMID: 26410867 DOI: 10.3233/ch-151985] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 12/18/2022]
Abstract
PURPOSE To evaluate the use of contrast-enhanced ultrasound (CEUS) after irreversible electroporation (IRE) of prostatic cancer tissue to assess the ablation status by depicting microvascularisation in the ablation area. MATERIALS AND METHODS Retrospective evaluation of CEUS of 13 patients (mean age: 61.4 ± 7.5 years) with histologically confirmed prostatic cancer who underwent percutaneous IRE. In the course of clinical routine, the tumor lesions were documented before, immediately after, and 1 day after the ablationusing color-coded transabdominal and transrectal CEUS. The obtained image data (DICOM loops and images) were subsequently evaluated by 2 experienced radiologists and assessed with regard to micro vascularisation by means of a 5-point scale. RESULTS CEUS images showed significantly reduced microcirculation of the lesions (mean 0.9 ± 0.6 cm (0.5-1.5 cm) after IRE. Microcirculation was reduced from 2.15 ± 0.56 prior to ablation to 0.65 ± 0.63 (p < 0.001) immediately after the ablation and to 0.27 ± 0.44 one day after IRE (p < 0.001). CONCLUSION This study showed rapid and significant reduction of the microcirculation in the ablation area afterpercutaneous IRE of prostatic cancer tissue.
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Affiliation(s)
- C Niessen
- Institute for Radiology, University Hospital Regensburg, Germany
| | - E M Jung
- Institute for Radiology, University Hospital Regensburg, Germany
| | - L Beyer
- Institute for Radiology, University Hospital Regensburg, Germany
| | - B Pregler
- Institute for Radiology, University Hospital Regensburg, Germany
| | - M Dollinger
- Institute for Radiology, University Hospital Regensburg, Germany
| | - M Haimerl
- Institute for Radiology, University Hospital Regensburg, Germany
| | - F Scheer
- Institute of Diagnostic and Interventional Radiology, Westküstenklinikum Heide, Heide, Germany
| | - C Stroszczynski
- Institute for Radiology, University Hospital Regensburg, Germany
| | - P Wiggermann
- Institute for Radiology, University Hospital Regensburg, Germany
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Heiß P, Wildgruber M, Müller-Wille R, Gößmann H, Wiggermann P, Zorger N, Stroszczynski C, Wrede C. CT versus mesenteriale DSA bei obskurer gastrointestinaler Blutung. Stellenwert der intraarteriellen CT-Mesenterikografie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581322] [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: 10/22/2022]
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33
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Beyer L, Pregler B, Nießen C, Stroszczynski C, Wiggermann P. Evaluation eines Robotersystems zur irreversiblen Elektroporation von malignen Lebertumoren. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581478] [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: 10/22/2022]
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34
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Scheer F, Kamusella P, Schlöricke E, Wiggermann P, Wissgott C, Andresen R. CT-gesteuerte thorakale Sympathikolyse (CTSy) zur Behandlung einer Hyperhidrose der Hände. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581517] [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: 10/22/2022]
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35
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Haimerl M, Verloh N, Utpatel K, Fellner C, Nickel D, Stroszczynski C, Wiggermann P. Abschätzung des Leberfibrosegrades mittels Gd-EOB-DTPA- gestützter T1 Relaxometrie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581341] [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: 10/22/2022]
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36
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Haimerl M, Jung EM, Beyer L, Pregler B, Dollinger M, Sieroń D, Niessen C, Stroszczynski C, Wiggermann P. Chronic liver disease: Correlation of CEUS-based microperfusion and indocyanine green clearance. Clin Hemorheol Microcirc 2015; 61:195-204. [DOI: 10.3233/ch-151990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M. Haimerl
- Institute for Radiology, University Hospital Regensburg, Germany
| | - E.-M. Jung
- Institute for Radiology, University Hospital Regensburg, Germany
| | - L.P. Beyer
- Institute for Radiology, University Hospital Regensburg, Germany
| | - B. Pregler
- Institute for Radiology, University Hospital Regensburg, Germany
| | - M. Dollinger
- Institute for Radiology, University Hospital Regensburg, Germany
| | - D. Sieroń
- Department of Radiology, District Hospital of Orthopedics and Trauma Surgery, Piekary Śląskie, Poland
| | - C. Niessen
- Institute for Radiology, University Hospital Regensburg, Germany
| | - C. Stroszczynski
- Institute for Radiology, University Hospital Regensburg, Germany
| | - P. Wiggermann
- Institute for Radiology, University Hospital Regensburg, Germany
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Beyer LP, Pregler B, Niessen C, Dollinger M, Graf BM, Müller M, Schlitt HJ, Stroszczynski C, Wiggermann P. Robot-assisted microwave thermoablation of liver tumors: a single-center experience. Int J Comput Assist Radiol Surg 2015; 11:253-9. [PMID: 26307269 DOI: 10.1007/s11548-015-1286-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 08/17/2015] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate and compare the needle placement accuracy, patient dose, procedural time, complication rate and ablation success of microwave thermoablation using a novel robotic guidance approach and a manual approach. METHODS We performed a retrospective single-center evaluation of 64 microwave thermoablations of liver tumors in 46 patients (10 female, 36 male, mean age 66 years) between June 2014 and February 2015. Thirty ablations were carried out with manual guidance, while 34 ablations were performed using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and MRI) was performed on all patients. RESULTS The total procedure time and dose-length product were significantly reduced under robotic guidance (18.3 vs. 21.7 min, [Formula: see text]; 2216 vs. 2881 mGy[Formula: see text]cm, [Formula: see text]). The position of the percutaneous needle was more accurate using robotic guidance (needle deviation 1.6 vs. 3.3 mm, [Formula: see text]). There was no significant difference between both groups regarding the complication rate and the ablation success. CONCLUSION Robotic assistance for liver tumor ablation reduces patient dose and allows for fast positioning of the microwave applicator with high accuracy. The complication rate and ablation success of percutaneous microwave thermoablation of malignant liver tumors using either CT fluoroscopy or robotic guidance for needle positioning showed no significant differences in the 6-week follow-up.
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Affiliation(s)
- L P Beyer
- Department of Radiology, University Medical Center Regensburg, Franz-Josef Strauss Allee 11, 93053, Regensburg, Germany.
| | - B Pregler
- Department of Radiology, University Medical Center Regensburg, Franz-Josef Strauss Allee 11, 93053, Regensburg, Germany
| | - C Niessen
- Department of Radiology, University Medical Center Regensburg, Franz-Josef Strauss Allee 11, 93053, Regensburg, Germany
| | - M Dollinger
- Department of Radiology, University Medical Center Regensburg, Franz-Josef Strauss Allee 11, 93053, Regensburg, Germany
| | - B M Graf
- Department of Anesthesia, University Medical Center Regensburg, Regensburg, Germany
| | - M Müller
- Department of Internal Medicine I, University Medical Center Regensburg, Regensburg, Germany
| | - H J Schlitt
- Department of Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - C Stroszczynski
- Department of Radiology, University Medical Center Regensburg, Franz-Josef Strauss Allee 11, 93053, Regensburg, Germany
| | - P Wiggermann
- Department of Radiology, University Medical Center Regensburg, Franz-Josef Strauss Allee 11, 93053, Regensburg, Germany
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Verloh N, Haimerl M, Zeman F, Teufel A, Lang S, Stroszczynski C, Wiggermann P. Multivariable Analyse klinischer Einflussfaktoren auf die Signalintensität bei Gd-EOB-DTPA 3T MRT der Leber. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550883] [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: 10/23/2022]
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Wiggermann P. Interventionelle Onkologie – Mehrwert für den Patienten durch Navigieren, Embolisieren und Abladieren? ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551083] [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: 10/23/2022]
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Jung E, Wiggermann P. Monitoring mit CEUS bei Ablation/TACE/OP beim HCC. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551402] [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: 10/23/2022]
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Spunar P, Scheer F, Wiggermann P, Zeman F, Kamusella P, Andresen R. Mesenteriale Pannikulitis (MP) in der Computertomografie (CT): Ein Prädiktor für Malignome? ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550898] [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: 10/23/2022]
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Haimerl M, Verloh N, Fellner C, Nickel D, Stroszczynski C, Wiggermann P. Volumen gestützte Abschätzung der Leberfunktion basierend auf MR-Relaxometrie mit Gd-EOB-DTPA. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550885] [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: 10/23/2022]
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Scheer F, Lüdtke CW, Kamusella P, Wiggermann P, Vieweg H, Schlöricke E, Lichtenberg M, Andresen R, Wissgott C. Combination of rotational atherothrombectomy and Paclitaxel-coated angioplasty for femoropopliteal occlusion. Clin Med Insights Cardiol 2015; 8:43-8. [PMID: 25983558 PMCID: PMC4406303 DOI: 10.4137/cmc.s15231] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/10/2014] [Accepted: 12/13/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The rotational atherothrombectomy with Straub Rotarex® is a safe and efficient treatment of acute/subactute vascular occlusions. The purpose of this study was to evaluate the benefit of paclitaxel-coated angioplasty after rotational atherothrombectomy over an observation period of six months. MATERIALS AND METHODS Overall, 29 patients were treated with the Rotarex catheter in combination with paclitaxel-coated angioplasty. All patients had acute/subacute and chronic occlusions of the superficial femoral artery (SFA) and/or popliteal arteries. The ankle-brachial index (ABI) was detected before the intervention, after the procedure, and after six months. Also clinical examination and ultrasound scans were done in the observation period. RESULTS There were no technical failures. The ABI shows a significant increase from 0.52 ± 0.17 to 0.91 ± 0.25 in the follow-up. By ultrasound examination, there were found two (6.9%) restenoses during the follow-up. There was one dissection during the intervention (3.5%). CONCLUSION The rotational atherothrombectomy in combination with paclitaxel-coated angioplasty might be an effective and safe method with a promising low rate of restenosis at six months.
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Affiliation(s)
- F Scheer
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - C W Lüdtke
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - P Kamusella
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - P Wiggermann
- Institute of Diagnostic Radiology, University Hospital Regensburg, Regensburg, Germany
| | - H Vieweg
- Department of Radiology and Neuroradiology, Asklepios Klinik Nord - Heidberg, Hamburg, Germany
| | - E Schlöricke
- Institute of Visceral, Thoracic and Vascular Surgery, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - M Lichtenberg
- Clinic for Angiology, Klinikum Arnsberg, Arnsberg, Germany
| | - R Andresen
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
| | - C Wissgott
- Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany
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Scheer F, Lüdtke C, Kamusella P, Wiggermann P, Vieweg H, Schlöricke E, Lichtenberg M, Andresen R, Wissgott C. Kombination einer Rotations-Atherothrombektomie und einer Angioplastie mit einem Paclitaxel freisetzenden Ballonkatheter bei femoropoplitealen Okklusionen. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551096] [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: 10/23/2022]
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Verloh N, Haimerl M, Zeman F, Teufel A, Lang S, Stroszczynski C, Fellner C, Wiggermann P. Multivariable analysis of clinical influence factors on liver enhancement of Gd-EOB-DTPA-enhanced 3T MRI. ROFO-FORTSCHR RONTG 2014; 187:29-35. [PMID: 25531338 DOI: 10.1055/s-0034-1385211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to identify clinical factors influencing Gd-EOB-DTPA liver uptake in patients with healthy liver parenchyma. MATERIALS AND METHODS A total of 124 patients underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3 T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 minutes after contrast injection. The relative enhancement (RE) between plain and contrast-enhanced signal intensity was calculated. Simple and multiple linear regression analyses were performed to evaluate clinical factors influencing the relative enhancement. Patients were subdivided into three groups according to their relative liver enhancement (HRE, RE ≥ 100 %; MRE, 100 % > RE > 50 %; NRE, RE ≤ 50 %) and were analyzed according to the relevant risk factors. RESULTS Simple regression analyses revealed patient age, transaminases (AST, ALT, GGT), liver, spleen and delta-liver volume (the difference between the volumetrically measured liver volume and the estimated liver volume based on body weight) as significant factors influencing relative enhancement. In the multiple analysis the transaminase AST, spleen and delta liver volume remained significant factors influencing relative enhancement. Delta liver volume showed a significant difference between all analyzed groups. CONCLUSION Liver enhancement in the hepatobiliary phase depends on a variety of factors. Body weight-adapted administration of Gd-EOB-DTPA may lead to inadequate liver enhancement after 20 minutes especially when the actual liver volume differs from the expected volume. KEY POINTS • Differences between actual and expected liver volume can cause inadequate liver enhancement after 20 min. • A liver volume-adapted dose of Gd-EOB-DTPA may help to improve liver enhancement.
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Affiliation(s)
- N Verloh
- Department of Radiology, University Hospital Regensburg
| | - M Haimerl
- Department of Radiology, University Hospital Regensburg
| | - F Zeman
- Center for Clinical Trials, University Hospital Regensburg
| | - A Teufel
- Department of Gastroenterology, University Hospital Regensburg
| | - S Lang
- Department of Surgery, University Hospital Regensburg
| | | | - C Fellner
- Department of Radiology, University Hospital Regensburg
| | - P Wiggermann
- Department of Radiology, University Hospital Regensburg
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Scheer F, Kamusella P, Wiggermann P, Lüdtke C, Wissgott C, Andresen R. Klinisches Outcome der CT gesteuerten lumbalen Sympathikolyse (CTSy) bei primärer fokaler Hyperhidrose der Füße in Bezug auf das Verteilungsmuster des Sympathikolytikumgemisches. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373054] [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: 10/25/2022]
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Haimerl M, Verloh N, Fellner C, Müller-Wille R, Schreyer A, Stroszczynski C, Wiggermann P. MRT- gestützte Abschätzung der Leberfunktion: T1 Relaxometrie vs. MELD score. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373478] [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: 10/25/2022]
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Haimerl M, Verloh N, Fellner C, Müller-Wille R, Stroszczynski C, Wiggermann P. Gd-EOB-DTPA- gestützte T1 Relaxometrie zur Abschätzung des Leberzirrhosegrades. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372839] [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: 10/25/2022]
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Haimerl M, Verloh N, Fellner C, Schreyer A, Müller-Wille R, Stroszczynski C, Wiggermann P. Gd-EOB-DTPA-gestützte Bestimmung des Leberzirrhosegrades: T1 mapping vs. relatives Enhancement des Leberparenchyms. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372840] [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: 10/25/2022]
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Jung EM, Wiggermann P. Moderne Ultraschalltechniken bei RFA und TACE. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373436] [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: 10/25/2022]
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